Development of a parent-report computer-adaptive test to assess physical functioning in children with cerebral palsy II: upper-extremity skills.
The specific aims of this study were to (1) examine the psychometric properties (unidimensionality, differential item functioning, scale coverage) of an item bank of upper-extremity skills for children and adolescents with cerebral palsy (CP); (2) evaluate a simulated computer-adaptive test (CAT) using this item bank; (3) examine the concurrent validity of the CAT with the Pediatric Outcomes Data Collection Instrument (PODCI) upper-extremity core scale; and (4) determine the discriminant validity of the simulated CAT with Manual Ability Classification System (MACS) levels and CP type (i.e. diplegia, hemiplegia, or quadriplegia). Parents (n=180) of children and adolescents with CP (spastic diplegia 49%, hemiplegia 22%, or quadriplegia 28%) consisting of 102 males and 78 females with a mean age of 10 years 6 months (SD 4y 1mo, range 2-21y), and MACS levels I through V participated in calibration of an item pool and completed the PODCI. Confirmatory factor analyses supported a unidimensional model using 49 of the 53 upper-extremity items. Simulated CATs of 5, 10, and 15 items demonstrated excellent accuracy (intraclass correlation coefficient [ICCs] >0.93) with the full item bank, had high correlations with the PODCI upper-extremity core scale score (ICC 0.79), and discriminated among MACS levels. The simulated CATs demonstrated excellent overall content coverage over a wide age span and severity of upper-extremity involvement. The future development and refinement of CATs for parent report of physical function in children and adolescents with CP is supported by our work.
Temple University, Philadelphia, PA 19140, USA. tuckerc@temple.edu
Carole A
CA
Tucker
Kathleen
K
Montpetit
Nathalie
N
Bilodeau
Helene M
HM
Dumas
Maria A
MA
Fragala-Pinkham
Kyle
K
Watson
George E
GE
Gorton
Pengsheng
P
Ni
Ronald K
RK
Hambleton
M J
MJ
Mulcahey
Stephen M
SM
Haley
D000293:Adolescent; D000465:Algorithms; D001132:Arm / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009716:Numerical Analysis, Computer-Assisted; D010290:Parents / Q000523:psychology*; D011594:Psychometrics; D015203:Reproducibility of Results; D055815:Young Adult