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.
Tucker
Carole A
CA
Temple University, Philadelphia, PA 19140, USA. tuckerc@temple.edu
Montpetit
Kathleen
K
Bilodeau
Nathalie
N
Dumas
Helene M
HM
Fragala-Pinkham
Maria A
MA
Watson
Kyle
K
Gorton
George E
GE
Ni
Pengsheng
P
Hambleton
Ronald K
RK
Mulcahey
M J
MJ
Haley
Stephen M
SM
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