title: Differences in activities of daily living (ADL) abilities of children across world regions: a validity study of the assessment of motor and process skills.
abstract: BACKGROUND
  One important goal of paediatric occupational therapy services is to improve activities of daily living (ADL) abilities of children. In order to plan and evaluate the effectiveness of targeted interventions, valid assessments are critically needed. The Assessment of Motor and Process Skills (AMPS) is an internationally standardized assessment of ADL performance that has not been validated for use with children in Middle Europe.
  
  
  OBJECTIVE
  To evaluate for (i) significant differences in mean ADL motor and mean ADL process ability measures among children from Middle Europe compared with children from North America, UK/Republic of Ireland, Nordic countries, Western Europe, Australia/New Zealand and Asia; and (ii) meaningful differences between the international age-normative means of the AMPS and those for children from Middle Europe.
  
  
  METHODS
  We analysed data of children across world regions extracted from the international AMPS database using many-facet Rasch and two-way anova analyses and by estimating contrasts to evaluate for significant group differences.
  
  
  RESULTS
  anova analyses of data for 11 189 children ages 2-15 revealed significant effects for mean ADL motor and ADL process ability by region [F ≥ 15.32, d.f. = (6, 11 091), MSE ≥ 0.20, P < 0.001, ή(2) ≥ 0.008], and age [F ≥ 253.47, d.f. = (13, 11 091), MSE ≥ 0.20, P < 0.001, ή(2) ≥ 0.229], and a significant interaction effect for mean ADL process ability [F = 1.48, d.f. = (78, 11 091), P = 0.004, ή(2) = 0.010]. Out of 168 estimated contrasts between Middle Europe and the other world regions for mean ADL motor and ADL process ability, seven were statistically significant (4.17%), but none exceeded ±1SE from the international means.
  
  
  CONCLUSIONS
  The AMPS remains free of relevant differences in mean ADL ability measures between Middle Europe and other world regions, indicating that the international age-normative mean values are likely to be applicable to children from Middle Europe. The AMPS can be used internationally to evaluate ADL performance in children and to determine if the child is eligible for occupational therapy services.
authors.affiliation: Institute of Occupational Therapy, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors.forename: B E
authors.initials: BE
authors.lastname: Gantschnig
authors.forename: A G
authors.initials: AG
authors.lastname: Fisher
authors.forename: J
authors.initials: J
authors.lastname: Page
authors.forename: A
authors.initials: A
authors.lastname: Meichtry
authors.forename: I
authors.initials: I
authors.lastname: Nilsson
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000375:Aging / Q000502:physiology; D001208:Asia; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills; D009520:New Zealand; D009656:North America; D009788:Occupational Therapy / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: Rasch analysis; development; evaluation; occupational therapy; performance