Community Integration as Acculturation: Preliminary Validation of the AIMS Interview

Background This paper introduces the Assimilation, Integration, Marginalization, Segregation (AIMS) interview, a new measure of community integration (defined as acculturation) and reports validation data supporting the use of AIMS with individuals with developmental disabilities. Methods Caregivers acted as informants for 66 adults with moderate‐to‐mild developmental disabilities. All participants were living in the community. Results The data gathered using AIMS provide evidence of sound psychometric properties including content, concurrent and construct validity. AIMS data for participants with developmental disabilities indicated that integration efforts have been relatively successful in the medical, dental, housing, social and community domains; however, education, employment, volunteer and spiritual activity require attention. Conclusions In addition to use as a research tool and outcome measure, AIMS can be used to inform service delivery by providing information regarding the supports available to individuals with disabilities in a number of domains.     

Psychometric Properties of the ASPeCT‐DD: Measuring Positive Traits in Persons with Developmental Disabilities

Background The Assessment Scale for Positive Character Traits‐Developmental Disabilities (ASPeCT‐DD) was designed to measure the presence and strength of selected positive or strength‐based traits in persons with developmental disabilities. These traits may help to determine level of happiness or value associated with the more commonly measured external indicators of quality of life. Method The present study examines the psychometric properties of this scale by exploring the factor structure, test‐retest and split‐half reliability, and inter‐rater reliability measures. Also presented is an analysis of descriminant and convergent validity. Results Results indicate a four‐factor solution, with poor to moderate correlation among the factors. Test‐retest reliability and measures of internal consistency were in the fair to excellent range, and inter‐rater reliability measures were good. Initial evaluation of validation is encouraging. Discussion Limitations of this study are discussed, as are related opportunities for future research endeavours.     

The Validity of a Personality Disorder Diagnosis for People with an Intellectual Disability

Background It has long been appreciated that people with intellectual disabilities experience mental health problems. Studies into the prevalence of personality disorder in the population of people with an intellectual disability indicate significant variations, which have no clear explanation. Method Work on personality disorder and personality is reviewed. Results This article will outline some of the reasons for the variations in the reported prevalence figures including the impact of diagnostic overshadowing, problems inherent within the diagnostic classification systems and instruments that have a significant impact upon the reliability of a diagnosis. It will also argue that there are some fundamental issues relating to the validity of the construct of personality disorder and its application to the population of people with intellectual disabilities. The article notes that the model of personality, which in itself is not without critics, is derived from research on the general population and has not been integrated with personality research conducted within the population of people with an intellectual disability. Conclusion It is suggested that the current diagnostic systems need to be reviewed in the context of an existing evidence base from within the field of intellectual disabilities. There are grounds to be cautious with the current diagnostic process and to question its clinical utility. Furthermore, diagnosis may only serve as an intermediate step and as part of a more detailed nomothetic approach.     

Validation of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in persons with disabilities and chronic illnesses for Chinese population

Abstract

Purpose: The aim of this study is to test the psychometric properties and validity of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in Traditional Chinese-speaking persons with disabilities and chronic illnesses. Method: The WHODAS II CT has been administrated to a sample of 1020 persons with disabilities and chronic illnesses. The construct validity, internal consistency, concurrent validity and convergent validity were evaluated. Results: WHODAS II CT showed a satisfactory model fit for the second-order confirmatory factor analysis model (χ²/df?=?3.05, root means square error of approximation?=?0.053, comparative fit index?=?0.912, standardized root mean square residual?=?0.076), high internal consistency (Cronbach’s α?=?0.98), high correlation with all domains of Dartmouth Primary Care Cooperative Research Network/World Organization of National Colleges, Academies, and Academic Associations of General Practices/Family Physicians (COOP/WONCA) charts (partial correlation coefficient ranged from 0.26 to 0.74) and significance between persons with and without co-morbidity (all regression coefficients >0). Conclusions: WHODAS II CT is a reliable and valid instrument to measure the disability in persons with disabilities and chronic illnesses among Traditional Chinese-speaking population. A further study is required to validate the short version of WHODAS II in order to enhance its applicability in usual and clinical practices.

• Implications for Rehabilitation

• This is the first study to evaluate the reliability and validity of WHODAS II in persons with disability and chronic illnesses among Traditional Chinese-speaking population.

• The WHODAS II CT is a valid instrument in Chinese adults with disabilities and chronic illnesses.

• The WHODAS II CT is recommended to be used in population-based survey to investigate the health needs of persons with disabilities and chronic illnesses as well as in the rehabilitation programs as an outcome measure.

     

Current perspective regarding adults with intellectual and developmental disabilities accessing computer technology

Purpose: This article was written to summarize current efforts in the research community in regards to assisting adults with severe developmental and intellectual disabilities to access a computer. Method: A literature search was conducted to determine contemporary research that has been conducted to enable computer use in persons with significant developmental disabilities utilizing databases such as ERIC or PubMed. Results: Although various assistive technology devices and interventions have been developed for persons with all types of disabilities, a lack of research into methods to help persons with severe developmental disabilities access a computer is evident. This perpetuates the underutilization of computers in this population such as those attending day programs or residing in residential facilities. Conclusions: Persons with developmental disabilities, particularly adults, are often overlooked and are not thought to be capable of using a personal computer. Though communities have endeavored to further enhance participation by persons with disabilities in many aspects of mainstream society, there is a scarcity of research pertaining to how adults with intellectual disabilities can access a computer, especially those with severe impairments. Once formal schooling is over, there appears to be scant interest in supporting adults using computers.

Implications for Rehabilitation

• Helping a person to access a computer use should be considered to be within the purview of rehabilitation professionals, even when an individual has an intellectual disability.

• Research into methods to enable access to computer technology should incorporate persons with severe intellectual disabilities, including adults.

• Assistive technology devices, including those associated with computer technology should be developed with persons with severe developmental disabilities in mind to facilitate access.

• Rehabilitation professionals such as speech therapists, occupational therapists and physical therapists should work in concert to develop guidelines and protocols founded on research to aid persons with severe and multiple disabilities who want to access a computer.

     

Measuring the social perceptions of persons with moderate and severe disabilities to construct social network maps

When social networks are defined in terms of the perceptions of the social network members, they should be measured through self-report or direct interviews. For persons with moderate and severe disabilities, however, self-reports are often unreliable and invalid; consequently, information from a knowledgable adult has often been used as a proxy. This study examined the utility of a Friendship Judgment Interview (FJI) for obtaining information on social relationships directly from 14 high school students with moderate or severe disabilities. Students made judgments on pairs of photographs, yielding data from which social network maps were produced. Stability of FJI results was assessed by repeating the interviews over a period of 2–4 weeks. Validity was evaluated by comparing FJI results with two concurrent criterion measures—another photo-selection task, and teacher ratings. Finally, the social network maps were interpreted. The FJI demonstrated reasonable stability and validity for approximately half of the students sampled, and produced interpretable social network maps. The results encourage further research on social perceptions of persons with moderate and severe disabilities.     

Canadian-French adaptation and test-retest reliability of the leisure time physical activity questionnaire for people with disabilities

ObjectivesThe Leisure Time Physical Activity Questionnaire (LTPAQ) measures the duration of physical activities performed during the past 7 days, and results are expressed in minutes. This study aimed to translate this questionnaire into Canadian-French and to evaluate the content validity and its test-retest reliability in people with physical disabilities.MethodsThe LTPAQ was translated from English to French by forward and backward translation. To assess content validity, 9 adults with physical disabilities read and provided comments regarding the relevance, wording and understanding of the items of the preliminary Canadian-French version of the questionnaire. For test-retest reliability, 37 adults with physical disabilities completed the questionnaire 2 or 3 times at T1 (baseline), T2 (2 days from baseline) and T3 (7 days from baseline). The test–retest reliability was investigated by intra-class correlation coefficients (ICCs), paired t test and Bland and Altman tests.ResultsThe translation and the content validation process resulted in a Canadian-French version of the LTPAQ (LTPAQ-CF). Total LTPAQ-CF scores between T1-T2 and T1-T3 featured strong ICCs, 0.90 and 0.75 (P ≤ 0.01). Paired t tests and Bland and Altman analyses confirmed the good reproducibility of results.ConclusionThe LTPAQ-CF has good test–retest reliability when self-administered or administered by interview to people with physical disabilities.     

The Reliability,Validity and Practical Utility of Measuring Supports using the I‐CAN Instrument: Part II

Background There is an urgent need for developing reliable, valid and practical instruments that assess and classify the support needed by persons with disability to function in their chosen living, working and social environments. I‐CAN is an instrument that addresses the frequency and level of support needed (not individual skills or deficits) for each individual with a disability. Method Studies were conducted to assess the test–retest reliability and inter‐rater reliability. Concurrent validity was investigated by exploring the relationship between the I‐CAN domain scales and the Inventory for Client and Agency Planning (ICAP) ( Bruininks et al. 1986 ) and the Quality of Life Questionnaire (QOL‐Q) ( Schalock & Keith 1993 ). Predictive validity studies were undertaken using day‐ and night‐time support hours. Regression analyses were run using these measures with I‐CAN domain scales. Two independent studies were also conducted to ascertain the practical utility of the instrument. Results The I‐CAN instrument demonstrated excellent inter‐rater and test–retest reliability in the Activities and Participation domains. Low‐to‐moderate test–retest results in Physical Health, Mental Emotional Health and Behaviour domains were tracked to actual change in support needs in these areas. Validity proved acceptable. The relationships between I‐CAN domain scales and adaptive behaviour were mixed but in the expected direction. Low‐to‐moderate correlation coefficients were evident between the I‐CAN scales and the QOL‐Q Total, but greater support needed in certain domains was associated with less empowerment and independence, and less community integration and social belonging. Attempts to explain current support hours against the I‐CAN scales were disappointing and suggest that a number of other factors apart from individual support need to play a significant role. There was general satisfaction with the assessment process from stakeholders and participant groups. Conclusions I‐CAN is a reliable, valid and user‐friendly instrument for assessing the support needs of people with disabilities. It uses a process that involves the persons with disability, their family and friends and staff as appropriate. It is also apparent that the current provision of paid support hours by agencies is a complex phenomenon that is not based solely on individual support needs. Further research is warranted on the influence of the environment and the perceptions of need for support based on negotiable and non‐negotiable support needs.     

住院患者满意和体验监测量表的研制

目的:编制住院患者满意和体验监测量表,并对其进行信度、效度检验,为研究住院患者对护理工作满意度提供测评工具。方法:参考《护理结局分类》中患者满意度结局,自行设计患者满意度调查表,采用专家咨询法进行内容效度检验,向江苏省某"三甲"医院舒心病房患者发放调查表209份,进行内部一致性信度、结构效度检验。结果:调查表总的Cronbach’sα系数为0.95,内容效度指数为0.76。采用主成分分析法提取了5个公因子,累积贡献率为75.516%。经最大正交旋转方法提取因子,共提取出因子37个。结论:初步形成了信度、效度较好的住院患者满意和体验监测量表,为评价临床护理工作质量提供依据。     

Empowerment in people with a mental illness: reliability and validity of the Swedish version of an empowerment scale

Empowerment has become a widespread concept in various social policy contexts referring to different marginalized groups. Empowerment has also been focused within the mental health field although little empirical research exists. The aim of the present study was to investigate internal consistency and construct validity of the Swedish version of an empowerment scale developed for people with a mental illness, Making Decisions. Ninety-two persons were subject to an interview also comprising assessments of quality of life, needs for care, psychiatric symptoms, psychosocial functioning, aspects of the social network, rejection experiences and attitudes of devaluation/discrimination towards people with mental illness. The results showed that the overall scale and the subscales had a good internal consistency, except for the subscale power–powerlessness. A factor analysis revealed two superordinate factors, self-esteem and activism and community and power, with a satisfactory internal consistency. These two factors showed a good construct validity with expected associations to validation measures. Stigma was most markedly associated with self-esteem and activism, and a higher level of education was most strongly associated with community and power. In conclusion, the Swedish version Making Decisions may well be used in further studies of empowerment among people with a mental illness.     

A Social Validation Assessment of Microswitch-Based Programs for Persons with Multiple Disabilities Employing Teacher Trainees and Parents as Raters

Social validation assessment of microswitch-based programs versus interaction/stimulation conditions for persons with multiple disabilities is a practically relevant research issue that was recently addressed (Lancioni et al., 2002, 2005a). The present study extended such validation assessment by involving a new group of students with multiple disabilities and two new groups of raters: one including teacher trainees and the other parents of children with disabilities. One hundred and forty teacher trainees and eighty-four parents watched videotapes showing the use of microswitch-based versus stimulation programs for seven students. All teacher trainees and parents scored the microswitch and the stimulation conditions on a 7-item questionnaire, the same as that used in previous studies. Data showed that both groups of raters rated the microswitch condition as more positive than the stimulation condition. These results strongly support those of the previous studies. Implications for use of microswitches with persons with profound and multiple disabilities seem unequivocal. Even so, caution needs to be used until additional replications across different cultural environments are carried out. To whom correspondence should be addressed at Department of Psychology     

Reliability and validity of the self-assessment of occupational functioning.

OBJECTIVE: Two studies examined the reliability and validity of the Self-Assessment of Occupational Functioning (SAOF), a 23-item self-assessment of perceptions of strengths, and weaknesses relative to occupational functioning, grounded in the Model of Human Occupation. METHOD: The first study examined the test-retest reliability of the SAOF, and involved 37 college students without disabilities who completed the SAOF twice. The second study, which involved 39 young persons hospitalized with psychiatric disorders, examined internal consistency reliability of the SAOF, and examined correlations between SAOF scores and composite scores on the Self-Perception Profile, a widely used measure of perceived competence. In addition, data from both studies were combined to examine the ability of the SAOF to discriminate between the college students without disabilities and the young persons with psychiatric disorders. RESULTS: Kappa and intraclass correlation coefficients (ICCs) were used to examine test-retest reliability and Cronbach's alpha was used to examine internal consistency. Acceptable levels of test-retest (ICCs) and internal consistency (Cronbach's alpha) reliability were found for the subscale and total scores of the SAOF. However, test-retest reliability (kappa) was lower than desirable for many of the individual SAOF items. The young persons with psychiatric disorders had lower item, subscale, and total scores on the SAOF than did the college students without disabilities. In addition, a discriminant analysis predicting group membership (college students without disability vs. young persons with psychiatric disorder) correctly classified 76.6% of the participants based on the four subscale scores of the SAOF. CONCLUSION: The SAOF has the potential to be a reliable and valid clinical assessment; however, additional research is needed.     

Validity and reliability testing of the Oulu patient classification: instrument within primary health care for the older people

Aim.  The aim of the study was to evaluate the reliability and validity of The Oulu Patient Classification (OPC) instrument to see whether the instrument that has been developed for hospital care is valid and useful within primary health care for older people.
Background.  Although different patient classification instruments have been under development since the 1960s, this is still a very important research area today.
Method.  Inter-rater reliability testing of the OPC instrument was undertaken. The inter-rater reliability was tested through parallel classification ( n  = 1722). Validity testing was conducted as an expert validation of the manual for the OPC instrument, using a questionnaire during June and July of 2005 ( n  = 61).
Results.  The inter-rater reliability testing achieved over 70% consensus, Cohen's Kappa showed a strong consensus for OPC classifications (0.65). The reliability measured with Cronbach's Alpha was also acceptable.
Conclusion.  The results show that the OPC instrument provides a good overview of the patient's care needs and is a reliable instrument within primary health care for older people.     

The development of an instrument to match individuals with disabilities and service animals

PURPOSE: There has been an increase in the use of service animals assisting persons with disabilities in the past decade. However many of the service dog agencies do not utilize an assessment that is designed to match the person to the animal in the rehabilitation and psycho-social domains. The purpose of this study was to develop the Service Animal Adaptive Intervention Assessment (SAAIA) and to measure the content validity, inter-rater reliability and clinical utility of the assessment. METHOD: Two subject groups were used. Subject group one had 43 subjects who measured the content validity and clinical utility of the SAAIA Survey. Subject group two had 12 subjects who measured the inter-rater reliability by completing the SAAIA using information obtained through a video-taped client case scenario. RESULTS: Content validity results indicated a good to high percentage of agreement and a fair percentage of agreement for clinical utility. Inter-rater reliability results indicate good to high agreement on six of the eight variables of the SAAIA. However, the Kappa score indicates low inter-rater reliability. CONCLUSION: Results indicate the SAAIA has good content validity and inter-rater reliability and fair clinical utility based on percent agreement. However, further research is needed on the reliability of the SAAIA.     

The development of an instrument to match individuals with disabilities and service animals

Purpose : There has been an increase in the use of service animals assisting persons with disabilities in the past decade. However many of the service dog agencies do not utilize an assessment that is designed to match the person to the animal in the rehabilitation and psycho-social domains. The purpose of this study was to develop the Service Animal Adaptive Intervention Assessment (SAAIA) and to measure the content validity, inter-rater reliability and clinical utility of the assessment. Method : Two subject groups were used. Subject group one had 43 subjects who measured the content validity and clinical utility of the SAAIA Survey. Subject group two had 12 subjects who measured the inter-rater reliability by completing the SAAIA using information obtained through a video-taped client case scenario. Results : Content validity results indicated a good to high percentage of agreement and a fair percentage of agreement for clinical utility. Inter-rater reliability results indicate good to high agreement on six of the eight variables of the SAAIA. However, the Kappa score indicates low inter-rater reliability. Conclusion : Results indicate the SAAIA has good content validity and inter-rater reliability and fair clinical utility based on percent agreement. However, further research is needed on the reliability of the SAAIA.     

The development of an instrument to match individuals with disabilities and service animals

Purpose : There has been an increase in the use of service animals assisting persons with disabilities in the past decade. However many of the service dog agencies do not utilize an assessment that is designed to match the person to the animal in the rehabilitation and psycho-social domains. The purpose of this study was to develop the Service Animal Adaptive Intervention Assessment (SAAIA) and to measure the content validity, inter-rater reliability and clinical utility of the assessment. Method : Two subject groups were used. Subject group one had 43 subjects who measured the content validity and clinical utility of the SAAIA Survey. Subject group two had 12 subjects who measured the inter-rater reliability by completing the SAAIA using information obtained through a video-taped client case scenario. Results : Content validity results indicated a good to high percentage of agreement and a fair percentage of agreement for clinical utility. Inter-rater reliability results indicate good to high agreement on six of the eight variables of the SAAIA. However, the Kappa score indicates low inter-rater reliability. Conclusion : Results indicate the SAAIA has good content validity and inter-rater reliability and fair clinical utility based on percent agreement. However, further research is needed on the reliability of the SAAIA.     

Validation of a measurement instrument to evaluate computer access in people with physical disabilities

The aim of this study was to develop an instrument to measure performance in computer tasks for persons with physical impairments. The objectives were to assure the content validity and the internal consistency of the test as well as the reliability of each task. The first step was to determine the mouse and keyboard actions necessary to use a computer. Resulting from these actions, 15 standardized computer tasks were designed as part of the test. To measure reliability and internal consistency, the test was administered twice to 19 persons without disabilities and 17 persons with disabilities. Reliability was established for most of the tasks and the test showed good internal consistency. This instrument could contribute to the improvement of occupational therapy interventions regarding computer access.     

Treatment Acceptability of Healthcare Services for Children with Cerebral Palsy

Background Although treatment acceptability scales in intellectual and developmental disabilities research have been used in large‐ and small‐scale applications, large‐scale application has been limited to analogue (i.e. contrived) investigations. This study extended the application of treatment acceptability by assessing a large sample of care givers’ perceptions of treatment for children with cerebral palsy (CP) in a real‐world setting and tested if responses differed across child characteristics, type of medical service or respondent demographics. Method One hundred and fifty four care givers’ for children with CP rated the acceptability of treatments and related medical services by clinicians working in a multi‐disciplinary children's specialty setting using Kazdin's (Journal of Applied Behavior Analysis, 13 , 1980, 259) Treatment Evaluation Inventory. Results There were significant (P < 0.05) differences between male and female respondents’ ratings of treatment acceptability. There were no other significant differences for caregiver ratings in relation to child characteristics, type of appointment, severity of CP or other respondent demographic characteristics. Conclusion Mothers and fathers of children with developmental disabilities may differ in their perceptions of the acceptability of medical treatment services for children with developmental disabilities. Future studies addressing treatment acceptability should expand the scope of demographic information assessed and include items specific to the roles respondents have in providing and coordinating therapeutic regimens for their children's medical needs.