Review of the Children's Assessment of Participation and Enjoyment and the Preferences for Activity of Children

The Children's Assessment of Participation and Enjoyment (CAPE) and Preferences for Activity of Children (PAC) are questionnaire-based assessments that are completed by self-report or by interview. The tool was published in 2004, and unless otherwise cited, all information describing the CAPE and PAC in this paper was obtained from the assessment manual () therefore the CAPE and PAC are not referenced except where direct quotations occur or alternate sources are used. The CAPE and PAC were developed using a clearly articulated conceptual model and focus. The CAPE measures multiple dimensions of participation, including participation diversity, intensity, with whom and where participation occurs, and enjoyment. The PAC measures activity preference. Both measures include 55 informal and formal activities that can be organized into five activity types: recreational, active-physical, social, skill-based, and self-improvement. Current evidence supports that the tools' validity and reliability is adequate. The detailed assessment of participation is highly useful for practice and research.     

Having Fun and Staying Active! Children with Disabilities and Participation in Physical Activity: A Follow-Up Study

Aim: This study investigated change in the participation profile of physical activity over 15 months after a three-week intensive rehabilitation that used physical activity as the main intervention. Methods: The Children's Assessment of Participation and Enjoyment (CAPE) was used in a longitudinal prospective study (pre- and post-design) with three measurements over 15 months. Eighty children with physical disabilities (6–17 years old; mean score 11.1; SD 2.4), some with additional cognitive challenges, completed all three measurements. Results: Participation diversity and intensity of all 55 leisure activities declined significantly over the 15-month period. The largest decline was for children aged between 10 and 13 years. Among physical activities, there was a stable level of participation of the total group, and sub-groups. Boys preferred “active physical activities” to a greater extent, while girls preferred “skill-based activities.” Both genders expressed a higher level of enjoyment in their preferred activities according to the Preferences for Activities of Children. Conclusions: This intervention may have the potential to maintain the level of physical activity among children and youths with disabilities, yet further controlled studies are needed. Gender differences should be taken into consideration to facilitate stable participation in physical activities with a high level of enjoyment.     

Psychometric Evaluation of the Young Children's Participation and Environment Measure (YC-PEM) for use in Singapore

Aims: To estimate the psychometric properties of a culturally adapted version of the Young Children's Participation and Environment Measure (YC-PEM) for use among Singaporean families. Methods: This is a prospective cohort study. Caregivers of 151 Singaporean children with (n = 83) and without (n = 68) developmental disabilities, between 0 and 7 years, completed the YC-PEM (Singapore) questionnaire with 3 participation scales (frequency, involvement, and change desired) and 1 environment scale for three settings: home, childcare/preschool, and community. Setting-specific estimates of internal consistency, test-retest reliability, and construct validity were obtained. Results: Internal consistency estimates varied from .59 to .92 for the participation scales and .73 to .79 for the environment scale. Test-retest reliability estimates from the YC-PEM conducted on two occasions, 2–3 weeks apart, varied from .39 to .89 for the participation scales and from .65 to .80 for the environment scale. Moderate to large differences were found in participation and perceived environmental support between children with and without a disability. Conclusions: YC-PEM (Singapore) scales have adequate psychometric properties except for low internal consistency for the childcare/preschool participation frequency scale and low test-retest reliability for home participation frequency scale. The YC-PEM (Singapore) may be used for population-level studies involving young children with and without developmental disabilities.     

Establishing the Cultural Equivalence of the Young Children's Participation and Environment Measure (YC-PEM) for Use in Singapore

Aims: Establishing the cultural equivalence of clinical assessments is critical to ensuring culturally competent care. Developed in North America, the Young Children's Participation and Environment Measure (YC-PEM) is a caregiver questionnaire of participation in home, preschool, and community activities and perceptions of environmental impact on participation. The purpose of this study is to establish the cultural equivalence of YC-PEM content for use in Singapore. Methods: We conducted semi-structured interviews with ten early childhood and healthcare providers and cognitive interviews with ten parents in Singapore to examine the relevance of original YC-PEM content (activities, environmental factors, item wording). Interviews were transcribed, summarized, and categorized according to item, semantic, conceptual, and operational dimensions of the Applied Cultural Framework that served as a decision-making guide to keep, modify, or delete the items. Results: Providers and parents agreed on conceptual, item and semantic changes but less on operational changes. Significant changes were made to improve comprehension of the YC-PEM. Conclusions: Despite using the same language, the majority of the YC-PEM items needed modification to be relevant to the Singapore culture. Cultural adaptation of the YC-PEM is important because there are cultural differences in children's participation and their environments, as well as the way people understand words.     

Measuring Outcomes of Family-Centered Intervention: Development of the Life Participation for Parents (LPP)

Raising a child with disabilities impacts the ability of parents to participate in life situations. This paper describes the development of a new instrument, Life Participation for Parents, to measure outcomes of pediatric therapy on parental participation. Items were reviewed by six occupational therapists with experience in pediatrics and instrument development. The number of items was reduced to 23. The resultant instrument was completed by 29 parents of children with disabilities. Their scores were reviewed by the nine occupational therapists working with the children. Parent and therapist respondents were interviewed regarding item content. Instrument responses were evaluated for internal consistency. The respondents confirmed the face and content validity of the construct, variability in responses, and readability of the items. Good internal consistency for items was demonstrated (Cronbach's alpha. 85). The preliminary results indicate that the Life Participation for Parents is a promising tool for evaluating parental issues and measuring parent outcomes in family-centered practice.     

Comparison of the Properties of the Handwriting Speed Test (HST) and Detailed Assessment of Speed of Handwriting (DASH): An Exploratory Study

Background: Handwriting speed is an important component of students’ ability to adequately express their ideas, knowledge and creativity in a timely and effective manner. Aims: Psychometric properties of the Handwriting Speed Test (HST) and Detailed Assessment of Speed of Handwriting (DASH) and accuracy of the norms for identifying current Australian students with handwriting speed difficulties were examined. Methods: An exploratory, cross-sectional study was conducted involving students, with and without handwriting difficulties, in Years 3–12 (mean age: 12.0 yrs, SD = 3.0 yrs; range = 7 to 18 yrs) in New South Wales (NSW; Australia). Participants were recruited through occupational therapists and schools. Students completed the HST and all DASH subtests. Results: Thirty-two students with, and 139 students without, handwriting difficulties participated. Intra-rater and inter-rater reliability were found to be excellent; sensitivity was low and specificity high for the HST and DASH. No significant differences were found between test scores and normative data for students without handwriting difficulties (year/age groups with n > 10). Conclusions: The HST and DASH are reliable assessments of handwriting speed. Further research is required into discriminant validity of the HST and DASH and need for updated norms.     

Adaptation and Preliminary Testing of the Developmental Coordination Disorder Questionnaire (DCDQ) for Children in India

Aims: While Developmental Coordination Disorder (DCD) has gained worldwide attention, in India it is relatively unknown. The revised DCD Questionnaire (DCDQ′07) is one of the most utilized screening tools for DCD. The aim of this study was to translate the DCDQ′07 into the Hindi language (DCDQ-Hindi) and test its basic psychometric properties. Methods: The DCDQ′07 was translated following guidelines for cross cultural adaptation of instruments. Parents of 1100 children (5–15 years) completed the DCDQ-Hindi, of which 955 were considered for data analysis and 60 were retested randomly after 3 weeks for test–retest reliability. Results: The DCDQ-Hindi showed high internal consistency (α = .86) and moderate test–retest reliability (.73). Confirmatory factor analysis showed equivalence to the DCDQ′07. The% probable DCD using DCDQ′07 cutoff scores (≤57) ranged from 22% to 68%. Using more stringent cutoffs (≤36) it ranged from 5% to 9%. Significant difference was seen for gender (p < .05) in subset 1(gross-motor skills) total scores. Conclusions: The DCDQ-Hindi reveals promise for initial identification of Hindi speaking Indian children with DCD. Based on more stringent cut-off scores, the “probable prevalence” of children with risk of DCD in India appears to be around 6–7%. Research with larger sample and comparison with the MABC-2 or equivalent is needed.     

Longitudinal Effect of Ambient Air Pollution and Pollen Exposure on Asthma Control: The Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Study

ObjectiveAlthough exposure to air pollution and pollen is associated with asthma exacerbation and increased health care use, longitudinal effects of fine particulate matter 2.5 (PM_2.5), ozone (O₃), and pollen exposure on asthma control status in pediatric patients are understudied. This study investigated effects of exposure to PM_2.5, O₃, and pollen on asthma control status among pediatric patients with asthma.MethodsA total of 229 dyads of pediatric patients with asthma and their parents were followed for 15 months. The Asthma Control and Communication Instrument was used to measure asthma control, which was reported weekly by parents during a 26-week period. PM_2.5 and O₃ data were collected from the US Environmental Protection Agency Air Quality System. Pollen data were obtained from Intercontinental Marketing Services Health. Mean air pollutant and pollen exposures within 7 days before the reporting of asthma control were used to estimate weekly exposures for each participant. Linear mixed-effects models were performed to test associations of PM_2.5, O₃, and pollen exposure with asthma control status. Sensitivity analyses were performed to evaluate the robustness of findings by different exposure monitoring days per week and distances between monitoring sites and participants’ residences.ResultsElevated PM_2.5 concentration and pollen severity were associated with poorer asthma control status (P < .05), yet elevated O₃ concentration was marginally associated with better asthma control (P < .1).ConclusionsPoorer asthma control status was associated with elevated PM_2.5 and pollen severity. Reducing harmful outdoor environmental ambient exposure may improve asthma outcomes in children and adolescents.