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.     

Concurrent Validity of the School Outcomes Measure (SOM) and Pediatric Evaluation of Disability Inventory (PEDI) in Preschool-Age Children

ABSTRACT

Aims: The purpose of this study was to examine the concurrent validity of the School Outcomes Measure (SOM) compared with the Pediatric Evaluation of Disability Inventory (PEDI) in preschool-age children. This study also examined the consistency of children's motor performance across the home and school settings. Methods: Five school-based physical therapists collected data on 44 preschool-age children with physical or combined physical and cognitive disability. Correlation coefficients analyzed the strength of association between SOM and PEDI subscale scores, while participant group mean scores analyzed agreement between measures regarding level of motor performance. Results: Correlations between homologous PEDI and SOM subscale scores varied from r_s = .53 to r_s = .92 supporting concurrent validity. With some exceptions, group mean SOM scores showed agreement with group mean PEDI scores when children were categorized by age, gross motor function level, or PEDI cutoff score (1 or 2 SD below the mean). Conclusions: The results partially support concurrent validity between the SOM and PEDI, and suggest that the children's motor performance was similar across home and school settings. The findings also suggest that as a minimal database the SOM can reliably assess motor performance in the school setting; the disadvantage is difficulty interpreting SOM scores.     

Item Bank Development for a Revised Pediatric Evaluation of Disability Inventory (PEDI)

ABSTRACT

The Pediatric Evaluation of Disability Inventory (PEDI) is a useful clinical and research assessment, but it has limitations in content, age range, and efficiency. The purpose of this article is to describe the development of the item bank for a new computer adaptive testing version of the PEDI (PEDI-CAT). An expanded item set and response options were reviewed by clinician experts and examined at parent and clinician focus groups. Eleven parents participated in 32 cognitive interviews to examine content, format, and comprehension of items and responses. A set of 76 self-care, 78 mobility, and 64 social function items with pictures and a four-point “Difficulty” scale were developed. The PEDI's Caregiver Assistance scale was replaced by a “Responsibility Scale” with 53 items. Content validity was established incorporating input from clinicians and parents. The new item bank covers a broad range of functional activities for children of all ages and abilities.     

To Explore the Validity of Change Scores of the Children's Hand-use Experience Questionnaire (CHEQ) in Children with Unilateral Cerebral Palsy

Aims: To explore the validity of change scores of the Children's Hand-use Experience Questionnaire (CHEQ). Methods: Analysis of the CHEQ included 44 children (15 girls) between 6–16 years (median 9.0; IQR 8–11) with unilateral cerebral palsy, with baseline and post- (two-week intensive) intervention assessments using the Goal Attainment Scale (GAS) as external anchor for change. Hypotheses on the magnitude of expected change were formulated and correlation coefficients and effect sizes calculated. Receiver operating curve analysis was performed and the area under the curve (AUC) calculated to investigate the ability of CHEQ to discriminate between improvement and non-improvement according to GAS. Results: All hypotheses about the magnitude of change were confirmed supporting longitudinal validity of CHEQ scales to measure change in the perception of bimanual performance. AUCs for the Grasp efficacy and the Time utilization were slightly below, and for the Feeling bothered slightly above the threshold. The latter one accurately discriminating between children that improved and did not improve according to the GAS. Conclusions: Evidence was found that CHEQ scales capture change in bimanual performance but with limited accuracy for two out of three scales. The validity of CHEQ change scores needs to be further explored in a wider population.     

Development and validation of the Child Post-Traumatic Cognitions Inventory (CPTCI)

Background:  Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with younger populations are lacking. A measure of negative trauma-related cognitions for use with children and adolescents, the Child Post-Traumatic Cognitions Inventory (CPTCI), is presented. The measure was devised as an age-appropriate version of the adult Post-Traumatic Cognitions Inventory ( Foa et al., 1999 ).
Methods:  The CPTCI was developed and validated within a large ( n  = 570) sample, comprising community and trauma-exposed samples of children and adolescents aged 6–18 years.
Results:  Principal components analysis suggested a two-component structure. These components were labelled 'permanent and disturbing change' and 'fragile person in a scary world', and were each found to possess good internal consistency, test–retest reliability, convergent validity, and discriminative validity. The reliability and validity of these sub-scales was present regardless of whether the measure was completed in the acute phase or several months after a trauma. Scores on these sub-scales did not vary with age.
Conclusions:  The CPTCI is a reliable and valid measure that is not specific to the type of trauma exposure, and shows considerable promise as a research and clinical tool. The structure of this measure suggests that appraisals concerning the more abstract consequences of a trauma, as well as physical threat and vulnerability, are pertinent factors in trauma-exposed children and adolescents, even prepubescent children.     

The Use of the Bayley Scales of Infant and Toddler Development III with Clinical Populations: A Preliminary Exploration

ABSTRACT

In response to concerns that the Bayley Scales of Infant and Toddler Development III (BSIDIII) underestimate delay in clinical populations, this study explores developmental quotient scores as an alternative to composite scores for these children. One hundred and twenty-two children aged ≤42 months, referred for diagnosis of developmental disability from January 2007 to May 2010, were assessed, and their composite and developmental quotient scores on each scale were compared. Composite scores identified only 22% (cognitive), 27% (motor), and 47.5% (language) of children as having a developmental disability. Developmental quotient scores were significantly lower than composite scores, giving rates of developmental disability of 56.6% (cognitive), 48.4% (motor), and 74.6% (language) and more closely matching both clinical impressions of delay and the proportions of those children who were also delayed on standardized tests of adaptive function.     

Development of the Preschool Occupational Therapy Assessment

Initial reliability and validity studies were completed for a newly created assessment tool called the Preschool Occupational Therapy Assessment (POTA). The POTA was designed to examine fine motor and sensory motor skills relevant to preschool academic function. Forty-five children, both typically developing and developmentally delayed, participated in the initial research. Results of data analysis support further development of this tool.     

Translation and validation of the Transition Readiness Assessment Questionnaire (TRAQ)

Objective

To translate and validate the Brazilian Portuguese version of the Transition Readiness Assessment Questionnaire in a population of adolescents and young adults with chronic rheumatologic disorders. This questionnaire evaluates the patient's readiness for making the transition from the pediatric health service to adult care.

Normative Scores for the Pediatric Evaluation of Disability Inventory in Norway

Aim: The aim of this study was to develop clinically useful normative scores for the Pediatric Evaluation of Disability Inventory (PEDI) for children in Norway, and provide information on the relative difficulty level of individual test items. Methods: Using PEDI protocols from 224 Norwegian children without disability, we computed and scrutinized the normative scores for their representativeness, and compared them with scores from 313 children in the original US PEDI sample. Item functioning was compared using Rasch model-based differential item functioning (DIF) analyses and comparisons of item mastery. Results: The normative scores yielded consistent and regular results. The mean scores for each age group in the Norwegian sample were lower than in their US counterparts, and age mean plots ran parallel. However, this difference may be misleading for clinical use, as item comparisons revealed differences in both higher and lower directions between the samples for about a third of all items. Estimates of relative item difficulty for children in Norway were developed. Conclusions: Identifying potential differences when using an instrument in another culture is important to avoid a risk of over- or underestimating a child's capability. In addition, item response patterns are required to make national normative scores clinically useful.     

French norms and validation of the Child Development Inventory (CDI): Inventaire du Developpement de l'Enfant (IDE)

The aim of this study was to determine the French norms and examine the validity of a parent-report inventory: the Child Development Inventory (CDI), called "Inventaire du Développement de l'Enfant (IDE)" in French. This assesses the general level of a child's development in 8 developmental domains. The norms were determined for a community sample of 1287 children, aged 15 to 72 months. The score for the CDI general development scale correlates closely with chronological age (r = .89). The intra- and interobserver (mother vs teacher) agreements were .97 and .76. The 1-year stability coefficient between the developmental quotient (DQ) values was .81. Correlation between the DQ (CDI) and the IQ of psychometric individual test was high (r = .84). The sensitivity and specificity for detecting borderline children (IQ < 86) were 84% (95% CI = 72% to 92%) and 92% (95% CI = 84% to 97%), respectively. Therefore, the French version of the CDI, like the English one, provides a useful tool for measuring children's development.     

Behavioral Testing in the Context of Reproductive and Developmental Toxicity Screening in the West*

Abstract Methods for assessing animal neurobehavior following prenatal/perinatal exposures have been in use for almost 20 years and screening tests incorporating them are regulated in three settings: in Japanese Segment II and III studies on drugs, European (EEC/UK) Segment I studies on drugs, and American neurotoxicity studies on chemicals. The methods used in the West for assessing behavior in these contexts at present are described in detail. The evolution of the methods over time, the concepts of apical tests and functional domains, the use of positive control agents, what the U.S. Collaborative Study has shown us, and justification for assessing animal behavior in predicting outcome from human exposures are discussed.     

Reliability of the Pediatric Evaluation of Disability Inventory (PEDI)

Pediatric Evaluation of Disability Inventory (PEDI) is an instrument for evaluating function in children with disabilities aged 6 months to 7.5 years. The PEDI measures both functional performance and capability in three domains: (1) self-care, (2) mobility, and (3) social function. The PEDI has recently been translated into Norwegian. The purpose of this study was to investigate the inter-rater, inter-respondent and intra-rater reliability of the Norwegian version of the PEDI. Reliability was investigated in a sample of 30 Norwegian children without disabilities between 1.0 and 5.0 years. Interviews with parents were conducted twice by the same occupational therapist, and once by a physiotherapist. Kindergarten teachers were also interviewed by the occupational therapist. Using children without disabilities allows us to set up a standard for functional ability. Deviation from the point may indicate improvement or worsening of the state. The inter-rater and intra-rater part of the study showed excellent agreement of the observations, indicated both by small differences and high Intraclass Correlation Coefficients (ICC) (0.95-0.99). The discrepancy between the different interviews was highest between the reports from the parents and the kindergarten teachers (inter-respondent reliability), indicated by ICC from 0.64-0.74. Results of this study indicate that improved reliability is secured when the same interviewer interviews the same respondent, as well as when two trained interviewers interview the same respondent. The consistency of scores should be reviewed when different respondents are interviewed. Professionals administering the PEDI needs to be trained following a required procedure in order to secure consistency in their rating.     

Use of the Child Engagement in Daily Life and Ease of Caregiving for Children to Evaluate Change in Young Children with Cerebral Palsy

ABSTRACT

Aims: Participation in family and recreational activities, self-care, and parent ease of caregiving are important outcomes for young children with cerebral palsy (CP). The aim of this study was to examine use of the Child Engagement in Daily Life and the Ease of Caregiving for Children to measure change over time. Methods: A convenience sample of 387 parents of young children with CP (18 months to 5 years of age) completed the measures twice, a mean of 12.7 months apart. Results: For the Child Engagement in Daily Life, parents of children in Gross Motor Function Classification System level I and levels II–III reported more change for the Self-care domain (medium effect) than the Family and Recreational Activities domain (small effect) and the Ease of Caregiving for Children (small effect). The change reported by parents of children in levels IV–V on all three measures was less than the criterion for a small effect. Minimal detectable change for each measure varied from 12.1 to 14.1, out of a total possible score of 100. Conclusion: Further research is recommended to determine responsiveness to change following intervention.     

Initial testing (stage 1) of vorinostat (SAHA) by the pediatric preclinical testing program

Vorinostat, a histone deacetylase inhibitor, was evaluated against the in vitro and in vivo childhood solid tumor and leukemia models in the Pediatric Preclinical Testing Program (PPTP). In vitro testing was performed by the DIMSCAN cytotoxicity assay. In vivo, vorinostat was administered intraperitoneally to mice bearing xenografts. Vorinostat demonstrated 2‐log cell growth inhibitory activity in vitro, but generally at concentrations not sustainable in the clinic. No objective responses were observed for any of the solid tumor or acute lymphoblastic leukemia xenografts. Preclinical studies with appropriate drug combinations may provide direction for further clinical evaluations of vorinostat against selected pediatric cancers. Pediatr Blood Cancer 2009;53:505–508. © 2009 Wiley‐Liss, Inc.     

Psychometric properties of the Ukrainian version of the Childhood Health Assessment Questionnaire (CHAQ)

Background: The objective of this study was to develop and validate the Ukrainian version of the Childhood Health Assessment Questionnaire (CHAQ) in sick by juvenile idiopathic arthritis (JIA) children. Methods: The Ukrainian version of the CHAQ was fully cross-culturally adapted from the original American-English version with 3 forward and 3 backward translations. The CHAQ has been validated in a cross-sectional study in 55 patients with and 30 healthy children. Results: The results were characterized by a high level of internal consistency and good reliability (the Cronbach alpha coefficient was 0.86 for 8/8 domains). The constructive validity was considered by the correlation of the CHAQ scales with each other. For the discriminant validity correlation of the domains and the disability index with the evaluation of pain was significant. The convergent validity was confirmed by correlation of the CHAQ and the Child Health Questionnaire (CHQ) physical summary score. The divergent validity was confirmed because there was no correlation between the CHAQ items and the CHQ psychosocial summary score. The discovered correlations between disability index and morning stiffness, number of active joints, number of joints with limited range of motion, number of joints with pain, number of swollen joints, Ritchie articular index, DAS, DAS28, SDAI, and CDAI have confirmed the external validity of the CHAQ. Sensitivity of the CHAQ to minimal changes of joints functions in patients with JIA also has been proven. Conclusions: The Ukrainian version of the CHAQ is a reliable, valid, and sensitive tool for the functional assessment of children with JIA.     

Influence of severity of congenital hypothyroidism and adequacy of treatment on school achievement in young adolescents: a population-based cohort study

AIM: To evaluate whether precociously treated subjects with congenital hypothyroidism (CH) are at risk of poor school performance in early adolescence, and to investigate which factors affect their school achievement. METHODS: All children treated early for congenital hypothyroidism and born in France during the first 7 y (1979-1985) of the national screening program for congenital hypothyroidism were selected for the study. School performance during childhood, assessed according to age at entry into the first grade of secondary school, was evaluated as normal (usually 11 y of age) vs late entry (> or = 12 y). The national register of children with congenital hypothyroidism enabled a comparison to be made with data from the national population for the same school years. RESULTS: School achievement was similar among the 682 patients with CH and in the national population. After an adjustment for the sex and socioprofessional category of the parents, the severity of CH as assessed by the type (athyreosis. the most severe vs other types), the initial low serum T4 levels (< or = 53 nmol/L vs >53 nmol/L), and the profound bone maturation delay (absence vs presence of the two knee epiphyseal ossification centres at diagnosis), initially low L-thyroxine dosage (below vs > or = 7 microg/kg/day), the absence of near normalization of thyroid hormone levels after 15 d of treatment and poor adequacy of treatment throughout childhood were associated with an increased risk of school delay. School achievement was unaffected by the age at start of treatment (mean age = 22.8 +/- 6.8 d). In a multivariate logistic regression analysis, recurrent episodes of insufficiently suppressed TSH levels (> or = 15 mUi/L at least four times during follow-up from the age of 6 mo onwards) were the most important variable associated with school delay. CONCLUSION: Careful follow-up of the adequacy of treatment is required throughout childhood, to reduce the risk of school delay.