The Chinese version of the Child and Adolescent Scale of Environment (CASE-C): Validity and reliability for children with disabilities in Taiwan

Measurement of children's participation and environmental factors is a key component of the assessment in the new Disability Evaluation System (DES) in Taiwan. The Child and Adolescent Scale of Environment (CASE) was translated into Traditional Chinese (CASE-C) and used for assessing environmental factors affecting the participation of children and youth with disabilities in the DES. The aim of this study was to validate the CASE-C. Participants were 614 children and youth aged 6.0–17.9 years with disabilities, with the largest condition group comprised of children with intellectual disability (61%). Internal structure, internal consistency, test-retest reliability, convergent validity, and discriminant (known group) validity were examined using exploratory factor analyses, Cronbach's α coefficient, intra-class correlation coefficients (ICC), correlation analyses, and univariate ANOVAs. A three-factor structure (Family/Community Resources, Assistance/Attitude Supports, and Physical Design Access) of the CASE-C was produced with 38% variance explained. The CASE-C had adequate internal consistency (Cronbach's α = .74–.86) and test-retest reliability (ICCs = .73–.90). Children and youth with disabilities who had higher levels of severity of impairment encountered more environmental barriers and those experiencing more environmental problems also had greater restrictions in participation. The CASE-C scores were found to distinguish children on the basis of disability condition and impairment severity, but not on the basis of age or sex. The CASE-C is valid for assessing environmental problems experienced by children and youth with disabilities in Taiwan.     

Psychometric evaluation of the Dutch language version of the Child and Family Follow-up Survey

Abstract

Aim: The Child and Family Follow-up Survey (CFFS) is developed to monitor long-term outcomes of children and youth with acquired brain injury (ABI). The aim of this study was to translate and adapt it into the Dutch language and to evaluate its reliability and validity.

Methods: The CFFS includes the Child and Adolescent Scale of Participation (CASP), the Child and Adolescent Factors Inventory (CAFI) and the Child and Adolescent Scale of Environment (CASE). The CFFS was translated into Dutch following international guidelines and adapted. The internal consistency, validity and test–retest reliability were examined among two groups of patients (n?=?140 and n?=?27) in the age of 5–22 years with ABI and their parents.

Results: The translation and adaptation resulted in the CFFS-DLV, Dutch language version. The CASP-DLV, CAFI-DLV and CASE-DLV had a good internal consistency, with Cronbach’s alpha being 0.95, 0.89 and 0.83, respectively. There were statistically significant correlations among the three CFFS subscale scores. These scores were also significantly correlated with the total scores of the Pediatric Quality of Life Inventory (PedsQL, parent) and the Pediatric Stroke Outcome Measure, but not with the domain scores of the Children’s Assessment of Participation and Enjoyment (CAPE). The test–retest reliability was good to moderate, with the intra-class correlation coefficients being 0.90 for the CASP-DLV, 0.95 for the CAFI-DLV and 0.81 for the CASE-DLV.

Conclusions: The CFFS-DLV, as translation and adaptation of the CFFS into Dutch, proved to be a promising instrument to measure long-term outcomes of children and youth with ABI. Further research is needed to examine its responsiveness to change and potential in other patient groups.     

Responsiveness and discriminant validity of the Child and Adolescent Scale of Participation across three years for children and youth with traumatic brain injury

ABSTRACT

Purpose: To examine responsiveness and discriminant validity of the Child and Adolescent Scale of Participation (CASP) across three years. Methods: Examined longitudinal data on 515 children and youth with TBI and arm injuries. Repeated measures analyses of variance were used to examine CASP scores (pre-injury; 3, 12, 24, 36 months post-injury). Results: Scores decreased from pre-injury to 3 months, but significantly only for moderate and severe TBI groups. Scores gradually increased post-injury for all groups except severe TBI. Scores were consistently lowest for severe TBI, followed by moderate TBI, mild TBI, and arm injury across time. Severe TBI scores were significantly lower than scores for mild TBI and arm injury, but not moderate TBI. Conclusions: CASP scores were responsive to change over time at most measurements and differentiated between groups, particularly severe TBI. Further research is needed with a larger sample of children with moderate/severe TBI as they were underrepresented in this study.     

Validation of the Chinese version of the Assessment of Preschool Children’s Participation for children with physical disabilities

Purpose: To examine the psychometric properties of the Chinese version of the Assessment of Preschool Children’s Participation (APCP-C). Method: The APCP, a measure of participation in play, skill development, active physical, and social activities of preschool children, was translated into Traditional Chinese. Data on 94 Taiwanese children with physical disabilities aged 2 to 6 years were analyzed. Results: Internal consistency (Cronbach’s α = 0.85 and 0.86) and test–retest reliability (ICCs = 0.79) were excellent for total scores, and varied from excellent to poor for activity type scores. Items were generally relevant to the Taiwanese culture. Correlations between scores for the APCP-C and the Chinese version of the Pediatric Evaluation of Disability Inventory Mobility and Social Functioning scales in general supported convergent validity (r = 0.33–0.68) but less support for discriminant validity. Conclusions: The results provide evidence of reliability, cross-cultural validity, and limited support for construct validity of the APCP-C in measuring participation of children with physical disabilities.     

Geographical patterns in the recreation and leisure participation of children and youth with cerebral palsy: A CAPE international collaborative network study

Purpose: To examine geographical variation in the leisure participation of children/youth with cerebral palsy (CP), using Children's Assessment of Participation and Enjoyment (CAPE) data from Australia, Canada (Ontario and Quebec) and the US.

Method: Data from 1076 children/youth ages 6–20 years with CP were included. Analyses examined CAPE diversity scores in activity types as a function of region, age group and Gross Motor Function Classification System (GMFCS) group, controlling for family income, education and child gender.

Results: There were only two substantial geographical differences: children/youth from the US took part in the fewest active physical activities; those from Ontario took part in the most self-improvement activities. The youngest age group took part in the most recreational activities, and those in GMFCS level IV/V had the lowest levels of participation in recreational, active physical and self-improvement activities, confirming previous findings.

Conclusions: There were more similarities than differences in participation patterns for the three countries.     

Predictors of Anxiety Symptom Trajectory in Children with or without ID from Early Childhood to Adolescence

ABSTRACT

Introduction: We examined the development of anxiety in youth with or without intellectual disabilities (ID). We also examined the effects of child delay status, temperament, ethnicity, and negative parenting on anxiety symptom trajectory.

Method: Participants were 177 families in (blinded). We employed latent growth curve modeling to examine the trajectory of anxiety symptoms (ages 3–13 years) and to examine the individual and interactive effects of variables in predicting age 3 anxiety and change in anxiety.

Results: Anxiety symptoms increased over time. Children with ID demonstrated higher levels of anxiety compared to typically developing (TD) children. Social fearfulness was positively associated with anxiety at age 3. Anxiety increased at a slower rate in Latino children. Negative parenting positively predicted rate of change in anxiety for children with ID but not TD children.Conclusions: These findings inform early intervention targets for culturally diverse families of children with or without ID.     

Screening for mathematical disabilities in kindergarten

Objective: This article is devoted to the potential early markers for mathematical learning disabilities in kindergarten in order to prevent children from falling further behind and from developing unrecognized mathematical disabilities later on.

Methods: Performances in preparatory arithmetic tasks were studied in 361 kindergartners focusing on differences between children at risk for mathematical disabilities and children who were at least moderately achieving in numerical arithmetic tasks.

Results: Evidence was found for several markers in kindergarten. Children at risk had lower scores on procedural counting knowledge, conceptual counting knowledge, seriation, classification, conservation and magnitude comparison tasks. Based on these kindergarten abilities, 77% of children who were at risk for mathematical disabilities could be detected.

Conclusion: Procedural and conceptual counting knowledge, seriation and classification skills and magnitude comparison abilities could possibly serve as powerful early screeners in the detection of mathematical disabilities.     

Comparing participation in activities among children with disabilities

IntroductionCompared to typically developing peers, children with disabilities due to neurodevelopmental disorders and disabilities (NDD/D) and to chronic medical conditions (CMC) have reduced participation in activities. The extent to which these two groups of children have different levels of participation is unknown and was examined in this study.MethodsThe 2006 Participation and Activity Limitation Survey children dataset collected by Statistics Canada was analyzed. Children with disabilities due to NDD/D and CMC were identified following review and classification of all ICD-10 codes in the dataset by two pediatricians. Dependent variables were parent-reported child participation in supervised and unsupervised physical activities within and outside of school, educational activities, and social/recreational activities. Logistic regression analyses, with relevant covariates (child and familial characteristics), were used to analyze the data.ResultsChildren with NDD/D were significantly more likely to take part in supervised and unsupervised physical activity at school than children with CMC (p < 0.001). A similar trend was observed for participation in school outings, although the effect was not significant at p < 0.01. Finally, a trend in the opposite direction was observed for educational activities, as children with NDD/D were less likely to take part in these activities than children with CMC.DiscussionFinding decreased participation among children with CMC compared with NDD/D was not predicted a priori but has potential implications for their mental and physical health.ConclusionsGaining a better understanding of the barriers to participation in physical activity may contribute to improving the overall health status of children with CMC.     

Activity participation of children with complex communication needs,physical disabilities and typically-developing peers

Objective: To describe and compare the context of participation of children with physical disabilities and complex communication needs (Group CCN) in out-of-school activities with children with physical disabilities only (Group PD) and typically-developing peers (Group TD).

Method: A cross-sectional, matched, multi-group design was used. Thirty-nine participants between 10–15 years of age were administered the Children's Assessment of Participation and Enjoyment.

Results: Kruskall-Wallis analyses revealed that there were significant differences among the three groups for overall location, enjoyment of the activities and with whom they did the social and self-improvement activities with. Mean trends showed that Group CCN participated in activities closer to home rather than in the community, were restricted in social participation and reported higher levels of enjoyment in activity participation than the other two groups.

Conclusions: Group CCN appeared to experience differences in participation when compared to peers with and without disability.     

Household size is associated with unintelligible speech in children who have intellectual disabilities: A South African study

Abstract

Objective: The purpose of this study was to examine whether four socioeconomic factors, namely caregiver age, caregiver education, family income and/or household size were related to the presence of motor delays or unintelligible speech in South African children with intellectual disabilities. Methods: Caregivers of children with intellectual disabilities completed a biographical questionnaire regarding their home environments. Other items on the questionnaire queried whether their children experienced co-occurring developmental impairments of motor delays or unintelligible speech. Results: A total of 145 caregivers were included in the analyses. Two logistic regressions were run with the set of four socioeconomic factors as predictors, and motor delays and intelligible speech as the outcome variables. Household size was a statistically significant predictor of whether children evidenced intelligible speech. Conclusion: Children living in dwellings with more people were less likely to have intelligible speech. The processes through which large household size might influence children’s language are discussed.     

Psychometric evaluation of the Participation and Environment Measure for Children and Youth

Aim The aim of this study was to examine the psychometric properties (reliability and validity) of the Participation and Environment Measure for Children and Youth (PEM‐CY). Method The PEM‐CY examines participation frequency, extent of involvement, and desire for change in sets of activities typical for the home, school, or community. Items in the ‘Environment’ section examine perceived supports and barriers to participation within each setting. Data were collected via an online survey from caregivers of children and young people, aged 5 to 17 years, with and without a range of different disabilities, residing in the USA and Canada. Caregivers were eligible for inclusion if (1) they identified themselves as a parent or legal guardian of the child who was the focus of the survey; (2) they were able to read English; and (3) their child was between 5 and 17 years old at the time of enrolment. Results Data were obtained from 576 respondents. About half were parents of children with disabilities and a little more than half were from Canada. Child mean age was 11 years (SD 3.1y); 54% were male and 46% were female. Internal consistency was moderate to good (0.59 and above) across the different scales. Test–retest reliability was moderate to good (0.58 and above) across a 1‐ to 4‐week period. There were large and significant differences between the groups with and without disabilities on all participation and environment scales. Although there were some significant age differences, they did not follow a consistent pattern. Interpretation Results support the use of the PEM‐CY for population‐level studies to gain a better understanding of the participation of children and young people and the impact of environmental factors on their participation.     

Psychometric validation of a Danish version of the Obsessive Beliefs Questionnaire - Child Version (OBQ-CV)

Abstract

Aim: The aim of the study was to examine the psychometric properties of a Danish version of the Obsessive Beliefs Questionnaire – Child Version (OBQ-CV). The OBQ-CV assesses dysfunctional beliefs concerning responsibility/threat estimation, perfectionism/uncertainty, and importance/control of thoughts, which according to cognitive theories are important in the development and maintenance of obsessive-compulsive disorder (OCD).

Methods: The study included a pediatric sample (age 7-17 years) consisting of 57 children and adolescents with OCD, 49 children and adolescents with an anxiety disorder (AD), and 58 typically developing (TD) children and adolescents without a psychiatric diagnosis. All participants completed the OBQ-CV and the Child Behavior Checklist – the School Age Scales (CBCL/6-18). The Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was used to assess OCD symptom severity in the OCD group.

Results: Confirmatory factor analyses supported the three-factor structure and thereby the construct validity of the OBQ-CV. Gender was not associated with subscale scores, whereas age influenced the subscale scores differently in the three groups. Reliability analyses showed acceptable to excellent internal consistency and acceptable test-retest reliability of the instrument. There were significant differences between the OCD group and the TD group, supporting the criterion validity. Results on convergent validity were mixed.

Conclusions: Overall, results supported the reliability and validity of the Danish OBQ-CV and thus the use of the questionnaire for future clinical and research purposes.     

Participation in extracurricular activities for children with and without siblings with autism spectrum disorder

Objective: To compare the number, frequency, enjoyment and performance in extracurricular activities of siblings of children with autism spectrum disorders (ASD) to their typically developing (TD) peers, and to identify differences between actual and desired participation. Methods: A case-control study with 30 siblings of children with ASD and 30 siblings of TD children was conducted using the Paediatric Interest Profiles and a questionnaire. Results: Siblings of children with ASD participated in fewer extracurricular activities than those with TD siblings. ASD symptoms were significantly associated with the sibling participating in fewer extracurricular activities. Children with TD siblings had higher enjoyment scores in relaxation activities than children with siblings with ASD. Conclusion: While results were mainly positive, some differences indicated that having a sibling with ASD may impact participation in extracurricular activities. Assessments of participation barriers, as well as support to minimise participation restrictions among siblings of children with ASD are required.     

What influences participation in leisure activities of children and youth with physical disabilities? A systematic review

In 2001 the International Classification of Functioning (ICF) defined participation as ‘someone's involvement in life situations’. Participation in leisure activities contributes to the development of children and their quality of life. Children with physical disabilities are known to be at risk for participation in fewer activities. The group of children with physical disabilities is highly heterogeneous consisting of children with different diagnosis and different ages.This systematic review aims to analyse the literature for the purpose of looking for variables involved in the frequency of participation in leisure activities for children and youth with different diagnoses and ages.Frequency of participation in leisure activities for children and youth with physical disabilities is associated with a variety of variables. Gross motor function, manual ability, cognitive ability, communicative skills, age and gender are the most important variables. The current evidence suggests that similar variables seem to apply to children with different diagnoses. Age is an important variable in participation of children and youth. However evidence about those variables associated with children at different ages is still lacking.     

Development of a preschool developmental assessment scale for assessment of developmental disabilities

The aim of this paper was to describe the development of the cognitive domain of the Preschool Developmental Assessment Scale (PDAS) for assessment of preschool children with developmental disabilities. The initial version of the cognitive domain consisted of 87 items. They were administered to 324 preschool children, including 240 children from preschools and 84 children with developmental disabilities. Initial Rasch analysis results indicated that the fit statistics of 42 of the items were outside the acceptable range. Based on the fit statistics and considering the overall structure of the scale, the revised version consisted of 40 items and this version conformed to the Rasch expectations. The revised 40-item scale could differentiate between children with typical development and children with developmental disabilities. It could also differentiate between children from different age groups. The internal consistency estimate (KR-20) was .93. The cognitive domain of the PDAS is considered a promising developmental assessment tool for assessment of developmental disabilities.     

Patterns of participation across a range of activities among Canadian children with neurodevelopmental disorders and disabilities

Aim

Children with neurodevelopmental disorders and disabilities (NDD/D) may experience barriers or restrictions to participation in activities. We examined the extent to which this is a problem for children in particular NDD/D subgroups.

Method

We analysed the 2006 Participation and Activity Limitation Survey children data set (5–14y) collected by Statistics Canada (n = 7072 and weighted n = 340 340), having identified the following NDD/D subgroups (weighted n = 77 470; 69.1% males and 30.9% females): gross or gross and fine motor (Motor⁺), communication/cognition/learning (CCL), social interaction, neurosensory (vision or vision and hearing), and psychological. We used logistic regression to assess differences in participation in supervised and unsupervised physical activities, educational activities, and social/recreational activities.

Results

Participation in some school‐based activities differed significantly among children in the NDD/D subgroups (p<0.01). Participation in supervised and unsupervised physical activity was lowest for the Motor⁺ and social interaction subgroups, and highest for the neurosensory and CCL subgroups. Participation for the psychological subgroup was mostly in the intermediate range. In contrast, participation in educational activities was lowest for the social interaction and psychological subgroups, and higher for the other groups.

Interpretation

Given the importance of participation to child health and well‐being, these differences in participation in various in‐school activities highlight an area of need regarding policies/programmes to support subgroups of children with NDD/D.     

The measure of stroke environment (MOSE): development and validation of the MOSE in post-stroke populations with and without aphasia

Objectives. The purpose of this paper is to present the development and psychometric properties of a new environmental measure that identifies barriers and facilitators in receptivity, physical environment and communication for post-stroke populations, including survivors with aphasia.

Methods. The Measure of Stroke Environment (MOSE) was developed using information from semi-structured interviews and three pilot studies. Reliability and validity were assessed in 43 post-stroke participants.

Results. The MOSE contains 47 items across 33 questions in three domains (receptivity, physical environment, communication). Internal consistency reliability was high (.83 to .85) across each domain and over the entire assessment (.91). Convergent validity showed moderate correlation with the Stroke Impact Scale (.33 to .37), the National Institute of Health Stroke Scale (-.31 to -.46) and the Boston Diagnostic Aphasia Examination (.55 to .61). Persons with aphasia had significantly lower scores on the communication domain. Stroke survivors with (26% overall difficulty) and without aphasia (31% overall difficulty) continue to experience difficulty ≥ 2 years post-stroke.

Discussion. The MOSE offers a brief, reliable and valid assessment of environmental barriers and facilitators to participation for post-stroke survivors reintegrating into their communities. Stroke survivors with very mild deficits continue to experience barriers from the environment many years post-stroke. These barriers are not typically identified during the rehabilitation process but persist post-reintegration.

Conclusion. The MOSE is able to determine how frequently a stroke survivor faces challenges in their environment and how that impacts his or her participation.     

Disability and family in the People's Republic of China: Implementation,benefits, and comparison of two mutual support groups

Abstract

Background The authors and 2 Chinese parents established 2 support groups in China. One group was for parents of children with autism, and the other was for young adults with either mental health issues or intellectual disability, and their parents. The purpose of this study was to examine the meaning and effectiveness of these groups from the parents’ perspectives.

Method Qualitative interviews and questionnaires were completed by members of the groups, across the first 16 months. Facilitator monthly reports were also analysed.

Results Members of both groups found the groups provided a feeling of belonging and a place to interact with similar people. Differences existed relating to perspectives on the purpose of the groups and how families benefited, as well as in participation rates. Suggestions were provided by members.

Conclusions Implications of the differences in participation and desires of the parents are considered, including the understanding and perceptions of various disabilities in China.     

Development and validation of a questionnaire to measure the service needs of families with children with developmental disabilities

The aim of this project was to develop and validate a Service Needs Questionnaire (SNQ) on the service needs of families with children with developmental disabilities. The SNQ and a measure of parenting stress were administered to 105 parents of children diagnosed with learning/behaviour problems and 233 parents of children attending primary schools. Initial Rasch analysis results indicated inadequate distinction of the categories and the fit statistics of three items were outside the acceptable range. The categories were collapsed and the removal of two misfitting items resulted in a scale which conformed to the Rasch expectations. For validity, the scale correlated positively with parenting stress, and it could differentiate between parents of children diagnosed with learning/behaviour problems and those attending primary schools. The internal consistency estimate (the Cronbach α) was above .70. The SNQ could be used to help identify the needs of families with children with developmental disabilities.