Developing an English-language ADOC-S for collaborative goal setting in schools: a Delphi study of cultural reconstruction and content validation

Historically, school-based occupational therapists have used more pullout than integrated therapy. Recent trends for therapy provision in regular classrooms may be a catalyst for changing practice patterns. This study examined current school-based Occupational Therapy delivery methods and perceived barriers to integrated services. Mixed methods. School-based occupational therapists (n = 61) and occupational therapy assistants (n = 2) in Colorado and Utah. Therapists completed an online survey. A subset of therapists (21 occupational therapists, 1 occupational therapy assistant) were interviewed. Descriptive statistics described survey data, with correlations calculated between potential moderator variables and the amount of integrated services. Interviews were coded for themes. Therapists provided 40% of services in an occupational therapy area (pullout services). Therapists favored integrated services for some children but reported the following system barriers to its use: lack of education and training for integrated services, meeting individual student needs, perceived high caseloads and workloads, the variability in the school environments and the relationships and attitudes within the schools. Therapists reported more use of integrated services since previous studies but continue experiencing barriers to its use as a primary service model.

Purpose A training program was provided to school-based occupational therapy practitioners (SBOTPs) in Massachusetts to support practices aligned with educational policies and regulations. The purpose of this study was to determine the impact of this training program on school-based practice patterns. Methods This study used a researcher-designed online exploratory survey to determine occupational therapy practice patterns in Massachusetts public schools following the training program. The survey was emailed to the 309 SBOTPs who participated in a Massachusetts Department of Education sponsored training between 2007 and 2019. The survey questions analyzed the frequency of reported participation-based intervention methods, in-context and out-of-context services, and interdisciplinary collaboration used by these practitioners. A Chi Square Goodness of Fit Test was performed to determine if there were categorical differences in the frequency of responses to each research question. Results After analyzing our 29 responses we determined that the training program was effective and had an impact on how SBOTPs practice within their schools. After the training, SBOTPs in Massachusetts reported engaging more frequently in participation-based practice in natural school contexts, and collaborating with teachers and other school professionals. Contribution to Occupational Therapy This research serves as evidence that professional development courses can impact how SBOTPs practice. This study suggests that practice patterns of SBOTS can be influenced by participating in trainings that include a model with rationale and facilitated practice for providing occupation-based services in the least restrictive environment and for increasing collaborative practices in schools. School-based occupational therapy (SBOT) is integral to the educational development of children who require this service as part of their individual educational program (IEP). SBOT helps students to achieve success in occupations within the school setting, such as education, play and leisure, activities of daily living (ADLs), and social participation. Students who receive special education services are eligible for occupational therapy if the IEP team determines that SBOT is necessary to achieve the prioritized student goals developed by the team, enhancing the student’s ability to succeed in the educational program. The overarching goal of school-based occupational therapy in working with eligible students with disabilities under the federal special education law, the Individuals with Disabilities Education Act (IDEA), is to support students’ abilities to successfully participate (academically and functionally) in their educational program in the least restrictive environment in order, ultimately, to prepare them for adult living (AOTA, 2017; IDEA, 2004).

Social scientists frequently study complex constructs. Despite plethora of measures for these constructs, researchers may need to create their own measure for a particular study. When a measure is created, psychometric testing is required, and first step is to study content validity of measure. The purpose of this article is to demonstrate how to conduct a content validity study, including how to elicit most from a panel of experts by collecting specific data. Instructions how to calculate a content validity index, factorial validity index, and an interrater reliability index and guide for interpreting these indices are included. Implications regarding value of conducting a content validity study for practitioners and researchers are discussed. Key words: constructs; content validity; measure; psychometric testing ********** Researchers in social sciences study complex constructs for which valid and reliable measures are needed. The measures should be brief, clear, and easy to administer. Measures that are too long or difficult to read may result in a lowered response rate or inaccurate responses. In addition, measure must be appropriate for use in targeted population. For example, measures designed for use with heterogeneous populations may not be appropriate for a specific population with certain characteristics. A plethora of measures exist with known psychometric properties, but researchers may need to develop a new measure for a particular construct because no measure exists that operationalizes construct as researcher conceptualized it. In these circumstances, a content validity study should be conducted. VALIDITY Traditionally, three types of validity may be demonstrated: content, criterion, and construct validity. Content Validity Content validity refers to extent to which items a measure assess same content or how well content material was sampled in measure. Content validity can be characterized as face validity or logical validity. Face validity indicates that measure appears to be valid, on its face. Logical validity indicates a more rigorous process, such as using a panel of experts to evaluate content validity of a measure. Nunnally and Bernstein (1994) did not distinguish among different types of content validity; but presented alternative ways of assessing content validity. They suggested evaluating content validity by demonstrating internal consistency through correlating scores from measure with another measure of same construct and by showing change in posttest scores over pretest scores. Criterion Validity Criterion validity is demonstrated by finding a statistically significant relationship between a measure and a criterion (Nunnally & Bernstein, 1994). Criterion validity is considered gold standard, and usually a correlation is used to assess statistical relationship. For example, Graduate Record Examination (GRE) has been found to predict graduate school success (as measured by first-year grade-point average) for certain disciplines (Rubio, Rubin, & Brennan, 2003). Three types of criterion validity are postdictive, concurrent, and predictive. If criterion has occurred, validity is postdictive. The validity is concurrent if criterion exists at same time as construct measured. The GRE example demonstrates predictive validity, because graduate school success (criterion) occurs after taking GRE (measure). According to Nunnally and Bernstein, a correlation of .30 indicates adequate criterion validity. Construct Validity Anastasi and Urbina (1997) described construct validity as the extent to which test may be said to measure a theoretical construct or trait (p. 126). Three kinds of construct validity are factorial, known groups; and convergent and discriminant (or divergent) validity. …

Internationally, it is suggested that school-based occupational therapy (SBOT) has an important role in supporting inclusion in educational settings. In SBOT, multitiered service delivery models are identified as a way forward to maximize school inclusion. Therefore, identifying evidence for the implementation of tiered interventions in SBOT is vital. To identify and map evidence in the occupational therapy literature relating to SBOT interventions delivered in elementary schools for all children, for those at risk, and for those with identified diagnoses. Peer-reviewed literature published in 14 occupational therapy journals between 1990 and 2020, indexed in the EBSCOhost database. Included studies were those within the scope of SBOT that reported on school occupations and focused on elementary school-age children (excluding kindergarteners or preschoolers). Forty studies met the criteria. Individual-tier intervention studies (n = 22) primarily reported direct interventions with children at risk or with identified diagnoses (Tier 2 or Tier 3), focusing mostly on remedial approaches. None adopted a whole-school approach. Despite handwriting and self-regulation being dominant areas of concern, these studies were not explicitly related to inclusion outcomes. Evidence for implementing multitiered models primarily used indirect, collaborative consultation, embedded in the school context (n = 18). These studies identified positive school staff and child outcomes when collaboration was timely, consistent, and authentic. More rigorous individual-tier intervention studies are required to inform the design and implementation of multitiered interventions in SBOT and to support participation and inclusion in schools. What This Article Adds: This scoping review provides evidence to support occupational therapists' professional reasoning in developing evidence-based, contextual, educationally relevant multitiered models of intervention in SBOT.

School-based occupational therapy practitioners (OTPs) experience burnout related to the excessive work demands associated with a commonly used approach, in which compensation is tied to students-facing time. The workload model has the potential to alleviate this burnout, in part because it compensates an OTP for all tasks performed. This model, promoted by the American Occupational Therapy Association for more than a decade, is not widely used in the United States. The reasons for this slow espousal are not yet understood. School administrators are believed to be the linchpin to a broader use of the workload model. A preliminary study aimed to understand school district administrators’ perspectives on the factors that influence occupational therapy compensation. To this aim, a qualitative study was conducted with school administrators (n = 7). Analytic rigor was ensured through audit trail, reflexivity journal, multiple coders, and triangulation via artifacts. Deductive analysis of transcribed semi-structured interviews revealed three interrelated themes: external factors, beliefs/knowledge, and service delivery. The external factors, such as finances, impact service delivery; compensation decision was affected by a combination of regulatory and fiscal factors, both real and perceived; administrator knowledge of the workload model remains limited; and occupational therapy is clearly valued within the school setting. The study, while giving voice to a key stakeholder group, identified factors influencing occupational therapy service delivery and compensation and avenues for promoting workload model adoption.

ObjectiveThe present study is aimed to elaborate and determinate the content and face validity of a virtual reality program attending the perspective of children. This simulation is designed to promote empathy and understanding towards children with motor disabilities through adapted sport scenes. This study proposed a validation approach with six phases to assess technical and aesthetic aspects.MethodSample: a) Content validity study, 20 children (11–18 years old) were recruited as lay and content experts, who assessed the properties of grade of realism and physical fidelity of wheelchair basketball scenarios. b) Face validity study, 395 children were recruited as lay experts and divided into two groups (7–9 years old and 10–12 years old), or into ten subgroups according to Age × Gender interaction. The face validity sample assessed the psychological fidelity and the presence of wheelchair basketball scenarios. Instruments: Virtual Reality Content Validity Questionnaire, GAMEX questionnaire and Simulator Sickness Questionnaire (SSQ).ResultsThe content validity study showed preference for technical aspects (music, colors and degree of realism). Therefore, modifications in the design were made. In the content validity study, the high agreement level was influenced by previous sport experiences. In the face validity study, the cognitive development of children determined the differences in agreement levels in some virtual properties (absorption and cybersickness). In this sixth step, the ages 7–8 years versus 10–11 years showed significant differences in validity. The study also criticized the face validity cut-offs often used in adult-focused research, emphasizing the need to adapt them for children´s developmental stages.ConclusionThis study proposes a sixth step not traditionally included in content and face validity processes, specially focusing on the child user. The suitability of content and scenes should follow the same principles of standardization as other methodologies, such as psychometric tests, considering age and gender.

Validity of the modified landing error scoring system (LESS-M) for screening non-contact ACL injury risk using a lateral single-leg jump-landing task.

The aim of this study is to describe the initial phase of the psychometric validation process, specifically focusing on the translation, cross-cultural adaptation and content validation of the Diabetes Management Knowledge Assessment Tool-17 (DMKAT-17) for Spanish nursing home settings. Methodological study of translation, cross-cultural adaptation and content validation. The translation and cultural adaptation process followed the ten steps recommended by Wild etal. Content validity was assessed using expert judgement and the modified Lawshe model proposed by Tristán-López. An expert panel evaluated the relevance of the items, and the content validity ratio and content validity index were calculated. The DMKAT-17 was reviewed by 13 experts. Based on expert ratings and qualitative feedback, items 1, 2 and 6 were removed, and wording changes were made to improve clarity and contextual appropriateness. This process resulted in a 14-item Spanish version (DMKAT-14). The scale-level content validity index was 0.841, indicating acceptable content validity based on expert judgement. This study provides a preliminary adapted Spanish version of the DMKAT-14 for the nursing home context and offers an initial basis for future psychometric evaluation.

Collaborative practices are espoused in the literature as best practice. Following a needs assessment, data indicated that collaborative practices between teachers and occupational therapists were not happening consistently and were in need of improvement. Further research is needed to determine elementary teachers’ perceptions of the value of collaboration with occupational therapists in order to ensure maximum benefit for the students. This study focused on identifying elementary teachers’ perceptions of the value of collaboration with occupational therapists and validating the need for improved occupational therapy supports in the school environment. An anonymous electronic survey approach was used as the data collection method. The invitation to participate and the survey link were distributed to five school administrators, within the chosen geographic area, who forwarded the invitation and survey link to their site’s teaching staff. The survey included nineteen close-ended questions and one open-ended item for additional comments. While the majority of the participants indicated having had students receive occupational therapy services (96.05%), only 36.84% (N = 28) of the participants reported collaborating often with the occupational therapist to address the needs of the students. 73.68% (N = 56) of the participants perceived collaboration with the occupational therapist as valuable for providing effective classroom strategies and having a positive impact on student success. 82.89% of participants reported that more education about school-based occupational therapy would be beneficial. Findings indicated that school-based occupational therapists need to find ways to improve their collaborative practices with teachers. Teachers would like to learn more about the role of occupational therapists and the classroom strategies they can offer.

ObjectiveThis study aimed to assess the content and face validity index of the development of the understanding, attitude, practice and health literacy questionnaire on COVID-19 (MUAPHQ C-19) in the Malay language.MethodsThe development of the MUAPHQ C-19 was conducted in two stages. Stage I resulted in the generation of the instrument’s items (development), and stage II resulted in the performance of the instrument’s items (judgement and quantification). Six-panel experts related to the study field and ten general public participated to evaluate the validity of the MUAPHQ C-19. The content validity index (CVI), content validity ratio (CVR) and face validity index (FVI) were analysed using Microsoft Excel.ResultsThere were 54 items and four domains, namely the understanding, attitude, practice and health literacy towards COVID-19, identified in the MUAPHQ C-19 (Version 1.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVR for all items was above 0.7, except for one item in the health literacy domain. Ten items were revised to improve the item’s clarity, and two items were deleted due to the low CVR value and redundancy, respectively. The I-FVI exceeded the cut-off value of 0.83 except for five items from the attitude domain and four from the practice domains. Thus, seven of these items were revised to increase the clarity of items, while another two were deleted due to low I-FVI scores. Otherwise, the S-FVI/Ave for every domain exceeded the cut-off point of 0.9, which is considered acceptable. Thus, 50-item MUAPHQ C-19 (Version 3.0) was generated following the content and face validity analysis.ConclusionsThe questionnaire development, content validity, and face validity process are lengthy and iterative. The assessment of the instruments’ items by the content experts and the respondents is essential to guarantee the instrument’s validity. Our content and face validity study has finalised the MUAPHQ C-19 version that is ready for the next phase of questionnaire validation, using Exploratory and Confirmatory Factor Analysis.

Over the past three decades, there has been considerable change in the education of children with disabilities in Canada. Children with developmental disabilities attend inclusive classrooms and are educated alongside their non-disabled peers, receiving services and supports to optimize their participation (Hutchinson, 2014; Slee, R. (2001). Social justice and the changing directions in educational research: The case of inclusive education. International Journal of Inclusive Education, 5(2), 167–177). In Canada, occupational therapists have provided services in schools for over three decades with the aim of supporting participation of children with disabilities (Graham, D. R., Kennedy, D., Phibbs, C., & Stewart, D. (1990). Position paper on occupational therapy in schools. Canadian Journal of Occupational Therapy, 57(4), 1–6; Reid, Chiu, Sinclair, Wehrmann, & Naseerl, 2006). This chapter presents examples from case study research conducted in Ontario, Canada, on the delivery of school-based occupational therapy (SBOT) for two young children (focal participants) with developmental disabilities. Case study research was used to describe the nature of SBOT service delivery from multiple stakeholder perspectives. Data were gathered over the duration of one school year using a combination of observation, document analysis, and interviews involving participants directly involved in the delivery of SBOT with each focal participant. Common characteristics in these two cases enabled cross-case analysis to identify features of collaborative working that facilitated educational programming and outcomes for students with developmental disability.

School-based occupational therapy (OT) is very important because it helps the student to be more successful and engage or participate in roles, habits, routines and occupations at school, and those related to the COVID-19 pandemic. The COVID-19 pandemic brought huge changes to the daily lives of people worldwide and affected their participation in almost all their daily activities or occupations. Occupation includes all purposeful human activity through which people can influence their health and well-being and adapt to change. Measures related to COVID-19 and lockdown (when there is one) require changes in the daily school and home routine of students who need new training (especially those in special schools) to protect their health and adapt to changes. School occupational therapists (OTs) work with teachers and the school team and have an important role among the interdisciplinary team in occupational engagement, in order to avoid the negative consequences of illness and disability and promote the positive impact of participating in occupations on a student’s health and well-being. They focus on a wide range of areas of occupational performance such as education, social participation, play, leisure, work and activities of daily living. The purpose of this short report is to highlight the usefulness of school-based OT in supporting students in everyday life, including new COVID-19 conditions. Some directions are also discussed, so as for OTs, teachers and school team to be able to help students meet the challenges during the COVID-19 pandemic in OT school-based services including self-care, hygiene, masks and facial coverings, daily school and home routine, social distancing, e-learning/technology management and telehealth in collaboration with parents, and other professionals in school.

IntroductionOccupational therapists play a crucial role in supporting students' participation in primary school by assessing factors that influence their performance. Measurement tools are essential for identifying supports and barriers to participation; however, their alignment with the International Classification of Functioning, Disability, and Health—Child and Youth Version remains unclear.ObjectiveThis scoping review was aimed at identifying available measurement tools used in occupational therapy practice in the primary school setting and mapping their focus according to the International Classification of Functioning, Disability, and Health—Child and Youth Version components.MethodsA comprehensive scoping review was conducted following the Joanna Briggs Institute Manual for Evidence Synthesis across four databases (PubMed, CINAHL, MEDLINE, and Web of Science), supplemented by a targeted gray literature search from ProQuest, and hand-searching articles between 2007 and 2025. Eligible studies included quantitative, qualitative, and mixed-method research that utilized measurement tools by OT in primary school settings. A total of 705 articles were retrieved, with 41 meeting the inclusion criteria.ResultsFifty-two measurement tools used by school-based occupational therapy were identified. Although schools encompass various occupations such as self-care tasks, learning activities, school leisure activities, and social activities, this literature review found that school-based occupational therapy practice in primary school settings primarily addressed handwriting as a student occupational problem. The most frequently used tools were the Minnesota Handwriting Assessment, the Beery-Buktenica Developmental Test of Visual-Motor Integration, the Persian Handwriting Assessment Tool, and the Evaluation Tool for Children's Handwriting. At the same time, most tools focused on handwriting assessment, and only a few incorporated environmental factors.ConclusionThese findings highlight the predominant focus of school-based occupational therapy measurements on cognitive and motor functions, with limited attention to environmental factors. Future research considers prioritizing the development of more comprehensive tools that holistically assess students' occupational performance.

Introduction: The healthcare system faces substantial challenges from disasters that require proactive healthcare practitioners, including Physiotherapists, to lead disaster prevention, preparedness, response efforts, and recovery initiatives. Physiotherapists require validated competencies for effective disaster health management, but there is a lack of standard tool. Aim: The present study aimed on developing the core competencies questionnaire possessed by the Physiotherapists for disaster health management and seeks the preliminary content and face validation of the questionnaire. Materials and Methods: The present methodological study was exploratory mixed method research to design and psychometrics the instrument measuring disaster health management competencies of Physiotherapists in India conducted from 25-09- 2023 to 28-02-2024 at Galgotias University, Greater Noida, India. The content validity of the questionnaire through two phases: questionnaire development and judgement. The development phase involved identification of constructs, followed by item generation and instrument formation. A seven-member expert panel did the judgement of the questionnaire with the Delphi method approach. After three rounds of panel discussions and based on expert comments, the questionnaire was modified and assessed for Content Validity Ratio (CVR), Item Content Validity Index (I-CVI), and Questionnaire/scale Content Validity Index (S-CVI). Further kappa statistics were performed for inter-rater reliability among experts through using IBM Statistical Package for Social Sciences (SPSS) statistics for windows version 27 (IBM Corp, Armonk, NY, USA). Final face validation was done through percentage agreement on experts’ comments. Results: The CVR analysis of 104 items produced 39 items with CVR higher than 0.99. Knowledge received 13 items and skills received 14 items while attitude included 12 items as the main constructs. The expert panel unanimously supported all chosen items because their I-CVI scores rested between 0.8 and 1. The calculated S-CVI score reached 0.95, which indicates high content validity for the questionnaire. The expert panel achieved good to very good agreement when rating construct clarity at 0.622, yet simplicity obtained very good agreement at 0.748, along with relevance scoring only moderate agreement at 0.404. The results from face validation showed that 97% of experts agreed on the items. Conclusion: Preliminary content and face validity assessment demonstrate suitable quantity indices for the tool. The research gives guidance for future psychometric testing of this new assessment questionnaire to evaluate Physiotherapists’ disaster health management competencies.

Telehealth is an accepted service-delivery model in a variety of health professions, including occupational therapy. Telehealth holds potential for school-based occupational therapy evaluation, intervention, consultation, monitoring, and supervision. As the use of telehealth becomes prevalent, it will be important to describe the benefits and barriers to potential types of occupational therapy evaluation, intervention, consultation, monitoring, and supervision delivered via a telehealth service-delivery model. Querying stakeholder perceptions of telehealth may help guide additional precipitating factors that have not yet been explored. This study gathers information regarding perceptions, perceived barriers, and benefits of the use of telehealth in school-based occupational therapy practice. School-based occupational therapy practitioners (OTP), district administrators, and related technology staff were invited to complete a survey intended to explore attitudes about the use of telehealth. 28.57% of respondents stated that their districts were likely to adopt the use of telehealth. Participants noted perceived barriers and benefits to the use of telehealth. This study provides preliminary feedback regarding school-based OTP and administrator perceptions of telehealth as a component of school-based OT practice.