Item-saving assessment of self-care performance in children with developmental disabilities: A prospective caregiver-report computerized adaptive test.

Cheng-Te Chen,Yu-Lan Chen,Jeng-Yi Tzeng,Kuan-Lin Chen,Yu-Ching Lin,Ching-Lin Hsieh,Yu Ru Kou

doi:10.1371/journal.pone.0193936

Abstract

ObjectiveThe purpose of this study was to construct a computerized adaptive test (CAT) for measuring self-care performance (the CAT-SC) in children with developmental disabilities (DD) aged from 6 months to 12 years in a content-inclusive, precise, and efficient fashion.MethodsThe study was divided into 3 phases: (1) item bank development, (2) item testing, and (3) a simulation study to determine the stopping rules for the administration of the CAT-SC. A total of 215 caregivers of children with DD were interviewed with the 73-item CAT-SC item bank. An item response theory model was adopted for examining the construct validity to estimate item parameters after investigation of the unidimensionality, equality of slope parameters, item fitness, and differential item functioning (DIF). In the last phase, the reliability and concurrent validity of the CAT-SC were evaluated.ResultsThe final CAT-SC item bank contained 56 items. The stopping rules suggested were (a) reliability coefficient greater than 0.9 or (b) 14 items administered. The results of simulation also showed that 85% of the estimated self-care performance scores would reach a reliability higher than 0.9 with a mean test length of 8.5 items, and the mean reliability for the rest was 0.86. Administering the CAT-SC could reduce the number of items administered by 75% to 84%. In addition, self-care performances estimated by the CAT-SC and the full item bank were very similar to each other (Pearson r = 0.98).ConclusionThe newly developed CAT-SC can efficiently measure self-care performance in children with DD whose performances are comparable to those of TD children aged from 6 months to 12 years as precisely as the whole item bank. The item bank of the CAT-SC has good reliability and a unidimensional self-care construct, and the CAT can estimate self-care performance with less than 25% of the items in the item bank. Therefore, the CAT-SC could be useful for measuring self-care performance in children with DD in clinical and research settings.

Highlights

Developmental disabilities (DD), a diverse group of chronic conditions due to mental or physical impairments, cause many difficulties in areas such as language, mobility, learning, and selfcare [1]
The newly developed computerized adaptive test (CAT)-SC can efficiently measure self-care performance in children with DD whose performances are comparable to those of TD children aged from 6 months to 12 years as precisely as the whole item bank
The results of this study show that the newly developed CAT-SC can efficiently measure self-care performance in children with DD whose performances are comparable to those of TD children aged from 6 months to 12 years as precisely as the whole item bank

Summary

Introduction

Developmental disabilities (DD), a diverse group of chronic conditions due to mental or physical impairments, cause many difficulties in areas such as language, mobility, learning, and selfcare [1]. For a child with DD, independent self-care is critical to successful participation in life, which is one of the ultimate goals of early intervention and rehabilitation. Clinicians and researchers commonly use self-care measures to assess and monitor self-care function. According to the International Classification of Functioning, Disability and Health (ICF) from the World Health Organization, a child’s functioning can be assessed in terms of capacity and performance. A child’s routine performance is not always equal to his/her capacity. Assessing performance provides a way of indicating how the environment in which the measurement takes place affects a child’s daily activities [3, 4]. As regards self-care function, assessment of self-care performance is necessary for clinicians and researchers to gain insights into how a child performs self-care activities routinely in his or her day-to-day context for further intervention planning

Methods

Discussion

Conclusion