Child And Adolescent Scale Of Participation Research Articles

Different trajectories of post-concussive symptom subscales after pediatric mild traumatic brain injury: Data from a prospective longitudinal study

PurposeThe aim of this study was to investigate the trajectory of parent-rated post-concussive symptoms (PCS), attentional performance and participation within 6 months in children after mild traumatic brain injury (mTBI). MethodsFor this prospective longitudinal study, we included data on 64 children after mTBI and 57 healthy control children (age 8–16 years). Parents rated PCS using the Post-Concussion Symptom Inventory (PCSI) immediately (T0), 1 week (T1), and 3–6 months after injury (T2). Attentional performance (alertness, selective and divided attention) was measured using the Test of Attentional Performance (TAP) at T1 and T2 and participation was measured using the Child and Adolescent Scale of Participation (CASP) at T2. ResultsFriedman tests showed different trajectories of PCS subscales over time: Compared to pre-injury level, the amount of somatic and cognitive PCS was still elevated at T1, while emotional PCS at T1 were already comparable to pre-injury level. The rating of sleep-related PCS at T2 was significantly elevated compared to the pre-injury rating. Quade ANCOVAs indicated group differences in PCS subscales between patients and controls at T1, but not at T2. Patients and controls showed a similar performance in tests of attention at T1 and T2, but parental rating of participation at school was significantly reduced. Although cognitive PCS and attention were not correlated, there were significantly negative Spearman correlations between participation at home and pre-injury and concurrent PCS at T2. ConclusionsOur data imply that sleep-related PCS are still elevated weeks after injury and are thus a target for interventions after mTBI.

An Evaluation of the Use of the Child and Adolescent Scale of Participation (CASP) to Measure Social Participation After Pediatric ABI in a Specialist Service in East Anglia

ABSTRACT Pediatric acquired brain injury (ABI) can lead to lifelong challenges restricting social participation, which is an important goal for rehabilitation due to associations with improved wellbeing. This evaluation considered the utility of the Child Adolescent Scale of Participation (CASP) in ABI rehabilitation services. The 20-item measure is rated on a Likert scale with reference to what the rater would expect of their child at that age, including ”not applicable” (N/A). It showed high internal consistency (α = 0.954–0.968). Two-step cluster analysis indicated greater difficulties in children with lower participation, including more impairments of executive function and higher staff involvement. Between-group analysis indicated higher rates of N/A answers for younger children and those of ethnic minorities. Overall, the CASP is reliable and clinically useful on an individual level, helping identify people who may need prioritizing for neurorehabilitation; however, group-level analyses were more challenging due to high frequency of N/A responses.

Long-term Participation and Functional Status in Children Who Experience Traumatic Brain Injury.

To evaluate the effect of child and family factors on children's participation outcomes 2 to 3 years following traumatic brain injury (TBI). Two level 1 pediatric trauma centers. Children aged 0 to 15 years with TBI at all severity levels or an orthopedic injury. Prospective cohort. Caregivers completed the Child and Adolescent Scale of Participation (CASP) at 2- and 3-year follow-ups. The CASP was categorized as more than 90 or 90 or less on a 100-point scale, with 90 or less representing the 10th percentile and below in this sample. Modified Poisson regression models were used to describe relative risk of the CASP at 90 or less at 2 to 3 years postinjury, adjusting for preinjury family environment variables and injury group. A secondary analysis only included children who were 31 months or older at injury ( n = 441) to determine whether changes in functional outcome (Pediatric Injury Functional Outcome Scale, PIFOS) and executive functions (Behavior Rating Inventory of Executive Function, BRIEF) from preinjury to 1 year after injury predicted CASP scores at the 2- or 3-year follow-up. Seventy-eight percent (596/769) of children who had a completed preinjury survey had a completed CASP. In the adjusted model, children with severe TBI had a nearly 3 times higher risk (RR = 2.90; 95% CI, 1.43-5.87) of reduced participation than children with an orthopedic injury. In the secondary analysis, lower functional skills (5-point increase in 1-year postinjury PIFOS score) (RR = 1.36; 95% CI, 1.18-1.57) and less favorable family function (RR = 1.46; 95% CI, 1.02-2.10) were associated with reduced participation in both girls and boys. Participation in home, school, and community activities after TBI is related to multiple biopsychosocial factors. Participation-focused interventions are needed to reduce barriers to involvement and assist children and families to close the participation gap across settings.

Weekly Calendar Planning Activity (WCPA): Validating a Measure of Functional Cognition for Adolescents With Attention Deficit Hyperactivity Disorder

Adolescents with attention deficit hyperactivity disorder (ADHD) often experience difficulties with executive function and participation in life roles. Ecologically valid performance-based tests (PBTs) are needed to assess functional cognition in this population. To examine the known-groups, concurrent, and ecological validity of a functional cognition PBT, the Hebrew version of the Weekly Calendar Planning Activity (WCPA) Middle/High School Version, among adolescents with and without ADHD. Cross-sectional between-groups design. Community. One hundred two adolescents (ages 12-18 yr), with (n = 52) and without (n = 50) ADHD. The Hebrew version of the WCPA Middle/High School Version, MOXO™-Continuous Performance Test (MOXO-CPT), Behavior Rating Inventory of Executive Function (BRIEF) parent form, and Child and Adolescent Scale of Participation (CASP). The results showed significant between-groups differences with medium to large effect sizes for scores on most WCPA measures, with the ADHD group receiving significantly lower scores. Significant correlations in the expected direction were found between scores on the MOXO-CPT Attention and Hyperactivity indices and WCPA measures. Significant correlations were also found between most WCPA measures and the BRIEF Global Executive Composite (GEC) and the CASP. Multiple linear regression on the CASP indicated that the WCPA strategy score and the BRIEF GEC were significant predictors in the model. Results support the known-groups validity of the WCPA Middle/High School Version between adolescents with and without ADHD. Concurrent and ecological validity were supported by significant associations with measures of cognition and participation. What This Article Adds: These results reinforce the premise that the WCPA Middle/High School Version can be implemented as a valid measure of functional cognition among adolescents with ADHD.

Participation of children in three Bavarian inclusive primary schools: parent and teacher perspectives

ABSTRACT Participation is one key element of inclusive education. While the inclusion rate in German schools is rising, little is known with regard to children’s participation in this context. This study examines the participation of children with and without impairments at three inclusive primary schools in Bavaria. Cross-sectional data was collected in parents and teachers of 124 3rd grade pupils (girls: n = 62, age: M = 9.5 years; boys: n = 62, age: M = 9.6). 27% of the parents stated their children had impairments (4.9% physical, 13.1% mental/ intellectual and 9.0% other/multiple). Participation in school and other life areas (‘neighborhood & community’, ‘home’ and ‘living activities’) was assessed by the ‘Child and Adolescent Scale of Participation (CASP)’. Parents and teachers of children with impairments reported significantly lower scores in all CASP subsections and total score. In school, according to teacher rating, all pupils showed the lowest participation scores in educational activities with other children in the classroom and in communicating with children/adults. The results highlight the continuing challenges to reach meaningful participation of all children as a condition for effective inclusive education. This seems to be true not only for school but also for other social contexts.

Improved Sitting Balance in Children with Cerebral Palsy: Body Functions to Activity and Participation

AbstractThe aim of this study is to evaluate the changes in activity and participation domains of International Classification of Functioning (ICF), Disability and Health, in children with cerebral palsy (CP) who received integrated botulinum toxin A (BoNT-A) treatment with intensive rehabilitation with a treatment goal of improved sitting balance. In this prospective observational study, 29 patients with CP (mean age: 6.7 ± 3.8 years) and the Gross Motor Function Classification System (GMFCS) levels of IV and V were included. The primary outcome measures were the mean changes from baseline to posttreatment weeks 10 to 12 of the Child and Adolescent Scale of Participation (CASP) and Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). The modified Ashworth scale (MAS) and Tardieu scale (TS) results at 6 to 8 weeks of posttreatment were the secondary outcome measures. Statistically significant improvements in home and community participation of CASP (p < 0.001 and 0.001), CPCHILD (p < 0.01), MAS (p < 0.001), and all parameters of TS (p < 0.05) were recorded after treatment. The result of this prospective, observational study showed that the functional improvements in sitting balance by the integrated BoNT-A treatment provides positive effects on activity and participation levels of the patient and quality of life of patients and their families.

Participation in Everyday Activities of Children with and without Neurodevelopmental Disorders: A Cross-Sectional Study in Spain.

Children with neurodevelopmental disorders (NDDs) often report significant difficulties performing activities of daily living (ADLs), which may restrict their daily participation. The aim of this study was to investigate the differences in ADLs participation between children with NDDs and typically developing (TD) children, and to explore the associations between different daily participation contexts. A cross-sectional study was conducted that included twenty children with a medical diagnosis of an NDD and 26 sex- and age-matched TD controls. The daily participation across home, community, school, and instrumental living activities was measured using the Child and Adolescent Scale of Participation (CASP). The results show that children with NDDs engaged in lower participation in all CASP contexts (Δ = 1.7–5.5, p < 0.001) and had a significantly higher prevalence of moderate or severe restricted participation than their TD peers (OR = 23.4, 95% CI = 3.6–154.2, p < 0.001). Additionally, a strong association was found between the different contexts of participation (r = 0.642–0.856). Overall, the children with NDDs experienced significant participation restrictions on their daily activities. This study adds to the growing evidence showing that intervention strategies in this population should adopt a participation-oriented approach.

Structural Validity of an ICF-Based Measure of Activity and Participation for Children in Taiwan’s Disability Eligibility Determination System

To assess activity and participation for children in Taiwan’s Disability Eligibility Determination System (DEDS), we developed a questionnaire, the Functioning Disability Evaluation Scale (FUNDES-Child), based on the Child and Adolescent Scale of Participation (CASP). The study follows a methodology research design to investigate the construct validity of the frequency and independence dimensions of FUNDES-Child 7.0. Two samples were randomly stratified from the databank of 13,835 children and youth with disabilities aged 6.0–17.9 years to examine structural validity by exploratory factor analysis (EFA, n = 4111, mean age of 11.3 ± 3.5) and confirmatory factor analysis (CFA, n = 4823, mean age of 11.4 ± 3.5)). EFA indicated a 4-factor structure for the frequency dimension (51.3% variance explained) and a 2-factor structure for the independence dimension (53.6% variance explained). The CFA indicated that the second-order factor structures of both dimensions were more parsimonious with adequate fit indices (Goodness fit Index, GFI; Normed Fit Index, NFI; Comparative Fit Index, CFI; and Tucker-Lewis Index, TLI ≥ 0.95, Root Mean Square Error of Approximation, RMSEA < 0.06). Results provide evidence that the participation part of FUNDES-Child 7.0 has acceptable structural validity for use in Taiwan’s DEDS. Utility of FUNDES-Child 7.0 in rehabilitation, welfare, and educational services needs further study.

Activities and Participation in the First 6 Months After Mild Traumatic Brain Injury in Children and Adolescents.

To investigate the natural course of activities and participation of children up to 6 months after a mild traumatic brain injury (mTBI). A prospective longitudinal cohort study with complete data sets of 231 children diagnosed with mTBI and their caregivers. Activities and participation assessed with the Child and Adolescent Scale of Participation (CASP) and the Children's Assessment of Participation and Enjoyment (CAPE) measured at 2 weeks, 3 months, and 6 months post-mTBI. Because of a ceiling effect, the primary outcome measure (CASP) was divided into deviant (not maximum score) or full functioning. Friedman's, Cochran's Q, and McNemar's tests (CASP) and repeated-measures analyses of variance (CAPE) showed significant increases in activities and participation between 2 weeks and 3 and 6 months after mTBI. Based on the parents' perspective, 67% of the children returned to full functioning at 6 months postinjury, with only 38% of the children describing themselves as functioning at their premorbid level. Findings indicate that most children return to maximum level of activities and participation over time after mTBI. In a substantial number of children, however, the level of activities and participation at 6 months postinjury is evaluated as lower than that of peers. The importance of investigating predictors for child and caregiver perspectives is emphasized.

A Study on Validity and Reliability of the Korean Version the Child and Adolescent Scale of Participation(CASP)

A Study on Validity and Reliability of the Korean Version the Child and Adolescent Scale of Participation(CASP)

Measuring social participation in children with chronic health conditions: validation and reference values of the child and adolescent scale of participation (CASP) in the German context

BackgroundWhile ICF-CY-based models of care are promising avenues for improving participation of children with chronic health conditions, feasible and valid instruments to assess participation as an outcome in routine are still needed. We aimed to validate a German parent-report version of the Child and Adolescent Scale of Participation (CASP) in children with chronic health conditions of different severity.MethodsCross-sectional data were collected in 327 children (mean age 7.8 years, 55% boys) from two paediatric centres (n = 112) and one population-based sample (n = 215). Cronbach’s alpha, factor analyses, face validity assessments, correlation analyses, receiver operating characteristics (ROC) curves, and parent-reported health-related quality of life (HRQoL: KINDL) were used to examine internal consistency, test-retest reliability, and capacity to differentiate between disease severity groups. Disease severity was operationalized according to ICD-diagnosis groups and/or parent-reports on health problems, medical and educational support, and medication. A newly developed item “overall perceived participation” was added to the CASP and evaluated.ResultsWe found good to excellent content validity, excellent internal consistency, and good-to-excellent test-retest reliability of the instrument. While children with mild disease had a significantly greater extent of participation (higher CASP scores) than children with severe disease, they did not differ from healthy children. Children with mild compared to severe disease much more differed in participation as measured by the CASP compared to the KINDL (area under the ROC curve: 0.92 vs. 0.75). In addition, the item “overall perceived participation” was highly correlated (r = 0.86) with the CASP total score, indicating the potential value of this specific single item. Finally, we provided preliminary reference values for the CASP obtained in a population-based sample of children without chronic health conditions.ConclusionsThe German version of the CASP and the new item are efficient, valid and reliable measures of social participation in childhood. The CASP-measured participation focuses more on attendance than on involvement into social circumstances of everyday life. To detect children with a high burden of disease on everyday life, the CASP may be more accurate than HRQoL instruments such as the KINDL. As outcome measurement, the CASP may facilitate the implementation of patient-centred paediatric health care.

Results from a randomized trial evaluating a hospital–school transition support model for students hospitalized with traumatic brain injury

ABSTRACTObjective: To evaluate the utility of the STEP model, a systematic hospital–school transition protocol for children hospitalized for TBI.Setting: Five children’s hospitals in Colorado, Ohio, and Oregon.Participants: Hundred families of children with mild, complicated mild, moderate, or severe TBI.Design: Randomized controlled trial (RCT); participants were randomized while hospitalized to the STEP (a standardized hospital–school transition protocol for children treated for TBI) or usual care condition.Main Measures: Questionnaire about child’s special education eligibility status, support services, and academic accommodations; Achenbach Child Behaviour Checklist (CBCL); Behaviour Rating Inventory of Executive Function (BRIEF); Child and Adolescent Scale of Participation (CASP); Child and Adolescent Scales of Environment (CASE)Results: There were no significant effects, indicating that STEP participants did not differ from usual care participants on any study outcome at one month post-discharge or at one-year follow-up.Conclusion: The lack of significant findings in this study does not imply that effective hospital-to-school transition programming is unnecessary. Rather, the findings raise important questions regarding timing and dosage/intensity of intervention, appropriate measurement of outcomes, and fidelity of programme delivery. The study highlights difficulties involved in the conduct of community-based RCTs in the paediatric TBI population.

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

ABSTRACTPurpose: 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 and psychometric properties of the French version of the Child and Adolescent Scale of Participation (CASP) in a sample of children with acquired brain injury

Childhood acquired brain injury (ABI) is the leading cause of acquired disability in childhood, with significant consequences on independence, academic achievement and participation. The “Child and Adolescent Scale of Participation” (CASP; Bedell 2004) has been specifically developed to assess participation following childhood ABI. The aim of this study was to examine the psychometric properties of the French version of the Child and Adolescent Scale of Participation. Cross-sectional, monocentric study. The CASP questionnaire was given to 133 caregivers of children or adolescents (5 to 18 years) who were followed-up in a rehabilitation department following ABI. The CASP is comprised of 20 items in 4 subsections: (1) home participation; (2) neighborhood and community participation; (3) school participation; (4) home and community living activities. Parents are asked to rate the 20 items of the CASP using a four-point Likert scale: (4 = aged expected; 3 = somewhat limited; 2 = very limited; 1 = unable), or “not applicable”. Cronbach's alpha and factor analyses were performed to examine the psychometric properties of the French translation of the CASP and correlations of the CASP with demographic and clinical factors were explored. Eighty-five parents [(64%response rate; 61% boys; age at onset 5.66 years (SD = 3.9); age at assessment 10.51 years (SD = 3.4)] answered the questionnaire. There was no significant difference between respondents and non-respondents regarding demographic, medical, injury severity or level of neurological or cognitive impairment. Internal consistency was high (Cronbach alpha 0.84). Factor analysis yielded a five-factor structure explaining 88% of the variance. The total score of the CASP was correlated with the mother's education level ( P = 0.04), but not with any of the other medical data, such as age at injury, age at assessment, injury severity, clinical condition (presence of hemiplegia, epilepsia, cerebellar signs), intellectual ability or number of ongoing rehabilitation types. Our results confirm the cross-cultural psychometric properties of the French adaptation of the CASP. Interestingly, the CASP was not correlated with any of the clinical factors. Parental ratings of their child's participation probably rely on other factors such as emotional status, coping ability and environmental factors.

Responsiveness and Discriminant Validity of the Child and Adolescent Scale of Participation (CASP) for Children With Traumatic Brain Injury

Abstract Date Presented 4/8/2016 This study examined the responsiveness and discriminant validity of the Child and Adolescent Scale of Participation for children with traumatic brain injury (TBI) across a 3-yr period. Results support its use to assess participation of children with TBI across levels of severity and time. Primary Author and Speaker: Anat Golos Additional Author and Speaker: Gary Bedell

Psychometric properties of the Child and Adolescent Scale of Participation (CASP) across a 3-year period for children and youth with traumatic brain injury.

Children with traumatic brain injury are often restricted in their participation due to impairments and environmental barriers. Reliable and valid instruments are essential for monitoring their participation over time. To examine the construct validity and internal consistency of the Child and Adolescent Scale of Participation (CASP) across a 3-year period. A longitudinal prospective cohort study (USA) that included 926 children (0-18 years) with TBI and arm injury. Three measures were administered at 3, 12, 24, and 36 months post-injury: The CASP, Pediatric Quality of Life Inventory (PedsQL), and Adaptive Behavior Assessment Scale II (ABAS). Associations between the CASP and PedsQL and ABAS were moderate-to-high at all time periods. Internal consistency of the CASP and its sub-sections was high, with a pattern of gradual increase over time. Factor analyses indicated a clearer four factor solution at 3, 12 and 24 months resembling the four CASP sub-sections. Results provide evidence of convergent validity and internal consistency of the CASP and support its use for assessing participation of children with TBI over time. Prudence should be taken when considering use of factor scores due to differences in factor solutions found in this study and prior studies.

Monitoring outcomes in children with acquired brain injury: a Persian validation study of Child and Family Follow-up Survey

To translate and validate the Child and Family Follow--up Survey (CFFS) in Iran. 49 cases with Acquired Brain Injury (ABI), and 30 healthy children were included and the CFFS was completed. The Pediatric Quality of Life Inventory (PedsQL) also was completed. The internal consistency, test-retest reliability, known groups comparison and criterion validity were assessed. The mean age of participants was 10.9 years. Cronbach's alpha coefficients were Child and Adolescent Scale of Participation (CASP) (0.91), Child and Adolescent Factors Inventory (CAFI) (0.90) and Child and Adolescent Scale of Environment (CASE) (0.89). Reliability, validity and correlation of CASP and CAFI showed satisfactory results. Significant correlations among the three CFFS subscale scores were observed. These scores were also significantly correlated with the total scores of the PedsQL. The findings suggest that CFFS is a valid measure to monitor long--term outcomes of children and young adolescents with ABI.

Validation and assessment of the psychometric properties of the French version of the Child and Adolescent Scale of Participation (CASP) in a sample of children with acquired brain injury

Validation and assessment of the psychometric properties of the French version of the Child and Adolescent Scale of Participation (CASP) in a sample of children with acquired brain injury

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

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.

Psychometric properties of the Child and Adolescent Scale of Participation – Traditional Chinese version

The child and adolescent scale of participation (CASP) was translated into traditional Chinese and has been included as part of the new Disability Evaluation System (DES) in Taiwan since July 2012 for school-aged children with special needs. The aim of this study was to examine the psychometric properties of the traditional Chinese version of the CASP (CASP-C). Participants were 231 parents/caregivers of children aged 6-18 years recruited from 31 hospitals who qualified for the DES in Taiwan. The majority of the children had intellectual disabilities (67%), followed by physical disabilities and autistic spectrum disorders. The CASP was translated into traditional Chinese according to the cross-cultural adaptation process. Content and known group validity, internal consistency, and internal scale structure were examined using a t-test, Cronbach's α, factor analysis, and Rasch analysis. The CASP-C items were mapped onto all nine chapters of the International Classification of Functioning--Children and Youth version. Children with less severe intellectual disabilities had significantly higher CASP-C scores than children with more severe disabilities. Internal consistency was acceptable on the subdomains and total CASP-C (Cronbach's α=0.88-0.97). Factor analysis yielded a two-factor CASP-C structure contributing 64.1% explained variance. Rasch analysis also indicated a unidimensional construct. The results in psychometric analyses are in agreement with those of other studies, and support that the CASP-C has acceptable psychometric properties for use in the DES in Taiwan. However, further study with a larger and more diverse sample is required to increase the generalizability of the results.