Development and Psychometric Evaluation of a New Measure for Children's Participation in Hand-Use Life Situations.

To describe the development of the Children's Assessment of Participation with Hands, a parent-report questionnaire that assesses children's participation in life situations requiring hand use specifically, and to investigate its construct validity (using Rasch analysis and known-group comparison) and reliability (test-retest reliability and internal consistency). Cross-sectional, validation, and test-retest studies. Schools. Parents/caregivers (N=202) reported on their children aged 2 to 12 years with (n=97) and without disabilities (n=105). Not applicable. The Children's Assessment of Participation with Hands was developed based on a content review of existing children's participation measures and literature, expert review, and pilot testing. The Children's Assessment of Participation with Hands included 37 items measuring participation diversity, frequency, independence, and desire for change in specific hand-use life situations across 4 domains of self-care, recreation, education, and domestic life and community. Evidence for construct validity of the Children's Assessment of Participation with Hands domains was established through Rasch analysis (after removing 2 misfitting items from the recreational domain and 1 item from the domestic life and community domain). Differences in summary scores of each domain between children with and without disabilities were also significant (P<.01). Test-retest reliability of the Children's Assessment of Participation with Hands was moderate to high (intraclass correlation coefficients, .69-.96), except for the desire for change dimension scale of the recreational domain (.40). Internal consistency was varied across the dimensions/domains. Results provide preliminary evidence for the construct validity and reliability of the Children's Assessment of Participation with Hands that could be used in clinical and research settings to gain a specific understanding of the impact of children's hand-use difficulties on their participation in life situations requiring hand use.

Chien CW ，Rodger S ，Copley J 《-》

Comparative content review of children's participation measures using the International Classification of Functioning, Disability and Health-Children and Youth.

To evaluate to what extent instruments that intend to measure children's participation actually do so, and to what extent their items can be classified according to the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). A systematic search was conducted in MEDLINE, CINAHL, PsycINFO, ERIC, and EMBASE and was limited to the period between January 2000 and May 2011. The search terms of participation, outcome measure, and children were used to identify potential children's participation measures. Instruments were included if they (1) evaluated children's participation based on assessment purpose; (2) were suitable for use with children aged 2 to 12 years; (3) were generic assessments that could be used with a range of disabilities; and (4) involved self-report, proxy report, or interview administrations. Instruments were obtained from identified full-text articles and were evaluated for inclusion through group discussion. Two researchers further independently reviewed each included instrument to determine which of the items measured participation based on a contemporary definition. These items were also classified using the ICF-CY linking rules to reflect each instrument's content coverage. Sixteen instruments were identified with 11 found to have more than half of their items measuring participation, but only the School Function Assessment-Participation section comprised 100% participation items. The participation items in each instrument captured between 3 and 9 ICF-CY Activities and Participation domains. Only the Child and Adolescent Scale of Participation and the Participation and Environment Measure for Children and Youth covered all domains. Among the ICF-CY Activities and Participation domains, the interpersonal interactions and relationships domain was addressed the least. This review revealed differences in the inclusion of participation items in existing children's participation measures and their classification according to the ICF-CY. These differences need to be considered when selecting an instrument.

Chien CW ，Rodger S ，Copley J ，Skorka K ... -  《-》

Construct validity of the Children's Hand-Skills ability Questionnaire (CHSQ) in children with disabilities: a Rasch analysis.

The Children's Hand-Skill ability Questionnaire (CHSQ) is a new parent-report questionnaire that assesses children's manual ability in three domains: leisure and play, school/education, and activities of daily living. The CHSQ can be used with children presenting with a range of disabilities and works as a companion assessment before detailed performance-based observations of hand skill are completed. This study further investigated the internal and external construct validity of the CHSQ. Participants included 53 Australian children and 70 Taiwanese children with known disabilities ranging age from 2 to 12 years. Rasch analysis results confirmed the appropriateness of the CHSQ's 3-level rating scale in this combined group of children. Twenty-one of the 22 items in the CHSQ formed three individual unidimensional scales representing with the domains of leisure and play, school/education, and activities of daily living. The CHSQ also exhibited sufficient person-response validity (all the three domains) and item-difficulty range (all but one domain) when applied to children with disabilities. Less than half of the CHSQ items were found to exhibit differential item functioning with regards to gender (4 items) and cultural difference (7 items). In addition, moderate to high correlations (0.61 ≤ Pearson's r coefficients ≤ 0.76, p<0.01) were found with the assessments of self-care and hand skill performance. Therefore, the CHSQ exhibits preliminary evidence of construct validity for its clinical use in obtaining children's manual ability based on parent-report information.

Chien CW ，Brown T 《-》

Examining construct validity of a new naturalistic observational assessment of hand skills for preschool- and school-age children.

The Assessment of Children's Hand Skills is a new assessment that utilises a naturalistic observational method to capture children's real-life hand skill performance when engaged at various types of daily activities in everyday living contexts. The Assessment of Children's Hand Skills is designed for use with 2- to 12-year-old children with a range of disabilities or health conditions. The study aimed to investigate construct validity of the Assessment of Children's Hand Skills in Australian children. Rasch analysis was used to examine internal construct validity of the Assessment of Children's Hand Skills in a mixed sample of 53 children with disabilities (including autism spectrum disorder, developmental/genetic disorders and physical disabilities) and 85 typically developing children. External construct validity was examined by correlating with three questionnaires evaluating daily living skills and hand skills. Rasch goodness-of-fit analysis suggested that all 22 activity items and 19 of 20 hand skill items in the Assessment of Children's Hand Skills measured a single construct. The Assessment of Children's Hand Skills items were placed in a clinically meaningful hierarchy from easy to hard, and the difficulty range of the items also matched the majority of children with disabilities and typically developing preschool-aged children. Moderate to high correlations (0.59 ≤ Spearman's ρ coefficients ≤ 0.89, P < 0.01) were found with the assessments of daily living and fine motor skills. This study provided preliminary evidence supporting the construct validity of the Assessment of Children's Hand Skills for its clinical application in assessing children's real-life hand skill performance in Australian contexts.

Chien CW ，Brown T ，McDonald R 《-》

Measures of participation outcomes related to hand use for 2- to 12-year-old children with disabilities: a systematic review.

Many interventions have been used to improve children's hand-related impairments or hand skill performance in functional activities so as to promote life participation. There is thus a need to have suitable instruments assessing children's participation in life situations that specifically require hand use in order to support and evaluate such interventions. This systematic review investigated the availability of potential instruments that can be used to assess children's participation specifically in life situations requiring hand use. Clinical utility and evidence for psychometric properties were also sourced. Database searches initially identified measures that were used to evaluate participation of children aged 2-12 years, involved self- or proxy report or interview administration and had generic application for a range of disabilities/diagnoses. These measures were further evaluated to determine if they fulfilled the above inclusion criteria and contained at least 60% of the items involving hand use. Further searches for psychometric evidence were undertaken for the eligible measures. Fourteen measures were identified and nine met the inclusion criteria. However, none of these measures, except for the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES), contained all items related to hand use. Most of the included measures had limited psychometric properties. Only the Children's Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC), the School Function Assessment-Participation section (SFA-P) and the Children Participation Questionnaire (CPQ) revealed sufficient evidence of validity and reliability. The findings suggest a need for adapting existing participation measures or developing new ones that specifically assess participation in life situations requiring hand use to support interventions.

Chien CW ，Rodger S ，Copley J ，McLaren C ... -  《-》