Computer Adaptive Testing of Pediatric Self-care and Social Function

DESCRIPTION (provided by applicant): The objective of this proposed project is to achieve a major transformation in the technology used to assess self-care and social disability in children and youth. Measurement and practical requirements to identify disability and evaluate individual progress across pediatric age-groups and care settings present a serious dilemma to current fixed-item instruments. To address these deficiencies, the principal aims of Phase I are to: (1) build a prototype computerized adaptive testing (CAT) system of self-care and social function (SC/SF-CAT) based on existing Pediatric Evaluation of Disability Inventory (PEDI) normative and clinical databases; (2) compare the accuracy, responsiveness and response burden of the prototype SC/SF-CAT with the full-length PEDI (SC/SF-PEDI); and (3) evaluate scoring comparability, respondent burden and acceptance of parallel versions of the SC/SF-PEDI and SC/SF-CAT in a prospective field test in pediatric clinical settings. Initial results of a PEDI-Mobility CAT have been promising. The product in Phase I will be prototype CAT versions of the PEDI self-care and social function scales. In Phase II of the research project, we will examine item calibrations of all three scales of the PEDI (mobility, self-care, and social function), add new functional items to broaden the age range coverage, conduct field studies to re-calibrate items, and create algorithms for a fully operational PEDI-CAT system. A practical and feasible PEDI-CAT will facilitate decisions on disability status, service eligibility, program needs and progress related to rehabilitation interventions across a wide spectrum of function content. The end-use product of this STTR project will be a marketable computer adapted testing system for the assessment of disability in children and youth between the ages of 6 months and 18 years. Adapted from the PEDI, and expanded to a broader age group, this new disability assessment will fill a critical void for a practical system tailored for clinical decisions (program eligibility, identification of functional needs, and assessment of progress) for individual children. Many rehabilitation settings may also find this measure helpful in meeting accreditation and institutional requirements for standardizing outcome monitoring in groups of children.