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

ABSTRACT: The 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.The 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.The 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).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. 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.

SUBMITTER: Chen CT

PROVIDER: S-EPMC5862472 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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

Chen Cheng-Te CT Chen Yu-Lan YL Lin Yu-Ching YC Hsieh Ching-Lin CL Tzeng Jeng-Yi JY Chen Kuan-Lin KL

PloS one 20180321 3

<h4>Objective</h4>The 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.<h4>Methods</h4>The 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 ...[more]

PMID: 29561879

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Project description:CONTEXT Unlike other areas of medicine, psychiatry is almost entirely dependent on patient report to assess the presence and severity of disease; therefore, it is particularly crucial that we find both more accurate and efficient means of obtaining that report. OBJECTIVE To develop a computerized adaptive test (CAT) for depression, called the Computerized Adaptive Test-Depression Inventory (CAT-DI), that decreases patient and clinician burden and increases measurement precision. DESIGN Case-control study. SETTING A psychiatric clinic and community mental health center. PARTICIPANTS A total of 1614 individuals with and without minor and major depression were recruited for study. MAIN OUTCOME MEASURES The focus of this study was the development of the CAT-DI. The 24-item Hamilton Rating Scale for Depression, Patient Health Questionnaire 9, and the Center for Epidemiologic Studies Depression Scale were used to study the convergent validity of the new measure, and the Structured Clinical Interview for DSM-IV was used to obtain diagnostic classifications of minor and major depressive disorder. RESULTS A mean of 12 items per study participant was required to achieve a 0.3 SE in the depression severity estimate and maintain a correlation of r = 0.95 with the total 389-item test score. Using empirically derived thresholds based on a mixture of normal distributions, we found a sensitivity of 0.92 and a specificity of 0.88 for the classification of major depressive disorder in a sample consisting of depressed patients and healthy controls. Correlations on the order of r = 0.8 were found with the other clinician and self-rating scale scores. The CAT-DI provided excellent discrimination throughout the entire depressive severity continuum (minor and major depression), whereas the traditional scales did so primarily at the extremes (eg, major depression). CONCLUSIONS Traditional measurement fixes the number of items administered and allows measurement uncertainty to vary. In contrast, a CAT fixes measurement uncertainty and allows the number of items to vary. The result is a significant reduction in the number of items needed to measure depression and increased precision of measurement.

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

Publications

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

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