UNLABELLED: Kramer JM, Smith EV Jr, Kielhofner G. Rating scale use by children with disabilities on a self-report of everyday activities. OBJECTIVE: To examine whether children with disabilities interpret a self-report of perceived competence and importance of everyday activities in a consistent manner and use the rating scales as intended. If not, are differences in how children interpret the scale associated with personal or contextual variables? DESIGN: Assessment and rating scale development using the Mixed Rasch Model. SETTING: Rehabilitation clinics, schools, and research sites in the United States and Europe. PARTICIPANTS: Children (N=407) aged 6 to 17 years; all had a diagnosed disability or received occupational therapy services. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The Child Occupational Self Assessment; 25 items representing everyday activities and two 4-point scales: competence and importance. RESULTS: For each scale, 2 groups of children were identified. Approximately 50% of the children used the rating scales as intended. The remainder used the scales as reversed 2-point scales; these children were younger and more likely to have an intellectual disability. Country and practice setting were also associated with rating scale use. All items but 1 had acceptable fit to the Rasch model, and groups of children differed in the relative competence and importance reported. CONCLUSIONS: Personal and contextual variables are associated with children with disabilities' use of self-report rating scales. Younger children and children with intellectual disabilities use a modified response pattern.
UNLABELLED: Kramer JM, Smith EV Jr, Kielhofner G. Rating scale use by children with disabilities on a self-report of everyday activities. OBJECTIVE: To examine whether children with disabilities interpret a self-report of perceived competence and importance of everyday activities in a consistent manner and use the rating scales as intended. If not, are differences in how children interpret the scale associated with personal or contextual variables? DESIGN: Assessment and rating scale development using the Mixed Rasch Model. SETTING: Rehabilitation clinics, schools, and research sites in the United States and Europe. PARTICIPANTS: Children (N=407) aged 6 to 17 years; all had a diagnosed disability or received occupational therapy services. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The Child Occupational Self Assessment; 25 items representing everyday activities and two 4-point scales: competence and importance. RESULTS: For each scale, 2 groups of children were identified. Approximately 50% of the children used the rating scales as intended. The remainder used the scales as reversed 2-point scales; these children were younger and more likely to have an intellectual disability. Country and practice setting were also associated with rating scale use. All items but 1 had acceptable fit to the Rasch model, and groups of children differed in the relative competence and importance reported. CONCLUSIONS: Personal and contextual variables are associated with children with disabilities' use of self-report rating scales. Younger children and children with intellectual disabilities use a modified response pattern.