Importance: Robust and psychometrically sound performance-based outcome measures are needed for clinical trials of occupational therapy interventions for children with autism. Objective: To demonstrate a systematic approach for choosing psychometrically sound performance-based outcome measures of daily living skills and socialization for use in clinical trials of occupational therapy interventions for children with autism. Design: Rapid literature review to identify appropriate measures for studies with this population followed by quality indicator ratings and a nominal group process. Setting: University. Participants: Four experts in autism and pediatric outcome measurement. Outcomes and Measures: Twenty-one outcome measures of daily living skills and socialization were identified and reviewed. Results: Seven measures met the inclusion criteria. The Assessment of Motor and Process Skills and the Evaluation of Social Interaction–Second Edition, received the highest ratings and group consensus. Several other measures were also scored highly. Conclusions and Relevance: Careful assessment of psychometric properties is an important component of choosing outcome measures for a clinical trial, but burden of assessment and study objectives are important considerations. What This Article Adds: This project demonstrates use of a systematic process for choosing outcome measures for a planned clinical trial.

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The purpose of this study was to analyze the Life Satisfaction Index–Z (LSI–Z) and provide its item-level psychometric properties. Although the LSI–Z consists of two separate unidimensional and valid subscales, it demonstrated poor precision. Therefore, OT should be aware of this critical measurement issue when using this instrument in their clinical settings and must be interpreted the test scores with some caution. Primary Author and Speaker: Heesu Choi Additional Authors and Speakers: Nam Sanghun, Ickpyo Hong

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Time management is a key OT intervention component. Valid and reliable instruments are essential for evaluating rehabilitation and OT interventions. The results of this study show that the Assessment of Time Management Skills has good measurement properties and consistent and replicable items and is useful in English-speaking countries. It can provide valid measures of time management skills, organization and planning skills, and regulation of emotion in a general population and presumably also a population with cognitive impairment. Primary Author and Speaker: Afsaneh Roshanai Contributing Authors: Gunnel Janeslätt, Suzanne Marie White, Kajsa Lidstroem Holmqvist, Marie Holmefur

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The need for diverse and culturally relevant assessment tools is the responsibility of all OTs when delivering client-centered care. Assessment tools for Arabic-speaking clients in the United States are close to none. The use of culturally less-relevant assessment tools sabotages the client-centered care approach (e.g., addressing self-care activities that are culturally or religiously mandated). This study reviews the adaptation and the psychometric properties of the A-PASS. Primary Author and Speaker: Razan Hamed Additional Authors and Speakers: Margo Holm

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This study examined the psychometrics of the Elderly Lifestyle Profile (ELP) that measures individuals' lifestyle. The unidimensionality and data–model fit of the ELP were supported by the Rasch model. OTs working with community-dwelling elderly people can apply ELP to their clients, and the results can be incorporated into the evaluation and intervention planning process for improving health of clients. Primary Author and Speaker: Kanghyun Park Contributing Authors: Ji-Hyuk Park, Ickpyo Hong

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The purpose of this study was to analyze the Coping Orientation to Problems Experienced (COPE) scale and provide item-level psychometric properties. A short form of the COPE (n = 12) demonstrated a unidimensional measurement construct and valid item-level psychometric properties. Clinicians would be able to precisely measure clients' stress levels using the valid outcome measure. Primary Author and Speaker: Nam Sanghun Additional Authors and Speakers: Ickpyo Hong, Heesu Choi, and Mi Jung Lee

OBJECTIVE. This study investigated the psychometric properties of the Here’s How I Write–Hebrew (HHIW–HE) and compared handwriting self-awareness between children with and without dysgraphia. METHOD. Fifty-eight children (29 with and 29 without dysgraphia) completed the HHIW–HE. Occupational therapists provided corresponding ratings that were based on objective handwriting assessments. Self-awareness was measured through child–therapist consensus. RESULTS. The HHIW–HE has an internal consistency of α = .884. Children with dysgraphia rated themselves as significantly more impaired than controls on 6 of 24 HHIW–HE items and on the total score, with medium to large effect sizes (0.37–0.61). Mean child–therapist agreement was significantly higher for the controls than for the research group, t(56) = 4.268, p = .000. CONCLUSION. Results support the HHIW–HE’s validity. Children with dysgraphia reported more handwriting difficulties than did controls; however, they tended to overestimate their handwriting abilities.

OBJECTIVE. This study evaluated the thoroughness and psychometric properties of fidelity measures used by or of relevance to occupational or physical therapy. METHOD. A systematic review of the literature was completed. Assessments used to measure occupational or physical therapy intervention fidelity were evaluated for thoroughness, reliability, validity, and clinical utility. RESULTS. Eight fidelity measures met inclusion criteria for this systematic review. Most of the measures had moderate levels of thoroughness in the coverage of key aspects of fidelity, reported adequate to excellent reliability and validity, and were highly variable in clinical utility. CONCLUSION. Additional research is recommended to validate existing occupational or physical therapy fidelity measures and to develop novel measures for other occupational therapy and physical therapy interventions. Clinicians and researchers must place greater emphasis on the development and implementation of fidelity measures to ensure uniformity in intervention delivery and high-quality, evidence-based care.

This secondary analysis quantified the psychometric properties of the Ohio Modified Arm–Motor Ability Test (OMAAT) in a sample of neurologically stable chronic stroke survivors (n = 67, 40 men; mean age 59.8 yr, standard deviation = 12.8; 42 White, 23 Black, 2 other; 92.5% right-sided lesion; 44 ischemic stroke). Findings indicate high OMAAT internal consistency (Cronbach’s α = .97, ordinal α = .98, Gugiu’s bootstrap reliability = .97), unidimensionality, and strong positive factor loadings for all 20 OMAAT items. Convergent validity between OMAAT and Action Research Arm Test total scores was strong (r = .90, p < .0001). The OMAAT is the first short measure of upper extremity functional limitation available to clinicians and researchers that includes an administration manual and that has been examined using nonparametric psychometrics. A detailed administration manual is provided as a supplement to this article.

OBJECTIVE. In this article, we evaluate psychometric properties of the Child’s Challenging Behaviour Scale, Version 2 (CCBS–2) with mothers of young, typically developing children. METHOD. A cross-sectional mail survey with Australian mothers (N = 337) included the CCBS–2, the Depression Anxiety Stress Scales, and the Parents’ Evaluation of Developmental Status scale. RESULTS. Internal consistency was good, and no gender differences in CCBS–2 scores were significant. Significant results included differences between CCBS–2 scores: among children grouped according to age, among children grouped according to pre– and post–school entry, among mothers grouped according to extent of any symptom type, and between this sample and a previously collected age-matched sample of children with disabilities. CONCLUSION. Of the properties tested, results support sound psychometrics. The CCBS–2 can be used to differentiate children according to age, school entry, and disability as well as to identify families for potential services in behavior management and mental health.

OBJECTIVE. The Health Promoting Activities Scale (HPAS) measures the self-rated frequency with which adults participate in activities that promote health. We evaluated the internal consistency, construct validity, and intrarater reliability of the HPAS with a cohort of mothers (N = 56) of school-age children. METHOD. We used an online survey that included the HPAS and measures of mental and physical health. Statistical analysis included intraclass correlation coefficients (ICCs), measurement error, error range, limits of agreement, and minimum detectable change (MDC). RESULTS. The HPAS showed good internal consistency (Cronbach’s α = .73). Construct validity was supported by a significant difference in HPAS scores among participants grouped by physical activity level; no other differences were significant. Results included a high aggregate ICC of .90 and an MDC of 5 points. CONCLUSION. Our evaluation of the HPAS revealed good reliability and stability, suggesting suitability for ongoing evaluation as an outcome measure.

OBJECTIVE. The objective of this study was to determine the psychometric properties of the Vocational Fit Assessment (VFA) by examining its factor structure and subscale reliability. METHOD. This prospective cross-sectional study used two surveys (one for worker abilities and one for job demands) to collect the data needed for the psychometric evaluation of the VFA. Latent parallel analysis and ordinal exploratory factor analysis were used to iteratively refine VFA subscales. RESULTS. Ten unidimensional subscales emerged from factor analysis of VFA items: (1) Cognitive Abilities, (2) Communication Skills, (3) Computer Skills, (4) Higher Task-Related Abilities, (5) Interpersonal Skills, (6) Lower Task-Related Abilities, (7) Physical Abilities, (8) Safety, (9) Self-Determination, and (10) Work Structure. Subscale internal consistency (ordinal α) was ≥.86 for VFA for worker abilities and ≥.77 for VFA for job demands. CONCLUSION. The unidimensional structure of VFA subscales and estimates of internal consistency lend initial evidence in support of their reliability and validity.

We investigated (1) the psychometric properties of data gathered with the Performance Analysis of Driving Ability (P-Drive), an on-road assessment; (2) P-Drive’s predictive validity in relation to a summed decision of passing or failing a medical driving evaluation; and (3) the success of implementing P-Drive. Drivers (N = 99) with neurological impairment referred for a driving evaluation were observed on road and scored using P-Drive. Results showed evidence of person response validity and internal validity. P-Drive separated the drivers into four different strata (reliability coefficient = .92). A cutoff raw score of 81 was optimal, with sensitivity of 93% and specificity of 92%. Although only 9 occupational therapists (of 19 initially trained) contributed data for analysis, 17 reported using the assessment. Data gathered with P-Drive yielded evidence of excellent psychometric properties. Moreover, P-Drive was implemented successfully in clinical settings, although initial training to full implementation took longer than 1 yr.

This study examined the psychometric properties of item pools relevant to upper-extremity function and activity performance and evaluated simulated 5-, 10-, and 15-item computer adaptive tests (CATs). In a multicenter, cross-sectional study of 200 children and youth with brachial plexus birth palsy (BPBP), parents responded to upper-extremity (n = 52) and activity (n = 34) items using a 5-point response scale. We used confirmatory and exploratory factor analysis, ordinal logistic regression, item maps, and standard errors to evaluate the psychometric properties of the item banks. Validity was evaluated using analysis of variance and Pearson correlation coefficients. Results show that the two item pools have acceptable model fit, scaled well for children and youth with BPBP, and had good validity, content range, and precision. Simulated CATs performed comparably to the full item banks, suggesting that a reduced number of items provide similar information to the entire set of items.

OBJECTIVE. The Self-Perceptions in Rehabilitation Questionnaire (SPIRQ) is a brief measure developed to monitor client self-perceptions, motivation, and emotional reactions throughout rehabilitation. We describe the SPIRQ’s development and preliminary psychometric evaluation. METHOD. One hundred five adults with traumatic brain injury attending two brain injury rehabilitation units completed the SPIRQ during occupational therapy sessions. A subset (n = 33) completed the SPIRQ twice over a 5- to 7-day interval to examine test–retest reliability. RESULTS. Exploratory factor analysis yielded three factors: Changes in Self and Life Plans, Self in Rehabilitation, and Emotional Reactions. Their internal consistency was sound (αs = .72–.83). Test–retest reliability was generally acceptable (rs = .67–.81), and scores did not significantly change between testing occasions (p > .05). CONCLUSION. We found preliminary support for the SPIRQ scales’ reliability and construct validity. Future empirical evaluation and potential clinical applications of the SPIRQ in occupational therapy are discussed.

The psychometric properties of assessments must be established for specific populations. The psychometric properties of the Children’s Assessment of Participation and Enjoyment/Preference for Activities of Children have been studied only in a sample of children with physical disability. We conducted a study to determine the appropriateness of drawing inferences from this assessment for children with high-functioning autism (HFA). The content validity and test–retest reliability (r > .7) were both found to be adequate for this population. Parents’ agreement with most of their children’s self-ratings on this assessment provided an estimate of interrater reliability. We also ascertained the feasibility of gathering recreational participation information from children with HFA and found that adaptations to facilitate the self-completion of the tool should be made available. The study findings support the use of this tool to assess recreational participation among children with HFA.

The Practical Skills Test (PST) is a new assessment of individuals’ knowledge of life skills. We evaluated the PST’s reliability, validity, and sensitivity to change among a homeless population. Participants were 123 homeless persons in a longitudinal experimental study who were assessed before and after intervention with the PST, Allen Cognitive Level Screen–2000 (ACLS–2000), and Impact of Event Scale–Revised (IES–R). The PST showed generally good internal consistency, no floor effects, and limited ceiling effects (<20% on each test). Supportive evidence for the PST’s convergent validity was seen in its moderate correlations with the ACLS–2000; we found no significant correlation with the IES–R. Paired t tests indicated that the PST is sensitive to changes in life skills after intervention, but effect sizes were small. The results suggest that the PST has generally good reliability and validity. However, ceiling effects suggest an area for further development.

The Health Enhancement Lifestyle Profile–Screener (HELP–Screener) is a 15-item self-report questionnaire conceptually excerpted from the original 56-item HELP. This article describes the development and validation of the HELP–Screener with a sample of 483 community-dwelling older adults. Data derived from the sample were first analyzed using the Rasch dichotomous model. Unidimensionality and data–model fit of the HELP–Screener were largely supported by the analyses of principal components of residuals, fit statistics, local dependency, differential item functioning, and item hierarchy. To delineate the clinical significance of the test results, the cutoff score for the HELP–Screener was established through the mean and standard deviation generated from the study sample. The HELP–Screener can serve as a time-efficient screening for identifying older adults who may require a comprehensive evaluation through HELP and, as a result, who may benefit from a lifestyle intervention. Of note, more studies are planned to further corroborate psychometric properties of this new instrument.

We examined the psychometric properties (internal consistency, concurrent criterion validity, and known-group validity) of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) in people with intellectual disabilities. A total of 111 people with intellectual disabilities and 19 people with no disabilities were included. We used Cronbach's alpha, Spearman's rho, the Kruskal–Wallis test, and one-way analysis of variance for analysis, where appropriate. Results showed good internal consistency on Orientation, Visual Perception, Spatial Perception, Visuomotor Organization, and Thinking Operations subscales (Cronbach's αs = .82, .74, .76, .86, and .80, respectively), but not on the Motor Praxis subscale (α = .48). We found significant correlations between participants’ performance on the Pictorial IQ test and disability level and scores on the LOTCA. The known-group validity of the LOTCA in people with intellectual disabilities was satisfactory. We concluded that the LOTCA is a suitable instrument for measuring cognitive abilities and visual perception in people with intellectual disabilities.

OBJECTIVE. Systematic literature reviews contribute to evidence-based occupational therapy, yet no data capture tool currently exists to validly and reliably appraise the characteristics and quality of primary studies. METHOD. We determined the psychometrics of Systematic Process for Investigating and Describing Evidence-Based Research (SPIDER) and piloted it with 201 studies included in a systematic literature review. RESULTS. Content validity showed item relevance with 73% agreement between two experts. For the quality construct, seven of nine quality indicators were positively (p < .05) correlated with the overall quality score. The quality scores were positively correlated (p < .05) with two objective measures, inferring criterion validity. Intrarater reliability was moderate to perfect (κ = 0.4–1.0). Cross-tab analyses showed less variation in experienced reviewers’ interrater reliability. CONCLUSION. SPIDER provides plausible opportunities for occupational therapy researchers and graduate students to appraise the characteristics and quality of primary studies but requires testing across other settings.