16. World Health Organization. List of Official ICF Updates.

Geneva, Switzer- participation in leisure and recreational activities by children with cere-
land: World Health Organization;2014. bral palsy. Dev Med Child Neurol. 2010;53(2):142–149.
17. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol 21. Chien CW, Rodger S, Copley J, Skorka K. Comparative content review
Meas. 1960;20(1):37–46. of children’s participation measures using the International Classifica-
18. Landis JR, Koch GG. The measurement of observer agreement for cate- tion of Functioning, Disability and Health-Children and Youth. Arch
gorical data. Biometrics. 1977;33(1):159–174. Phys Med Rehabil. 2014;95(1):141–152.
19. Altman DG. Practical Statistics for Medical Research. London, England: 22. Fayed N, Cieza A, Bickenbach J. Illustrating child-specific linking
Chapman and Hall; 1999. issues using the Child Health Questionnaire. Am J Phys Med Rehabil.
20. Palisano RJ, Chiarello LA, Orlin M, et al. Determinants of intensity of 2012;91(13, suppl 1):S189–S198.

CLINICAL BOTTOM LINE

Commentary on “Linking the Pediatric Evaluation of Disability Inventory-Computer

Adaptive Test (PEDI-CAT) to the International Classification of Function”

“How can I apply this information?”

The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) is a pediatric outcome mea-
sure using item response theory and computer-adaptive testing to evaluate typical performance of infants, children, and
youth in the domains of Daily Activities, Mobility, Social/Cognitive, and Responsibility. These investigators examined
the 276 items of the PEDI-CAT to determine whether items are representative of the Activity and Participation level
of the International Classification of Functioning, Disability and Health (ICF). This study supports content validity
of the measure. The PEDI-CAT was intended to measure typical functional performance of a child in natural settings
and this was confirmed with this study. Because the PEDI-CAT uses a CAT platform, a limited number of items are
administered; however, therapists can be confident in coverage of the Activity and Participation components because
all items were linked to the Activity and Participation ICF codes.
Parent comments: As a parent of a child with a physical disability, I am pleased that pediatric physical therapists are
interested in using and validating objective measurement tools that focus on everyday activities that children experience
in life. Since the PEDI-CAT is often completed by parents, the concept of Activity and Participation can be confidently
used to explain the intent of the PEDI-CAT and provide instructions to parent or other caregiver respondents.
“What should I be mindful about when applying this information?”
Pediatric physical therapists require valid, reliable, and responsive measures in clinical practice and research to
objectively document abilities, plan interventions, and document changes after interventions for children with dis-
abilities. This study supports the content validity of the PEDI-CAT; however, additional research on psychometric
properties such as diagnosis- and setting-specific validity and responsiveness is needed. Therapists are encouraged to
review the manual to best understand the purpose and administration procedures.
Parent comments: Although this article presents useful information, reliance on dense physical therapy jargon and
technical information makes it difficult for a layperson to understand.

Maria Fragala-Pinkham, PT, DPT, MS

Franciscan Children’s Hospital
Brighton, Massachusetts
Andrew Fehlner
Parent of a child with hemiplegic cerebral palsy
Watertown, Massachusetts
Dr Fragala-Pinkham is one of the authors of the PEDI-CAT, and she does not currently receive royalties. In previous years, she
received less than $100/year. Andrew Fehlner has no potential conflicts of interest.
DOI: 10.1097/PEP.0000000000000501

118 Thompson et al Pediatric Physical Therapy

Copyright © 2018 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.
Unauthorized reproduction of this article is prohibited.