Pediatric Evaluation oy Diseoirsy ae (PED)) Devel sarge utr ice tiieit] CNet reclelelam Cate)PED! PEDIATRIC EVALUATION OF DISABILITY INVENTORY Development, Standardization and Administration Manual Research inquiries regarding this product should be addressed to: PEDI Research Group Health and Disability Research Institute Boston University 53 Bay State Road Boston,MA02215-2101 Email: hdr@buedu URL: http://www-bu.edu/hdr/products/pedi/index. html Phone (617) 353-3277, Fax (617) 358-1355Pediatric Evaluation of Disability Inventory (PEDI) Version 1.0 Development, Standardization and Administration Manual October, 1992 Stephon M. Haley, Ph.D, PI. Wendy J. Coster, Ph.D.,OTR/L Larry H. tudlow, Ph.D. Jane T. Haltiwanger, Ph.D. Peter J. Andrellos, Ph.D. (Original Sponsoring Inston: New England Medial Center Hospitals, Inc, Boston, MA Current Sponsoring Istcation: Center or Rebabitaton Effectiveness, Sarge Health and Rehabltation Scenes, stn Universi, Boston, MA 1 Callege of Funded by Grant No, 1133680043 and by a Mary E. Switzer Rehabilitation Research Fellowship (WJC), National Insitute on Disability and Rehabilitation Reseatch, Office of Special Education and Rehabilitation Services, US. Depatinent of Education. Additional suppor was provided bya grant from the Ameriean (Occupational Therapy Association and Foundation tothe Neurobehavioral Rehabilitation Research Cente, Department of Occupational Therapy, Sagent College, Boston University ©Copyright 1998 Tastes of Boston University All rights reserved, including translation. No portion of ths material may be repro duced, stored in 2 veeval system, or transmitted in any form by any means ~ electronic, mechanical, photocopying, recording, or otherwise — without prior vniten permission ofthe copyright ownersDedication ‘To our fm — Barbara Emily, and Bethany Carol, Jlia, Tyler, and Holly — Kurt, Sth, and Johanna ‘—Mom (Mrs. Anne Andrllos)About the Authors Dr. Haley received a BS. in Psychology anda Cenificate Degree in Physical “Therapy at Ohio State Univesity, a Master of Sience Degree in Education atthe University of Kentucky, and a Ph.D. in Educational Psychology tthe University ‘of Washington. Dr Haley hasan extensive clinical background in pedatric physical therapy, practicing both as clinician and asa consultant He served on the Physical Therapy faculty t Boston Universi, and then joined the faculty st “Tuli Univesity School of Medicine. Since 1986, he has been associated with the Department of Rehabilitation at Tufts University School of Medicine andthe Research and Training Centr in Rehabilitation and Childhood Trauma at New England Medical Center. He scurenly the Dueetor of Research at the Research and Training Center, and Research Associate Professor at Tufts Unversity School ff Medicine. Dr. Haley’s areas of professional interest include physical and motor ‘ehubltation of children with injures and the aeessment of disablement in ‘ildren. Articles by Dr Haley have appeared in many pediatric and rehabilitation journals Dr. Coster received B.A, from Antioch College, an MS. in Occupational ‘Therapy from Boston University, and a PRD. in Psychology from Harvard Univer sity. Dr Coster has abroad background in pediatric occupational therapy, practic- ing as both clinician and consultant to programs serving children with emo- tional, behavioral, and cognitive disabilities. She has been an Assistant Professor fon the Occupational Therapy faculty at Sargent College, Boston University, since 1986. She has also been aftiated with the Department of Rehabilitation Medicine and the Research and Training Center in Rehabilitation and Childhood Trauma at [New England Medical Center since 1988, Dr. Coster’ aeas of professional intrest Include the social and emotional development of children with disabilities and the development of assessments for preschool age children. Articles and chapters by Dr. Coster have appeated in rehabilitation and developmental psychology books sand journals. Dr. Ludlow received a B.A. in Psychology (clinical) and an M.A. in Psychology (stasis) from California State Univesity, Sacramento, and a PhD. n Education ‘measurement, evaluation, and stastical analysis) fom the University of Chicago Dr. Ludlow has been associated with Boston College since 1983 and is curently {Associate Professor, School of Education, Educational Research, Measurement and Evaluation Program, He has a background in tatstical consulting that includes the fields of education, psychology, musing, social work, economics, and physical rehabilitation. He has Served on various sate and national committees, including the American Society of Clinical Pathologists, Board of Rest, Research and.Development Committe; the New England Educational Research Organization; and the Board of Cooperating Editors for Educational and Psychological Measure- ‘ment. Dr. Ludiow's areas of special interest include the application of item re- sponse theory models forthe purpose of developing objective measurement instruments. Articles and chapters by Dr Ludlow have appeared in numerous professional journals and books. Ms, Haltiwanger received a B.A. in Psychology a the Ohio State University, an Ed.M. from Harvard Graduate Schoo! of Education, and an M.A. in Developmental Paychology fom the Unversity of Denver. She is curently working a Assistant Director of Training atthe Research and Training Center in Rehabilitation and (Childhood Trauma at New England Medical Center and is a doctoral candidate in Developmental Psychology atthe University of Denver. Ms Haltiwanger areas of research intrest include social-emotional development of young children, parenting, and measurement development, Dr. Andrellos received a BS. in Chemistry from MassachusetsInstitte of Technology, an MS. in Chemisty from Tufts Univesity, and an MLA. and Ph.D. ‘in Chemistry from Harvard University Dr. Andrellos served asa research chemist for the Food and Drug Administration before accepting «postion atthe Boston CCuldren’s Hospital as Director ofthe Clinical Research Center Laboratory. Be ‘cause of an acquired disability, Dr. Andellos lef the chemistry profession for ‘computer programming, Dr. Andrellos joined the Tufts New England Medical Center's Rehabilitation Engineering Center in 1985. Dr. Andrellos collaborated with rehabilitation engineers on the preparation of the book, “Making Honeywell Computers Accessible for Disabled People,” fr the Honeywll Corporation. ‘Afterwards, Dr. Andtellos worked asa member ofa research team on the program ring of "Nellie," a computer software program used as an augmentatvecommi- nication device for persons with a severe motor disability. Dr. Andrelos has setup Base database programs and compute software programs fora numberof est. development projects, including the Tufts Assessient of Motor Performance and the PEDITable of Contents ‘Acknowledgements ” Prefice si Part | Introduction Chapter 1 Introduction to the PEDI.. Description Applications Design Specifications Features. Population for Whom the PEDI is Deigned CConstrct of Pediatrie Function References chopter 2 Content and Scale Development... ‘Overview ‘Content Areas Selfcare Mobility Social Function Item and Measurement Sele Sources Content Validity Study. “Measurement Seales Functional Skills (Caregiver Assistance Moaifiations Rasch Measurement Mode! ‘General Theory Speatie PEDI Application Summary Scores. ‘Normative Standard Scores, Sealed Scores Frequency Counts ReferencesPort It Standardization and Technical Data chapter 3 ‘Standardization of the PED! soumnsnsninennnsnsnsnn General Sampling Strategy Procedure for Data Collection Normative Standardization Sample. Description of Normative Sample Mem Analysis of Normative Data Summary Scores for Normative Dat, (Clinical Validation Samples Description of lineal Sarmples. Summary Scots for Clinical Samples References chapter 4 Structure of PEDI Scales. ‘Correlations of PEDI Sea Strvcture of the Hierarchical Scales 48 Them Attetion and Revision Irom the Standardization Version 0 chapter 5 Peychometrc Properties ofthe PEDI ‘Overview Reliability Internal Cansisiency of Seales Interinterviewer Reiabilty i the Normative Study 62 Interinterviewer Rehabil in a Clinical Sample 62 Reliability of Two Respondents 2 Validity 3 Construct Validity 65 Concurrent Validity 63 Discriminant Validity oT Evaluative Validity (Responsiveness to Change) 70 References 1%Part it Administration and Scoring TD : 7 Choice of Respondent. 7 Methods of Administration. 78 ‘Administration by Parent ReporuSeructred Interview 18 ‘Administration by Profesional Judgment 78 ‘Administration by a Combination of Methods 9 Procedures for Training 80 Qualifications of the lnterviewee/Examiner 80 Training in PEDI Administration 80 Scoring Tips and Common Pills 81 Cover Sheet of Score Form. a1 Funetional Skills Scoring. 81 Problem-Solving 8 Functional Comprehension and Expresion. 2 Caregiver Assistance 2 Modifieations 2 Social Function Modifications 8 Completeness. 8 Use ofthe PEDI Score Farm 8 ‘Demographic Data (Front Page) 8 Part E-Fusion Sil Seales % Pars Il and Il Caregiver Assistance and Modifications Seales 85 Scone Summary (Back Page) 85 ‘Example of PEDI Score Form 86 Use ofthe Sotware Progra. 88 References 88 chapter 7 Scoring Criteria for the Functional Skills Seales. ‘Overview Sel-cate Domain Mobility Domain Social Function Domain 10 chapter 8 Scoring Criteria for Caregiver Assistance and Modifications Seales wu. 123. ‘Overview 123 ‘Part IL: Caregiver Assistance Seales 13 Pat Il: Moaifiatons Seales 124 (Questioning Strategy forthe Caregiver Assistance and Modifications Seales 135 ‘Selfcare Domain. 126 ‘Mobility Domain. 12 Social Funetion Domain 156 Guide o Caregiver Assistance and Modifications Sales. 167 Selcate Domain 169 ‘Mobiity Domain. 1B Social Funetion Domain WTSting and rpg PED Summary Sere Procedures for Scoring Computing Raw Scores ‘Determining Normative Standard Scores Devrining Scaled Sere Determining Conidence Interval for invidal Scores 183 Determining Ft Sores 183 Interpreting PEDI Summary Scores 183 Tnterpreting Normative Sundard Scores 13 Interpreting Scaled Scares 185 Comparison of Normative Standard and Scaled Scores. 185 Use of tem Maps 187 Interpreting Fit Scores. 189 Interpretation of Overall Functional Profile ago Examples of Error it Inerpeaion . 190 chapter 11 Use of PEDI Scoring Softwar nent Introduction. ‘System Requirement, PEDI Disk Installation Starting the PEDI Program Files Data Entry Current Dts The Escape Key, “The Main Men ‘The PEDI Data File Exit from the PEDI Program Addendum Format of PEDI Output Data FileAppendices Appendix | en ‘Normative Dats Collection Stes Appendix I von ‘Schematics of Age Ranges st Which Children Maser Functional Skil tems Appendix Maren ‘Schematic of Tem Dilfculty Append IV nn “ables for Determining Normative Standard Scores — Functional Sl Seales Appendix V “ables for Determining Normative Standard Scores — Caregiver Assistance Sales Appendix WI. "able for Determining Scaled Scores — Functional Skil Seales vu "able for Determining Sealed Scores — Caregiver Assistance Scales ‘Appendix Vit ‘Clinictan\Consumer Feedback FormList of Figures Figure 1-1 ‘Conceptual Model of Measurement (Constructs Included in the PEDI Figure 21 'PEDI Caregiver Assistance Scale Figure 5-1 ‘Developmental Functions: Functional kills Scales Figure 5-2 Developmental Functions: Caregiver Assistance Seales Figure 9-1 Example of Normative Standard and Sealed Scores con the PED Figure 9.2 ‘Score Profiles for Normative Standard and Scaled Scores Figure 9-3 "Correspondence of Scaled Scores to Item Map Figure 10-1 ‘Normative Standard and Scled Scores: Case 1 Figure 10-2 Example of Using em Map: Case 1 Figure 10-3 Expected Score Profile: Case 2 Figure 10-4 "Case 4: Functional Skil Figure 10-5 {Case 4: Caregiver Assistance 1s 186 205 295 216 2a 22List of Tables Table 21 unetional Skills Content ofthe PEDL Table 2-2 ‘Complex Activities Assessed withthe Caregiver Assistance and Modifications Scales Table 2-3 Results of Content Validity Study Table 2-4 "Rating Seales fr the Three Types of Measurement Seales Table 2-5 List of Scales and Summary Scores forthe PEDI Table 3-1 Distribution ofthe Normative Sample by Age Level and Gender Table 3-2 Representation ofthe PEDI Normative Sample, [Northeast Region, and US. Population by Race and Origin, Table 33 Representation ofthe Normative Sarmple by Parent Education Table 3-4 Representation ofthe Normative Samnple by Community Sie Table 3-5 Representation of Family Characteristics i the Normative Sample Table 3-6 ‘School Attendance by Age Group inthe Normative Sample Toble 3-7 ‘imple Corelations between Demographic Variables and Total Score Toble 3-8 ‘Age Ranges at Which 107255077590 Percent of Children Master Sell-cae Functional Skills, Toble 3-9 ‘Age Ranges at Which 10/25/5075/90 Percent of Children Master Mobility Funetonal Skills, B 4 16 16 29 29 30 3 a a 35Table 3-10 ‘Age Ranges at Which 10725/50/75790 Percent of Children ‘Master Social Function Functional Skills Table 3-11 ‘Age Ranges at Which 1025/50/75/90 Percent of Children ‘Achieve Independence in Caregiver Assistance Items. Table 3-12 ‘Functional Skis: Ranges of Standard Scores, Means and Standard Deviations of Scaled Scores Obtained from Normative Sample Table 3-13 Caregiver Assistance: Ranges of Standard Scores, Means and Standard Deviations of Sealed Scores Obtained ftom Normative Sample Table 3-14 Functional Skils: Ranges of Standard Scores, Means and Standard Deviations of Scaled Scores Obtained from Clinical Samples, Toble 3-15 Caregiver Assistance: Ranges of Standard Scores, Means and Standard Deviations of Scaled Scores Obtained from Clinical Samples Tobie 4-1 Correlations Among Domain: Total Normative Sample Table 4-2 Correlations Among Domains: Infant Group Table 4-3 ‘Correlations Among Domains: Preschool Group. Table 4-4 ‘Correlations Among Domains: School-age Group, Table 4-5 ‘Comtelations Among Domains: Clinical Samples. Table 4-6 ‘Mem Calration Order for Self-care Functional hills ems. Table 4-7 ‘Mem Calibration Order for Mobility Functional Skills lems Table 4-8 Mem Calibration Order for Socal Function Functional Skil Items Table 4-9 “Average Item Calibration Order fr Self-care Caregiver Assistance Items 37 2 n 8 8 46 a av 30 33 35 38Tobie 4-10 “Average Item Calibration Orde for Mobility Caregiver “Assistance Items 38 Table 4-11 “Average Item Calibration Order for Social Function Caregiver ‘Assistance lems, 38 Toble 4-12 "Hem Attrition from Standardization Version by Sale 39 Toble 5-1 Intemal Conssteney Estimates for PEDI Seales Oy Toble 5-2 TInter-interviewer Reiabilty of PEDI Scales for Normative Sample. 6 Toble 5-3 Tne interviewer Reliability of PEDI Scales fo Clinical Samples. s Table 5-8 ‘Consistency of PEDI Scores Between Rehabilitation Team and Family Respondents 6 Table 5-5 Means, Standard Deviations and Carlations Rerween PFD Raw ‘Scores and Chronological Age o* Table 5-6 Resuls of Pilot Study of Concurrent Validity of PEDI and Batele Developmental Inventory Screening Test or Toble 5-7 (Correlations Between PEDI Scales and Batlle Developmental Inventory Screening Test sa Table 5-8 ‘Correlations Between PEDI and Wee-Functiona Independence Measute..69 Table 5-9 Comparison of Discriminant Abily of PED! and Batlle Developmental Inventory Screening Test n Table 5-10 Discriminant Validity of PEDI Normative Standard Scores in Normative and Clinical Samples for Three Age Groups n Table 5-11 Discriminant Validity of PEDI Scaled Scores in Normative and Clinical Samples for Three Age Groups nResponsiveness of the PEDI Normative Standard Scores in “Two Clinical Samples Toble 5-13, Responsiveness of PEDI Scaled Scores in Two Clinical Samples Table 10-1 ‘Observed and Expected Scores for Case 2on the Mobility Caregiver Assistance Scale Table 10-2 ‘Case 4: Modifications. ™ a7Acknowledgements Completion ofthis version ofthe Peiatric Evaluation of Disability Inventory (PEDI) was possible only through the effos of many people Dr. Bruce Gans orginally conceived the dea of developing functional assess- rent instrument for children and encouraged the research staff atthe Reseach and ‘Training Center on Rehabilitation and Childhood Trauma to implement his sugges tion. Dr Hany Webster af the Department of Rehabilitation provided excellent ‘support and feedback throughout chi effort. Ruth Faas, OTR, was orginally associated withthe conceptlizatin and development ofthe project. She played the major role i developing the content forthe self-care tems and her efforts were instrumental nthe inital Held testing and development of the PEDI. A number of ‘consultants tothe projet were extremely helpful as we struggled to develop intial ‘versions of the PEDL These included: Susan MeBride, PhD, Carol Fergason, RN, Rarhara Kenefict, Ph.D. and Martha Hofman. MS, CCC-SPA. Prnjct Adv ‘sory Board Memiers Susan Harts, Ph.D, PT, FAPTA, Anne Henderson, PhD, (OTWL, FAOTA, Cael Granger, M.D. and Byron Hamilton, M.D., PhD. were very helpful in our early deliberations regarding the content and format ofthe PEDL Although the individuals wh took part ae too numerous to mention individually, collegues from New England Medical Center Hospitals, Tuts University School of ‘Medicine and local therapists fom the Boston community attended two early meetings onthe PEDI that had s profound impact on its concepualization and ‘eventual format. Thirty-one experts inthe field of pediatrics and rehabilitation gave us ther valuable time and expertise to critique the content development ofthe PEDI. Many oftheir specific suggestions regarding item content were incorporated into the final version ofthe PED. ‘Our grateful appreciation is extended to the pediatric nurse practitioners who participated inthe monumental effort of collecting the normative dat. full list of the nurse practitioner sites ie provide in Appendix I Additionally, our deepest frtiude s extended tothe parents and children who served as respondents and icipansin the normative data collection. Many others contsbuted tothe data tollection ofthe PEDI on samples of children with disabilities. Jo Ann Kluzak, MS. PT, from Cotting School assisted us in an eary data collection effort. Amy Feldman, M.S. P-, conducted a project that was to serve asthe intl validation study forthe PEDL. Kathy Binds Sundberg, MS, P.T, and Cathy Schultz, MA, (TRA, fom Franciscan Children's Hospital and Rehabilitation Center, contributed famporiant reliability and validity data to support the use ofthe PEDI. Mary Jo Baryza, MS.,P-T, contibuted longitudinal data from the Research and Training Center and provided us valuable feedback dnoughout the projet. Rabert M Gordon, Psy ,, fom Rusk Insutute also contributed clinical data to us that are dlescebed in this manualMajor contributions were also made by the combined elfrs, feedback and suppor of additional dedicated persons. The development of the Score Form and “Manual were enhanced by the early design work of John Groton and later by Mare Kaufman, Darisse Paquette from Educational Media at Tufts University designed ‘many of the graphics and tables. Data entry throughout the project was provided by Cheryl Grant, Ana Colon and Kimberly Fada, We alo gratefully acknowledge the typing and editorial contsbutions of Barbara Saunders and Edward Parks, J. ‘We also owe our appreciation to Lucy Jane Mille, Ph.D, OTR, Dianne Russel, Ms, and Alan Jett, PhD.,P., who provided us with extremely valuable input toward the final stages ofthe manual development ‘We express our thanks tothe Research Administration Office at New England Medical Center fr ther financial support that enabled publiation of this mana ‘We acknowiedge the continual support and encouragement ofthe Department of Rehabilitation Medicine, particularly Marvin Brooke, MD.,BetySaiegosk, and Katherine Rowe Finally we gratefully acknowledge the Sinaia support provided bythe National Iasttute on Disability and Rehabilitation Research, U.S. Department of Education, through Grant No, H133G80043,“This manuals intended to provide basic administrative and scoring information for the Pediatric Evaluation of Disability Inventory (PEDI). This manual presents the conceptual framework, applications, administrative guidelines, scoring instruc- tons and technical support for Version 1.0 ofthe PEDL ‘The manual s writen primarily fr clinicians and educators who regulary ‘evaluate fanetional performance in children with isablliies, Intended ses ofthe PEDI include deserption of functional stats, program evaluation of in-patient, ot patient and school-based programs, and monitoring of change i individuals oF {groups of children with inetional disabilities, We have attempted to provide Silequate criteria for administering and scoring the PEDI, whether itis administered by professional judgment or through structured parent interview. These administra: tive and scoring criteria have been writen based on extensive field testing of ‘numero plot edtions ofthe PEDI. We have enplayed rigors methodalogy for the development of tem content, sale development, and derivations of sm mary scores. “As the product of an ongoing research effort to develop a standardize clinica Instrument for pediatric functional assesment, we have assembled in this manual ‘complete information on the standardization procedures and scale development of the inital version ofthe PEDL. Although the normative sample by some san dards, relatively small (n=412), the development ofthe PEDI represents one ofthe frst attempts to provide a funcional assessment instrament with developmental norms for use in rehabitation settings. As part of the standardization process, we have also collected data on several clinical samples of children with dlabiles Adutional studies are planned to further examine the reliability and validity ofthe PDI with various groups of children with disabilities, It must be clearly noted fom the outset that addtional reliably and validity studies need to be completed belore the PEDI can be used with complete confidence for descrpuive and evaluative purposes in various groups of children wih disabilities. Although suficint stan ‘dardization and technical data ate provided in thls manval to demonstrate the potent ofthe PEDI to be use as powerful instrument for functonal assessment, ‘much more work on further defining the technical characteristics of the isirument fs required, Iis the authors’ hope that researchers and clinicians in pediatric rehabilitation wil begin using the PEDI as formal data collection instrament and ‘ha, by thei use and data collection, they will contribute tots technical validation and further development “The authors welcome input and feedback from users ofthe PEDI. A feedback form fs provided in Appendix VI ofthis manual, This information wil be very useful othe authors as updated and revised versions of the PEDI are made avallable nthe fata,Part | Introduction(CHAPTER 1: INTRODUCTION To THE FEDI Chapter 1 Introduction to the PEDI Description The Pediatric Evaluation of Disability Inventory (PEDI) isa comprehensive linia assessment instrument that samples key functional capabilities and perfor rmance in children fom the ages of 6 months to 7.5 years. The PED! is primarily ) rllecs that a greater percent ‘ge of children achieved the ski than indicated in the spective column. Thus, ia ‘Table 3-8, since greser than 99% of the children ween the ages of 6 months and 28Toble 3-1 ‘Age (yrs) Femeles Moles | Total Number nee a % 0509 oz | om 589 % Lola 2 sea | 17 436 3 1519) “467 | 16 53 30 2024 “438 | 18 562 32 2529 359 | 25 oat » 3034 % 640 | 9 360 2 3539 4 412 | 2% 508 3 404d wu 560 | 440 25 4549 % 615 | 10 385 % 5054 1% 457 | 19 4a 35 5559 13 467 | 15 533 2 60464 4 560 | ado 2 65469 3 662 | 7 218 2 70+ 12 750 | 4 250 16 EDI Totale me 07 | 29 42 aa U.S. Population a6 5h4 Toble 32 Representation of the PEDI Normative Sample, Northeast Region, and U.S. Population by Race and Origin (n = 412) ‘Asin (8) | ck) | Coveasion (%) | Native | Other) Higpani 8) Aericon 8) PEDI Sample | 07 187 76 10 a0 | 78 Northeast Region 19 109 880 02 08 55 us. | Population 16 wz 5 o7 25 45 Nee Pcs sit ion prc ro mod ih US FHepenc group is coniered independence Gagner ol panic ar counted ao os ther Couconon Bock o OrCHAPTER 9: STANDARDIZATION OF THE PEDI Toble 2.3 Ropresentotion of the Normative Sample by Parent Education tes than | High School | T-S years | Four or more High Schoo! (8) | Graduate (2) | College (3) | years College (8) PED! zomple 103 221 ad 399 Now England Region 29 360 135 72 U.S. Population 336 346 157 162 Toble 3:4 Representation of the Normative Sample by Community Size Urban Non-urban (population grater [population es thon 50,000 | than 50,000) 8) EDI sample 696 wa U.S. Population ais | 85 ‘Now: New-urbon ince bah rural and uihuhn commune with ppulaions last $0,000, ‘Sburboncomunes geographically coniguovs wit lrgor urban areas are counted os urban. Table 35 Representation of Family Characteristics in the Normative Sample Mortal Status Married Single . » [oo % aa 7a | a9 26 Fomily tow Moderate Socioeconomic (020) (a1-a0} (ar) States a x ja % | % “6 1o7 | 138 342 | 89 216 * Helingsheod Four Fctor Model 2Toble 36 School Attendance by Age Group in the Normative Sample (n = 408) 20yr aoson |7 59 157 si7|18 oo |s 44 [— — 25.0 yr 2 17 | ws|s 70 | 51 |s2 a8 Totals wa 7s |e 216 | 2% 463 | 18 |s2 128 Table 37, Simple Correlations Between Demographic Variables and Total Score lnfonts | Preschoolers | Schookage | Total Sample (oss 2 yrs) (25) (grote 5 ys) naa) (o= Tai) =I) (n=412) Chronological Age ose oe 0.50" os Community Size (Crbon/nonurbon) on 010 oor 00 Sex (male/temele) 0.09 018 018 0.09 (Mother Education (years) 0.09 0.08 001 013 Socioeconomic status 0.02 on on 018 ace (Caucasian ‘vs non Covearian) oa 0.02 0.06 on *p<001 [Notes Raw ttl Functional Skil Score ccros secare, mobiliy ond socal function domoine was used in onalCHAPTER 2: STANDARDIZATION OF THE FED! Toble 3.8 ‘Range (yrs) at Which 10/25/50/75/90 Percent of Children Master it-care Functional Skills tems Eating 1. Strained fod 2. umpy foods ‘cup foods A.A entre of fble fod 5 Finger fede 6. Spoon use 7. Good spoon vse Us of ke 10. Holds continer 1 Le with ping 12, hs cup 2 hands 13. up hand Pours guid ‘ond Bathing 15. Allows toothbrushing 16 Molde toothbrush 17 Bshes tat, nat thorough 18. Thoroughly brushes teth 19. Properes toothbrush 20, Holds head when brushed 21. Brings comb to aie 22. Brushes hair 23. Manages tangles/pars 24, lows nose wiped 25, Tes to blow nose 26. Wipes when requered 27. Wipes note w/oa request 28. Blows and wipes on wn 29. Holds out hands for wath 120, Rb hands together 231. Tone water on/off 232. Woshes hands thoroughly 33, Washes/ dries hands thoroughly 210% oso 2025 10% lois 2820 osi0 2530 2025 225% 2830 ro1s 1520 225% a0as lows a0as 2820 2590 250% tous ros 4ous 205 250% 1520 sous 1520 as40 aoas 20as o75%. 406s as40 390% Ls20 tous 2530 2025 290% 2590 1520 1520 1520 1520 4570 sousTable 38 feoninved) CHAPTER 3: STANDARDIZATION OF THE PED! ‘Age Range (yrs) at Which 10/25/50/75/90 Percent of Children Master Self-care Functional Skills Items Grooming and Bathing cont.) 14. es wath body 35. Washes body thoroughly 36. obi soap and washcloth 137. Drles body thoroughly ‘38, Woshea/ die foc thoroughly Dressing 99, Asis pullover 40, Removes shit 181. Pate om hit 42. Front opening shirt 43. Front opening shit & fstoners (4, hast with fosters 45, Zpslunsps 6, Seaps/unsneps {7 tuons/unbuttons |. Hooks & separates sipper 29, Assis th pants 50. Removes ponte 51 Pts on pont, late waist 52. Removes & unfstont 58. Pte on & festont S54. Remover socks/shous | 55. Pus on shows, wrong feet 156. Pts on socks 57. Shoes on core feet 50. The shoelaces Teileting 59, Aust with clothing 60, Aerts wiping 61. Manages tlle! 62. clothes management 163. thoroughly wines (64. indian when wat 10% 1520 1520 2590 10% lows 1520 2820 2025 >10% 225% 2025 035 225% 2590 2590 3540 osi0 a0as 225% 1520 250% 2820 250% 1520 2820 540 1520 as40 120 sous lous 3540 >50% sous 275% 03s o75% 3095 4550 sous 2025 4550 1520 4550 278% 2025 5560 4550 290% ta20 sso 2330 Seo seo 290% a0as 406s a”CHAPTER 3: STANDARDIZATION OF THE FEDI Teble 3-8 (continued) ‘Age Range (yrs) at Which 10/25/50/75/90 Percent of Children Mastor Self-care Functional Skills Nes Tolleting (cont) 210% | 225% | 250% | 275% | 290% 65. Occasional indicates need (edder) | 1520 > 202s | asao | aoas (6, Consett indicates need (ladder) | > 2025 > . 2035 67.5 to batiroom 202s | 2520 > : aoas (68. Dry dy & night 2025 > 03s > 4550 (9. idiot sled osio | 191s | is20 > 2025 70. Occasionally indicates need (bowel) | 1.520 : 2025 | 2sa0 | aoas 171. Consistently inctes ned (bowel) > 2025 > * a0as 72. Dsingulshes need > 202s > » 2035 73. Ne bowel ocients zors | 2530 > aoas | 540 ‘Note: Grco-hon ss at eso gtr percriog of didren maser ovr om on epee tral column Seep 28 rer da iCHAPTER 3: STANDARDIZATION OF THE PED! Table 3.9 ‘Age Range (yrs) at Which 10/25/50/75/90 Percent of Children Master ‘Mobility Functional Skills tems Transfers 210% | 225% | 250% | 275% | 290% 1. Supported siting: tot | osio | 1520 > 2025 2 Unsupported sing tol | rors | 1520 > 2025 3. On/ot tw pay rors | 1520 > 2025 | 3035 4. On/ot ele arms 1520 > 2025 > | anes 5 on/ottraistneam | 2530 | a03s | 404s | 4550 | 4045 6. Supported siving: chal | > > > osi0 7. Unsupported siting chair | > 0510 > rors n/t ow chai . > > rors | 1520 nfo adh choir > > rois | 1520 | 2025 10. Onfotchaieneorms | 2025 | 3035 > 4550 | 5560 11, Moves in cor > > rors | 1520 | 2025 12 nvout cor witht help | 1520 > 2025 | 2830 13, Spe infor cor 1520 > 2025 > | a0as 14, Manages sec belt 2025 > 3035 | 404s | 4550 15. Mange car door = aoas | as40 * 5560 | 16, Comes to stn bod > > > 0510 rors | 17. Sits ot bed edge > > dons 1520 2025 | 18, Chine in/out bed > tors | 1520 > 2025 | 19. cin in/owrbed:neerms| 1520 | 2025 | 3025 | soss | 5560 20, supported sit tb > > > > os10 271. Unsupported st a . > oso | 101s | 1520 22. Climb infor > rors | 1520 | 2025 | s035 23, Si & std up tb > rors | 1520 | 2025 | 2530 24, Spe infout > 2025, | 2530 | a0as | 404s Note: Grate-thon sign >) ofl hat a greater percenlge of children mastered o given tem thon represented by tht column See p28 for father dea,CHAPTER 2; STANOARDIZATION OF THE PEDI Table 3-9 (ontinved) ‘Age Range (yrs) at Which 10/25/50/75/90 Percent of Children Master ‘Mobility Functional Skills Roms Locomotion 210% | 225% | >50% | >75% | 290% 25, tndors on aoe > > . osio | ois 6, ervinet > esto > > 11s 27. Walks > > ros > 1520 28. Moves in room w/ifiaity oe osi0 > ois 29, Moves in room/ne difisty > > osi0 > tos 30, Moves between rooms w/difcdty > > os10 > tons 231. Moves between room difcly > * os10 > lous 132. Open/clote doors > rors | 1520 | asa0 | aoa £38, Moves (nt cases) > > > oso | sors 34, Moves objec on Hor > > osio > | ms 35, Cores small bjoats > > osto > ros 36, Cars lrge objets osi0 > ros > 1520 37. Cores rail objects rors | 1520 | 2028 | 2530 | sous 38, Wells outdoors with dl support > > > oso | 01s 20, Walls outdoor: ne support - > to1s > 1520 40, Moves outdoors 10-50 feet > oso > rors | 1520 Moves outdoors 50-100 fest > > rons + 1520 142. Moves otors 100-150 fst - ros > ‘ 1520 43. Moves outdoors 150 fet & more wl difeley > > > | 1520 | a0as |, Moves outdoors 150 fet & more/ icy . > . 1s20 | aoas 45. Level serfs > os10 » rors | 1520 146, Uneven surface > oso | rors . 1520 {7 nowgh/ameven sraces > esto | so1s | 1320 | 2025 48. Rompe > lois > ts20 | 2025 19.curbs tons > 1520 > 2025 50. Up petal fight > osio > rors | 1520 151. Up fal ight os10 > tors > 1520 ‘52. Walks up pol Hight > rors | 1520 > 2025 |. Walks up fl fight w/itcaly > 1520 | 2025 > 03s 54, Walkup fll fight /neifcly > 1520 | 2025 7 03s 15. Down partial ight os10 > ro1s > 1520 56. Down ul ight tors > > vs20 | 2025 57, Walks down pat fight > rors | 1520 . 2025 58, Walks down ul igh w/ity > > 2025 * 2035 59, Walks down ul igh/no lily . > 2025 > 3035 2»Tale 210 Je ange yr] at Which 10/25/50/75/90 Percent of Children Master $Sscltoncton honchonel Ske ome Communization P10% | 928% | >80% | 275% | 290% 1. Oran . > > > oso 2. Responds tna" > > > oso | tors. 3. Comprahend 10 words > > 11s : 1520 |. Understands relationships > rors | us20 > 2025 5. Understands time > > 2025 : 3540 (6. Comprahends short sentences osio > > rors | 1520 7.One sep commands > > rows > 1520 1. Understands diectone ros > 1520 > 202s 9. Two sep commands > 1520 > rors | 3540 Comprehends 2 sentence forme > 22s | 2520 | a0as | as4o Nemes tinge > osio > tors | 1520 12, Requests ection > 101s > 1s20 | 2025 13, Asks quetions rors | 1820 > 202s | 2520 Deseibes objets 1520 > zoas | 2sa0 | aos 15, Detrbas own felings 1520 > 202s | aoas | asao 16. Uses gees > osio > ros | 1520 User sngle word > esto > tors | 1520 ses two words together > rors | 1520 : 2025 1S word satances 120 > 2025 > 2590 20. Tele simple tory > | 2025 | soas | sao | assoCHAPTER 3: STANDARDIZATION OF THE PEDI Tobe 3-10 (continued) ‘Age Range (yrs) at Which 10/25/50/75/90 Percent of Children Master Secial Function Functional Skills Items Social Interaction 210% | >25% | >50% | 275% | 90% 21. haw pean » | esse | + | ros | 1520 22. ager ned help ee | ee | aes | aes) | oes 23. hat srt ley > | seo | 202s | sae | asco 124. Describes problem/feelings 2025 > wa | > 4045 28 Werk ou non > | aso | asa | asso | asso 26 Aver ey 7 | ee | ea 2. aes poy oo | > | seis | isz0 | 202s 2. takectne oso | iors | iso | > | zoas 29. nee | ee | | 20. eggs nw iene zers | asao | a0as | aso | sous toto pos | > | esto 22. reat ay oe | ee 28. ors er ple tszo | 2tas | asso | seas | sous 2 couparae poy | re | | 235. domes wi des aso | a0as | sous | asso | ssa 36 maida ote ee | ee | 27. Simpl prod ley Sl > | tse 3 Anebiee spe | ee | | 23. add peyote > | 2028 | asso | asco | sous 10. ahve prt ploy asso | sons | asco | asso | sso 28CHAPTER 3: STANDARDIZATION OF THE FED! ee we t/a rt i ee setenv ser Home/Community 210% | 25% | >50% | 975% | 90% |. Sate fat nme > > 1520 > 2025 42. Ste fall ome > 202s | 2530 | s0as | 3340 143, Nemes, deseibesfomily > 202s | 2ss0 | acas | asso (48, Store fll ome edrose aoas | asao | sous | soss | soss 45. Giver directions home > aso | sso | sso | 4570 146. Generel eweronee tie oso | 101s | 1520 : 202s 1. Aororeness oh aquenee 2oas | 2830 » asao | aoas 148, Simp iene concepts > 2530 . asa | 404s 49, Aasoetesinelevents zsa0 | suo | sous | asso | sous. 50. Keeps wack of shade aoas | asso | ssso | 4570 | 70 ‘51. Begin care own belongings > ros > > 1520 152. teginshovscold chores rors | 1520 | 2025 | sao | aoas 53. nates care own belongings vs20 | 2025 | saa | saa | aoas ‘54 nites household chores > asa0 | 3035 | sous | asso ‘58. consstenty inate Howsahaldchares | 2530 | 3035 | asso | oss 70» |56. Caution with ties ros > 1520 | 2025 | 2530 57. Couton hot objets 101s > us2o | 202s | sao S50. Crosses sont with od asso | 3035 > sous | 608s 9. Coution with srongert aoas | 3540 > sous | 5540 (60. Crosses busy ret soss | 6570 > > 70 (61. Ply aot home osio | 101s > vs20 | 2025 42. Gees eeu fetaremivonmet > 1520 | 2025 | soas | ssa0 (69. Fellows school guidelines > 2sa0 | seas > 404s 64. teplores fami soning w/eadst | 3035 | 4350 | S340 > sous (65. Troan in ore soss 6870 > 708CHAPTER 3: STANDARDIZATION OF THE PED! Toble 3-11 ‘Age Range at Which 10/25 /50/75/90 Percent of Children Achieve Independence on, Caregiver Assistance Items Selfare P10% | 928% |) r8O% | 975% | >90% A teting 1s20 | 2520 | sous | soss | 4570 1. Grooming aoas | soss | 4570 > 700 Bathing soas | scas | 5560 > 70% .Dreaing Upper Body 2530 | aoa | sous | soss | sseo Dressing Lower Body zsao | aoas | asso | suo | 4570 Telleting zsao | asao | sous > 5560 6. Bledder Management 2590 > aoas | aus | 4570 H. towel Menogement zszo | soas | asuo | sous | sos Mobility ‘A chalet ranetors vois | 1520 | 2025 > aoas 1 car Toners | acas | asao | sous | sso | 570 ted Tronfere . 1s20 | 2028 | 2sa0 | a0as Tb Tronfore | 2025 | 2830 | soas | soss | ssao Indoor Locomotion : tors > 1520 | 2530 rors | 1520 | 2025 | 2530 | 4580 » 1520 > zors | s0a5 | | > 2025 | 2ss0 | 404s | co4s 202s | 2530 | 202s | asso | sos zss0 | aoas | 4550 > 706 Note: Grectorthan signs (+ reflect thao greater parcenage of children mastered given tem thon represented by tht ealmn. Soe p.28 fr futher deol . :Summary Scores for Normative Description of lineal Samples ‘Summary Scores {for Clinical CHAPTER 3: STANDARDIZATION OF THE PEO! 1 year mastered item 1 (strained foods), greater-than sigs are placed in all columns wth smaller percentages. The developmental ranges at which 25%, 50%, and 75% ofthe sample achieved each Functional Skill and Caregiver Assistance stem are splayed schematically in Appendix I. These developmental ables establish the framework for the normative standard scores described inthe previous chapter. To date, these data represent one ofthe largest empirically derived tables of functional stall development yet tobe reported in the erature Ranges of standard scores (mean50; standard devition=10) and means and standard deviations of sealed scores for each 6-month age group are listed in Tables 3-12 and 3-13, Note the inreasng scaled score mean as the groups increase in chronological age, These results suggest thatthe PEDI is appropriately detecting ‘consistent gains in functional abilities with increasing age Clinical Validation Samples “Three groups of children with disabilities composed the clinical samples for validation purposes. ‘Sample A comprises 46 children under the age of 6 yeas who entered a tertiary pediate trauma center and were hospitalized at least overnight due to an uninten- tional injury. A majority of the children had velaiely minor injuries; however, some had serious residual functional deficits ‘Sample B comprises 32 children between the ages of 1 and 9.8 years with severe disabilities entolled ina hospital-based school program ‘imple C comprises 24 children between the ages of 3.5 t0 10.4 years who are ‘enrolled ina hospital-based day school program, These children were selected on the bass of not functioning above the 7-year level n general cogative functioning The three major diagnoste categories within ths group of children ae cerebral pally, developmental delay, and waumati bain injury “Tables 3-14 and 315 kent the means and standard deviations forthe Norma tive Standard and Scaled scores Inthe tree clinical group forthe Functional Skill and Caregiver Assistance Scales, respectively. Both the normative standard scores land scaled score in these clinical groups ae well below age expectations as defined bythe normative sample. As will be formally discussed in Chapter 5, these data sippor the notion thatthe PEDI Scores are abet discriminate between non- ‘isbled children and children with disblits.Tobe 3-12 Functional Skills: Ranges of Standard Scores, Means and Standard Deviations of Scaled Scores Obtained from Nermative Sample Selfcare ‘Mobility Socal Function Standard Scaled Standard Scoled | Standord Sealed ‘Age Grovp| | Score Score Score Score Score Score 2) a | Range Mean so | Range Mean SD | Range Mean SD osos |36| m0459 26 53 | 150 se 03 |rsee we 02 tora || 213689 6 71 | mera Soa 92 |iseeas 323 71 1si9 | 30 | siver7 wo 53 | marae a7 72 |s33705 wo 36 2024 || 012707 54 71 | as77s me 49 |wi7ss m5 35 2529 |x| wars 4 42 | vase mse 61 |33073 571 50 3034 | 25) sereas a79 93 | s0s2 47 a4 | 325768 ood 81 sae |sa| 234757 a9 59 | sa4sas ass 73 | 373701 os 62 4oae | 25| 346757 747 56 | see vod 49 | 21009 77 45 4549 |26| 323739 783 41 | 9007 m4 42 | 3474 726 63 sosa | 35| s07721 907 87 | weer m9 70 |a17e8 m7 79 sso |m| a75e62 sas 95 | lrsis 983 40 |3aa715 798 94 ose | 25| 267424 925 71 | 143549 963 36 |34se78 57 80 549 |z| sase2a ons 93 | zs4sn9 2 21 | 252004 987 108 706 te | 307553 968 61 | 299547 v9 24 |a1e5%4 964 105 Table 212 Seregiver Assistance: Ranges of Standard Scores, Means and Stondard Devicion of Sealed ores Obtained from Normative Sample Selfcare Mobility Social Function Standerd Scoled Stonderd Scaled | Standard Scaled ‘Age Group| | Score Score Score Score, Score Score, 2) | Range Mean SD | Range Mean SD | Renge Mean SD osos || araere a9 03 | s34e79 207 129 | a19756 74 94 roa | 39 | 207604 248 122 | 162453 47 132 | 327477 2462 151 isis | 30| 20eeea a2 08 | 263499 577 88 | isis a5 131 2024 || mera v1 95 | a13460 oS 87 |mouno m8 138 2529 || 20727 536 11 | w2737 743 108 | 350759 617 48 aoae | 25| a10701 2 90 | rages 5 106 |261770 460 126 asa9 |u| 3i97a2 067 47 | 312706 24 85 |s21739 75 123, 4oae | 25) 327402 725 59 | 13608 a4 107 |2097a7 757 102 4549 | 26) 311784 753° a7 | 4538 907 103 |a09668 798 107 ose | 35| wasas 77 117 | masz 914 92 |ursea we 116 5559 | 28 | 22645 o84 101 | 1o*s30 979 64 | 28068 843 113, soca | 25| arseas o4a 107 | 136508 974 68 | 267657 052 94 569 | 2| 329632 a80 90 | 112527 987 43 | e823 066 109 706 16| wasie ase ui7 | ass79 saa 03 |a70741 761 100CHAPTER 3: STANDARDIZATION OF THE PED! Table 3-14 Functional Skills: Ranges of Standard Scores, Means and Standard Deviations of Scaled Scores Obtained from Clinical Samples Description of Somple Selfcare 8 Mean Age SD Renge Slonderd Sore Sealed Score Semple (ye) Ronge Moon ” 4% 28 © 09 28-45 | 29-690 © 30 2 41 2710-98 || 51.1618 on 74 21 35-104 | 0-624 540 ‘Mobility ‘Secial Function Stondord Sere Send Score SD | Standard Score Scaled Score Somple Ronge ‘Neon Ronge ‘Moon ” 2-820 450 m3 | 24-823 422 c o-09 679 2 | 0-515 6d on 2-88 618 22 | 0-09 529 “Sona & Orbe! not ot ep daca lwp de rama ~ Sng Cher wth ry se Slit ead hha a prog Segal th pele eis mele nl cy el gen Toble 2:15 ” 40 26 160 132 nz Ne Caregiver Assistonce: Ranges of Standard Scores, Means ond Standard Deviations of Scaled ‘Scores Obtcined by Clinical Semple Description of Sample 1 Selfcare Mean Age SD Ronge Slondard Sere Scaled Score ‘Semple yr) | Range Meon ” 4 28 © 09 28-45 0-505 403 a 2 At 27 10-98 84-792 549 on 74 21 35-104 | 0-646 524 ity Social Function Stondord Sore Secled Score SD | Standard Seore Scaled Score Semple ange Men Ronge Meon “ 0-82 450 ai | 231-567 433 8 0-699 890 8 | 797-638 589 | oo }o-79 657 2 | 0-09 02 *Songe A Chane 1 no post ap daca lapel hy + Sop. Cher wth ey sve dub edn plod ho prego Spl C Cie th ye and cgi dailies ena inh bed yw rege “CHAPTER 2: STANOAROIZATION OF THE PEDI References 1. Hollingshead AB. Four Factor Inde of acl Stu, New Haven, Conn: Department of Sociology, Yale University 1975.Chapter 4 Structure of PEDI Scales Correlations of PEDI Scales ‘Correlations among scales ofthe PEDE forthe overall normative group and 3 major age groups within the standardization sample ae summarized in Tables 4-1 to-4, Age clusters thought to provide the most distinct developmental groupings ‘were 1) infants and toddlers (younger than 2 years of age), 2) preschoolers {through 5 years of age), and 3) school-aged children Colder than 5 years of age). ‘These correlations were computed to help understand the relationship between pis of PEDI measurement scales and to understand how these relationships might {fer with age. As noted in Tables 4-2 through 4-4, the strength ofthe corelations mong Functional Skills and Caregiver Assistance Scales was found tobe strongly ‘cpendenton age, with generally higher corespondence noted at younger ages than inthe older age group. Although there isa high degree of correspondence inthe ‘overall sample across most ofthe scales, correlations fall inthe moderate low range in the two older age groups (preschoolers and school-aged children). This can bbe partially explained bya ceiling elec, particularly in the mobility scales. How. ‘ever, the overall pattern suggests that as children increase in age, tel particular areas of capability become mote clearly separate and distinguishable “Table 45 lists the correlations among PEDI sales forthe 102 children who ‘constitute the clinical sample. The pattern and magnitude ofthese correlations are consistent with the normative sample results, although the magnitude is generally Smaller than forthe normative sample. The moderate to low corelations noted in {he ewo older age groups andthe moderate correlations across domains (4 Mobility vs Social Function) in the total normative sample andthe combined clinical sample support the notion thatthe PEDI Scales are measuring sila, but fitinet, ares of fnetional behaviorCHAPTER 4: STRUCTURE OF PEDI SCALES Table 4-1 Correlations Among Domains: Total Normative Sample (n = 412) Functional Sill _ Functional Skits | Slfcore | Mobility | Sexi Fimcon Selcore 10 Moby ost 10 Seca Fecion 09 ov 10 Caregiver Assistance Caregiver Asistonce | Seleore | Mobiity | Sail Fancion Sihcore 10 obiy 08s 10 Seca Fncon 090 os 10 Caregiver Assstonce : Functional skis | Sofeare | Mabity | Soc Fncon Saheore 098 ost oss iy oa 09% os S00 unton ove ost ova Toble 42 Correlations Among Domains: Infont Group (less than 2 yeors)(n = 114) Functional Sill Functional skits | Safeare | Mebiliy |] Sacl Fncon salheore 10 Neb oa 10 Sexi Futon os ost 10 Caregiver Assstonce Coregiver Assistance | Sefcore | Mobily | Soc Fncon Sekcore 10 Masi o7 10 Seca Fncon o78 079 10 Coregiver Assistance Functional Skits | Salicore | Mobliy | Socal ancion Shore o7 082 on sity 075 ot 078 Sil Futon o7 085 ost 4Toble 4-3 CHAPTER 4: STRUCTURE OF PEDI SCALES Correlations Among Domains: Preschool Group (2-5 years old) (n = 181) Function Skills saeore Mobily Socal Fureton| Caregiver Assistance Sere Mobily Sei Fonction Functional Skills sacore Mobily Socal Function Tablet Correlations Among Dom: Functional skills Seltcoe Metliy Soc Function Caregiver Assistance secore Mobily Soca Function Fonetional Skills Salbcore Mosiliy Sec Function Functional Skils ‘Salhcore [Mobility | SocilFuneion lo 046 19 074 los2 10 Coregiver Assistance Salfcare [Mobily | Sociol Function 10 069 10 063 056 10 Caregiver Assistonce Selfcare [Mobility | SocilFuncon| 089 043 os7 oar 0.6 os7 049 054 076 5: School-age Group (greater than 5 yeors old) (n = 117), Foneional Skills Selheare | Mobily ‘Sociol Function | 10 039 10 044 os 10 Caregiver Assistance | Salfcore [Mobily ‘Social Function 10 | 045 10 oss 043 jro Caregiver Assistance ‘Saheore ——-[Mebiy | Soda Fanefon 042 ong 016 031 on 012 052 0.26 0.36CHAPTER 4: STRUCTURE OF PEDI SCALES tinical Samples (n = 102) Functional Skills Functional Skills ‘Selfcore | Mabiliy | Social Funcion Selheore 19. Mobility ost 10 ‘Seca Fundon| 04 on 10 Caregiver Assistance Caregiver Assistance | Selfcore | Mobily ‘Social Function Selheae 10 Mobily 80 10 ‘Seca Funeon| 0.80 061 10 Coregiver Assistance : Functional Skills ‘Selfcore | Mobility Social Funeion Salkcore 095 08a 080 eb o7 094 089 Sil Function ost o74 086 Structure of the Hierarchical Seales The Rasch psychometric model provides an estimate of item difficulty based on the responses given tothe items by the normative sample. These item dificuly calibrations are represented in logit units. An iter logit is defined as the natural log, ofthe ols of child with a logit ability of 0 being able on that item. Pose logit values represent increasing difculty (or decreasing likelihood that children wall be ‘apabl ofan item). Negative logit values represent decreasing difculty (or increas ‘ng likelihood that children willbe capable fan tm). “The ordering ofthese items provides the bass fr interpreting a score for an Sndividval child slong the continuum of hierarchically arranged items A review of the item ordering and the relative distance between adjacent items will enable the test user to become familar withthe hierarchical model on which summary scores are based. We have convereed these logit values wo a sealed score metric with a ange from 0 10 100 tn the ealeulation ofthese scaled scores it was necessary to provide some means of accounting for children who were not capable on any tem (a 20 Score) and for those who were capable om all tems (a perfect score). Zero and perfect scores cannot he estimated because ofthe mathematical impossibility of Giving by 2er0 —a circumstance that arses inthe equations employed bythe IRT ‘models. Thus, hypothesized logit value was defined for pefet scores asthe logit ‘estimate generated for having been capable on allitems except one pls the standard ‘error of estimate corresponding to that logit. Likewise, the lg for a zero score was Gefined as the logit corresponding o being capable on only one tem mins is respective standard ertor. The logit values serve oaly as boundary estimates — they ‘donot enter into the computing algorithm for the other parameters estimated in theCHAPTER 4: STRUCTURE OF PEDI SCALES ‘model. The practical consequence of his strategy is that any child with a 20 ot Defect score wil be loated on the scale cntinstum either below or above, respec- "ively aller defining that scale. This explains why no tem can havea sale score of 20 0 100. ‘As with the logit, smaller scaled values represent items with low difficulty, large values indicate greater difficulty, The logit ad scaled values for the Functional, Skills Scales ae located in Tables 46 through 48, Tables 49 through 411 concaln the logis and sealed score values for the three Caregiver Assistance Scales. Since the CCareiver Assistance tems have sx categories, the values given in Tables 49 ‘rough 4-11 represent the average item dificult ves acros the sx eategoris ‘Although the item lists (Tables 46 through 4-11) appear long and complex at first lance, we strongly encourage the reade to examine them cateflly. The lists provide eritealy important information about the PEDI content in that they enable fccurate interpretation of summary seores, Specifically, they provide a clear mea sure ofthe degree of dificult of diferent skills and acuvtes relative to one a ther within each scale "tem information i also summarized in a seres of tem maps located in Appen- ix IL The em maps represent the tems using the transformed 0-100 score metre ‘used forthe sled scores. These graphic representations provide a convenient, method of interpreting a given Functional Skil score in ers of the sem ex pected wo be accomplished (scored as capable) or not yet accomplished (seored as Unable). The item maps fo the Caregiver Assistance Scales show the placement of the most likely rating Scale category for each tem along the ability Tevel continuum, CChapters 9 and 10 contain further detailed discusion of how the item maps can be ‘se for hterpetation of summary scores ‘One of the most important criteria forthe content validation of hypothesized bierarchical scales ithe degree to which the sequence of items and the relative distances between items cotresponds with general knowledge of the development of functional competencies in childven. Unfortunately, ew detailed hypotheses could bbe made about the predicted order for al the funcional items because of avery limited literature hase in this area, However, we have carefully inspected the item sequences presented in Tables 4-6 through 4-11, and we believe that they represent 8 very reasonable sequent pattern of functional tems thats consistent with ‘current knowledge regarding functional development Item Attrition and Revision from the Standardization Version Eight Functional Skills items were eemoved from this version ofthe PEDI that ‘were orginally included in the Standardisation Version. ltems were removed due to ‘poor it values as determined by Rasch analysis, or because they resulted in limited ‘arab within the normative sample, In some cases, stems with poor ht values ‘were retained and item criteria slightly revised when i became clear that subset of tespondents was misinterpreting the stem. In addition to revising some tem enteria, ‘we have also made the distinction between capability and performance, as measured Inthe Functional Skills Scales, more clear in the scoring instructions a well asin the tem scoring criteria in this version, No Items were deleted from the Caregiver Assistance of Modifications Scales, However, because of problems Wenuied during teliablity studies, a decision was made to omit the “chld-oiented, nonspecalzed” ‘category of Modifications for tems A through D onthe Social Function Modifica- tons Seale. These changes wall be fully described in Chapier 8. A summary of the stem attrition from the Standardisation Version is given in Table 4-12 °