基于ICF儿童发展和适应性行为测量工具的内容和心理测量特性研究

doi:10.3969/j.issn.1006-9771.2024.03.002

Abstract

Abstract:

Objective To analyze the items and psychometric properties of assessment for development and adaptive behavior.

Methods The standardized assessments commonly used in evaluation of children development and adaptive behavior were selected such as Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), Vineland Adaptive Behavior Scales (VABS-II), Adaptive Behavior Assessment System (ABAS-III), Bayley Scales of Infant and Toddler Development (Bayley-III) and Diagnostic Adaptive Behavior Scale (DABS). Using the ICF's classification framework, linking rules and coding methods, this study conducted a content analysis of the measurement dimensions and items of the five assessments, and explored the psychometric properties.

Results PEDI-CAT items covered ICF categories such as washing oneself (d510), caring for body parts (d520), toileting (d530), eating (d550), drinking (d560), looking after one's health (d570), basic interpersonal interactions (d710), complex interpersonal interactions (d720), changing basic body position (d410), maintaining body position (d415), and fine hand use (d440), among others. VABS-II items covered speaking (d330), conversation (d350), washing oneself (d510), caring for body parts (d520), using transportation (d470), acquisition of goods and services (d620), basic interpersonal interactions (d710), complex interpersonal interactions (d720), changing body position (d410), and maintaining body position (d415). ABAS-III items covered speaking (d330), communicating with-receiving-nonverbal messages (d315), reading (d166), recreation and leisure (d920), community life (d910), handling stress and other psychological demands (d240), looking after one's health (d570), and acquiring, keeping and terminating a job (d845). Bayley-III items covered memory functions (b144), thought functions (b160), speaking (d330), fine hand use (d440), walking (d450), basic interpersonal interactions (d710), carrying out daily routine (d230), and recreation and leisure (d920). DABS items covered higher-level cognitive functions (b164), reading (d166), basic economic transactions (d860), basic interpersonal interactions (d710), solving problems (d175), handling stress and other psychological demands (d240), carrying out daily routine (d230), and using transportation (d470). All the five assessments were norm-referenced measures. PEDI-CAT had high discriminative validity and reliability, with computer-adaptive testing enabling more precise measurement of children's functional levels. VABS-II possessed good reliability and validity, with multiple versions for different age and ability levels. ABAS-III offered a wide range of adaptive behavior measures with medium to good reliability and validity. Bayley-III had excellent internal consistency and test-retest reliability, while DABS showed high validity and reliability indices. The five assessments had high applicability, including norms for different groups and versions for various cultural and language contexts.

Conclusion The items of assessments involves multiple ICF categories at the levels of body functions, and activities and participation, mainly focusing on the areas of intellectual functions, high-level cognitive functions, and ability of daily living. All five assessments are norm-referenced and multidimensional, structured assessment tools with strong reliability, validity and applicability.

Key words: development, adaptive behavior, assessment, psychometric property

CLC Number:

R493

WU Liang. Research on the content and psychometric properties of assessment tools of development and adaptive behaviors in children using ICF[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(3): 257-264.

Figures/Tables 2

Table 1

Content analysis of measurements of development and adaptive behaviors for children based on ICF"

测量工具	测量项目		ICF编码
PEDI-CAT	日常活动：自理、移动和社交功能		盥洗自身(d510)、护理身体各部(d520)、如厕(d530)、吃(d550)、喝(d560)、照顾个人的健康(d570)、准备膳食(d630)、做家务(d640)、照管居室物品(d650)、在不同地点到处移动(d460)、基本人际交往(d710)、复杂人际交往(d720 )
	责任感：评估儿童在家和社区中的表现		照顾个人的健康(d570)、帮助别人(d660)、基本人际交往(d710)、基本经济交易(d860)
	社交/认知：评估社交交往和认知任务		基本人际交往(d710)、复杂人际交往(d720)、解决问题(d175)、做出决策(d177)、进行日常事务(d230)、家庭人际关系(d760)
	活动能力：评估身体移动和运动		改变身体的基本姿势(d410)、保持一种身体姿势(d415)、精巧手的使用(d440)、步行(d450)、在不同地点到处移动(d460)
VABS-II	沟通	口头沟通	言语表达(d330)、交谈(d350)、交流-接收-口头讯息(d310)
		非口头沟通	交流-接收-非言语讯息(d315)
		书面沟通	书面讯息(d345)、使用交流设备与技术(d360)
	日常生活技能	个人自理	盥洗自身(d510)、护理身体各部(d520)、如厕(d530)、吃(d550)、喝(d560)、照顾个人的健康(d570)
		家务	准备膳食(d630)、做家务(d640)
		社区生活	利用交通工具(d470)、获得商品和服务(d620)、基本经济交易(d860)、社区生活(d910)
	社交化	人际关系	基本人际交往(d710)、复杂人际交往(d720)
		社交规则	正式人际关系(d740)
		社交技能	非正式社交关系(d750)
	运动技能	粗大运动	改变身体的基本姿势(d410)、保持一种身体姿势(d415)、移动自身(d420)
	运动技能	精细运动	精巧手的使用(d440)、手和手臂的使用(d445)
ABAS-III	概念领域	沟通理解和使用语言非言语沟通	交流-接收-口头讯息(d310)、言语表达(d330) 交流-接收-非言语讯息(d315)
		功能性学术基本的阅读、写作数学技能	阅读(d166)、写作(d170) 思考(d163)、计算(d172 )
		自主性	解决问题(d175)、做出决策(d177)
	社交领域	社交技能	基本人际交往(d710)、非正式社会关系(d750)
	社交领域	休闲	娱乐和休闲(d920)
	实践领域	自理	盥洗自身(d510)、护理身体各部(d520)、如厕(d530)、吃(d550)、喝(d560)、照顾个人的健康(d570)
		家庭或学校生活个人卫生食物准备家务	盥洗自身(d510) 准备膳食(d630) 做家务(d640)
		社区使用使用公共设施理解和遵守社会规则	社区生活(d910) 控制应激和其他心理需求(d240)
		健康和安全	照顾个人的健康(d570)
		工作技能	得到、保持或终止一份工作(d845)、有报酬的就业(d850)
Bayley-III	认知领域，评估感知、记忆、理解、探索和解决问题的能力		智力功能(b117)、高水平认知功能(b164)、记忆功能(b144)、思维功能(b160)、解决问题(d175)
	语言领域，评估听力理解和表达能力		交流-接收-口头讯息(d310)、言语表达(d330)
	运动领域，评估精细和粗大运动技能		改变身体的基本姿势(d410)、保持一种身体姿势(d415)、移动自身(d420)、精巧手的使用(d440)、步行(d450)、精巧手的使用(d440)、手和手臂的使用(d445)
	社交-情感领域，评估社交互动和情感表达与理解		基本人际交往(d710)、复杂人际交往(d720)、其他特指或未特指的一般人际的交往(d729)
	适应性行为领域，评估日常生活技能		进行日常事务(d230)、娱乐和休闲(d920)
DABS	概念技能，涉及语言、阅读、写作、数学、时间和金钱管理		高水平认知功能(b164)、阅读(d166)、写作(d170)、思考(d163)、基本经济交易(d860)
	社交技能，涉及人际关系、责任感、自我控制、遵守规则和法律		基本人际交往(d710)、复杂人际交往(d720)、解决问题(d175)、控制应激和其他心理需求(d240)
	实用技能，涉及自理、安全、健康、工作、使用交通工具、计划和组织		进行日常事务(d230)、照顾个人的健康(d570)、得到、保持或终止一份工作(d845)、利用交通工具(d470)

Table 1

Table 2

Psychometric properties of measurement of development and adaptive behavior for children"

测量工具	主要内容	适应人群	测量性质	心理测量特性	心理测量特征指标
PEDI-CAT	日常活动责任感社交/认知活动能力	从出生到20岁儿童青少年	常模参照	判别效度优秀	1.活动和日常活动域的判别效度：AUC = 0.97~0.98 2.日常活动领域对独立手功能和依赖手功能的区分效度：AUC = 0.93^[10]
PEDI-CAT	日常活动责任感社交/认知活动能力	从出生到20岁儿童青少年	常模参照	构建效度中等至良好，重测信度优秀	1.构建效度：0.76~0.85 (P < 0.001) 2.重测信度：ICC = 0.96~0.99^[11]
VABS-II	沟通日常生活技能社交化运动技能	从出生到90岁： 1.智力和发育障碍； 2. ASD； 3.多动症； 4.创伤后脑损伤； 5.听力障碍； 6.痴呆症/阿尔茨海默病	常模参照	测量工具内各项之间的相互关联程度一般至优秀	1.领域水平： CCC = 0.78 (0.70, 0.84)(交流) CCC = 0.86 (0.76, 0.92)(运动) 2.子域： CCC= 0.71(0.62, 0.78)(接受语言) CCC = 0.91(0.85,0.95)(精细运动)^[13]
VABS-II	沟通日常生活技能社交化运动技能		常模参照	特异性良好，敏感性较低，诊断效果良好	特异性87% 敏感性43% AUC：0.80 (95%CI 0.68~0.90)^[14]
ABAS-III	概念领域社交领域实践领域	从出生到89岁： 1.注意力缺陷多动症； 2.获得性脑损伤； 3.听觉或视力障碍； 4.ASD； 5.发育迟缓； 6.情绪/行为障碍； 7.学习障碍； 8.身体障碍等	常模参照	构建效度中等，重测信度中等至良好	构建效度：0.72~0.83 (P < 0.001) 重测信度：ICC = 0.75~0.88^[15]
ABAS-III	概念领域社交领域实践领域		常模参照	内部一致性系数优秀，重测信度中等至良好	内部一致性系数：0.85~0.99 重测信度：ICC = 0.7~0.8^[16]
Bayley-III	认知领域语言领域运动领域社交-情感领域适应性行为领域	1~42个月	常模参照	内部一致性信度优秀，重测稳定性优秀	Cronbach α = 0.93 重测信度：ICC = 0.96^[18]
Bayley-III	认知领域语言领域运动领域社交-情感领域适应性行为领域	1~42个月	常模参照	内部一致性优秀，重测信度良好至优秀	Cronbach α = 0.88~0.96 重测信度：ICC = 0.82~0.92^[19]
DABS	概念技能社交技能实用技能	4~21岁	常模参照	所有获得的效度和信度指标都较强	收敛效度：0.70~0.84 重测信度：0.78~0.95 评定者间信度0.61~0.87^[21]
DABS	概念技能社交技能实用技能	4~21岁	常模参照	敏感性良好，特异性非常优秀	敏感性86% 特异性99% AUC：0.92^[22]

Table 2

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Research on the content and psychometric properties of assessment tools of development and adaptive behaviors in children using ICF

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