Measuring the Reliability and Construct Validity of the Pediatric Evaluation of Disability Inventory – Computer Adaptive Test (PEDI-CAT) in Children with Cerebral Palsy

Publication date: Available online 18 August 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Benjamin J. Shore, Benjamin G. Allar, Patricia E. Miller, Travis H. Matheney, Brian D. Snyder, Maria Fragala Pinkham

Abstract

Objective

The purpose of this study was to (1) investigate the construct validity and (2) test-retest reliability of the Pediatric Evaluation of Disability Inventory – Computer Adaptive Test (PEDI-CAT) in children with cerebral palsy (CP).

Design

A prospective convenience cross-sectional sample

Setting

Multidisciplinary CP clinic in a tertiary level pediatric children's hospital

Participants

One hundred and one, English and Spanish speaking school aged children with a diagnosis of CP, stratified by Gross Motor Function Classification System level, who presented to our multidisciplinary clinic. Participants were excluded if they underwent recent surgery (<6months) or Botulinum Neurotoxin A injection (<3months). A subset of seventeen families participated in retest reliability.

Main Outcome Measures

Convergent and divergent validity were evaluated using Spearman's correlation analysis; test-retest reliability was assessed using intraclass correlation coefficients (ICC).

Results

Mean age was 12 years (SD=3.7). Convergent validity was established between Mobility (PEDI-CAT) and Functional Mobility Scale (FMS) (5m, r=0.85; 50m, r=0.84; 500m, r=0.76; p<0.001). In ambulant children, convergent validity was established between Daily Activities (PEDI-CAT versus Pediatric Quality of Life CP (PedsQL-CP) (r=0.85, p<0.001) and between Social/Cognitive (PEDI-CAT) and Speech and Communication (PedsQL-CP) (r=0.42; p<0.001). In non-ambulant children, convergent validity was established between Daily Activities (PEDI-CAT) and Personal Care [Caregiver's Priority and Child Health Index of Life with Disabilities – (CPCHILD^TM)] (r=0.44, p<0.001) and between Social/Cognitive (PEDI-CAT) and Communication (CPCHILD^TM) (r=0.64; p<0.001). A lack of correlation between Daily Activities, Social/Cognitive, and Responsibility (PEDI-CAT) and FMS and between the Mobility (PEDI-CAT) and Communication (PedsQL) domains confirmed divergent validity. Test-retest reliability was excellent for all domains of the PEDI-CAT (ICC=0.96-0.99).

Conclusions

The PEDI-CAT is an outcome measure which demonstrates strong construct validity and reliability in children with CP.

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