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1 Downloaded from http://ajot.aota.org on
Downloaded from http://ajot.aota.org on 09/02/2021 Terms of use: http://AOTA.org/terms Downloaded from http://ajot.aota.org on 09/02/2021 Terms of use: http://AOTA.org/terms Downloaded from http://ajot.aota.org on 09/02/2021 Terms of use: http://AOTA.org/terms Downloaded from http://ajot.aota.org on 09/02/2021 Terms of use: http://AOTA.org/terms mustbeincludedintheIEPprocesswhen-everpossible,andtheymustbeinvitedtoattendtheIEPmeetingifthepurposeofthemeetingistodiscusspostsecondarygoals.WhenchildrencannotattendtheirownIEPmeeting,theirpreferencesandinterestsmustbeconsideredbytheIEPteam(IDEA2004,300.321).Inadditiontogeneratingclient-centeredIEPgoals,wealsosuggestusingtheCOSAasanoutcomemeasure.Beforeanoutcomemeasurecanbeusedwiththeut-mostcondence,itneedstohaveestablishedsensitivityandreliability.Toourknowledge,nostudieshaveexaminedwhethertheCOSAcandetectchangesinchildren’sperceptionsafteranintervention(sensitivity)orwhetherchildren’sperceptionsoftheirabilitiesontheCOSAarestableoverashortperiodoftime(test–retestreliability).Thepurposeofthecurrentstudywastoexaminethetest–retestreliabilityoftheCOSAforschool-agechildren.AlthoughtheCOSAmanualrecommendsadminis-trationtochildrenbetweenages8and13yr,wechosetoincludechildrenages6to13yrinourdatacollection.Clinically,theCOSAcanbeusedwithchildrenyoungerthan8yrifthecliniciandeemstheyhavethecognitiveabilityforself-reectionandplanning.Otherstudiesofchildself-reportmeasureshavefoundyoungerchildrentobelessreliablethanolderchildren(Dowell&Ogles,2008;Mellor,2004);thus,asecondaimofthisstudywastoexaminewhetheranyage-relateddifferencesoc-curredintest–retestreliability.ProceduresThisresearchwasapprovedbytheStateUniversityofNewYorkDownstateMedicalCenterinstitutionalreviewboard.Partic-ipantswererecruitedfromthecommunityandaprivateschool.Writtencaregiverper-missionandchildassentwereobtainedforallstudyparticipants.Datacollectiontookplaceinclassroomsattheprivateschoolandinchildren’shomes.Datawerecollectedbythelastthreeauthorsofthisstudy(Crook,Mac-Saveny,andMcLaughlin)andthreeoccupa-tionaltherapygraduatestudents.AlldatacollectorswerefemaleandweretrainedintheadministrationoftheCOSAbytherstau-thorofthisstudy(Ohl).Aftercaregiverpermissionandchildassentwereobtained,theCOSAwasadministeredtoeachparticipanttwicebythesamedatacollector7–14daysapart.Ademographicquestionnairewascom-pletedbyeachcaregiverattheonsetofthestudy.ScoringandDataAnalysisThecompletedCOSAformswerescoredaccordingtotheguidelinesoutlinedbyKellerandKielhofner(2005).Competenceratingsweregivenscoresof1(Ihaveabigproblemdoingthis),2(Ihavealittleproblemdoingthis),3(IdothisOK),or4(Iamreallygoodatdoingthis).Valueratingsweregivenscoresof1(Notreallyimportanttome),2Importanttome),3(Reallyimportantto),or4(Mostimportantofalltome).AtotalscorewascalculatedforboththeCompetenceandValuescales.AdditionalCompetenceandVa

2 luescoreswerecalcu-latedbygroupingCOSAit
luescoreswerecalcu-latedbygroupingCOSAitemsaccordingtothefollowingcategories:ActivitiesofDailyLiving/InstrumentalActivitiesofDailyLiving(ADLs/IADLs;Items1–6and8),MotorandPraxisSkills(Items9and23–25),CognitiveSkills(Items7,10,11,16,and17),EmotionalRegulationSkills(Items20–22),andCommunicationandSocialSkills(Items12–15,18,and19).Toensureaccuracy,allformswerescoredtwice.ThedatawereanalyzedusingIBMSPSSStatistics(Version20;IBMCorpo-ration,Armonk,NY).Test–retestreliabilitywasestimatedusingintraclasscorrelationcoefcients(ICCs).BasedontheICCndingsofotherchildself-reportmeasures(Bult,Verschuren,Gorter,Jongmans,Piskur,&Ketelaar,2010;Dowell&Ogles,2008;Imms,2008;Mellor,2004),weconsideredICCvalues.70tobegood,valuesbetween.50and.70tobemoderate,andvalues.50tobepoor.Apointbiserialcorrelationco-efcientwasusedtoexaminetherelation-shipbetweentheparticipants’ageandadifferencescore,whichwasderivedbycal-culatingthedifferenceintheirinitialCOSAscores(pretest)andfollow-upCOSAscores(posttest). Table1.ParticipantCharacteristicsCharacteristicMale27(51.9)Female25(48.1)RaceorethnicityWhite38(73.1)BlackorAfricanAmerican—Asian7(13.5)HispanicorLatinAmerican1(1.9)Twoormore5(9.6)Notreported1(1.9)TypeofschoolPublic30(57.7)Privatenonparochial5(9.6)Privateparochial8(15.4)Other6(11.5)Notreported3(5.8)IndividualizededucationprogramYes9(17.3)No43(82.7)RelatedservicesreceivedOccupationaltherapy3(5.8)Physicaltherapy1(1.9)Speechtherapy4(7.7)Counseling1(1.9)Specialeducationteachersupport—Other—ADHD2(3.8)Cerebralpalsy1(1.9)Learningdisability1(1.9)Orthopedicimpairment1(1.9).ADHDattentiondecithyperactivitydisor-der;—notapplicable. Table2.CompetenceScores:DescriptiveDataandICCs(CategoryPretest,)Posttest,)ICCADLs/IADLs23.79(3.43)24.38(3.23).612MotorandPraxis13.88(2.14)14.00(1.86).621Cognitive17.10(2.04)16.88(2.82).559EmotionalRegulation9.60(1.76)9.71(2.06).442CommunicationandSocial20.83(2.59)20.67(3.27).699Total85.21(9.23)85.71(10.73).717.ADLs/IADLsactivitiesofdailyliving/instrumentalactivitiesofdailyliving;ICCintraclasscorrelationstandarddeviation.TheAmericanJournalofOccupationalTherapy Aconveniencesampleof52childrenranginginagefrom6to12yr(mean[8.56,standarddeviation[1.59)par-ticipatedinthisstudy.Themajorityofpar-ticipantswereidentiedbytheircaregiversasWhite(73.1%),attendedpublicschools(57.7%),anddidnotreceiveanyrelatedservices(82.7%)atthetimeofthestudy.Table1providesadditionaldemographiccharacteristics.DescriptivedataontheCompetenceandValuetotalandcategorypretestandposttestscoresandICCsareprovidedinTable2andTable3.ICCsfortheCom-petence(ICC.717)andValue.772)totalscoresweregood.TheCompetencecategoryscores(ADLs/IADLs,MotorandPraxisSkills,Cogni-tiveSkills,EmotionalRegulationSkills,andCommunicationandSocialSkills)rangedfrompoortomoderate(ICC.442–.699),andtheValuecategoryscoresrangedfrommoderatetogood(ICC.578–.779).EmotionalR

3 egulationSkillscoreswerethelowestforboth
egulationSkillscoreswerethelowestforbothCompetence(ICC2,1.442)andValue(ICC2,1.578)Additionalanalyseswereconductedtodeterminewhetherthechildren’sagewasrelatedtothedifferencebetweentheirpretestandposttestscores.WedidnotndasignicantrelationshipbetweenageanddifferencescoresacrossthetotalCompe-tence(.296)andValue.074,.604)scoresorthefollowingcategories:ADLs/IADLs,MotorandPraxisSkills,EmotionalRegulationSkills,andCommunicationandSocialSkills.Wedid,however,ndaweakstatisti-callysignicantrelationshipbetweenageandtheCognitiveSkillsCompetencedifferencescores(–.317,.022),indicatingthatolderchildrenhadasmallerchangeintheirscoresthandidyoungerchildren.DiscussionWeexaminedthetest–retestreliabilityoftheCOSAusingtotalCompetenceandValuescoresandcategoryCom-petenceandValuescores(ADLs/IADLs,MotorandPraxisSkills,CognitiveSkills,EmotionalRegulationSkills,andCommunicationandSocialSkills).Ourndingsindicatethatthechildren’sre-sponsestotheCOSAitemsremainedfairlyconsistentovera2-wkperiod,withtotalValueandCompetencescores(ICC.717–.772)havinggreaterconsistencythancategoryscores(ICC2,1.442–.779).ThelowestICCswerefoundundertheEmotionalRegulationSkillscategoryforbothCompetence(ICC2,1.442)andValue(ICC2,1.578)scores,whichisnotsurprisinggiventhatemotionsaregenerallymorevariablethanphysicalandcognitiveperformance.Wealsoexaminedtherelation-shipbetweenageandchangeinpre-andposttestscores,hypothesizingthatmorevariabilitywouldoccurinscoresamongyoungerchildren.Onthewhole,ourndingsdidnotsupportourhypothesis.Youngchildren’sperceptionsoftheirabilitiesandthevaluetheyplacedonev-erydaytaskswerejustasreliableasolderchildren’sperceptionsandvalues,withoneexception:WefoundaweakstatisticallysignicantcorrelationbetweenageandCognitiveSkillsCompetencedifferencescores,indicatingthatyoungerchildren’sperceivedcompetenceoncognitivetasksuctuatedmorethanolderchildren’s.Giventherelativeweaknessofthecorrela-tion,furtherstudyisneeded.LimitationsandFutureResearchThisstudywaslimitedbyasmallsampleofgeographicconvenience.MoreresearchisneededtodeterminewhethertheCOSAissensitiveenoughtodetectchangeinchildren’sperformancepostintervention.Additionalresearchisalsoneededtoex-aminewhetherchildren’sperceptionsoftheircompetenceadequatelymatchestheirabilitiesonotherstandardizedassessments.ImplicationsforOccupationalTherapyPracticeTheresultsofthisstudyindicatethatwhenusingtheCOSAasanoutcomemeasure,occupationaltherapypractitionerscanbereasonablycertainthatthechangestheydetectinachild’sperceivedCompetenceandValuearenotduetothechild’suc-tuatingperceptionofhisorherownabili-ties.However,furtherstudyisneeded.AcknowledgmentsWethankJoyceSabariforhersupportandguidanceandHanaAbdelrasoulEnnab,TamarBlumenkranz,NataliaZlotnikov,andAnnabelleWufortheirassistancewithdatacollection.Weextendspecialthankstothechildrenandfamilieswhopartici-patedinthestudy.ReferencesB

4 ult,M.K.,Verschuren,O.,Gorter,J.W.,Jongm
ult,M.K.,Verschuren,O.,Gorter,J.W.,Jongmans,M.J.,Piskur,B.,&Ketelaar,M.(2010).Cross-culturalvalidationandpsycho-metricevaluationoftheDutchlanguageversionoftheChildren’sAssessmentofPar-ticipationandEnjoyment(CAPE)inchildrenwithandwithoutphysicaldisabilities.Rehabilitation,24,843–853.http://dx.doi.org/10.1177/0269215510367545Dowell,K.A.,&Ogles,B.M.(2008).TheOhioScalesYouthForm:Expansionandvalidationofaself-reportoutcomemea-sureforyoungchildren.JournalofChildandFamilyStudies,17,291–305.http://Harney,S.,&Kramer,J.M.(2007,November).UsingtheChildOccupationalSelf-Assessmenttogeneratestudent-centeredIEPgoals.Practice,12,Imms,C.(2008).ReviewoftheChildren’sAs-sessmentofParticipationandEnjoyment Table3.ValueScores:DescriptiveDataandICCs(CategoryPretest,)Posttest,)ICCADLs/IADLs20.44(4.96)21.73(4.76).666MotorandPraxis12.13(3.02)12.40(2.99).646Cognitive15.29(3.37)15.37(3.33).779EmotionalRegulation9.15(2.38)9.04(2.54).578CommunicationandSocial18.83(3.89)18.90(4.29).695Total75.75(15.50)77.44(15.98).772.ADLs/IADLsactivitiesofdailyliving/instrumentalactivitiesofdailyliving;ICCintraclasscorrelationcoefcient;standarddeviation.March/April2015,Volume69,Number2 Test–RetestReliabilityoftheChildOccupationalSelf-Assessment(COSA)AlishaM.Ohl,EmilyCrook,DianeMacSaveny,AlannaMcLaughlinMeSHTERMSactivitiesofdailylivingpatientoutcomeassessmentreproducibilityofresultsselfconceptselfreportWeexaminedthetest–retestreliabilityoftheChildOccupationalSelf-Assessment(COSA).Fifty-twochildren andthePreferencesforActivityofChil- dren. PhysicalandOccupationalTherapy inPediatrics,28, 389–404.http://dx.doi. org/10.1080/01942630802307135 IndividualsWithDisabilitiesEducationIm- provementActof2004,Pub.L.108– 446,20U.S.C. xx 1400–1482. Keller,J.,Kafkes,A.,Basu,S.,Federico,J.,& Kielhofner,G.(2006). Theuser’smanual forChildOccupationalSelf-Assessment (COSA) .Chicago:ModelofHumanOc- cupationClearingHouse. Keller,J.,&Kielhofner,G.(2005).Psychomet- riccharacteristicsoftheChildOccupa- tionalSelf-Assessment(COSA),parttwo: Reningthepsychometricproperties. ScandinavianJournalofOccupational Therapy,12, 147–158.http://dx.doi.org/ 10.1080/11038120510031761 Kramer,J.M.,Kielhofner,G.,&Smith,E.V., Jr.(2010).ValidityevidencefortheChild OccupationalSelf-Assessment. AmericanJournal ofOccupationalTherapy,64, 621–632.http:// dx.doi.org/10.5014/ajot.2010.08142 Kramer,J.M.,Smith,E.V.,Jr.,&Kielhofner,G. (2009).Ratingscaleusebychildrenwith disabilitiesonaself-reportofeverydayactiv- ities. ArchivesofPhysicalMedicineandRe- habilitation,90, 2047–2053.http://dx.doi. org/10.1016/j.apmr.2009.07.019 Mellor,D.(2004).Furtheringtheuseofthe StrengthsAndDifcultiesQuestionnaire: Reliabilitywithyoungerchildrespon- dents. PsychologicalAssessment,16, 396– 401.http://dx.doi.org/10.1037/1040-3590. 16.4.396 TheAmericanJournalofOccupationalTherapy 6902 350010p4