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Using cognitive interviewing for test items to assess physical function in children with cerebral palsy
Helene M Dumas1, Kyle Watson, Maria A Fragala-Pinkham
1Research Center for Children with Special Health Care Needs, Franciscan Hospital for Children, Boston, Massachusetts 02135, USA.
Summary
Cognitive interviewing improved the clarity and relevance of test items for children with cerebral palsy (CP) in a computer adaptive test (CAT). This enhances the validity of physical function assessments for pediatric rehabilitation.
Area of Science:
- Pediatric Rehabilitation
- Health Outcomes Measurement
- Assistive Technology
Background:
- Computer adaptive tests (CATs) offer efficient assessment of physical function.
- Children with cerebral palsy (CP) require specialized and accurate functional assessments.
- Existing assessment tools may not fully capture the nuances of physical function in children with CP.
Purpose of the Study:
- To evaluate the content, format, and comprehension of items for a new CAT assessing physical function in children with CP.
- To identify areas for improvement in test item development for pediatric rehabilitation.
- To ensure the validity and appropriateness of assessment tools for this population.
Main Methods:
- Cognitive interviewing techniques were employed to train investigators.
- Item intent was defined, and questions were developed.
- Parents of 27 children with CP participated in interviews to assess item meaning, wording, and response options.
Main Results:
- Qualitative analysis revealed three key themes: item clarity, relevance/context/attribution, and wording/tone issues.
- Parents emphasized the need to clearly define task components, assistance levels, and environmental context.
- Specific feedback was gathered on the adequacy and appropriateness of response choices.
Conclusions:
- Cognitive interviewing proved valuable in assessing item validity and improving relevance and context.
- The findings provide insights for refining CATs in pediatric rehabilitation.
- Addressing identified issues can reduce assessment challenges and improve the impact of CATs for children with CP.
