Validity and reliability of physical functioning computer-adaptive tests for children with cerebral palsy

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Children with cerebral palsy (CP) require reliable measures of physical functioning.
• Existing assessment tools may have limitations in capturing the nuances of physical function in CP.
• Parent-report measures offer a valuable perspective on a child's daily functional abilities.

Purpose of the Study:

• To evaluate the concurrent validity of four new parent-report computer-adapted testing (CAT) programs for assessing physical functioning in children with CP.
• To determine the reliability (scale and test-retest) of these novel CP-CAT programs.
• To support the clinical utility of these digital tools in pediatric CP assessment.

Main Methods:

• A prospective study involving 91 children with CP for cross-sectional testing.
• Test-retest reliability assessed in 27 children with CP over approximately one month.
• Concurrent validity examined using Pearson correlations with established parent-report instruments.
• Scale reliability estimated using marginal reliability; test-retest reliability using intraclass correlations (ICC).

Main Results:

• Pearson correlations indicated moderate to high agreement between CP-CAT scores and comparative measures.
• The CP-CAT programs consistently demonstrated superior scale reliability compared to existing instruments.
• High average test-retest reliability was observed across the four CP-CATs (ICC3,1=0.91, range 0.88-0.94).

Conclusions:

• Parent-report CP-CAT scores align well with external measures, confirming their validity.
• The developed CAT programs exhibit strong scale reliability and score stability.
• These findings support the adoption of parent-report CATs for evaluating physical functioning in children with CP.