The Clinical Functional Impairment Scale Development.

Area of Science:

• Pediatric Healthcare
• Clinical Assessment Tools
• Child Development

Background:

• The Clinical Functional Impairment Scale (CFIS) is a new tool for assessing childhood functional impairments.
• Content validity and response variability are crucial for the utility of any clinical assessment scale.

Purpose of the Study:

• To review the content validity of the newly developed Clinical Functional Impairment Scale (CFIS).
• To assess the span of responses and identify potential variability in clinician ratings using the CFIS.

Main Methods:

• A cross-sectional content validity study involving focus groups of developmental-behavioral pediatric clinicians.
• Qualitative analysis of focus group data informed adjustments to the CFIS.
• A survey of 94 clinicians assessed the CFIS using case studies, with response dispersion measured by the index of dispersion.

Main Results:

• The CFIS was refined to include 20 functional impairments with 5-point severity and 7-point interval change Likert scales.
• The index of dispersion ranged from 0.49 to 0.88, indicating moderate to high response spread.
• Ratings for severity and interval change showed lower dispersion than initial symptom severity scores.

Conclusions:

• The CFIS facilitates mutual prioritization of a child's functional impairments by families and clinicians.
• Clinician ratings demonstrated more variability in initial symptom severity compared to subsequent symptom severity and interval change.
• Future research will involve face-to-face encounters and incorporate parent/caregiver ratings to further validate the CFIS.