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Activity competence among infants and toddlers with developmental disabilities: Rasch analysis of the Infant Toddler
Catherine R Hoyt1, Allison J L'Hotta2, Anna H Bauer2
1Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA. hoytcr@wustl.edu.
Insights
The Infant Toddler Activity Card Sort (ITACS) effectively measures child activity competence in early intervention. Rasch analysis confirms ITACS items assess a key developmental construct, guiding targeted support for children.
Area of Science:
- Developmental Psychology
- Early Intervention
- Occupational Therapy
Background:
- Early childhood development is rapid, with delays having lifelong impacts.
- Existing assessments lack focus on integrating skills into meaningful daily routines.
- The Infant Toddler Activity Card Sort (ITACS) is a new tool for assessing activity competence via caregiver reports.
Purpose of the Study:
- To validate the Infant Toddler Activity Card Sort (ITACS) using Rasch analysis.
- To determine if ITACS items comprehensively measure the construct of child activity competence.
Main Methods:
- Rasch analysis was performed on dichotomous caregiver-reported responses for 40 ITACS items.
- Data from 51 child/caregiver dyads were analyzed across three model iterations.
- Item and person reliability, infit, and outfit statistics were evaluated.
Main Results:
- ITACS items demonstrated adequate spread of ability and difficulty measures.
- Most items showed adequate infit, with some exceptions requiring attention (e.g., sleeping).
- Challenging activities identified included 'crying/communicating' and 'going to school'.
Conclusions:
- Rasch analysis supports ITACS measuring a unidimensional construct: activity competence.
- Findings validate ITACS as a caregiver-report measure for early intervention.
- Identified challenging activities can inform targeted intervention and caregiver-driven goal development.
Background:
Development is rapid in the first years of life. Developmental delays appearing during this critical period have the potential to persist throughout the child's life. Available standardized assessments for this age record a child's ability to successfully complete discrete skills but fail to capture whether the child incorporates those skills into daily routines that are meaningful to the child and family. The Infant Toddler Activity Card Sort (ITACS) is a newly developed photograph-based early intervention tool to measure the participation-related concept of activity competence using caregiver report. The purpose of the present study was to use Rasch analysis to determine if ITACS items comprehensively measure the construct of child activity competence.
Results:
A total of 60 child/caregiver dyads participated. The dichotomous caregiver-reported responses (present vs. absent) on the 40 individual ITACS items were used in Rasch analysis, and three iterations of the model were completed. The final model included 51 child/caregiver dyads and 67 ITACS assessments with a good spread of individual ability measure (6.47 logits). All items demonstrated adequate infit except for "sleeping" (range 0.68-1.54). Five items (sleeping, eating at restaurants, brushing teeth, crawling, and interact with pets) demonstrated high Mean Square (MNSQ) outfit statistics and one (take a bath) demonstrated low MNSQ outfit. ITACS items demonstrated a good spread of item difficulty measures (6.27 logits), and a clear ceiling was observed. Three activity items (smiling, breastfeeding, and playing with adults) were rarely endorsed as concerns. The activities most likely to be reported as challenging were "crying/communicating" and "going to school". Person and item reliability statistics were adequate (0.79 and 0.80, respectively). The separation between individuals and between items were adequate to good (1.96 and 1.99, respectively).
Conclusions:
Findings indicate that ITACS items are measuring a unidimensional construct--activity competence in early childhood. The Rasch analysis of caregiver responses suggest that some activities are more likely to be considered challenging and may be important targets for intervention. These results provide evidence to further validate the ITACS as a caregiver report measure and support its use in the early intervention setting to facilitate caregiver driven goal development.
