ICF-Based simple scale for children with cerebral palsy: Application of Mokken scale analysis and Rasch modeling

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Health Informatics

Background:

• Children with cerebral palsy (CP) experience long-term functional impairments.
• The International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) offers a framework but is complex for clinical use.
• Existing assessment methods for CP may not fully capture functional health degrees.

Purpose of the Study:

• To establish a Mokken scale based on the ICF-CY for assessing children with CP.
• To evaluate the psychometric properties of the developed scale using a Rasch model.
• To simplify the assessment of functional abilities in children with CP.

Main Methods:

• A Mokken scale was developed using ICF-CY 'b' (body functions) and 'd' (activities and participation) components.
• 150 children with CP were assessed, and their data was binarized.
• Mokken scale analysis and Rasch modeling were employed to screen data and generate a reliable model.
• Model validity was assessed by correlating person ability with the Gross Motor Function Classification System (GMFCS) and total scores.

Main Results:

• A reliable Mokken scale was successfully established based on the ICF-CY for children with CP.
• The Rasch model demonstrated good psychometric properties, validating the scale.
• The developed scale allows for a simplified assessment of person abilities in children with CP.
• Correlation analysis confirmed the validity of the person ability estimates.

Conclusions:

• The Mokken scale, guided by Rasch modeling, effectively parameterizes ICF-CY properties for CP assessment.
• This approach provides a feasible and simplified method for evaluating functional abilities in children with CP.
• The study highlights the potential of integrating psychometric models with functional classification systems for improved clinical practice.