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Updated: Aug 9, 2025

Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Reliability, Construct Validity and Completeness of the "Winterthur Observation Protocol" Applied to Early
Schirin Akhbari Ziegler1, Ximena Suárez2,3
1School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences ZHAW, Winterthur, Switzerland.
Aim:
To assess intra- and inter-rater reliability, construct validity and completeness of the "Winterthur Observation Protocol" (WOP).
Methods:
Intra-rater and inter-rater reliability were calculated with the interclass correlation coefficient (ICC) with 95% confidence intervals and Cohens's kappa coefficient based on 18 5-min sequences from six video-recorded early intervention sessions rated by two assessors. Construct validity was based on an increase of coaching over time (three video-recorded sessions) in six therapists during a course on coaching techniques. WOP's completeness - the capacity to cover at least 95% of the specific coaching strategies - was assessed based on 18 video-recorded sessions.
Results:
Intra-rater reliability was excellent: ICCs of continuous variables varied from .87 to 1.0; the kappa-value of categorical variables was 0.90. Inter-rater reliability was sufficient to excellent: ICCs of continuous variables were .47-1.0; the kappa-value of categorical variables was .89, indicating excellent intra-rater reliability. Increasing application of coaching behavior during the course provided evidence of construct validity. More than 95% of the specific coaching strategies could be scored with the WOP.
Conclusion:
The WOP is a promising instrument to quantify the contents of early intervention approaches in pediatric physical therapy using coaching. Results must be interpreted with caution due to limited generalizability.
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