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Development of a Computerized Adaptive Test of Children's Gross Motor Skills

  • Chien-Yu Huang
    Affiliations
    Department of Occupational Therapy, I-Shou University, Kaohsiung, Taiwan
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  • Li-Chen Tung
    Affiliations
    Department of Physical Medicine and Rehabilitation, Da Chien General Hospital, Miao Li, Taiwan

    Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan
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  • Yeh-Tai Chou
    Affiliations
    Research Center for Psychological and Educational Testing, National Taiwan Normal University, Taipei, Taiwan
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  • Hing-Man Wu
    Affiliations
    Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan
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  • Author Footnotes
    ∗ Chen and Hsieh contributed equally to this work.
    Kuan-Lin Chen
    Correspondence
    Corresponding author Kuan-Lin Chen, PhD, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan City 701, Taiwan, ROC.
    Footnotes
    ∗ Chen and Hsieh contributed equally to this work.
    Affiliations
    Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
  • Author Footnotes
    ∗ Chen and Hsieh contributed equally to this work.
    Ching-Lin Hsieh
    Footnotes
    ∗ Chen and Hsieh contributed equally to this work.
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan

    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
    Search for articles by this author
  • Author Footnotes
    ∗ Chen and Hsieh contributed equally to this work.
Published:August 30, 2017DOI:https://doi.org/10.1016/j.apmr.2017.07.017

      Abstract

      Objectives

      To (1) develop a computerized adaptive test for gross motor skills (GM-CAT) as a diagnostic test and an outcome measure, using the gross motor skills subscale of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT-GM) as the candidate item bank; and (2) examine the psychometric properties and the efficiency of the GM-CAT.

      Design

      Retrospective study.

      Setting

      A developmental center of a medical center.

      Participants

      Children with and without developmental delay (N=1738).

      Interventions

      Not applicable.

      Main Outcome Measures

      The CDIIT-GM contains 56 universal items on gross motor skills assessing children's antigravity control, locomotion, and body movement coordination.

      Results

      The item bank of the GM-CAT had 44 items that met the dichotomous Rasch model's assumptions. High Rasch person reliabilities were found for each estimated gross motor skill for the GM-CAT (Rasch person reliabilities =.940-.995, SE=.68-2.43). For children aged 6 to 71 months, the GM-CAT had good concurrent validity (r values =.97-.98), adequate to excellent diagnostic accuracy (area under receiver operating characteristics curve =.80-.98), and moderate to large responsiveness (effect size =.65-5.82). The averages of items administered for the GM-CAT were 7 to 11, depending on the age group.

      Conclusions

      The results of this study support the use of the GM-CAT as a diagnostic and outcome measure to estimate children's gross motor skills in both research and clinical settings.

      Keywords

      List of abbreviations:

      AUC (area under the receiver operating characteristic curve), CAT (computerized adaptive test), CDIIT (Comprehensive Developmental Inventory for Infants and Toddlers), CDIIT-GM (gross motor skills subscale of the CDIIT), DIF (differential item functioning), DQ (developmental quotient), GM-CAT (CAT for gross motor skills), MnSq (mean square)
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