Psychometric Properties of the Make My Day Tool to Assess Perceived Performance of Children’s Daily Activities

ions, such as the quality of their life (Varni, Limbers, & Burwinkle, 2007), and between multiple dimensions of self-concept (physical, appearance, peers, parents, verbal, and math) (Marsh, Ellis, & Craven, 2002) when given an ageappropriate instrument. A central focus in occupational therapy is the performance of routine daily activities. With this in mind, we designed and developed the Make My Day (MMD) (Ricon, Hen, & Keadan-Hardan, 2013) to enable children aged 4 to 7 years and their parents to inform therapists about the children’s strengths and difficulties in performing routine daily tasks and so aid in the collaborative identification and prioritization of relevant occupational therapy intervention goals. The MMD was recently assessed by Cordier et al. (2016), who undertook a systematic review to identify instruments that measure occupational performance in children through child-report methods and to appraise their psychometric properties. Their review identified six instruments that had been designed for use by occupational therapists to measure skills and behaviors relating to occupational performance in children aged 2 to 18 years (including identifying the child’s occupations, what occupations are important, and how the child’s characteristics combine with the occupational environment to create successful occupational performance) and for which psychometric data were available. Four of these six measures aimed to evaluate children’s perceptions of their competence in performing activities. However, only three of the four were designed for use with young children, namely the Perceived Efficacy and Goal-Setting System (PEGS) (Missiuna & Pollock, 2000), the Child Occupational Self-Assessment (COSA) (Keller, Kafkes, & Kielhofner, 2005; Keller & Kielhofner, 2005) and our MMD tool (Ricon, Hen, & KeadanHardan, 2013). The review (Cordier et al., 2016) evaluated the studies with respect to the relevant COnsensusbased Standards for the selection of health measurement INstruments (COSMIN) quality 1 Or and Ricon: Psychometric properties of Make My Day children’s self-assessment Published by ScholarWorks at WMU, 2017 domains (see Table 2 of Cordier et al., 2016, for a complete yet concise description of the COSMIN domains). For each tool, the review authors examined (a) its reliability through the measurement properties of internal consistency, reliability, and measurement error; and (b) its validity, via the measurement properties of content validity, construct validity (i.e., hypothesis testing and structural and cross-cultural validities), and criterion validity. Among the instruments of relevance to the current study, the PEGS, which was designed to enable children aged 5 to 9 years to report how they perceive their competence in everyday activities and to set their own goals for intervention, scored the best. The review found it to have excellent reliability, good hypotheses testing, and excellent cross-cultural validity, but no data were reported for the other measurement properties. The COSA, which measures how competently children aged 6 to 17 years feel engaging in and completing activities and the values associated with these activities, was rated as having fair structural validity and hypotheses testing, but again there were no reports for any of the other measurement properties. The MMD was found to possess fair internal consistency and hypothesis testing, but similar to the other tools, it was found not to have reported against any of the other measurement properties. Thus, no tool having strong psychometric qualities currently exists for young children. The current study aimed to begin to rectify this lack with respect to the MMD. The specific aims of this study were twofold. We sought to investigate the reliability of the MMD by exploring its internal consistency for children in different age sub-groups and its interrater reliability in a comparison between children aged 4 to 7 years and their parents. We also examined the validity of the MMD by determining its content validity with children aged 4 to 7 years and its concurrent validity, including its discriminant (or divergent) validity and its convergent validity. Investigating the other aspects of the COSMIN quality domains that Cordier et al. (2016) found lacking was beyond the scope of the present work, which was in advanced stages of preparation when the Cordier et al. (2016) review came to our attention; however, we intend to examine these domains in the future. Reliability is defined as the degree to which the measurement is free from measurement error (Mokkink et al., 2010). The COSMIN relates to three reliability measurement properties (internal consistency, reliability, and measurement error), with the reliability measurement property having three components, namely, test-retest, inter-rater, and intra-rater (Mokkink et al., 2010). Here we focused on the internal consistency measurement property, which we measured by means of correlation, and the inter-rater component of the reliability measurement property, which we examined by t-test. In our context, internal consistency describes the degree of correlation between the MMD items in each of the occupational dimensions of its activity domains. The term interrater reliability may imply that, in the case of disagreement, one rater is more or less reliable than another. This implication is somewhat problematic in our context because the MMD was designed to enable children’s concerns to be discussed in a 2 The Open Journal of Occupational Therapy, Vol. 5, Iss. 4 [2017], Art. 2 https://scholarworks.wmich. edu/ojot/vol5/iss4/2 DOI: 10.15453/2168-6408.1308 therapy context alongside those of their parents in the full expectation that they may differ considerably from each other on some points. Therefore, we also aimed to explore the differences (i.e., analyze the variance) that we expected to find between the child and parental ratings and, in particular, if and how these differences correlated with the child’s demographic characteristics (e.g., age and gender). Content validity is defined as the degree to which the content of an instrument adequately reflects the content to be measured (Cordier et al., 2016), and we investigated it by means of factor analysis. Discriminant (or divergent) validity is an aspect of construct validity that tests whether constructs that should have no relationship do, in fact, have no relationship. We examined the ability of the MMD to discriminate between children in three different age groups and between the parents of the children in each age group. Finally, we set out to determine the concurrent validity of the MMD by means of Pearson’s correlations. Concurrent validity is an aspect of criterion validity, which assesses the degree to which the scores on an instrument (the MMD) satisfactorily reflect a gold standard (Cordier et al., 2016). However, as detailed above, no currently-available tools can be considered to approach such a standard. We therefore compared the MMD to the PEGS and the Children Participation Questionnaire (CPQ/CPQ-School). We chose the PEGS because, although the COSA also shares aims similar to those of the MMD, the PEGS was designed for a younger age group, closer to that targeted by our instrument. No validity data are available for the PEGS, and therefore we also used the CPQ, for which such data are available (Rosenberg, Jarus, & Bart, 2010; Rosenberg & Bart, 2015). Since the CPQ does not include a child selfassessment version, the MMD to the CPQ correlation was necessarily limited to their respective parental versions.