Goal Attainment Scale

Cytrnbaum (1979): r= .70 (3 wks. and 2 mos), r= .47 (2 mos. and 6 mos), r=.20 (3 wks. And 6 mos.) (Garwick,1974); r= .45 (for behavior change scale), r=.60 (for emotional change scale), r=.77 (for all scales) (McGagme and Menges, 1975)

Psychogeriatric patients with cognitive disorders

• Bouwens (2008): Rockwood et al. interrater reliability ICC=0.9, Stolee et al. interrater reliability ICC=0.9 and 0.9, Stolee et al. interrater reliability ICC=0.9 for change, 0.9 for discharge, r=0.9 for change, 0.9 for discharge

• Cytrnbaum (1979): Inter-rater: r= .65 (total, first vs second interviewer), r=.61 (MSWs, first vs. second interviewer), r=.57 (RNS first vs second interviewer), r=.80 (RN first int., sec. int MSW), r=.59 (MSW first int., sec. int. RN), (Audette,1974); avg.=93 (range= .55 to 1.0 for 0-DTC), avg. =.95 (range =.55 to 1.0 for DTC II) (Austin, 1976); r = .71 (client vs. interviewer), r=.73 (client vs. interviewer), r=.51, r=.51, r=.85, (Garwick,1974), r= .71 (mean correlation sd=.23, range=.15-.95), Goodyear and Bitter, 1974; r= .52, (Jacobs and Cytrynbaum, 1977); Inter-rater score first to second interview: r= .704, inter-rater for intake guide: .711, inter-rater for therapist guide: .625 (Sherman et al., 1974) 

Nursing home patients

• Gordon (1999): Excellent – ICC of 0.80

Cognitive rehabilitation patients

• Rockwood (1997): Interrater reliability = 0.95 

 Patients with communication disorders

• Schlosser (2004): Intrarater = 0.51-0.95 

Cytrnbaum (1979): Internal consistency indicators scales scores and overall GA score: .69; Internal consistency scale scores and total follow-up guide scores (by no. of scales): .98 (one scale), .78 (two scales), .68 (three scales), .66 (four scales), .64 (five scales), (Garwick,1974)

Psychogeriatric patients with cognitive disorders

• Bouwens (2008): Rockwood et al. Pearson correlations of change scores BI r=0.6, FIM r=0.5, MMSE r=0.0, KADL r=0.5, PSMS r=-0.5, IADL r=-0.4; Rockwood et al. Pearson correlations of change scores ADAS-Cog r=-0.5, GDS r=-0.5, CGI 4=-0.9, MMSE r=0.0, PSMS r=-0.3, IADL r=-0.4; Rockwood et al. MMSE, ADAS-Cog, PSMS, IADL, FAQ, CDS, CES-D, CIBIC-plus, patient/caregiver Spearman r=0.0 to 0.6, clinician Spearman r=0.0 to 0.8; Stolee et al. Pearson correlation of change scores BI r=0.9, GCOR r=0.8; Stolee et al Pearson correlation of change scores BI r=0.6, OARS IADL r=0.5, MMSE r=0.2, NHP r=0.0; follow up scores BI r=0.7, OARS IADL r=0.5, MMSE r=0.3, GCOR r=0.7, NHP r=-0.2; Yip et al. SMMSE Spearman r=0.1 BI, IADL, OARS IADL Spearman r between 0.4 and 0.5 

• Cytrnbaum (1979): Concurrent validity: .63 (Pearson) of GA change score and total satisfaction score (p<.05), .92 of GA change score and GA score (p<.001), .67 of GA score and total satisfaction score (p<.02) (Carlson, 1974); 

• GAS and Taylor Manifest Anxiety Scale at 2-month follow up= .52 (p<.05), though outcome measures excluding GAS highly inter-correlated over time (.73-.80) (Garwick, 1974b); 

• GAS and Baxter Consumer Satsifaction Index (seven item) = .21 (N=686) and .23 (N=199) (Garwick, 1974b); 

• GAS and Therapists Global Ratings (.58 -.85) (Garwick, 1974b); r=.24 for GA scores and “Relief” (p<.05) (three of 4 items highly intercorrelated r=.61, .59, .54 (p<.001)); r=.43 for GA scores and global ratings (p<.001); r=.63 for GA scores and type of discharge (p<.001); r=.45 for GA scores and LOS (p<.001) (Jacobs and Cytrynbaum, 1977); 

• r=.43 (Spearman-rho) between program level GAS scores and patient ratings of program (NS); r=.16 between program level change scores (GAS) at pt. ratings (NS) Recalculated excluding activities led by staff member w/less GAS training, rose to .74 (p<.01) and .36 (NS) (Lefkowits, 1974); 

• GAS and Mean change Index = .285; GAS and Mean change score =.306 (Mauger et al., 1974); Pearson r= .14 (Santa-Barbara et al., 1974); 

• r=.49 for client GA rating and client satisfaction (p<.01); r=.28 for LOS and client GA rating (p<.05); r=.31 for goal specific adjustment (sub-scales of self-assessment guide) and client GA rating (p<.05) (Willer and Miller, 1976) 

Nursing home patients

• Gordon (1999): Convergent: r = 0.15 with Barthel Index; r = 0.17 with HABAM. 

Patients with communication disorders

• Schlosser (2004): compared to Health Sickness Rating scale: r = 0.71; target complaints scale: r = 0.50; brief symptom inventory: r = 0.38; Rosenberg Self-Esteem Scale: r = 0.34

Psychogeriatric patients with cognitive disorders

• Bouwens (2008): Good - Rockwood et al. expert panel, Stolee et al. position statements, Stolee et al. expert panel, Yip et al. position statements 

Patients with communication disorders

• Schlosser (2004): recommends content validity be assessed on a case-by-case basis 

Psychogeriatric patients with cognitive disorders

• Bouwens (2008): Hartman et al. t test=2.9 d.f.=9 p=.02 ES= 2.3 ANOVA=0.4, Rockwood et al. ES=4.9 RE=4.5, Rockwood et al. ES=0.6 RE=0.5, Rockwood et al. SRM caregiver=0.4/0.2 SRM clinician=0.4/0.4, Stolee et al. ES=3.5 SRM=1.7 RE=3.1 ANOVA=0.8, Yip et al. SRM=1.6 RE=3.2 

Nursing home patients

• Gordon (1999): Good - effect size = 1.29; highest relative efficiency = 53.7 

Children with Cerebral Palsy: (Desloovere, et al. (2012); n = 438; mean age 8.167 (4) years)

Pediatric rehabilitation – CP, movement

Steenbeek (2007): 7, (maximum score = 50; MDC = 10)

Children with Cerebral Palsy: (Desloovere, et al. (2012); n = 438; mean age 8.167 (4) years)

Children with Cerebral Palsy: (Desloovere, et al. (2012); n = 438)

• <40 T-score indicates low response groups while >60 T-score indicates high response groups.

Cut-off scores were introduced to define clear treatment success or failure (excluding treatments with minor success or failure).

Children with Cerebral Palsy: (Desloovere, et al. (2012); n = 438; mean age 8.167 (4) years)

Infants with motor delay (defined by PDMS) 

• Palisano (1992): ICC = 1.00 

Infants, 4-24 months, with motor delay

• Palasino (1993): kappa (behavioral) = 1.0; kappa (GAS) = 0.75 kappa; ICC = 0.96 for PDMS 

Pediatric rehabilitation – CP, movement

• Steebeek (2007): Good – ICC of 0.89.

Children with cerebral palsy

• Steenbeek (2010): Good/excellent interrater reliability – therapist kappa = 0.82; kappa for individual rater = 0.64, (Steenbeek, 2010) 

Children with Cerebral Palsy: (Desloovere, et al. (2012); n = 30)

• Excellent intrarater reliability (ICC = .988; SEM = 0.964)
• Excellent interrater reliability (ICC = 0.945; SEM = 1.992)

Children with autism: (Ruble et al., 2012)

• Excellent interrater reliability (ICC=.99)

Pediatric rehabilitation – CP, movement

• Steenbeek (2007): Low – r = 0.44 

Infants with motor delay (defined by PDMS)

• Palisano (1992): Concurrent: compared to PDMS Gross Motor = 0.44; compared to PDMS Fine Motor = 0.18 

 Infants, 4-24 months, with motor delay

• Palisano (1993): Concurrent to PDMS, Pearson’s r = 0.25 for months 1-3; Pearson’s r = 0.33 for moths 4-6.

 Infants, 4-24 months, with motor delay

• Palasino (1993): 10 expert Pediatric PTs rated 10 randomly selected goals in each dimension of content validity, on a 5-point ordinal scale. They rated whether expected levels of goal attainment represented progress infants were capable of achieving; and, and whether these levels represented clinically important change. 

Pediatric rehabilitation – CP, movement disorders Gordon (1999): Nursing home patients; long-term geriatric care

• Steenbeek (2007): Acceptable – 77-88% of physical therapist ratings met criterion of GAS.

Children with Cerebral Palsy: (Desloovere, et al. (2012); n = 438)

• Adequate content validity between low response and high response groups (Area under the curve from ROC = .860)

Children with autism (Ruble et al., 2012):

• “Goal attainment scale measurement of student progress of the experimental groups was evaluated against student progress of the control groups toward three IEP objectives selected at the start of the school year.”
• “To create the GAS descriptions for both experimental and control groups, a protocol was developed to ensure that the descriptions were written using a systematic approach that would facilitate comparability between groups.” 

Pediatric rehabilitation – CP, movement disorders

• Steenbeek (2007): avoided by using Likert coding 

Children with cerebral palsy

• Steenbeek (2010): No floor, and improbable ceiling effects

Infants with motor delay (defined by PDMS)

• Palasino (1992): Excellent: GAS T-Score = 55.4; score of 50 indicates significant change 

Infants, 4-24 months, with motor delay

• Palasino (1993): Excellent: GAS T-Score (months 1-3) = 53.0; (months 4-6) = 60.3; score of 50 indicates significant change 

Patients with chronic pain

• Fischer (2002): Satisfactory

Patients with chronic pain

• Fischer (2002): -1 was scored as their current level of function to avoid floor effect 

Male and female lower extremity amputees between ages 72.3 years old +/- 10.7 years.

• Rushton (2002): ICCs of .87 and .91 have been reported for GAS among the geriatric population. ICCs of .92 and .94 have been reported for GAS within brain injury populations. 

Male and female lower extremity amputees between ages 72.3 years old +/- 10.7 years

• Rushton (2002): Correlation scores between the GAS and the Barthel Index has ranged between r = .59 and .86 when used in geriatric care settings. 

• Correlation between GAS and Barthel Index (postal version) in the population of lower extremity amputees was r =.44; and between GAS and LCI was r =.35. 

Male and female lower extremity amputees between ages 72.3 years old +/- 10.7 years

• Rushton (2002): If it was possible for patient status to deteriorate, subject’s current status was defined as -1, rather than defining baseline at -2, (to account for floor effect). 

Male and female lower extremity amputees between ages 72.3 years old +/- 10.7 years

• Rushton (2002): Effect size = 6.5

Children with cerebral palsy

• Steenbeek (2010): Good/excellent interrater reliability – therapist kappa = 0.82; kappa for individual rater = 0.64, (Steenbeek, 2010) 

Children with cerebral palsy

• Steenbeek (2010): No floor, and improbable ceiling effects

Geriatric patient population

Stolee (1999): 

• Excellent interrater reliability = 0.88-0.93

Rural, frail, older adults

• Rockwood (2003): GAS Self-care: Effect size = 2.93; standardized response mean = 1.07; relative efficiency >100; Norman’s responsiveness = 0.57; GAS Mobility: Effect size = 4.43; standardized response mean = 0.91; relative efficiency >100; Norman’s responsiveness = 0.32; GAS Incontinence: Effect size = 3.51; standardized response mean = 0.78; relative efficiency = 29.92; Norman’s responsiveness statistic = 0.34 

Mental Health (Shefler et al., 2001; 33 patients were recruited from the general population applying to a mental health clinic. 9 had no diagnosis, 7 had anxiety disorder, 6 had depressive disorders, 10 had adjustment disorders, and 1 had a life-phase problem).The 5 content goals created for this particular study were severity of symptoms, self-esteem, romantic relationship, same-sex friendships, and work performance.

• Excellent interrater reliability (ICC=.86)

Mental Health: (Shefler, Canetti, & Wiseman, 2001)

• Adequate internal consistency at termination (r = 0.61-0.78) 
  • This is based on 5 content areas reflected upon the goals created for this specific study.
• Poor to excellent internal consistency at 6 month follow-up (r = 0.32-0.84)
  • This is based on 5 content areas reflected upon the goals created for this specific study.

Mental Health: (Shefler, Canetti, & Wiseman, 2001; n=33)

• Excellent correlation with Health–Sickness Rating Scale(r = .70, p < .001)
• Adequate correlation with the Target Complaints Scale (r = .50, p < .01),
• Adequate correlation with the Brief Symptom Inventory (r = .38, p < .05)

First row scores measures at the end of treatment, second row scores measured at 6-month follow-up

Mental Health: (Shefler, Canetti, & Wiseman, 2001; n=33)

“To test the content validity of the GAS scales, patients’ self-reported complaints, as stated on the Target Complaints Scale pretherapy, were compared with the verbal formulation by the clinical judges of the GAS therapy goals. Results showed that the first complaint appeared in an explicit formulation on the GAS for 75.5% of the patients, the second complaint appeared for 56.25%, and the third for 43.75.” (Shefler et al. 2001, p. 967)