Pediatric Evaluation of Disability Inventory

Traumatic Brain Injury, Spinal Cord Injury, Lower Extremity Trauma, Non-traumatic Brain Injury, Developmental Disorders: (Iyer, 2003; n = 53; mean (standard deviation) age = 9.7 (4.5); Mean Length of Stay = 65.36 days)

• Mean for each of the 6 scales = 11 points

• Mean (Standard Deviation) for Likert Scale categories = 11.3 (2.5)

• Likert scale ranged from 8.7 to 14.9 (X = 10.9 for Functional Skills and X = 11.6 for Caregiver Assistance)

• Mean for visual analog scale categories = 11.5 (3.5)

• Visual analog scale scores ranged from 6.0 to 15.6 (X = 11.6 for Functional Skills and X = 11.2 for Caregiver Assistance)

Normative Sample: (Haley, Coster, Ludlow, Haltiwanger, & Andrellos, 1992; n = 412)

The normative sample was selected to be representative of the U.S. population. It should be noted that the sample is non-disabled. See first point under Considerations for more information on the use of a non-disabled population as a comparison group.

Demographics

Note: In accordance with the US census protocol at publication, Hispanics were counted twice, as also Black, Caucasian, or other. Therefore, percent for race totals 100 before adding Hispanic data.

Normative Standard Scores, Scaled Scores, and Standard Deviations by Self-Care Domain

Normative Standard Scores, Scaled Scores, and Standard Deviations by Mobility Domain

Normative Standard Scores, Scaled Scores, and Standard Deviations by Social Function Domain

Clinical Samples: (Haley et al., 1992)

Description of Sample Groups

Functional Skills: Means and Standard Deviations by Domains

Caregiver Assistance: Means, and Standard Deviations by Domains

Spina Bifida: (Tsai, Yang, Chan, Huang, & Wong, 2002; n = 63)

Notes: The mean standard score is 50 for a child’s chronological age; scores between 30 and 70 indicate that a child is within 95% of the normative sample's scores.

Normative Sample: (Haley et al., 1992)

• Excellent interrater reliability when tested by a nurse practitioner and a PEDI research member (n = 29):

  • caregiver assistance across all domains: self-care (ICC = 0.99), mobility (ICC = 0.96), and social function (ICC = 0.99)

  • modifications across all domains: self-care (ICC = 0.91), mobility (ICC = 1.00), and social function (ICC = 0.79)

Clinical Samples: (Haley et al., 1992)

• Excellent interrater reliability when tested by a rehabilitation team for:

  • caregiver assistance across all domains: self-care, mobility and social function (ICC = 1.00 for all)

  • modifications across all domains: self-care (ICC = 1.00), mobility (ICC = 0.93), and social function (ICC = 1.00)

• Excellent interrater reliability when tested by family member report for:

  • caregiver assistance across all domains: self-care (ICC = 0.88), mobility (ICC = 0.98), and social function (ICC = 0.97)

  • modifications across all domains: self-care (ICC = 1.00), mobility (ICC = 1.00), and social function (ICC = 0.84)

Cerebral Palsy, Developmental Delay, Other: (Nichols & Case-Smith, 1996; n = 23; mean age = 60.6 months; parent interviews were one week apart)

• Excellent intrarater reliability among all domains, Functional Performance and Caregiver Assistance

• ICC for normative scores ranged from .70 to .98

• Excellent intrarater reliability for scaled scores among Self-care domain, Mobility domain, and Social domain on Functional Performance

• Excellent intrarater reliability for scaled scores among Self-care and Mobility domain on Caregiver Assistance; adequate reliability on Self-care domain on Caregiver Assistance

Chronological Age: (Haley et al., 1992)

• Excellent correlation between Functional Skills in Self-care, Mobility, and Social Function in infants < 2.0 years (r = 0.87, 0.90*, 0.89 respectively)

• Excellent correlation between Caregiver Assistance in Self-care, Mobility, and Social Function in infants < 2.0 years (r = 0.76, 0.85, 0.74)

• Excellent correlation between Functional Skills in Self-care, Mobility, and Social Function in preschoolers 2.0 - 5.0 years (r = 0.77, 0.70, 0.78)

• Excellent correlation between Caregiver Assistance in Self-care, and Social Function in preschoolers 2.0 - 5.0 years (r = 0.77, 0.63)

• Adequate correlation between Caregiver Assistance in Mobility in preschoolers 2.0 - 5.0 years (r = 0.57)

• Adequate correlation between Functional Skills in Self-care, Mobility, and Social Function in school age children >5.0 years (r = 0.44, 0.41, 0.43)

• Adequate correlation between Caregiver Assistance in Self-care in school age children >5.0 years (r = 0.36)

• Poor correlation between Caregiver Assistance in Mobility and Social Function school age children >5.0 years (r = 0.21. 0.09)

• Overall Excellent correlation for Functional Skills and Caregiver Assistance in Self-care, Mobility, and Social Function for the total sample of children (r = 0.89, 0.77, 0.89, 0.91*, 0.78, 0.84)

Normative Sample: (Haley et al., 1992)

• Excellent: Cronbach's alpha range from 0.95-0.99*

*Scores higher than .9 may indicate redundancy in the scale questions.

Concurrent Validity Evidence:

Cerebral Palsy, Developmental Delay, Other: (Nichols et al., 1996)

• Excellent correlation between the Fine Motor Scale of the PDMS and each domain of the Functional Skill and Caregiver Assistance Scales of the PEDI

• Excellent correlation between the Gross Motor Scale, except for the reflexes subscale, of the Peabody Developmental Motor Scales (PDMS) and each domain of the Functional Skill and Caregiver Assistance Scales of the PEDI.

• Poor correlation (r = .24) of the reflexes subscale of the PDMS and each domain of Functional Performance of the PEDI

• Poor correlation (r=.25-.26) of the reflexes subscale of the PMDS and the Self-care and Social domain of the PEDI

• Adequate correlation of the Mobility domain of the PEDI and the reflexes subscale of the PDMS

• Excellent correlation between age equivalent scores for the PEDI and PDMS (r=.82-.95)

Myelodysplasia, Juvenile Rheumatoid Arthritis: (Haley et al., 1992; n = 20 (disabled), mean age = 5.1 years (1.43); n = 20 (non-disabled); mean age = 5.1 years (1.37); PEDI and Battelle Developmental Inventory Screening Test (BDIST))

• Excellent correlation between children with disabilities in PEDI Functional Skills and Caregiver Assistance with BDIST (r = 0.70, 0.73)

• Excellent correlation between children who are not disabled in PEDI Functional Skills and Caregiver Assistance with BDIST (r = 0.81, 0.62)

• Overall Excellent correlation between Functional Skills with BDIST (r = 0.73)

• Overall Excellent correlation between Caregiver Assistance with BDIST (r = 0.71)

Convergent Validity:

Identification of Disability and Degree of Delay: (Haley et al., 1992)

• Overall Excellent correlation between the PEDI Scales BDIST in total Caregiver Assistance and Personal Social domain (r = 0.79)

• Overall Excellent correlation between the PEDI Scales and BDIST in total Functional Skills and total Caregiver Assistance (r = 0.92, 0.89)

• PEDI modifications and Functional Skills Scales were better predictors of group status than the BDIST (p. 70).

• Overall Excellent correlation between the PEDI Scales and Wee-Functional Independence Measure (Wee-FIM) in total Functional Skills and total Caregiver Assistance (r = 0.92, 0.93)

• Between the normative sample (n = 412) and the clinical samples (n = 102), PEDI summary scores can accurately predict a child’s correct group membership for ages > 2.0 years (p.70). (p= <.001 - 0.27)

Content validity of the PEDI was determined by a panel of 31 experts in physical therapy, occupational therapy, medicine, education, and speech therapy. Each expert ranked items quantitatively and qualitatively. From the results of this panel, Haley and colleagues (1992) concluded that the instrument has strong content validity.

Cerebral Palsy: (Vos-Vromans, Ketelaar, & Gorter, 2005; n = 55; mean age = 4.6 years; 18 months after baseline)

• Poor ceiling effect; 24.1% of subjects scored equal to or higher than 90 points

• Adequate ceiling effect of caregiver assistance on Self-care domain with 10.9% scoring equal to or higher than 90 points

• Excellent ceiling effect for children less than 48 months of Functional Skills on the Self-care or Mobility domains

• Excellent ceiling effect for the Self-care domain of caregiver assistance for children less than 48 months; Adequate ceiling effect (9.1%) for Mobility domain of Caregiver Assistance for children less than 48 months

• Only Self-Care and Mobility domains were tested; Social Function domain was not included in the study

Spastic Cerebral Palsy: (McCarthy et al., 2002; n = 115; mean age= 5.67 years (SD = 1.5 years))

• Excellent/No ceiling or floor effects found in Self-care or Social Function domains.

• Adequate ceiling effect of 6% found for the Mobility domain and excellent floor effects found.

Cerebral Palsy: (Vos-Vromans et al., 2005)

• For children less than 48 months, Functional Skills of Self-Care (r = 1.29) and Mobility (r = 1.27) had a change/effect size

• For children less than 48 months, Caregiver Assistance of Self-care (r = 1.45) and Mobility (r = 2.14) had a large change

• For children equal to or older than 48 months, Functional Skills of Self-care had a large change (r = 0.98). Functional Skills of Mobility had a moderate change (r = 0.78).

• For children equal to or older than 48 months, Caregiver Assistance of Self-care (r = 1.41) and Mobility (r = 0.98) had a large change.

Minor to Moderate Traumatic Injury: (Haley et al., 1992; n = 21-23; assessed at 1 and 6 months after discharge from the hospital; PEDI scaled scores of clinical sample)

• Statistically significant, positive changes for all Functional Skills in Self-care, Mobility, and Social Function were found (p = <0.001, 0.011, 0.004)

• Statistically significant, positive changes for all Caregiver Assistance in Self-care, Mobility, and Social Function were found (p = <0.001, 0.021, 0.005)

Multiple Significant/Severe Disabilities: (Haley et al., 1992; n = 22-23; assessed 8 months apart on 2 occasions; PEDI scaled scores of clinical sample)

• Statistically significant, positive change only found for Functional Skill and Caregiver Assistance in Mobility was found (p = <0.001, <0.001)