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Young Children’s Participation and Environment Measure

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Purpose

The YC-PEM is a new computer-administered proxy questionnaire for caregivers of children aged 0 to 5 years with and without developmental disabilities and delays, which assesses (1) young children's participation in home, daycare/preschool, and community activities and (2) qualities of the environment in which these activities take place.

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instrument details

Acronym YC-PEM

Area of Assessment

Activities of Daily Living
Developmental
Infant & Child Development
Life Participation
Quality of Life

Assessment Type

Proxy

Administration Mode

Computer

Cost

Not Free

Actual Cost

$99.00

Cost Description

$99 for a single user
$198 for 2 users
$300 for 3 or more users
$500 for a teaching copy or university use

Populations

Non-Specific Patient Population

Key Descriptions

  • The YC-PEM is a 28-item survey modeled after the Participation and Environment Measure for Children and Youth (PEM-CY) for children ages 5-17 years of age with and without disabilities. It was developed to provide a comprehensive, detailed, and feasible tool for proxy assessment of younger children 0 to 5 years of age.
  • For each type of activity, caregivers assess 3 dimensions of their child’s participation:
    1) Frequency (8-point scale, from never [0] to once or more each day [7])
    2) Level of involvement (5-point scale, from not very involved [1] to very involved [5]
    3) Caregiver’s desire for change in the child’s participation (yes [1] vs no [0])
  • If yes, caregivers clarify whether change is desired in terms of frequency (i.e., more often or less often), level of involvement (i.e., more interactive, more helpful, or both), and/or participation in a broader variety of activities of that type. When caregivers desire change, they are prompted to describe 3 strategies that have been used to promote the child’s participation in activities of that type.
  • Caregivers then evaluate the impact of environmental features and resources on the child’s participation in that setting (13 items for home, 16 items for daycare/preschool, and 17 items for community).
  • Perceived impact of environmental resources on participation is assessed on a 3-point scale, not needed/usually yes (3) to usually no (1). Caregivers also describe up to 3 strategies for promoting their child’s participation in that setting.
  • Since the YC-PEM has 3 participation scales and 1 environmental scale, 4 YC-PEM setting scores are calculated by the computer program:
    1) Frequency = the average of all ratings (range, 0-7)
    2) Level of involvement = the average of all ratings (range, 1-5)
    3) Percent desire change = sum of number of items scored as “yes, change desired” divided by the total number of items and multiplied by 100 (range 0-100)
    4) Environmental support = sum of responses across all environmental features and resource items for a setting, divided by the maximum possible score, and multiplied by 100 (range 0-100)
  • Maximum score = up to 212

Number of Items

28

Equipment Required

  • A license for the measure must be purchased via CanChild e-store.

Time to Administer

20-40 minutes

Required Training

No Training

Age Ranges

Infant

0 - 2

years

Preschool Child

2 - 5

years

Instrument Reviewers

Reviewed by Kathleen Kennedy Cianca, OTR/L.

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
General Health

Considerations

  • The YC-PEM test manual is still under development. When the manual is finished, it will be provided with purchase of a license.

  • There appears to be initial support for using the YC-PEM in research to assess the engagement of young children with disabilities/delays in areas of (1) home, daycare/preschool, and community participation patterns; (2) perceived environmental supports and obstacles to their participation; and (3) parent strategies to promote their participation (Khetani et al, 2015).

  • The YC-PEM and CHF-CP items were first mapped to the International Classification of Functioning, Disability, and Health (IFC)-Children and Youth Version to identify items for pairwise comparison. Significant items were reportedly found for items in all five IFC-Children and Youth Version environmental domains (Khetani, 2015). 

  • The YC-PEM can discriminate between young children with and without developmental disabilities and delays (Khetani, 2015).

  • The YC-PEM can detect discrepancies in school participation between young children with and without disabilities for early childhood intervention (Benjamin et al, 2016).

  • Future research is needed to confirm results using paper forms; diverse samples relative to child characteristics (race/ethnicity, income, and respondent education); and equal sample sizes (Khetani, 2015)

  • Validity study limitations include limited generalizability to larger U.S. and Canadian populations based on child race/ethnicity, education level and marital status of respondents, and family income. Some YC-PEM environmental content is not captured in the CHIEF-CP and thus is not validated. Further validation of the YC-PEM environmental content with different caregiver perspectives and with more diverse and representative samples is needed (Khetani, 2015).

  • Research has been conducted to establish the cultural equivalence of YC-PEM content for use in Singapore (Chun, Law, Khetani, Pollock, & Rosenbaum, 2015; n = 10).

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Non-Specific Patient Population

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Standard Error of Measurement (SEM)

Caregivers of Young Children With and Without Developmental Disabilities/Delays: (Calculated from Khetani et al., 2015; n =395, n = 93 with developmental disabilities and delays, n = 302 without developmental disabilities and delays between the ages of 0 and 5 years; mean age = 35.33 months; North American sample)

SEM for Young Children’s Participation and Environment Scales according to Child’s Age*

YC-PEM Scales

0-23  

48-71  

48-71

Home

 

 

 

     Frequency

.71

.64

.56

     Level of involvement

.20

.30

.31

      Environmental support

4.24

4.53

7.75

Daycare/Preschool

 

 

 

     Frequency

.47

.89

.90

     Level of involvement

.28

.48

.44

     Environmental support

3.14

3.34

4.31

Community

 

 

 

     Frequency

.58

.56

.49

     Level of involvement

.17

.29

.57

     Environmental support

4.07

4.05

7.51

 

Unable to calculate SEM for “Percent desire change” scale as ICC values were not reported .

Minimal Detectable Change (MDC)

Caregivers of young children with and without developmental disabilities/delays: (calculated from Khetani et al, 2015)

MDC for Young Children’s Participation and Environment Scales According to Child’s Age

YC-PEM Scales

0-23  

48-71  

48-71

Home

 

 

 

     Frequency

1.97

1.77

1.55

     Level of involvement

.55

.83

.86

      Environmental support

11.75

12.56

21.48

Daycare/Preschool

 

 

 

     Frequency

1.30

2.47

2.49

     Level of involvement

.78

1.33

1.22

     Environmental support

8.7

9.26

11.95

Community

 

 

 

     Frequency

1.61

1.55

1.36

     Level of involvement

.47

.80

1.58

     Environmental support

11.28

11.23

20.82
 

Test/Retest Reliability

Caregivers of young children with and without developmental disabilities/delays: (Khetani et al, 2015)

Home Setting

  • Adequate test-retest liability within 2-4 weeks for total score for Frequency (ICC = .69)
  • Excellent test-retest liability within 2-4 weeks for total score for Level of Involvement (ICC = .82)

  • Excellent test-retest liability within 2-4 weeks for total score for Environmental Support (ICC = .91)

 

Daycare/Preschool Setting

  • Poor test-retest liability within 2-4 weeks for total score for Frequency (ICC = .31)
  • Excellent test-retest liability within 2-4 weeks for total score for Level of Involvement (ICC = .78)
  • Excellent test-retest liability within 2-4 weeks for total score for Environmental Support (ICC = .92)

 

Community Setting

  • Adequate test-retest liability within 2-4 weeks for total score for Frequency (ICC = .59) 
  • Excellent test-retest liability within 2-4 weeks for total score for Level of Involvement (ICC = .93)
  • Excellent test-retest liability within 2-4 weeks for total score for Environmental Support (ICC = .94)

Internal Consistency

Caregivers of young children with and without developmental disabilities/delays: (Khetani et al, 2015)

Home Setting  

  • Excellent internal consistency for total score for Frequency (Cronbach’s alpha = .82)
  • Excellent internal consistency for total score for Level of Involvement (Cronbach’s alpha = .86)
  • Excellent internal consistency for total score for Change Desired (Cronbach’s alpha = .84)
  • Excellent internal consistency for total score for Environmental Support (Cronbach’s alpha = .96)

 

Daycare/Preschool Setting

  • Adequate  internal consistency for total score for Frequency (Cronbach’s alpha = .72)
  • Excellent internal consistency for total score for Level of Involvement (Cronbach’s alpha = .80)
  • Poor internal consistency for total score for Change Desired (Cronbach’s alpha = .67)
  • Excellent internal consistency for total score for Environmental Support (Cronbach’s alpha = .92)

 

Community Setting

  • Poor internal consistency for total score for Frequency (Cronbach’s alpha = .68)
  • Excellent internal consistency for total score for Level of Involvement (Cronbach’s alpha = .96)
  • Excellent internal consistency for total score for Change Desired (Cronbach’s alpha = .85)
  • Excellent internal consistency for total score for Environmental Support (Cronbach’s alpha = .96)

Criterion Validity (Predictive/Concurrent)

Caregivers of young children with and without developmental disabilities/delays: (Khetani, 2015; n = 381, consisting of 85 children with and 296 children without developmental disabilities/delays between 1 and 71 months of age; mean age = 36.4 (+/- 20.18 months); United States and Canadian sample)

  • Adequate negative correlations for YC-PEM Environmental content scores with a criterion measure, the Craig Hospital Inventory) of Environmental Factors-Child and Parent Version (CHIEF-CP) on 10 of 66 pairwise comparisons (r = -.31 to -.39; p < .01)
  • Poor associations for 56 of 66 pairwise comparisons involving CHIEF-CP and YC-PEM Environment scores (r = .002 to .30)

Construct Validity

Caregivers of young children with and without developmental disabilities/delays: (Khetani et al, 2015) 

Home Frequency

  • Poor association with PEDI-CAT normative scores for Daily Activities domain (r = .09, p <.001)
  • Poor association with PEDI-CAT normative scores for Mobility domain (r = .03)
  • Poor association with PEDI-CAT normative scores for Social/Cognitive   domain (r = .04)
  • Poor association with PEDI-CAT normative scores for Responsibility domain (r = .10)

 

Home Involvement

  • Poor association with PEDI-CAT normative scores for Daily Activities domain (r = .26, p <.001)
  • Poor association with PEDI-CAT normative scores for Mobility domain (r = .19)
  • Poor association with PEDI-CAT normative scores for Social/Cognitive domain (r = .21)
  • Poor association with PEDI-CAT normative scores for Responsibility domain (r = .14)

 

Daycare/Preschool  Frequency

  • Poor association with PEDI-CAT normative scores for Daily Activities domain (r = .29, p <.001)
  • Poor association with PEDI-CAT normative scores for Mobility domain (r = .22)
  • Poor association with PEDI-CAT normative scores for Social/Cognitive domain (r = .14)
  • Poor association with PEDI-CAT normative scores for Responsibility domain (r = .27)

 

Daycare/Preschool  Involvement

  • Adequate association with PEDI-CAT normative scores for Daily Activities domain (r = .36, p <.001)
  • Poor association with PEDI-CAT normative scores for Mobility domain (r = .23)
  • Adequate association with PEDI-CAT normative scores for Social/Cognitive domain (r = .31)
  • Adequate association with PEDI-CAT normative scores for Responsibility domain (r = .35)

 

Community Frequency

  • Poor association with PEDI-CAT normative scores for Daily Activities domain (r = .03, p <.001)
  • Poor association with PEDI-CAT normative scores for Mobility domain (r = .01)
  • Poor association with PEDI-CAT normative scores for Social/Cognitive domain (r = .05)
  • Poor association with PEDI-CAT normative scores for Responsibility domain (r = .07)

 

Community  Involvement

  • Adequate association with PEDI-CAT normative scores for Daily Activities domain (r = .40, p <.001)
  • Adequate association with PEDI-CAT normative scores for Mobility domain (r = .38)
  • Adequate association with PEDI-CAT normative scores for Social/Cognitive domain (r = .33)
  • Poor association with PEDI-CAT normative scores for Responsibility domain (r = .27)

 

Caregivers of young children with and without developmental disabilities/delays: (Khetani et al, 2015)

Discriminant Validity for Age in Home, Daycare/preschool, and Community settings 

  • No significant differences in scores across age groups for the 4 scales (p = .09 to .97)

 

Discriminant Validity for Disability in the Home Setting 

  • Significant differences identified between disability status and Level of involvement and Environmental Support (p <.001)
  • No significant difference between disability status and scores on the Frequency and Percent Desire Change scales

 

Discriminant Validity for Disability in the Daycare/Preschool Setting 

  • Significant differences identified between disability status and Level of Involvement and Percent Desire Change scores (p <.001)
  • No significant difference between disability status and scores on the Frequency and Environmental Support scales

 

Discriminant Validity for Disability in the Community Setting:

  • Significant differences identified between disability status and Level of involvement and Environmental Support (p <.001)
  • No significant difference between disability status and scores on the Frequency and Percent Desire Change scales

Bibliography

Benjamin, TE, Lucas-Thompson, RG, Little, LM, Davies, PL, Khetani, MA. Participation in early childhood educational environmentsfor young children with and without developmental disabilities and delays: A mixed methods study. Physical & Occupational Therapy in Pediatrics. 2016; Early Online: 1-21.

CanChild. Young Children’s Participation and Environment Measure (YCPEM). Copyright 2016; McMaster University. Accessed March 20, 2016 from https://canchild.ca/en/resources/223-young-children-s-participation-and-environment-measure-ycpem

Coster, W, Law, M,  Bedell, G, et al. The Participation and Environment Measure for Children and Youth (PEM-CY): An innovative measure for home, school, and community. 2013.  Accessed March 20, 2016 from https://www.canchild.ca/en/resources/228-the-participation-and-environment-measure-for-children-and-youth-pem-cy-an-innovative-measure-for-home-school-and-community

Khetani, M. Psychometric evaluation of the Young Children’s Participation and Environment Measure (YC–PEM). American Journal of Occupational Therapy. July, 2013; 69: 6911500184p1. doi:10.5014/ajot.2015.69S1-RP301D 

Khetani, MA. Validation of environmental content in the Young Children's Participation and Environment Measure.  Archives of Physical Medicine and Rehabilitation. 2015; 96(2): 317-332.

Khetani, MA, Coster, WJ, Law, MC, Bedell, GM. Young Children’s Participation & Environment Measure (YC-PEM): Review copy.  Colorado State University. 2013.  

Khetani, MA, Graham, JE, Davies, PL, Law, MC, Simeonsson, RJ. Psychometric properties of the Young Children's Participation and Environment Measure.  Archives of Physical Medicine and Rehabilitation. 2015; 96(2): 307–316. 

Lim, CY, Law, M, Khetani, M, Pollock, N, Rosenbaum, P. Establishing the cultural equivalence of the Young Children's Participation and Environment Measure (YC-PEM) for use in Singapore. Physical & Occupational Therapy in Pediatrics. 2015; Early Online: 1-18. http://dx.doi.org/10.3109/01942638.2015.1101044

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