Content Validity and Reliability of the Persian Version of School Function Assessment in Children With Cerebral Palsy Aged 7-12 Years

Abstract

Objective: Cerebral Palsy is one of the most common neurodevelopmental disorders in children. Due to the increase in the number of students with Cerebral Palsy (CP) entering ordinary schools and facing problems with independent functioning, there is a need for a valid and comprehensive assessment tool for their successful entry as well as providing a proper treatment plan. The School Function Assessment (SFA), by measuring many school-related functional skills, can identify the strengths and weaknesses affecting the students’ independence and participation in school assignments. It has 320 items and three main parts of participation, task support, and activity performance. The test score can be reported in general or based on each part, separately. The purpose of this study is to examine the validity and reliability of the Persian version of the SFA in children with CP. Materials & Methods: This is a cross-sectional study with methodological design. The study population consists of all children with CP aged 7-12 years in Tehran. Of these, 120 were selected from exceptional public school using a convenience sampling method. The inclusion criteria were: CP diagnosed by a neurologist, age between 7 and 12 years, no other disabilities (e.g. deafness or blindness), and the willingness of children’s parents to participate in the study. A demographic form and the Persian SFA were used for data collection through interview. In order to measure the content validity, Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated according to the standard protocol of International Quality of Life Assessment. In this regard, 8 experts in the field of pediatrics completed the Persian SFA. To determine the test-retest reliability, the questionnaire was completed by the parents of children with a 4-week interval. The internal consistency and test-retest reliability were examined by using Cronbach’s alpha coefficient and Intra-class Correlation Coefficient (ICC), respectively. Data was analyzed in SPSS V. 22 software. Results: Participants were 64 boys and 56 girls with CP (mean age= 9.4 years). The distribution of CP was as follows: 10% hemiplegic CP, 27.5% diplegic CP, 5.8% monoplegic CP, and 56.7% quadriplegic CP. Eighty hundred-eight percent of respondents were the mothers of students. The CVR and CVI values were in a range of 0.7-1 and 0.87-1, respectively indicating an acceptable validity. All the items had acceptable content validity. The Cronbach’s alpha coefficient was obtained 0.95 for participation, 0.95-0.99 for task support, 0.83-0.99 for activity performance, and 0.92 in total. Moreover, the ICC value was reported 0.90 for participation; 0.84-0.91 for task support; 0.84-0.97 for activity performance; and 0.89 for the overall test. Conclusion: The Persian version of SFA has acceptable content validity and reliability (internal consistency and test-retest) for children with CP. Therefore, it can be applied as a research and clinical tool to assess the school-related performance of these children.