Abstract
Study design:
The items and response scales of the Spinal Cord Independence Measure (SCIM-III) self report (SR) were exposed to formal cognitive testing with children with SCI, and in parallel a survey using the modified Delphi Technique was conducted to engage content experts in an iterative critical review of the SCIM-III SR.
Objectives:
To evaluate the validity of the SCIM-III SR for pediatric utilization.
Setting:
United States of America.
Methods:
Formal cognitive testing was conducted with 17 youths with SCI and required them to read and answer each SCIM-III SR item aloud. Think aloud methodology was used to record details about how youths understood and interpreted items and why they selected a given response. The interviews were audiotaped and transcribed verbatim. Content analysis focused on identifying words that children could not read or understand. In parallel, the Modified Delphi Technique engaged expert therapists to critically review the SCIM-III SR for pediatric utilization.
Results:
Every SCIM-III SR item and response scale required modification before children were able to read, understand and respond to them. Youth encountered difficulties because of vague terms, medical jargon and complex words and phrases. Three iterative Delphi rounds were required before achieving 80% agreement that items and response scales were written well for children.
Conclusion:
Our findings informed modifications to every SCIM-III SR item and response scale, producing a pediatric version of the tool that we formally refer to as the SCIM-III SR-Youth (SCIM-III SR-Y).
Sponsorship:
The study was funded by the Craig H Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592 (Mulcahey, PI).
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References
Catz A, Itzkovich M, Agranov E, Ring H, Tamir A . SCIM-Spinal Cord Independence Measure: a new disability scale for patients with spinal cord lesions. Spinal Cord 1997; 35: 850–856.
Anderson KD, Aito S, Atkins M, Biering-Sorensen F, Charlifue S, Curt A et al. Functional recovery measures for spinal cord measures for spinal cord injury: an evidence based review of clinical practice and research. J Spinal Cord Med 2008; 31: 133–144.
Itzkovich M, Gelernter I, Biering-Sorenson F, Weeks C, Laramee MT, Craven BC et al. The spinal cord independence measure (SCIM) version III: reliability and validity in a multi-center international study. Disabil Rehabil 2007; 29: 1926–1933.
Bluvshtein V, Front L, Itzkovich M, Aidinoff E, Gelernter I, Hart J et al. SCIM III is reliable and valid in a separate analysis for traumatic spinal cord lesions. Spinal Cord 2011; 49: 292–296.
Anderson KD, Acuff ME, Arp BG, Backus D, Chun S, Fisher K et al. United states (US) multi-center study to assess the validity and reliability of the spinal cord independence measure (SCIM III). Spinal Cord 2011; 49: 88–885.
Scivolette G, Tamburella F, Laurenza L, Molinari M . The spinal cord independence measure: how much change is clinically significant for spinal cord injury subjects. Disabil Rehabil 2013; 35: 1808–1813.
Aidinoff E, Front L, Itzkovich M, Bluvshtein V, Gelernter I, Hart J et al. Expected spinal cord independence measure, third version, scores for various neurological levels after complete spinal cord lesions. Spinal Cord 2011; 49: 893–896.
Fekete C, Eriks-Hoogland I, Baumberger M, Catz A, Itzkovich M, Luthi H et al, Development and validation of a self-report version of the spinal independence measure (SCIM III). Spinal Cord 2013; 51: 40–47.
Vogel LC, Betz RR, Mulcahey MJ . Spinal cord injuries in children and adolescents. In: Verhaagen J, McDonald J (eds). Handbook of Clinical Neurology. Elsevier, 2012, pp 138–148.
Merenda L, Dean G. . Neurogenic bladder and bowel: assessment, management and outcomes. In: Vogel L, Zebracki K, Betz R, Mulcahey MJ (eds). Spinal Cord Injury n the Child and Young Adult. McKeith Press: London, UK, Chapter 11, 2014; pp 153–166.
Dumas H, Haley SM, Boyce M, Peters C, Mulcahey MJ . Self-reported measures of physical function for children with spinal cord injury: a review of current tools and an option for the future. Dev Neurorehabil 2009; 12: 113–118.
Drennan J . Cognitive interviewing: verbal data in the design and pretesting of questionnaires. J Adv Nurs 2003; 42: 57–63.
Mulcahey MJ, Calhoun C, Riley A, Haley S . Children’s reports of activity and participation after sustaining spinal cord injury: a cognitive interviewing study. Dev Neurorehabil 2009; 12: 191–200.
Mulcahey MJ, Samdani A, Chafetz R, Santangelo AM, Merenda L, Costello K et al, Cognitive testing of the spinal appearance questionnaire with typically developing youth and youth with idiopathic scoliosis. J Pediatr Orthop 2011; 31: 661–667.
Van Somerson M, Barnard YF, Sandberg JA . The Thin Aloud Method: A Practical Guide tom Modelliing Cogntive Processes. Academic Press: San Diego, CA, USA,. 1994.
Dalkey NC. The Delphi method: an experimental application of group opinion In: Dalkey NC, Dl Rourke R, Lewis, Snyder D (eds). Studies in the Quality of Life. Lexington Books: Lexington, MA, USA.
Mulcahey MJ, Vogel L, Betz R, Samdani A, Chafetz R, Gaughan J . The international standards for neurological classification of spinal cord injury: psychometric evaluation and guidelines for use with children and youth. Phys Med Rehabil 2011; 92: 1264–1269.
Riley AW . Evidence that school-age children can self-report on their own health. Ambul Pediatr 2004; 4: 371–376.
Matza LS, Patrick DL, Riley AW, Alexander JJ, Rajmil L, Pleil AM et al. Pediatric patient reported outcome instruments for research to support edical product labeling: report of the ISPOR PRO good research medical practices for the assessment of children and adolescent task force. Value Health 2013; 16: 461–479.
Acknowledgements
We acknowledge the Physical and Occupational Therapy who participated in the surveys unnamed; their collective expertize greatly informed the development of the SCIM-III SR-Y. The study was funded by the Craig H Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592 (Mulcahey, PI).
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Mulcahey, M., Calhoun, C., Sinko, R. et al. The spinal cord independence measure (SCIM)-III self report for youth. Spinal Cord 54, 204–212 (2016). https://doi.org/10.1038/sc.2015.103
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DOI: https://doi.org/10.1038/sc.2015.103
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