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Examining differential responses of youth with and without autism on a measure of everyday activity performance

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Abstract

Purpose

This study further investigated items with differential item function (DIF) in the Social/Cognitive domain of a measure of everyday activity performance, the Pediatric Evaluation of Disability Inventory-Computer Adapted Test version for Autism “PEDI-CAT (ASD),” to understand possible sources of response variation in a heterogeneous sample of youth with autism compared to the national standardization sample.

Methods

Cross-sectional design. A convenience sample of parents who identified they had a child between 3 and 21 years (M = 11.9 years, SD = 4.67 years) with autism (n = 365) completed an online survey that included the PEDI-CAT (ASD) and descriptive measures. For 28 items previously identified as having DIF, the PEDI-CAT (ASD) expected item score curves for the autism sample were compared to the original PEDI-CAT standardization sample. The weighted area between expected score curves (wABC) was also calculated; values >0.24 indicate significant DIF.

Results

All items had wABC that exceeded the criterion. Compared with peers without disabilities at the same ability level, 11 items were significantly more difficult for the youth with autism and 16 items were significantly easier. One item demonstrated non-uniform DIF.

Conclusion

Differential responses could indicate that: (1) children with autism have a different developmental pattern of skill acquisition for everyday activities in the Social/Cognitive domain, or (2) parents of children with autism utilize a unique appraisal process when assessing their children’s functional performance of everyday activities. Further research is required to better understand the factors leading to differential responses on the targeted items. The study illustrates the value of in-depth analysis of DIF to gain insight into the impact of a clinical condition on functional performance.

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Notes

  1. The y-axis on Figs. 1 and 2 depicts rating scale thresholds for the four-point PEDI-CAT 284 rating scale.

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Acknowledgments

This research was supported through a Grant from NIH/NICHD R21HD065281 (PI: Coster) to Boston University and the National Center Medical Rehabilitation Research, National Institute of Child Health and Human Development/National Institute Neurological Disorders and Stroke, National Institutes of Health K12 HD055931 (Awardee Dr. Kramer).

ASD sample data featured in this manuscript are available through the NIH-supported National Database for Autism Research (NDAR). Collection ID 1880: http://ndar.nih.gov/data_from_labs.html?id=1880&showSingle=true Original standardization data were collected with the support of National Institutes of Health/National Institute of Child Health and Human Development/National Center for Medical Rehabilitation Research grants R42HD052318 (STTR phase II award) and K02 HD45354-01 (Independent Scientist Award to Dr. Stephen H. Haley).

Conflict of interest

Pengsheng Ni has acted as a paid consultant to CRE Care, distributor of the PEDI-CAT, and has received funding for research carried out in this work. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Ph.D. Program in Rehabilitation Sciences, Department of Occupational Therapy, Boston University, Boston, MA, 02215, USA

    Jessica M. Kramer, Kendra Liljenquist & Wendy J. Coster

  2. Health and Disability Research Institute, Health Policy and Management, Boston University, Boston, MA, USA

    Pengsheng Ni

Authors
  1. Jessica M. Kramer
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  2. Kendra Liljenquist
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  3. Pengsheng Ni
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  4. Wendy J. Coster
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Correspondence to Jessica M. Kramer.

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Kramer, J.M., Liljenquist, K., Ni, P. et al. Examining differential responses of youth with and without autism on a measure of everyday activity performance. Qual Life Res 24, 2993–3000 (2015). https://doi.org/10.1007/s11136-015-1035-2

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