Abstract
The purpose of the study is to examine the content validity index (CVI) and clinical utility (CU) of the iCan-Play assessment. iCan-Play is a play-based assessment for children with severe disabilities (SD), using assistive technology. We used mixed methods to analyze the CVI and CU data from seven experts. iCan-Play has good content validity and CU. The assessment provides a unique opportunity for children with SD to engage in active play through the use of assistive technology.
Primary Author and Speaker: Stephanie Hui
Additional Authors and Speakers: Katherine Dimitropoulou
Children with severe multiple disabilities (SMD) are often deprived of play opportunities. This study describes the development and content validity of an evidence-based assessment entitled the Interactive Child Activity Narrative of Play (iCan-Play). iCan-Play uses the developmental progression of play (i.e., sensorimotor, pre-construction, etc.) and two types of play, physical and electronic, to assess children's play repertoire. The assessment further examines play preferences, frequency of play and the context of play. iCan-Play is developed on an assistive technology (AT) platform that allows eye-gaze, switch scanning, and direct touch selection, for children to make their own choices. The purpose of the study is to describe the development of the iCan-Play, and examine its content validity index (CVI) and clinical utility (CU). We used a mixed methods (quantitative/qualitative) approach. Children (7-18 years), with a diagnosis of multiple disabilities, or brain injury, had to: have 2 or more neuromuscular or sensory impairments, be medically stable and cognitively able to answer yes/no questions, be using or be exposed to AT 3 months. We recruited two children (n = 2) to carry out the assessment. Then, we recruited a panel of experts. Experts had to: be working with children with SMD for a minimum of 3 years, had to be using AT for 1 year. A panel of seven (n = 7) experts participated in the study. Experts analyzed the videotapes of the children performing the iCan-Play, and rated the relevance, necessity, and clarity of the items using the content validity index (CVI). We computed the Item-CVI (I-CVI) and the Scale-level-CVI (S-CVI). We further computed the Kappa statistic of the degree of agreement. We used the same approach for the clinical utility (CU). We also conducted a sentence by sentence analysis to extract themes for the qualitative data. Content validity measures I-CVI and S-CVI revealed high relevance and necessity scores. In the area of relevance raters' scores had a median score of 4 (highly relevant) for physical and electronic play. Only three items (flipping through books, pre-construction items and point-based games) received a median score of 3 (quite relevant). In the area of clarity, the iCan-Play received a median score of 4 (very clear) on 15/18 items on physical play and 12/16 items on electronic play. Only 2 items on physical play received a score of 3 (quite clear): point-based games and creating. The activity of ‘dancing’ on the physical play received a score of 2 (somewhat clear). On the electronic play, three items received a score of 3 (quite clear): deconstruction, building and creating. The necessity median score was 1 (very necessary) for most of the items in both physical and electronic play, with the exception of two items that received a 2 (useful, not necessary): swimming and dancing. In the area of CU, the majority of the experts rated the iCan-Play as, ‘useful, can be utilized.’ Common themes extracted from the qualitative data include: ‘useful tool,’ ‘functional,’ ‘variety of activities for the population to explore,’ and ‘lengthy.’ This study demonstrated that the iCan-Play has good content validity and clinical utility. Revisions have been made to address length of administration, clarity of wording for specific items, clarity of administration directions for items that scored lower. Limitations of this study includes a small sample size of the children. The next steps include testing the reliability of iCanPlay. The iCan-Play is a unique tool to assess play preferences in children with SMD using AT. The assessment results generate a Play Profile that can assist therapists, caregivers, and teachers to select meaningful activities when interacting with children with SMD.
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