Psychometric Properties of the Spinal Cord Independence Measure-III Self Report- Youth
1Mulcahey M, 1Thielen C, 2Sadowsky C, 2Martin R, 3Vogel L, 4Taylor H, 5Davidson L
1Thomas Jefferson University, Philadelphia, PA, United states; 2Kennedy Krieger Institute, Baltimore, MD, USA; 3Shriners Hospitals for Children, Chicago, IL, United states; 4TIRR Herman Memorial, Houston, Texas, USA; 5Shriners Hospitals for Children Northern CA, Sacramento, CA, USA
Objective: To examine the psychometric properties of the Spinal Cord Independence Measure -III Self Report-Youth (SCIM-III SR-Y).
Design/Method: This was a non-intervention multi-center study, using a repeated measures design. A sample of youth between 8-17 years of age with chronic spinal cord injury\dysfunction (SCI\D) was recruited at the point of usual care across six pediatric facilities in the United States. Youth completed the SCIM-III SR-Y twice, separated by at least one hour. Mean (m), standard deviation (SD) and range (r) values were calculated for the total sample, three age groups (8-12, 13-15, 16-17 years), neurological levels (NL) C1-C4, C5-T1, T2-T12 and L1-S4/5, and American Spinal Injury Association Impairment Scale (AIS) A, B, C, D. Analysis of variance (ANOVA) was used to examine differences in SCIM-III SR-Y total, self-care (SC), sphincter\respiration (S\R) and mobility subscales across groups with known differences. Ceiling and floor effects for the total score and each subscale score were examined for the entire sample, and for paraplegia and tetraplegia. Intraclass Correlation Coefficient (ICC) with 95% confidence intervals (CI) was calculated to examine test-retest reliability.
Results: 75 youth with a mean age of 13.6 years (SD 2.8, range=8-17) were enrolled. The majority of the sample was female (54.7%), Caucasian (80%), non-Hispanic (62%), and had paraplegia (64%). An equal number of youth with motor complete (50.6%) and incomplete injuries were enrolled. There were no differences in SCIM-III SR-Y total or subscale scores across the three age groups. There were significant differences between C1-C4 and T2-T12 NL in total (p=.004) and SC (p<.001) scores; C1-C4 and L1-S4/5 NL in total (p=<.001), SC (p=<.001), S\R (p=.027) and mobility (p=.001) scores; C5-T1 and T2-T12 and L1-S4/5 in SC score (p<.001); C5-T1 and L1-S4/5 in total (p<.001), S/R (p=.042) and mobility (p=.001) scores. Mobility subscale scores differed between AIS A and D (p<.001) and AIS B and D (p=.004). Except for a moderate ceiling effect (20%) in the mobility subscale for the paraplegia group, ceiling and floor effects were acceptable and ranged between 0 and 10%. Except for the S\R subscale, test-retest reliability was high (ICC range=0.97-0.99).
Conclusion: This study is the first to examine the psychometric properties of the SCIM-III SR-Y. In this sample, it discriminated among known groups (known group validity) and reliability of scores on repeated administrations was high (test-retest reliability). Ceiling and floor effects for the total scale and each subscale were negligible, except for mobility in the group with paraplegia. These initial psychometric data support the use of SCIM-III SR-Y in youth 8 years of age and older. As investigators and practitioners use the SCIM-III SR-Y, they are encouraged to further examine the psychometric properties in their own samples and clinical populations.
Support: Funded by the Craig H. Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592.
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