Reliability and validity of the acquired brain injury challenge assessment (ABI-CA) in children

Abstract

Primary objective: The Acquired Brain Injury Challenge Assessment (ABI-CA) was created to fill a measurement gap and evaluate deficits in advanced motor skills in children with acquired brain injury (ABI). Study objectives were to refine ABI-CA response options and evaluate (i) inter-/intra-rater reliability, (ii) concurrent validity and difficulty level in relation to the Community Balance & Mobility Scale (CB&M) and (iii) administration efficiency of the refined ABI-CA.

Research design: Measurement study.

Methods: Phase I involved ABI-CA revisions. Phase 2 consisted of live-/video-scoring of the ABI-CA with 15 typically-developing (TD) children and 15 with ABI (7–17 years) to assess reliability/validity.

Results: The revised 20-item ABI-CA displayed excellent reliability for the entire sample (ICCs > 0.90; 95% CI = 0.92–1.00; SEM ≤ 3.60) and within ABI and TD sub-groups. The ABI-CA and CB&M correlated strongly (r = 0.75, p < 0.0001). The ABI-CA mean score (/100) was 11.3 points lower (p < 0.0001) than the CB&M’s mean score (/100).

Conclusion: The ABI-CA demonstrated excellent reliability and initial evidence of validity. ABI-CA scores were lower overall than the CB&M, indicating the ABI-CA may have greater capacity to evaluate improvements in advanced motor skills in children with ABI. Multi-centre research is needed to confirm the ABI-CA’s test-retest reliability and, assuming acceptability, assess responsiveness to change.

• Children
• closed head injury
• measurement
• paediatric
• rehabilitation
• traumatic brain injury

Acknowledgements

This research was completed in partial fulfilment of the requirements for an MScPT degree at the University of Toronto, Department of Physical Therapy. The research was partially funded by Bloorview Research Institute and the Bloorview Children’s Hospital Foundation Chair in Paediatric Rehabilitation (held by the senior author V. Wright). We thank our youth participants for their time, energy and insights that they gave us about the ABI-CA and also appreciate the assistance provided by Gloria Lee (H.BSc, CCRP) during the course of the study.