Development and Validation of the Subjective Awareness of Neuropsychological Deficits Questionnaire for Children (SAND-C)

Abstract

Although lowered awareness of abilities has been associated with poorer outcome in adults with neurological compromise, a dearth of research exists examining whether lowered awareness exists in younger populations. Using findings from recent literature and expert opinion, a 47-item Subjective Awareness of Neuropsychological Deficits Questionnaire for Children (SAND-C) was created to assess awareness of cognitive functioning in 6 domains (attention, psychomotor, visual-spatial, language, memory, and executive functioning). Confirmatory factor analysis (CFA) of the SAND-C was conducted on a sample consisting of 365 healthy children and 48 children with epilepsy. The SAND-C was found to have strong reliability. Factor analysis confirmed the a priori 6 factor model, but the 6-factor model was only marginally better than a more parsimonious 1-factor solution. Post-hoc exploratory factor analyses indicate that the SAND-C may measure more constructs for adolescents than for younger children. The difference between younger and older children may reflect developmental changes in metacognitive awareness and abstraction about their own abilities.

This manuscript is an elaboration of a paper presented at the Annual Meeting of the American Epilepsy Society in Orlando, Florida, in December, 1999, and the Annual Meeting of the International Neuropsychological Society in Denver, Colorado, in February, 2000. This research was supported in part by an Epilepsy Foundation of America Behavioral Sciences Fellowship, and a Dissertation Research Award from the American Psychological Association. In addition, this study utilized samples of children who participated in two larger studies: a study of children with chronic epilepsy, funded by a grant from the National Institute of Nursing Research (Joan Austin, DNS, RN, Principal Investigator) and a study of children with recent-onset epilepsy, funded by grants from the National Institute of Neurological Disorders and Stroke (Joan Austin, DNS, RN, Principal Investigator) and from the Epilepsy Foundation of America (Philip S. Fastenau, Ph.D., HSPP, Principal Investigator). The authors would like to acknowledge Drs. Joan R. Austin, John H. McGrew, Lisa L. Conant, Kathy E. Johnson, and Daniel J. Venezia, Jr., for providing their expert appraisal on the content and format of the survey instrument.

Notes

This manuscript is an elaboration of a paper presented at the Annual Meeting of the American Epilepsy Society in Orlando, Florida, in December, 1999, and the Annual Meeting of the International Neuropsychological Society in Denver, Colorado, in February, 2000. This research was supported in part by an Epilepsy Foundation of America Behavioral Sciences Fellowship, and a Dissertation Research Award from the American Psychological Association. In addition, this study utilized samples of children who participated in two larger studies: a study of children with chronic epilepsy, funded by a grant from the National Institute of Nursing Research (Joan Austin, DNS, RN, Principal Investigator) and a study of children with recent-onset epilepsy, funded by grants from the National Institute of Neurological Disorders and Stroke (Joan Austin, DNS, RN, Principal Investigator) and from the Epilepsy Foundation of America (Philip S. Fastenau, Ph.D., HSPP, Principal Investigator). The authors would like to acknowledge Drs. Joan R. Austin, John H. McGrew, Lisa L. Conant, Kathy E. Johnson, and Daniel J. Venezia, Jr., for providing their expert appraisal on the content and format of the survey instrument.