Norwegian validation of the Pediatric Evaluation of Disability Inventory (PEDI) : assessing children's ADL skills

Abstract

Activities of Daily Living (ADL) are among the first achievements in childhood, and provide a sense of mastery, independence and social approval for the child. Self-dependence in everyday living skills is important to everyone, not least for children with disabilities. The Pediatric Evaluation of Disability Inventory (PEDI), is a widely used functional assessment and an evaluative tool of ADL skills intended for children with a disability, originally designed for use in the U.S.A. <br> Aim: The overall objective of this thesis was to translate the American PEDI into Norwegian and to assess the applicability and validity of the Norwegian version. The specific research questions investigated were if the Norwegian version of the PEDI is functionally equivalent to the American version, reliable in relation to inter-rater, intra-respondent rater, and intra-rater reliability, and useful according to US normative data for a general Norwegian population.<br> Method: Guidelines for cross-cultural adaptation were used in translating the Norwegian version of the PEDI. A pilot study based on cross-sectional principles of the Norwegian version was investigated in a small, but carefully selected, sample. A population-based crosssectional study evaluated the applicability of PEDI American normative data for a general Norwegian population. Rater agreement was investigated.<br> Results: The results confirmed the Norwegian version of the PEDI’s translational equivalence with the original American version and reliability of measures. However, the results showed that the Norwegian sample scored significantly lower than US reference values, especially for self-care skills. Capability and caregiver assistance mean values ranged from 38.0 to 46.8 for self-care, mobility and social function against an expected mean of 50. For mobility and social function the results were of less significance.<br> Conclusion: The age-norms for the PEDI deviated from the American normative values, and need adjustment to fit the Norwegian culture. However, PEDI has the particular feature to report outcomes in two scales: normative scores and scaled scores. The scaled score provides a criterion referenced indication of the child’s ability to perform the total amount of tasks in the PEDI and is not adjusted for age. The scaled score describes and measures the function of children, and is relevant and useful in a Norwegian setting.