A Systematic Review on Clinimetric Properties of Play Instruments for Occupational Therapy Practice.
Muhammad Hibatullah Romli, Farahiyah Wan Yunus
PMID 32821250WHAT IT FOUND
Most play instruments used in occupational therapy have limited evidence for their accuracy and are not commercially available.
The Revised Knox Preschool Play Scale is the most established tool, but it only measures observable skills, not the child's internal enjoyment or motivation.
Key findings
01The review identified eight play instruments developed by occupational therapists, but only three are commercially available, and most were tested only in Western countries.
02Evidence for these tools is narrow: most studies only checked if different raters agree and if the content is relevant, ignoring other important validity measures.
03The Revised Knox Preschool Play Scale is described as the 'gold standard' for assessing observable play behaviors, while the Test of Playfulness is unique for assessing the child's internal motivation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review only included English-language peer-reviewed journal articles, so evidence from instrument manuals or grey literature was missed. Most instruments were tested in Western, developed countries, limiting their known applicability to other cultures. The quality of the included studies was only moderate, and many psychometric properties were not investigated at all. Authorship bias may exist, as the original developers of some instruments were involved in the studies testing them.
Declared interests
The text does not specify funding sources or conflicts of interest for this systematic review.
The easy way to misread this
Do not assume these instruments are fully validated for all children. The evidence for most tools is limited to basic reliability and content checks, and they were largely developed in Western contexts, which may bias results when used elsewhere.