Refining the Pediatric Evaluation of Disability Inventory-Patient-Reported Outcome (PEDI-PRO) item candidates: interpretation of a self-reported outcome measure of functional performance by young people with neurodevelopmental disabilities.
Jessica M Kramer, Ariel Schwartz
PMID 28580593WHAT IT FOUND
Young people with disabilities understood 86% of self-report items as intended and matched their ratings to spoken descriptions.
They interpreted tasks literally, so unfamiliar wording or specific methods caused confusion. The measure works, but items need familiar contexts to avoid misinterpretation.
Key findings
01Across 116 items, young people interpreted them as intended 86% of the time, with Daily Activities showing the highest comprehension and Mobility the lowest.
02Participants generally selected response categories that matched their open-ended descriptions of ability, though some chose positive ratings even after describing challenges.
03Literal interpretation caused errors when items referenced unfamiliar tasks, specific methods not used by the participant, or situations they did not personally encounter.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was a convenience group with fewer young people who had significant mobility impairments or identified as a minority, limiting generalizability. Males were under-represented in the sample. Some participants provided extensive or off-topic responses, requiring subjective judgment during coding to determine if this reflected misunderstanding or simply detailed reporting.
The easy way to misread this
Do not assume a high self-rating indicates independent performance without support. Young people often rate tasks as 'Very easy' because they successfully use strategies or environmental supports, or because they interpret the item literally and miss the intended functional challenge.