The Participation and Environment Measure-Children and Youth (PEM-CY): Cultural Adaptation, Validity, and Reliability of the Persian Version for 5- to 17-Year-Old Children With Cerebral Palsy.
Marzieh Pashmdarfard, Sara Zamiran, Navid Mirzakhani and 1 others
The Persian PEM-CY is a valid, reliable tool for measuring participation and environmental barriers in children with CP.
Children with CP participated in fewer activities and faced more barriers than typically developing peers, especially in school and community settings.
Key findings
1The Persian PEM-CY showed good face validity (all 20 parents and all 15 occupational therapists found every item acceptable), content validity (all items scored CVI ≥ 79%), and divergent validity (children with CP scored significantly lower than typically developing peers in most participation and environment domains, p < 0.01).
2Internal consistency (Cronbach's alpha) ranged from 0.77 to 0.95 across all settings and domains, and test-retest reliability (ICC) ranged from 0.80 to 0.95, indicating the tool produces stable scores over a two-week interval.
3No significant differences were found between the two groups in home participation frequency or in the desire for change at home, suggesting families provide similar support at home regardless of the child's disability.
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What it does not show
Children with cognitive impairment (SPARKLE score ≤ 70) were excluded, so the tool's performance in children with intellectual disability is unknown. Only children with CP were included; children with other movement disorders or physical disabilities were not studied. All respondents in the CP group were mothers, so fathers' perspectives are not represented. The study was conducted at a single site in Tehran, so generalisability to other Persian-speaking regions or countries is untested. No analysis was done by disability severity (hemiplegia, diplegia, quadriplegia, etc.) or by family income, so you cannot tell whether the tool performs differently across these subgroups. The test-retest sample was only 40 parents, smaller than the 100 used for internal consistency.
Declared interests
No funding was received and the authors declare no conflicts of interest. The original PEM-CY was purchased from Shop CanChild and permission for translation was obtained from the CanChild group; the final Persian version was reviewed and approved by Rachel Teplicky, CanChild's Business and Engagement Officer.
The easy way to misread this
Do not read the lower participation scores of children with CP as evidence that a specific therapy or environmental modification will improve their participation — this is a measurement validation study, and the group differences simply confirm the tool can tell the two groups apart. The study also excluded children with cognitive impairment (SPARKLE score ≤ 70), so it says nothing about the participation of children with intellectual disability, and it included only children with CP, not other physical disabilities.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →