Use of the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test in Denmark, the Netherlands, and Norway.

The study included only typically developing children, so the findings may not apply to children with disabilities. Respondents were predominantly non-immigrants with higher levels of education, which may limit generalizability. The sample size was relatively small for detecting differential item functioning across all items. A high percentage of extreme responses (ceiling effects) were observed in several domains. The study could not analyze differential item functioning by age due to the data collection method.

The authors declared no conflicts of interest. The research received no specific funding.

Do not assume the PEDI-CAT domains are unidimensional or that all items function perfectly in these populations. The study found evidence of multidimensionality and local dependency, meaning scores may not reflect a single underlying ability as intended. Clinicians should interpret results with caution, especially when problematic items are involved.