The development of Children’s and Adolescents’ Functional Assessment Rating Scale
Keywords:Questionnaire Function Children and Adolescents Validity Reliability
Objectives To develop and test the validity and reliability of a functional assessment rating scale for use with children and adolescents with mental illness in Thailand.
Methods Documents and studies related to functional rating scales both in Thailand and other countries were reviewed and used in developing a clinician-rated functional assessment rating scale. The scale consists of 15 items in 4 functional domains: performance, risky behaviors, presenting symptoms and strengths. The draft questionnaire was evaluated for content validity by three experts using the index of item-objective congruence (IOC). The rater agreement index (RAI) was calculated. Patients of the outpatient, inpatient and day hospital units of the Division of Child and Adolescent Psychiatry at Siriraj Hospital, Bangkok were recruited into this study. The 10 clinicians who rated the patients included physicians, psychologists and occupational therapists. The standardized Children’s Global Assessment Scale (CGAS) was used as a comparator for convergent validity. Cronbach’s alpha was used to measure reliability and the Pearson correlation was used to measure validity.
Results The study identified 250 eligible patients, 243 of whom were included in the analysis. Most of the participants were male (65.4%) and the mean age of the group was 11.5 years. The three most frequent principle diagnoses were attention-deficit/hyperactivity disorder (63%), depression (20.2%) and autistic spectrum disorder (3.7%). The Cronbach’s alpha coefficient for the functional assessment rating scale was 0.825 and the Pearson correlation coefficient between the newly developed scale and CGAS was statistically significant (r = 0.781).
Conclusions The Children’s and Adolescents’ Functional Assessment Rating Scales demonstrated good validity and reliability. This instrument is appropriate for use by clinicians in evaluating, following up and developing treatment plans for patients.
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