Yes / Purpose: To develop and validate the first patient-reported outcome measure (PROM) to quantify vision-related dizziness. Dizziness is a common, multifactorial syndrome that causes reductions in quality of life and is a major risk factor for falls, but the role of vision is not well understood. Methods: Potential domains and items were identified by literature review and discussions with experts and patients to form a pilot PROM, which was completed by 335 patients with dizziness. Rasch analysis was used to determine the items with good psychometric properties to include in a final PROM, to check undimensionality, differential item functioning, and to convert ordinal questionnaire data into continuous interval data. Validation of the final 25-item instrument was determined by its convergent validity, patient, and item-separation reliability and unidimensionality using data from 223 patients plus test–retest repeatability from 79 patients. results: 120 items were originally identified, then subsequently reduced to 46 to form a pilot PROM. Rasch analysis was used to reduce the number of items to 25 to produce the vision-related dizziness or VRD-25. Two subscales of VRD-12-frequency and VRD-13-severity were shown to be unidimensional, with good psychometric properties. Convergent validity was shown by moderately good correlations with the Dizziness Handicap Inventory (r = 0.75) and good test–retest repeatability with intra-class correlation coefficients of 0.88. conclusion: VRD-25 is the only PROM developed to date to assess vision-related dizziness. It has been developed using Rasch analysis and provides a PROM for this under-researched area and for clinical trials of interventions to reduce vision-related dizziness. / College of Optometrists (UK) research studentship.

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<p>Traditionally, measures have been developed using Classical Test Theory (CTT). Modern psychometric methods (e.g. Rasch analysis) are being applied to increase understanding of item-level statistics and to aid in interpreting rating scale scores. This thesis aims to compare and contrast psychometric findings for the PedsQL^TM 4.0 Generic Core Scales using CTT and Rasch analysis to determine if a Rasch approach provides information that furthers our understanding of scale scores. The assumptions, advantages and limitations of each psychometric paradigm are presented.</p> <p>Issues that arise when measuring quality of life are discussed to set the stage for a psychometric analysis of the PedsQL^TM in a childhood cancer sample. The PedsQL^TM measures child health in terms of physical, social, emotional and school function. The parent-report version was used in a Canadian study of 385 parents of children aged 2 to 17 years on active cancer treatment and data was re-analyzed for this thesis. CTT analysis was performed using PASW Statistics and Rasch analysis was performed using Rumm2030.</p> <p>Internal consistency reliability was higher using CTT (a = 0.93) than Rasch analysis (Person Separation Index = 0.78). Rasch analysis item curves showed respondents did not discriminate between response categories and a 3 point scale (vs. 5) was preferred. Item curves also indicated most items were free of bias. There are no equivalent visual representations in CTT of how respondents use response categories or of whether items display bias. Both approaches indicate a large ceiling effect associated with the overall score.</p> <p>Results challenge internal consistency reliability of the PedsQL^TM 4.0. Rasch analysis permits detailed and visually pleasing examination of item-level statistics more effectively than CTT. Research is needed to determine which testing circumstances render Rasch analysis useful and justify time and resources to use both paradigms as complementary tools to maximize understanding of rating scale scores.</p> / Master of Science Rehabilitation Science (MSc)

The focus of this study is the development and implementation of the Iterative Needs Assessment/Evaluation Model for use as part of an English curriculum reform project at a four-year university in Japan. Three questions were addressed in this study: (a) what model components were necessary for use in a Japanese university setting; (b) what survey instruments would work with such a model; and (c) what needs would the stakeholders in the project report? The site for the study was a mid-sized private, four-year university in Japan. Set as an instrumental case study (Stake, 1998), multiple methods and sources were employed. Stakeholders in the project included university students (n = 1533), teaching staff (n = 33), university administrators and staff (n = 5), and domain experts (n = 7). Data collection included the use of questionnaires, unstructured and semi-structured interviews, and systems and materials analyses. Questionnaires were developed and analyzed using Rasch analysis. The Needs Assessment/Evaluation Model was assessed using a modified version of the Checklist for Judging the Adequacy of an Evaluation Design (Sanders & Nafziger, 1985). Implementation of a full iteration of the Model indicated that use of the Iterative Needs Assessment/Evaluation Model could guide the development and evaluation of the English language program. As part of the study, valid survey instruments that can continue to aid the assessment of needs for and evaluation of the courses were developed. Data from multiple sources indicated a difference in the perception of needs between stakeholders. The processes followed through the development and application of the Iterative Needs Assessment/Evaluation Model served to incorporate these different perceptions into a cohesive language program curriculum. / CITE/Language Arts

Willingness to communicate (WTC) in a second language (L2) is crucial to the development of communicative speaking skills. This study is a cross-sectional investigation of the role in models of second language (L2) willingness to communicate of three personality variables hitherto underresearched in the L2 field: extroversion, ego permeability (one's capacity to tolerate ambiguity), and perceived distance from one's core persona. A sample of 252 Japanese university students responded to a set of instruments used to measure individual difference variables and personality variables; the instruments were drawn from the fields of L2 acquisition and psychology as well as a 5-item instrument designed to measure perceived distance in a series of participatory L2 speaking activities. Confirmatory factor analysis, Rasch analysis, and structural equation modeling were utilized to validate the respective instruments. The International Posture instrument was best represented by a two-factor configuration consisting of Intergroup Approach-Avoidance Tendency and Intercultural Friendship Orientation, while the L2 Communicative Confidence was altered to consist of three factors (L2 Anxiety, Perceived L2 Communicative Competence, and Extroversion). The hypothesized additions of Ego Permeability and Perceived Distance failed to improve the measurement models, and the original Ego Permeability variable functioned poorly in this context. The MacIntyre and Charos (1996) model had marginal fit to the data even after undergoing considerable respecification. The models of Yashima (2002) and Yashima, Zenuk-Nishide, and Shimizu (2004) were found to have good fit as originally conceptualized, but the addition of Extroversion and paths from International Posture and L2 Communicative Anxiety improved the fit of both models. Collectively, the results indicate that extroversion plays an important role in models of L2 WTC and that the basic models of Yashima and colleagues are robust. These findings provide crucial insights into the process of L2 WTC, an important factor in the students' acquisition of communicative competence. / CITE/Language Arts

Most research on confirmatory factor analysis using global fit indices (AIC, BIC, AICc, and CAIC) has been in the structural equation modeling framework. Little research has been done concerning application of these indices to item response models, especially within the framework of multidimensional Rasch analysis. The results of two simulations studies that investigated how sample size, between-dimension correlation, and test length affect the accuracy of these indices in model recovery using a multidimensional Rasch analysis are described in this dissertation. The first study analyzed dichotomous data, with model-to-data misfit as an additional independent variable. The second study analyzed polytomous data, with rating scale structure as an additional independent variable. The interaction effect between global fit index and between-dimension correlation had very large effect sizes in both studies. At higher values of between-dimension correlation, AIC indicated the correct two-dimension generating structure slightly more often than does the BIC or CAIC. The correlation by test length interaction had an odds ratio indicating practical importance in the polytomous study but not the dichotomous study. The combination of shorter tests and higher correlations resulted in a difficult-to-detect distinction being modeled with less statistical information. The correlation by index interaction in the dichotomous study had an odds ratio indicating practical importance. As expected, the results demonstrated that violations of the Rasch model assumptions are magnified at higher between-dimension correlations. Recommendations for practitioners working with highly correlated multidimensional data include creating moderate length (roughly 40 items) instruments, minimizing data-to-model misfit in the choice of model used for confirmatory factor analysis (MRCMLM or other MIRT models), and making decisions based on multiple global indices instead of depending on one index in particular. / Ph. D.

Yes / A large proportion of children are not able to perform age-appropriate fundamental movement skills (FMS). Thus, it is important to assess FMS so that children needing additional support can be identified in a timely fashion. There is great potential for universal screening of FMS in schools, but research has established that current assessment tools are not fit for purpose. To develop and validate the psychometric properties of a FMS assessment tool designed specifically to meet the demands of universal screening in schools. A working group consisting of academics from developmental psychology, public health and behavioural epidemiology developed an assessment tool (FUNMOVES) based on theory and prior evidence. Over three studies, 814 children aged 4 to 11 years were assessed in school using FUNMOVES. Rasch analysis was used to evaluate structural validity and modifications were then made to FUNMOVES activities after each study based on Rasch results and implementation fidelity. The initial Rasch analysis found numerous psychometric problems including multidimensionality, disordered thresholds, local dependency, and misfitting items. Study 2 showed a unidimensional measure, with acceptable internal consistency and no local dependency, but that did not fit the Rasch model. Performance on a jumping task was misfitting, and there were issues with disordered thresholds (for jumping, hopping and balance tasks). Study 3 revealed a unidimensional assessment tool with good fit to the Rasch model, and no further issues, once jumping and hopping scoring were modified. The finalised version of FUNMOVES (after three iterations) meets standards for accurate measurement, is free and able to assess a whole class in under an hour using resources available in schools. Thus FUNMOVES has the potential to allow schools to efficiently screen FMS to ensure that targeted support can be provided and disability barriers removed. / ESRC White Rose Doctoral Training Partnership Pathway Award (ES/P000745/ 1). ActEarly: a City Collaboratory approach to early promotion of good health and wellbeing funded by the Medical Research Council (grant reference MR/S037527/). National Institute for Health Research Yorkshire and Humber ARC (reference: NIHR20016).

Maintaining relationships and interacting socially are essential aspects of children’s occupational performance. Social participation occurs during many childhood occupations such as play and school work. Rather than assessing social skills deficits in isolation, occupational therapists are well placed to assess and treat children with difficulties in social participation during their daily childhood occupations. The existing models of social competence fail to consider or describe the social skills required during learning-related tasks. Therefore, a comprehensive model is needed to guide occupational therapists in understanding social competence during both interpersonal and learning-related social tasks and in specific contexts (e.g., early childhood settings) (Lim & Rodger, 2008). Background and Research Aims: “Social participation” falls within the occupational therapy domain of concern according to the Occupational Therapy Practice Framework (2nd edition) (American Occupational Therapy Association [AOTA], 2008), However, surveys conducted in the United Kingdom, Australia and Canada indicate that there has been limited provision of services for children with poor social skills compared to areas such as sensory processing, motor skill development and visual perceptual skills training (Brown, Rodger, Brown, & Roever, 2005; Howard, 2002; Rodger, Brown, & Brown, 2005). Factors such as a limited knowledge of available tools and limited access to social skills models have hampered occupational therapists’ accurate assessment of social skills (Doble, Bonnell, & Magill-Evans, 1991). This study was conducted in Singapore, where generally there has been limited occupational therapy research, and even less in specific early childhood and school environments. High levels of proficiency in pre-literacy and mathematic skills are expected of young Singaporean children (Ko, 1992; Tan, 2007). With the emphasis on gaining academic skills to be ready for primary education from as early as 3 to 4 years of age, Singaporean children are also expected to demonstrate compliance and ability to sit still while attending to a lesson (Tan, 2007). Hence, it is important to conduct research on specific cultural contexts such as early childhood environments in Singapore. The early childhood literature has begun to differentiate between interpersonal social skills (IPS) and learning-related social skills (LRSS). IPS is needed for maintaining friendships and engaging in play, while LRSS is required for positive classroom behaviours (e.g., staying on task) (McClelland & Morrison, 2003). This research aimed to investigate the validity of the Proposed Model of Social Competence relevant to occupational therapists working with children in early childhood settings. First, this study aimed to investigate whether LRSS and IPS exist as separate unidimensional constructs as suggested in the Proposed Model of Social Competence and second, how these constructs contribute towards young children’s social competence. This research also intended to identify reliable and valid instruments that can be used for the comprehensive assessment of children’s social competence by therapists and educators in early childhood settings. Methodology and Study Findings First, a preliminary content validity study with Singaporean and Australian experts was conducted to investigate whether LRSS and IPS were represented by items from two pre-existing behaviour rating questionnaires (Lim, Rodger & Brown, 2010b). Next, in the main study, 117 young children (aged 3 to 6 years) were assessed using a combination of naturalistic observational tools and behaviour rating questionnaires. The children were observed during free play and school work tasks and their teachers completed two behaviour rating questionnaires regarding the children’s social skills. Rasch analysis and confirmatory factor analysis (CFA) were employed in this study to analyse the data. Results from the content validity study indicated that the two behaviour rating questionnaires selected for inclusion in this study contained items representing IPS and LRSS. In addition, the experts found it clinically useful to consider IPS and LRSS as two separate constructs exhibited by young children. In the main study, IPS and LRSS were found to exist as separate unidimensional constructs, in addition to two other constructs named Compliance and Group Social Interaction which were found to also exist. Scales with acceptable measurement properties were found within the existing social skills assessment tools to measure these constructs. Furthermore, the CFA revealed Social Competence as an underlying multidimensional factor that was composed of the four indicator variables IPS, LRSS, Compliance, and Group Social Interaction. As a result of this study, the Proposed Model of Social Competence was revised. Conclusions and Recommendations Different social skills constructs that contributed to social competence in young children were identified and validated in the study. As Social Competence is a multi-dimensional factor, it is insufficient to assess only children’s interpersonal social skills. The Model of Social Competence-Revised aims to guide occupational therapists and other professionals to consider different types of social skills and elements that may contribute to poor social competence. Depending on the different presenting concerns, practitioners can select specific instruments to assess the different types of social skills identified in this research. Instead of designing new assessment tools that measure newly hypothesised constructs, this study demonstrated a novel approach to extend the validity of existing instruments to measure new constructs (Lim, Rodger & Brown, 2010a). This thesis has extended the extant body of literature by presenting the development, testing, and revision of a proposed theoretical model to assess young children’s social competence within early childhood contexts. This thesis has also contributed by identifying and validating existing assessment tools that can be used to evaluate the different social skills constructs observed in young children within early childhood environments.