Further validation of the Child and Adolescent Scale of Participation (CASP)

Primary objective: To further validate the Child and Adolescent Scale of Participation (CASP) for children and youth with acquired brain injuries and other disabling conditions. Research design and methods: A cross-sectional design was used. Data were collected on 313 children and youth, aged 3-22, with and without disabling conditions. Children with acquired brain injuries (ABI) were the largest group (56%). Cronbach's alpha, factor analyses and Rasch analyses were used to examine internal scale consistency and structure. Correlation analyses were conducted to examine associations between CASP scores and scores that reflect extent of impairment and impact of environmental barriers. Independent t-tests or analyses of variance were used to examine mean differences in CASP scores in relation to sex, age and disability groups. Main outcomes and results: Children without disabilities had significantly greater extent of participation (higher CASP scores) than children with disabilities. Greater extent of participation was associated with lesser extent of impairment and environmental barriers. Evidence of internal consistency and internal structure validity was demonstrated. Factor analyses showed that items from similar domains loaded onto one of three factors and a large (63%) proportion of variance was explained. Rasch analyses revealed essentially one unidimensional construct. The item difficulty order closely matched the expected pattern of life situations that children would find more to less challenging to participate in. Conclusions: Findings were similar to prior research and suggested that the CASP is a promising new measure of participation. However, study design features limit generalizations and definitive conclusions that can be made. Future research is needed to assess the ability of the CASP to detect change over time and to include a larger and more diverse sample.