Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity
IntroductionChildren with medical complexity (CMC) are medically fragile with severe brain damage and chronic conditions, necessitating daily care. Their neurological impairments often limit participation in childhood activities, affecting quality of life. Current assessment tools fail to detect sub...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1479298/full |
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| author | Brooke Mulrenin Bryant A. Seamon Carrie Cormack Kimberly Lane Kascak Cynthia Dodds |
| author_facet | Brooke Mulrenin Bryant A. Seamon Carrie Cormack Kimberly Lane Kascak Cynthia Dodds |
| author_sort | Brooke Mulrenin |
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| description | IntroductionChildren with medical complexity (CMC) are medically fragile with severe brain damage and chronic conditions, necessitating daily care. Their neurological impairments often limit participation in childhood activities, affecting quality of life. Current assessment tools fail to detect subtle abilities in CMC, hindering development of effective rehabilitation goals and interventions. The Pediatric Awareness and Sensory Motor Assessment (PASMA) was created to fill this gap, providing sensitive measurement of sensory awareness and motor response across five domains (i.e., olfactory, visual, auditory, gustatory, and tactile).MethodsIn this retrospective study, a Rasch analysis was conducted on PASMA data for CMC. The PASMA was administered five times over ten weekdays to each child, reflecting its intended clinical use to gain a reliable sense of each child's awareness.ResultsAnalysis of data from 36 CMC revealed that the PASMA is sufficiently unidimensional, effectively measuring sensory awareness and motor response as a single construct. Its rating scale structure was validated without modifications, and the item hierarchy matched clinical expectations. High item reliability (0.97) was observed, with one item (V2 blink in response to light) slightly misfitting, but without affecting overall measures. Adequate person reliability was observed (0.81), with 15% person misfit. Person misfit did not degrade item measures or model statistics. Differential item functioning (DIF) was noted for the three easiest items on specific days. The PASMA successfully stratified participants into three distinct awareness levels (low, medium, and high awareness), without floor or ceiling effects.DiscussionThe PASMA is a valid unidimensional measure of sensory awareness and motor response in CMC. Rating scale characteristics, item hierarchy, and person separation measures all support the PASMA's measurement properties within this heterogeneous sample of CMC. DIF findings support a potential reduction in the recommended number of PASMA administrations per individual. Future research will focus on establishing rater reliability and external validity. Additional efforts will support health professionals to utilize the PASMA for baseline assessments, guiding personalized interventions, and tracking progress.ConclusionClinical use of the PASMA could provide new opportunities to detect subtle abilities, preferences, and changes in CMC, to promote meaningful participation and improve quality of life. |
| format | Article |
| id | doaj-art-cf74a83b665b42c0b23e6bffd8bad93f |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj-art-cf74a83b665b42c0b23e6bffd8bad93f2025-01-29T06:46:20ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011310.3389/fped.2025.14792981479298Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexityBrooke Mulrenin0Bryant A. Seamon1Carrie Cormack2Kimberly Lane Kascak3Cynthia Dodds4Division of Occupational Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, United StatesDivision of Physical Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, United StatesCollege of Nursing, Medical University of South Carolina, Charleston, SC, United StatesOffice of Interprofessional Initiatives, Medical University of South Carolina, Charleston, SC, United StatesDivision of Physical Therapy, College of Health Professions, Medical University of South Carolina, Charleston, SC, United StatesIntroductionChildren with medical complexity (CMC) are medically fragile with severe brain damage and chronic conditions, necessitating daily care. Their neurological impairments often limit participation in childhood activities, affecting quality of life. Current assessment tools fail to detect subtle abilities in CMC, hindering development of effective rehabilitation goals and interventions. The Pediatric Awareness and Sensory Motor Assessment (PASMA) was created to fill this gap, providing sensitive measurement of sensory awareness and motor response across five domains (i.e., olfactory, visual, auditory, gustatory, and tactile).MethodsIn this retrospective study, a Rasch analysis was conducted on PASMA data for CMC. The PASMA was administered five times over ten weekdays to each child, reflecting its intended clinical use to gain a reliable sense of each child's awareness.ResultsAnalysis of data from 36 CMC revealed that the PASMA is sufficiently unidimensional, effectively measuring sensory awareness and motor response as a single construct. Its rating scale structure was validated without modifications, and the item hierarchy matched clinical expectations. High item reliability (0.97) was observed, with one item (V2 blink in response to light) slightly misfitting, but without affecting overall measures. Adequate person reliability was observed (0.81), with 15% person misfit. Person misfit did not degrade item measures or model statistics. Differential item functioning (DIF) was noted for the three easiest items on specific days. The PASMA successfully stratified participants into three distinct awareness levels (low, medium, and high awareness), without floor or ceiling effects.DiscussionThe PASMA is a valid unidimensional measure of sensory awareness and motor response in CMC. Rating scale characteristics, item hierarchy, and person separation measures all support the PASMA's measurement properties within this heterogeneous sample of CMC. DIF findings support a potential reduction in the recommended number of PASMA administrations per individual. Future research will focus on establishing rater reliability and external validity. Additional efforts will support health professionals to utilize the PASMA for baseline assessments, guiding personalized interventions, and tracking progress.ConclusionClinical use of the PASMA could provide new opportunities to detect subtle abilities, preferences, and changes in CMC, to promote meaningful participation and improve quality of life.https://www.frontiersin.org/articles/10.3389/fped.2025.1479298/fullchildren with medical complexity (CMC)Pediatric Awareness and Sensory Motor Assessment (PASMA)Rasch analysisitem response theory (IRT)pediatric assessmentassessment validation |
| spellingShingle | Brooke Mulrenin Bryant A. Seamon Carrie Cormack Kimberly Lane Kascak Cynthia Dodds Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity Frontiers in Pediatrics children with medical complexity (CMC) Pediatric Awareness and Sensory Motor Assessment (PASMA) Rasch analysis item response theory (IRT) pediatric assessment assessment validation |
| title | Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity |
| title_full | Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity |
| title_fullStr | Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity |
| title_full_unstemmed | Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity |
| title_short | Item-level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity |
| title_sort | item level measurement properties of the pediatric awareness and sensory motor assessment in children with medical complexity |
| topic | children with medical complexity (CMC) Pediatric Awareness and Sensory Motor Assessment (PASMA) Rasch analysis item response theory (IRT) pediatric assessment assessment validation |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1479298/full |
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