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The Infant Toddler Activity Card Sort (ITACS) is a new measure that engages caregivers in goal development by measuring participation in early childhood. Initial evaluation of the ITACS is required to assess its psychometric properties. To evaluate test–retest reliability, concurrent validity, and between-group differences of the ITACS. Caregivers ( N = 208) of children 0–3 years, who were typically developing (TD) or had a developmental delay (DD), completed the ITACS and Pediatric Evaluation of Disability Inventory–Computer Adaptive Test (PEDI-CAT) with repeat assessment after 2 weeks later ( n = 117). The ITACS demonstrated moderate concurrent validity with the PEDI-CAT. Children with DD had significantly more activity concerns on the ITACS than TD. Adequate test–retest reliability was not achieved. The ITACS is a useful tool for identifying caregiver concerns in activity engagement; interventions can be tailored to address concerns and increase participation in childhood routines.

BackgroundDevelopment is rapid in the first years of life. Developmental delays appearing during this critical period have the potential to persist throughout the child’s life. Available standardized assessments for this age record a child’s ability to successfully complete discrete skills but fail to capture whether the child incorporates those skills into daily routines that are meaningful to the child and family. The Infant Toddler Activity Card Sort (ITACS) is a newly developed photograph-based early intervention tool to measure the participation-related concept of activity competence using caregiver report. The purpose of the present study was to use Rasch analysis to determine if ITACS items comprehensively measure the construct of child activity competence.ResultsA total of 60 child/caregiver dyads participated. The dichotomous caregiver-reported responses (present vs. absent) on the 40 individual ITACS items were used in Rasch analysis, and three iterations of the model were completed. The final model included 51 child/caregiver dyads and 67 ITACS assessments with a good spread of individual ability measure (6.47 logits). All items demonstrated adequate infit except for “sleeping” (range 0.68–1.54). Five items (sleeping, eating at restaurants, brushing teeth, crawling, and interact with pets) demonstrated high Mean Square (MNSQ) outfit statistics and one (take a bath) demonstrated low MNSQ outfit. ITACS items demonstrated a good spread of item difficulty measures (6.27 logits), and a clear ceiling was observed. Three activity items (smiling, breastfeeding, and playing with adults) were rarely endorsed as concerns. The activities most likely to be reported as challenging were “crying/communicating” and “going to school”. Person and item reliability statistics were adequate (0.79 and 0.80, respectively). The separation between individuals and between items were adequate to good (1.96 and 1.99, respectively).ConclusionsFindings indicate that ITACS items are measuring a unidimensional construct--activity competence in early childhood. The Rasch analysis of caregiver responses suggest that some activities are more likely to be considered challenging and may be important targets for intervention. These results provide evidence to further validate the ITACS as a caregiver report measure and support its use in the early intervention setting to facilitate caregiver driven goal development.

Date Presented 04/9/21 Development in the first years of life is often characterized by a child’s aptitude to complete discrete tasks, such as walking or stacking blocks. True participation requires the child to incorporate skills into everyday activities. This presentation will provide an overview of the Infant Toddler Activity Card Sort, the initial psychometrics, and a Rasch analysis. Primary Author and Speaker: Catherine R. Hoyt Contributing Authors: Ching-Fan Sheu

Early intervention (EI) therapy services aim to address family-centered goals to facilitate young children’s development and participation in meaningful life activities. Current methods to evaluate children in EI assess discrete developmental skills but provide little information on the child’s ability to successfully incorporate that skill in everyday life. Furthermore, traditional measures have limited opportunity for parent report, despite parent engagement being a critical component for successful implementation of EI services. A measure that involves parents in the therapeutic process to track family-driven EI goals related to a child’s occupational engagement in meaningful family activities and routines is desperately needed. Using a qualitative design and conventional content analysis, we identified 41 distinct activities of infant–toddlers from a cohort of 23 caregivers. Activity items were matched with photographs and validated with experts in pediatric rehabilitation using the Delphi method. The resulting 40 activity/photograph pairs were used to develop a new measure of pediatric occupational engagement, the Infant Toddler Activity Card Sort (ITACS).

Date Presented 03/29/20 Development in the first years of life is often characterized by a child’s aptitude for completing discrete tasks, such as walking or stacking blocks. Real-life participation requires the child to incorporate skills into everyday activities. The ITACS is a newly developed assessment that measures a child’s engagement in daily activities. This presentation will provide an overview of the ITACS and discuss its initial psychometrics. Primary Author and Speaker: Catherine Hoyt Contributing Authors: Ashley Chuck, Taniya Varughese, Laura Fisher, Regina Abel, Allison King

Date Presented 04/06/19 While many pediatric assessments are based on developmental milestones, achievement of discrete skills may not truly capture their use in functional contexts. Difficulties in transferring skills to everyday life may manifest in specific activity deficits, creating a need for direct measures of participation. The Infant Toddler Activity Card Sort (ITACS) was created to fill this gap by summarizing occupational development in early childhood. Here, we describe the ITACS test-retest reliability. Primary Author and Speaker: Ashley Chuck Additional Authors and Speakers: Laura Pilney Contributing Authors: Catherine Hoyt, Taniya Varughese, Evelyn Shen, Allison King, Regina Abel, Hannah Manis, Kelly Baker, Emma Grandgeorge, Jianna Fernandez

Date Presented 04/04/19 Early intervention therapists rely on developmental milestone-focused assessments to identify deficits and justify services. However, these measures fail to assess a child’s ability to incorporate discrete skills into functional activities. The Infant Toddler Activity Card Sort (ITACS) will meet this need. Primary Author and Speaker: Catherine Hoyt Contributing Authors: Jianna Fernandez, Ashley Chuck, Laura Pilney, Taniya Varughese, Regina Abel, Allison King