Use of the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test in Denmark, the Netherlands, and Norway

AIM: To investigate whether the items of the Danish, Dutch, and Norwegian versions of the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) align with the location-order used in the original algorithm and to assess their structural validity.

METHOD: Three convenience samples without disability (0-20 years; Danish [n = 318], Dutch [n = 349], Norwegian [n = 362]) responded to the language-specific versions. Item location-order was estimated using the graded response model and structural validity was tested using confirmatory factor analysis and Rasch analysis.

RESULTS: For most items, the item location-order was largely consistent with the location-order used in the original PEDI-CAT algorithm. Items showing a different order were primarily related to the daily activity domain. However, the confirmatory factor analysis and Rasch analysis indicated poor model fit, multidimensionality, and local dependency. Additionally, the Rasch analysis revealed that some items were misfitting, with a few also showing signs of misfit in the original PEDI-CAT version. Few items displayed differential item functioning by sex.

INTERPRETATION: The Danish, Dutch, and Norwegian version of the PEDI-CAT can be used to measure the degree of functioning or responsibility. However, clinicians should interpret the PEDI-CAT results with caution due to evidence of multidimensionality, some misfit items, and differential item functioning by sex. Further research is warranted in a population of children and young people with disabilities.