Psychometric Evaluation of the Young Children’s Participation and Environment Measure (YC–PEM)

SIGNIFICANCE: Participation in occupation is a valued but infrequently documented outcome in pediatric rehabilitation, early intervention, and early childhood special education. The Young Children’s Participation and Environment Measure (YC–PEM) is designed to enable comprehensive, detailed, and feasible proxy survey of young children’s participation. The YC–PEM is modeled after the Participation and Environment Measure for Children and Youth (PEM–CY). Additional research informed revisions to survey content and scaling prior to validation.

APPROACH: Research hypotheses included the following: (1) YC–PEM internal consistency is moderate to very good; (2) YC–PEM scores are reproducible within 2 to 4 wk; (3) there are significant negative associations between YC–PEM environmental items and Craig Hospital Inventory of Environmental Factors—Child and Parent Version (CHIEF–CP) items, and there are significant positive associations between children’s performance and participation; and (4) younger children and children with disabilities participate less often and are less involved in activities than older children and children without disabilities. The validity and reliability of the YC–PEM were examined prior to its use in occupational therapy relevant research.

METHOD: This was a cross-sectional study that occurred between June 2013 and October 2013. Data were collected in three parts: (1) demographic, YC–PEM, and CHIEF–CP (online); (2) Pediatric Evaluation of Disability Inventory—Computer Adaptive Test (PEDI–CAT; telephone); and (3) YC–PEM retest (online). Convenience and snowball sampling were used to recruit participants who could read and write in English, resided in North America, identified as a parent or legal guardian who was aged 18 yr or older, had a child who was aged 0 to 5 yr, and had Internet access. Participants were caregivers of 395 children (93 children with disabilities, 302 without disabilities) aged 0 to 5 yr (M = 35.3 mo, SD = 20.3).

Measures/targeted outcomes included the following: demographic, YC–PEM, CHIEF–CP, and PEDI–CAT. Cronbach’s alphas, intraclass correlation coefficients (ICCs), and kappa coefficients were used to examine the internal consistency and test–retest reliability of YC–PEM scales (three participation scales, one environment scale) for the three survey sections. Pearson/Spearman correlational analyses were used to explore associations between YC–PEM environmental items and CHIEF–CP items and between children’s performance (PEDI–CAT) and participation (YC–PEM). Kruskal–Wallis one-way analyses of variance (ANOVAs), independent-samples t tests, and Mann–Whitney U tests were used to examine the effect of child age (four levels) and disability (two levels) on participation scores.

RESULTS: Internal consistency ranged from .68 to .96 and from .92 to .96, and test–retest reliability ranged from .31 to .93 and from .91 to .94, for participation and environment scales, respectively. Significant negative associations were found for 77.3% of CHIEF–CP and YC–PEM item-level comparisons. Higher functional performance was associated with greater involvement in activities. Group differences by disability, but not age, were found for two YC–PEM scales across all three settings.

CONCLUSION: Results provide initial evidence to support use of the YC–PEM in research on young children with and without disabilities. Future research is needed to confirm results using paper forms; diverse samples relative to child race/ethnicity, income, and respondent education; and equal sample sizes.