Background Developmental disorders (DDs) in children are a priority condition and guidelines have been developed for their management within low-resource community settings. However, a key obstacle is lack of open access, reliable and valid tools that lay health workers can use to evaluate the impact of such programmes on child outcomes. We adapted and validated the World Health Organization's Disability Assessment Schedule for children (WHODAS-Child), a lay health worker-administered functioning-related tool, for children with DDs in Pakistan. Methods Lay health workers administered a version of the WHODAS-Child to parents of children with DDs (N = 400) and without DDs (N = 400), aged 2–12 years, after it was adapted using qualitative study. Factor analysis, validity, reliability and sensitivity to change analyses were conducted to evaluate the psychometric properties of the adapted outcome measure. Results Among 800 children, 58% of children were male [mean (s.d.) age 6.68 (s.d. = 2.89)]. Confirmatory Factor Analysis showed a robust factor structure [χ2/df 2.86, RMSEA 0.068 (90% CI 0.064–0.073); Tucker–Lewis Index (TLI) 0.92; Comparative Fit Index (CFI) 0.93; Incremental Fit Index (IFI) 0.93]. The tool demonstrated high internal consistency (α 0.82–0.94), test–retest [Intra-class Correlation Coefficient (ICC) 0.71–0.98] and inter-data collector (ICC 0.97–0.99) reliabilities; good criterion (r −0.71), convergent (r −0.35 to 0.71) and discriminative [M (s.d.) 52.00 (s.d. = 21.97) v. 2.14 (s.d. = 4.00); 95% CI −52.05 to −47.67] validities; and adequate sensitivity to change over time (ES 0.19–0.23). Conclusions The lay health worker administrated version of adapted WHODAS-Child is a reliable, valid and sensitive-to-change measure of functional disability in children aged 2–12 years with DDs in rural community settings of Pakistan.

中文翻译：

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测量资源匮乏地区发育障碍儿童的功能障碍：巴基斯坦农村地区发育障碍儿童残疾评估表 (DD-CDAS) 的验证


背景 儿童发育障碍 (DD) 是一种优先病症，并且已经制定了在资源匮乏的社区环境中对其进行管理的指南。然而，一个主要障碍是缺乏开放获取、可靠和有效的工具，非专业卫生工作者可以使用这些工具来评估此类计划对儿童结局的影响。我们调整并验证了世界卫生组织儿童残疾评估表 (WHODAS-Child)，这是一种由非专业卫生工作者管理的功能相关工具，适用于巴基斯坦患有残疾的儿童。方法 非专业卫生工作者向 DD 儿童的父母实施 WHODAS-Child 版本（氮= 400) 且没有 DD (氮= 400），年龄 2-12 岁，使用定性研究进行改编后。进行因子分析、有效性、可靠性和变化敏感性分析，以评估适应结果测量的心理测量特性。结果 在 800 名儿童中，58% 的儿童是男性 [平均 (标准差） 6.68 岁（标准差= 2.89）]。验证性因素分析显示出稳健的因素结构 [χ 2 /df 2.86，RMSEA 0.068（90% CI 0.064–0.073）；塔克-刘易斯指数 (TLI) 0.92；比较适合指数（CFI）0.93；增量拟合指数 (IFI) 0.93]。该工具表现出高度的内部一致性（ α 0.82–0.94)、测试-再测试[类内相关系数 (ICC) 0.71–0.98] 和数据收集器间 (ICC 0.97–0.99) 可靠性；好的标准（ r −0.71), 收敛 ( r −0.35 到 0.71) 和判别性 [M (标准差) 52.00 (标准差= 21.97) v 。 2.14（标准差= 4.00); 95% CI -52.05 至 -47。67] 有效性；对随时间变化的足够敏感性（ES 0.19-0.23）。结论 由非专业卫生工作者管理的改编版 WHODAS-Child 是一种可靠、有效且对变化敏感的衡量巴基斯坦农村社区 2-12 岁 DD 儿童功能障碍的方法。