School Function Assessment (SFA)
School Function Assessment (SFA):
Evaluative
These are the prices of the SFC kits and components as of 2018. These prices have not updated since 2017:
SFA Complete Kit: $243
SFA User’s Manual: $151.50
SFA Record Forms: $102.50
SFA Rating Scale Guidelines: $25
Reference:
Li, X., Dong, V. A., & Fong, K. N. (2015). Reliability and Validity of School Function Assessment for Children with Cerebral Palsy in Guangzhou, China. Hong Kong Journal of Occupational Therapy,26, 43-50. doi:10.1016/j.hkjot.2015.12.001
Title: Reliability and Validity of School Function Assessment for Children with Cerebral Palsy in Guangzhou, China.
Background and Purpose: According to this article, the School Function Assessment (SFA) is a comprehensive design that measures the typical social and academic functional task performance of an elementary school-aged child. The three associated parts of this assessment are as follows: activity performance, participation, and task support. Students with disabilities typically score much lower on this assessment than typically developing children. With that said, results of the SFA can be utilized to help individualize the goals and objectives for the educational programs that children with disabilities are involved in. However, there has been minimal research on the functional performance of the school-aged children with disabilities in China, likely impacting the types of interventions and services that may be provided to them. The purpose of this study was to examine the usefulness and analyze external reliability, internal consistency, and content and construct validities of the Chinese version of the SFA.
Population: There were 93 participants, with a diagnosis of cerebral palsy (CP), whom were included in the study. The participants were from a special school in Guangzhou, they were in the 1st-5th grade, and their ages ranged from 6-18-years-old. Written and informed consent forms were obtained, prior to conduction of the study.
Methods and Intervention: The first part of the study included developing a Chinese prototype of the SFA, by very carefully and strategically having the SFA translated into a Chinese format. Translating the SFA required a five-stage process: “translation, synthesis, back translation, expert panel review, and pilot testing.” To evaluate the quality of the linguistics and content of the translation, an expert opinion questionnaire was developed, and experts rated the translation using a 5-point Likert-type scale. Once the SFA was translated, 12 primary school teachers were trained on the administration of the SFA to the 93 consenting students. There was a total of 21 individual Activity Performance Scales, according to the SFA, and this was on a continuum of 0-100, with standard scoring procedures. Next, a test re-test procedure was performed using 11 males and 3 female participants whose ages ranged from 8-15-years-old. The same teachers conducted the SFA on each of these students, in the same environment as the initial assessment. Lastly, Gross Motor Function Classification System (GMFCS) was administered to each of the participants to identify any correlations between motor impairments, medical history, and GMFCS.
Data Analysis and Results: Upon examining the results of the GMFCS, there were no significant relationships found between the participants motor impairments, medical history, and GMFCS scores. Test re-test reliability of the SFA items were explored using interclass correlation one-way random single measures; resulting ranges were from .49 to .97, indicating good reliability with those above .75 and poor-moderate reliability with those below .75. With that said, 71.4% of the Activity Performance items were within the good-to-excellent reliability ranges. Extracting the factor structure of the summary scores for the SFA’s Activity Performance Scales was achieved using the principle component analysis with direct oblique rotation; aside from recreational movement, Up/Down Stairs, and Physical Adaptation, the majority of the SFA items resulted in a mean score of more than 50 out of 100. The best performance, with a mean score of greater than 70 points, was seen in Eating and Drinking, Participation, and Setup and Cleanup. Exploratory factor analysis was used to examine construct validity of the Chinese SFA. Most of these items ranged around 70% However, agreement of the semantic meaning of the Chinese words resulted in the highest percentage of 85.3%. In addition, significance was noted with the Bartlett’s test of sphericity and the measure of sampling adequacy was .92 for the Kaiser-Meyer-Olkin. Lastly, internal consistency was assessed using Cronbach’s alpha; values of the coefficient resulted in ranges from .91-.96. These values suggest a high internal consistency, as anything above .90 is considered excellent.
Strengths: (1) There was a large sample size. (2) Translation of the SFA into the Chinese language was a well-constructed process and was thoroughly analyzed to enhance good carryover of the SFA into this clinical population. (3) Measures were consistent throughout the study, including utilizing the same teachers per student and maintaining the same environment during test re-test. (4) Multiple tests/measures were utilized to account for correlations between different variables within the population of participants.
Limitations: (1) There was a significant imbalance of participant age and sex, as the majority of participants were male, and all of the participants were utilized form one school setting. These factors decrease the generalizability of the study to the Chinese culture. (2) The study was only analyzing children with CP, further decreasing the generalizability. (3) Finally, this study only included those in a special school, so the results do not account for the children with disabilities who are in a school setting alongside typically developing children.
Discussion and Conclusion: Although the limitations of this study centered around poor generalizability within the Chinese population, this study was important for increasing the generalizability at an international level. Working towards translating these types of assessment and developing validity and reliability will enhance patient care worldwide. The results of this study suggested that there is a high internal consistency with test re-test reliability in the Chinese version of the SFA. All of the questionnaire items, including the Chinese SFA, resulted in a satisfactory degree of agreement, up to 85.3%. Based on these results, it is suggested that the Chinese SFA is a safe evaluative measure to assess the school activity performance of children with CP, up to 18-years-old, in special schools within China.
2 responses to “School Function Assessment (SFA)”
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Is there a similar test that was used for elementary school testing that could be used for comparison with this translation of the SFA?
Hey Amanda, thank you for your question. I wouldn’t necessarily say there is another similar test that was used to compare the translated version of the SFA with, at least not in this study. However, the GMFCS was utilized in the study as a means of determining functional ability levels and to classify the children with cerebral palsy. As a matter of fact, the GMFCS was utilized, and the results were compared, in almost all of the studies I have found that are examining the SFA. Based on what I gathered from this article. there is not a reliable standardized assessment in China to assess the functional participation and performance in children with special needs. Therefore, this study placed a heavy emphasis on the reliability of the translation of the SFA, prior to administering it to their population. In other words, translation and analysis of the translated SFA was what the entire first half of the study focused on. I hope that I was able to help with your question. Please let me know if you have anymore.