PEDI Article Summary – Are PEDI Normative Values Applicable to the German Version (PEDI-G) of the Pediatric Evaluation of Disability Index?
Wenger, C. Schulze, A. Kottorp, Are the American normative standard scores applicable to the German version of the Pediatric Evaluation of Disability Inventory (PEDI-G)? Scandinavian Journal of Occupational Therapy. 28, 110–120 (2020), doi:10.1080/11038128.2020.1726452.
Purpose: The United States of America utilizes the Pediatric Evaluation of Disability Inventory (PEDI) as an outcome measure to assess children’s abilities to accomplish activities of daily living. The PEDI is an outcome measure that primarily evaluates children from 6 months to 7.5 years of age. It is utilized in the clinic for children who have developmental or cognitive disabilities. The PEDI is also utilized in other countries, but it’s validity across various cultures had not yet been studied. The German version of the PEDI outcome measure is called the PEDI-G, and is utilized in Germany, Austria, and Switzerland. The purpose of this study was to investigate if the normative scores from the American PEDI were comparable and applicable to the PEDI-G.
Population details: All children within this study were between the ages of 9 months and 7.3 years of age, and the mean age was 3.6 years old. There were a total of 75 participants, 42 participants from Switzerland, 16 from Austria, and 17 from Germany.
Outcome Measures included: The PEDI-G contains a Functional Skills Scale (FSS), Caregiver Assistance Scale (CAS), and Modification Scale (MS).
Methods and Interventions: PEDI-G interviews were performed on all parents of the children from Austria, Germany, and Switzerland. Almost all of the parents who were interviewed were mothers, and the interviews lasted between 30 and 90 minutes. For the study, the FSS and the CAS were analyzed, but the MS was excluded due to the necessary environmental adaptations that come along with that portion of the assessment. To compare the normative scores from the PEDI-G to the PEDI, an independent sample t-test was used to detect any significant differences between each sample regarding the FSS and the CAS per age group. PEDI-G means and standard deviations were also calculated and compared for the FSS and CAS. This was done because the means and standard deviations of the PEDI were already published.
Results summarized: There were no significant differences between the German, Austrian, and Swiss countries, except for the CAS self care, where there were significant differences identified between Switzerland and Germany specifically. The results determined that the children in all three countries as well as within the United States had comparable performances in activities of daily living; focusing specifically on self care, social function, and mobility. The results indicate that the normative standard values of the PEDI utilized in the United States are applicable to the PEDI-G as well.
Author’s overall conclusion: No significant differences were found between the German-speaking patients who took the PEDI-G compared to English speaking patients who took the PEDI. Due to the sample size of 75 participants, it is not possible to determine if the scores are systematic or random. The authors conclude that the normative scores from the PEDI are applicable for patients in Germany, Austria, and Switzerland. A larger, randomized sample is recommended for a future study.
Personal assessment of overall strengths and weaknesses: Some strengths form this study include their ability to incorporate participants from various countries, and their ability to make comparisons within the three German-speaking countries who are utilizing the PEDI-G. It is a strength that the study also compares the PEDI-G to the normative values of the PEDI outcome measure. Another strength was that they were able to acquire children from the age groups of 9 months to 7.3 years of age, which practically encompasses the entire range of ages that this outcome measure applies to. A weakness to this study was that they had a disproportionate number of participants from Switzerland (42), compared to the lower number of participants from Austria (16) and Germany (17). This was also a non-randomized study, which could be considered a weakness or limitation for the validity and reliability of the results.
Overall Conclusion: The PEDI normative values are able to be utilized for the PEDI-G as well. I really thought this article was fascinating, and I enjoyed how they included participants from different countries. I would also be interested to see results from the modification scale (MS) portion of the outcome measure, which was not addressed within this specific study, to see if there are any variations between patients and families from different countries.
One response to “PEDI Article Summary – Are PEDI Normative Values Applicable to the German Version (PEDI-G) of the Pediatric Evaluation of Disability Index?”
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I found your post to be very interesting because it looks at the idea that outcome measures can be interpreted differently based on environmental factors like culture and country. I think it’s very beneficial to compare normative data between countries for all outcome measure so we know they are as reliable and valid as possible. Lastly, I agree this study was a good start but a larger sample size and randomized control trials are needed in future research.