Development of the Avoidance Daily Activities Photo Scale for Patients With Shoulder Pain.

OBJECTIVES: The purpose of this study was to develop the Avoidance of Daily Activities Photo Scale (ADAP Shoulder Scale) to measure shoulder pain-related avoidance behavior in patients with shoulder pain and evaluate and report the structural validity and internal consistency of the scale. METHODS: Potential daily activities involving the shoulder were selected from the activities and participation domain of the International Classification of Functioning, Disability and Health. The selected activities were presented to an expert panel, health care professionals, and patients with shoulder pain with the question "How much do you think it is important to ask patients with shoulder pain about this activity?" Activities attaining a content validity index (CVI) ≥ 0.8 were represented using a digitally colored photograph. Activity photographs were evaluated by health care professionals and patients with shoulder pain. Photographs with a CVI ≥ 0.8 were included in the scale. To evaluate structural validity and internal consistency of the scale, exploratory factor analysis was performed to determine the presence of any scale domain. Cronbach alpha was calculated to indicate the internal consistency of each domain. RESULTS: Of the 107 preselected activities, 21 attained a CVI ≥ 0.8. Eighteen photographs (CVI ≥ 0.8) were included in the scale after being analyzed by 120 health care professionals and 50 patients with shoulder pain. Exploratory factor analysis (N = 156) showed that the ADAP Shoulder Scale consists of 3 domains: free movement, high effort, and self-care. The internal consistencies of the domains were 0.92, 0.89, and 0.92, respectively. CONCLUSION: The ADAP Shoulder Scale included 15 photographs distributed in 3 domains. All domains had a high internal consistency. The scale is easily applicable, well understood, and relevant for shoulder pain. IMPACT: The ADAP Shoulder Scale can be used to rate shoulder pain-related avoidance behaviors.

Validation of the Social Responsiveness Scale (SRS) to screen for atypical social behaviors in juvenile macaques.

Primates form strong social bonds and depend on social relationships and networks that provide shared resources and protection critical for survival. Social deficits such as those present in autism spectrum disorder (ASD) and other psychiatric disorders hinder the individual's functioning in communities. Given that early diagnosis and intervention can improve outcomes and trajectories of ASD, there is a great need for tools to identify early markers for screening/diagnosis, and for translational animal models to uncover biological mechanisms and develop treatments. One of the most widely used screening tools for ASD in children is the Social Responsiveness Scale (SRS), a quantitative measure used to identify individuals with atypical social behaviors. The SRS has been adapted for use in adult rhesus monkeys (Macaca mulatta)-a species very close to humans in terms of social behavior, brain anatomy/connectivity and development-but has not yet been validated or adapted for a necessary downward extension to younger ages matching those for ASD diagnosis in children. The goal of the present study was to adapt and validate the adult macaque SRS (mSRS) in juvenile macaques with age equivalent to mid-childhood in humans. Expert primate coders modified the mSRS to adapt it to rate atypical social behaviors in juvenile macaques living in complex social groups at the Yerkes National Primate Research Center. Construct and face validity of this juvenile mSRS (jmSRS) was determined based on well-established and operationalized measures of social and non-social behaviors in this species using traditional behavioral observations. We found that the jmSRS identifies variability in social responsiveness of juvenile rhesus monkeys and shows strong construct/predictive validity, as well as sensitivity to detect atypical social behaviors in young male and female macaques across social status. Thus, the jmSRS provides a promising tool for translational research on macaque models of children social disorders.

Optimization of behavioral testing in a long-term rat model of hypoxic ischemic brain injury.

BACKGROUND: Hypoxic ischemic (HI) brain injury is a significant cause of childhood neurological deficits. Preclinical rodent models are often used to study these deficits; however, no preclinical study has determined which behavioral tests are most appropriate for long-term follow up after neonatal HI. METHODS: HI brain injury was induced in postnatal day (PND) 10 rat pups using the Rice-Vannucci method of unilateral carotid artery ligation. Rats underwent long-term behavioral testing to assess motor and cognitive outcomes between PND11-50. Behavioral scores were transformed into Z-scores and combined to create composite behavioral scores. RESULTS: HI rats showed a significant deficit in three out of eight behavioral tests: negative geotaxis analysis, the cylinder test and the novel object recognition test. These individual test outcomes were transformed into Z-scores and combined to create a composite Z-score. This composite z-score showed that HI rats had a significantly increased behavioral burden over the course of the experiment. CONCLUSION: In this study we have identified tests that highlight specific cognitive and motor deficits in a rat model of neonatal HI. Due to the high variability in this model of neonatal HI brain injury, significant impairment is not always observed in individual behavioral tests, but by combining outcomes from these individual tests, long-term behavioral burden can be measured.

Development and Validation of the General Dietary Behavior Inventory (GDBI) in Scope of International Nutrition Guidelines.

Unhealthy eating is associated with various diseases, such as cardiovascular, neurodegenerative, or oncological. There are neither economical nor behavior-related questionnaires available in the German language to assess general dietary behavior. Therefore, the aim of this validation study was to develop an instrument considering these aspects and verifying its construct and criterion validity. The new questionnaire is based on the general nutrition recommendations of the World Health Organization and the German Nutrition Society. It consists of 16 items that contrast dietary behaviors on a semantic differential scale. Our German-speaking convenience sample consisted of 428 participants. The construct validity of the General Dietary Behavior Inventory (GDBI) could be confirmed by examining convergent and discriminant validity. Furthermore, criterion validity was confirmed (significant negative correlations with body weight, Body Mass Index, and positive correlations with physical/mental health as well as life satisfaction). A cluster analysis revealed two different dietary behavior clusters representing a rather healthy and a rather unhealthy dietary behavior cluster. The results indicate that the GDBI is a validated and economical instrument to assess general dietary behavior. In practical research, this questionnaire helps to assess dietary behavior and to derive interventions for a healthy dietary behavior in concordance with international nutrition recommendations.

Reliability and validity of the Japanese version of the Behavior Problem Inventory-Short Form.

BACKGROUND: The Behavior Problems Inventory-Short Form (BPI-S), which assesses behavior problems in individuals with intellectual disabilities (ID), is a shorter version of the BPI-01. This study investigated the reliability and validity of the BPI-S Japanese version (BPI-S-J) for adolescents/adults with ID and behavior problems. METHODS: The test-retest reliability included participants with ID and behavioral problems who were enrolled in welfare services. For test-retest reliability, 42 caregivers independently responded to the BPI-S-J every two weeks. Inter-rater reliability was independently assessed using the BPI-S-J by two caregivers who were familiar with the 42 participants. The participants of the validity assessment were 227 students from special needs schools or patients with ID admitted to medical institutions. The total frequency total score was compared based on the degree of ID. To examine the criterion-related validity, we analyzed the total frequency score, the total score of the Criteria for Determining Severe Problem Behavior (CDSPB) and the total score of the Aberrant Behavior Checklist-Japanese version (ABC-J). RESULTS: The BPI-S-J of test-retest reliability was satisfactory (intra-class correlation; ICC) = 0.954), and the total score significantly (ICC = 0.721) represented good inter-rater reliability. For the validity, the BPI-S-J score of participants who had severe and profound ID was significantly higher than those who had mild and moderate ID. Significant correlations were observed between the BPI-S-J score and CDSPB score (r = 0.499), and the ABC-J score (r = 0.699), indicating adequate criterion-related validity. CONCLUSION: This study showed the utility of the BPI-S-J to assess behavior problems in the Japanese ID population.

Validity and Reliability of Executive Function Measures in Children With Heavy Prenatal Alcohol Exposure: Correspondence Between Multiple Raters and Laboratory Measures.

BACKGROUND: Rating scales are designed to complement traditional performance-based measures, and both can provide useful information about the functioning of youth with histories of prenatal alcohol exposure. Few studies, however, have compared ratings from multiple informants or the relationship between these subjective rating scale scores and the objective results from laboratory performance-based scales. METHODS: The current study addressed both of these questions in 3 study groups: children with histories of prenatal alcohol exposure (n = 47), attention-deficit/hyperactivity disorder (ADHD; n = 41), and typically developing controls (CON; n = 73). All subjects completed a standardized neuropsychological test battery, including laboratory measures of executive functioning and a self-report measure of executive function behaviors. Parents and teachers completed corresponding rating scales of executive function behaviors for each subject. This study assessed the relationship between these behavior rating scales and corresponding neuropsychological tests, and interrater agreement among the multiple informants. RESULTS: Weak correlations were found between the rating scales and laboratory measures, indicating poor convergent validity for the behavior rating scale. Interrater reliability was found but it differed by group. Agreement was found between parent and teacher ratings for children with prenatal alcohol exposure, whereas teacher-child agreement was found for those with ADHD. CONCLUSIONS: Findings from this study indicate that behavior ratings can be used to supplement laboratory measures but may not be measuring cognitive abilities regardless of whether a clinical diagnosis is present. A multimethod approach should be used when measuring skills in this domain. This was one of the first studies to examine cross-informant agreement in a sample of children with prenatal alcohol exposure. Further research is necessary to understand why interrater agreement differed for children with prenatal alcohol exposure and those with ADHD.

Digital phenotyping of negative symptoms: the relationship to clinician ratings.

Negative symptoms are a critical, but poorly understood, aspect of schizophrenia. Measurement of negative symptoms primarily relies on clinician ratings, an endeavor with established reliability and validity. There have been increasing attempts to digitally phenotype negative symptoms using objective biobehavioral technologies, eg, using computerized analysis of vocal, speech, facial, hand and other behaviors. Surprisingly, biobehavioral technologies and clinician ratings are only modestly inter-related, and findings from individual studies often do not replicate or are counterintuitive. In this article, we document and evaluate this lack of convergence in 4 case studies, in an archival dataset of 877 audio/video samples, and in the extant literature. We then explain this divergence in terms of "resolution"-a critical psychometric property in biomedical, engineering, and computational sciences defined as precision in distinguishing various aspects of a signal. We demonstrate how convergence between clinical ratings and biobehavioral data can be achieved by scaling data across various resolutions. Clinical ratings reflect an indispensable tool that integrates considerable information into actionable, yet "low resolution" ordinal ratings. This allows viewing of the "forest" of negative symptoms. Unfortunately, their resolution cannot be scaled or decomposed with sufficient precision to isolate the time, setting, and nature of negative symptoms for many purposes (ie, to see the "trees"). Biobehavioral measures afford precision for understanding when, where, and why negative symptoms emerge, though much work is needed to validate them. Digital phenotyping of negative symptoms can provide unprecedented opportunities for tracking, understanding, and treating them, but requires consideration of resolution.

Concurrent Validity of the ABAS-II Questionnaire with the Vineland II Interview for Adaptive Behavior in a Pediatric ASD Sample: High Correspondence Despite Systematically Lower Scores.

We examined the correlation between interviewer-administered Vineland Adaptive Behavior Scale II (VABS-II) and the parent-rated Adaptive Behavior Assessment System II (ABAS-II) questionnaire in 352 participants (ages 1.5-20.8 years) with autism spectrum disorder (ASD) to determine if ABAS could be used as a screen to reduce the number of VABS interviews. Corresponding domain scores between the two measures were highly correlated but scores were significantly lower on the ABAS-II. Screening with ABAS-II significantly reduced the number of VABS-II interviews required with little cost to overall accuracy. The ABAS-II provides a cost- and time-saving alternative to the VABS-II to rule out functional impairment; however, scores are not strictly comparable between the two measures.

Reliability and validity of the Japanese version of the Paediatric Pain Profile for children with severe motor and intellectual disabilities.

Children with severe motor and intellectual disabilities experience chronic pain but cannot communicate verbally. However, no Japanese tool currently exists for assessing pain in this population. This study aimed to develop and evaluate the reliability and validity of a Japanese version of the Paediatric Pain Profile, which is a behavioral rating scale to assess pain in children with severe neurological disabilities. The sample comprised 30 children with severe motor and intellectual disabilities at three hospitals in Japan. Three specialist nurses rated low and high pain video scenes of the children (twice at 1-week intervals) using the Face, Legs, Activity, Cry, Consolability behavioral scale and a translated Japanese version of the Paediatric Pain Profile. On the basis of their ratings, we calculated the internal consistency, test-retest reliability, and intra- and inter-observer reliabilities of the Paediatric Pain Profile. Additionally, we assessed concurrent validity using the Face, Legs, Activity, Cry, Consolability behavioral scale and construct validity using low versus high pain scenes. Both internal consistency (low pain: alpha = 0.735; high pain: alpha = 0.928) and test-retest reliability (r = 0.846) of the Japanese version of the Paediatric Pain Profile were good. Intra-observer reliability was substantial (r = 0.748), whereas inter-observer reliability was only moderate (r = 0.529). However, the concurrent validity with Face, Legs, Activity, Cry, Consolability scores was good (r = 0.629) and construct validity was confirmed (p < 0.001). We confirmed the validity of the Japanese version of the Paediatric Pain Profile, but reliable pain assessment may require repeated ratings by the same person. To accurately assess pain in children with severe motor and intellectual disabilities, healthcare staff must be properly trained and become more skilled in using the Japanese version of the Paediatric Pain Profile.

Development and validation of the Intervention Skills Profile-Skills: A brief measure of student social-emotional and academic enabling skills.

The purpose of this study was to support the development and initial validation of the Intervention Selection Profile (ISP)-Skills, a brief 14-item teacher rating scale intended to inform the selection and delivery of instructional interventions at Tier 2. Teacher participants (n = 196) rated five students from their classroom across four measures (total student n = 877). These measures included the ISP-Skills and three criterion tools: Social Skills Improvement System (SSIS), Devereux Student Strengths Assessment (DESSA), and Academic Competence Evaluation Scales (ACES). Diagnostic classification modeling (DCM) suggested an expert-created Q-matrix, which specified relations between ISP-Skills items and hypothesized latent attributes, provided good fit to item data. DCM also indicated ISP-Skills items functioned as intended, with the magnitude of item ratings corresponding to the model-implied probability of attribute mastery. DCM was then used to generate skill profiles for each student, which included scores representing the probability of students mastering each of eight skills. Correlational analyses revealed large convergent relations between ISP-Skills probability scores and theoretically-aligned subscales from the criterion measures. Discriminant validity was not supported, as ISP-Skills scores were also highly related to all other criterion subscales. Receiver operating characteristic (ROC) curve analyses informed the selection of cut scores from each ISP-Skills scale. Review of classification accuracy statistics associated with these cut scores (e.g., sensitivity and specificity) suggested they reliably differentiated students with below average, average, and above average skills. Implications for practice and directions for future research are discussed, including those related to the examination of ISP-Skills treatment utility.

Psychometric evaluation of the Farsi version of the diabetes foot self-care bahavior scale.

BACKGROUND: Diabetes foot self-care is one of the self-management behaviors of diabetic patients leading to a reduction in the incidence of pressure ulcers and amputation. Having a valid, reliable, simple and comprehensive tool is essential in measuring the self-care behavior of diabetic patients. The aim of this study was to evaluate the psychometric properties of the Farsi version of the diabetes foot self-care bahavior scale (DFSBS) in Iran. METHODS: In this cross-sectional and methodological study, 500 patients with type 2 diabetes were recruited by convenience sampling. Construct validity was assessed by exploratory factor analysis (over 300 patients) and confirmatory factor analysis (over 200 patients). Internal consistency was calculated by Cronbach's alpha coefficient and its stability was calculated by intraclass correlation coefficient (ICC). RESULTS: In the exploratory factor analysis, two self-care factors related to feet and shoes were extracted which had specific values of 38.49 and 1.24, respectively, and were able to account for 56.22% of the total self-care variance of diabetes foot. Confirmatory factor analysis had excellent fit model. The internal consistency and ICC of the whole instrument were 0.83 and 0.791 (95% CI: 0.575-0.925; P < 0.001), respectively. CONCLUSIONS: The Farsi version of DFSBS (F-DFSBS) has good validity and reliability, and due to its appropriate psychometric properties, this tool can be used in future studies.

Involvement of NLRP3 inflammasome in schizophrenia-like behaviour in young animals after maternal immune activation.

OBJECTIVE: To evaluate the involvement of nod-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome in schizophrenia-like behaviour in young animals exposed to maternal immune activation (MIA). METHODS: To this aim, on the 15th gestational day, the females received an injection of lipopolysaccharides. When the animals completed 7, 14 and 45 postnatal days, they were killed and the whole brain was dissected for biochemical analysis. Animals with 45 postnatal days were submitted to behavioural tests of locomotor activity, social interaction and stereotyped movements. RESULTS: It was observed that the animals presented schizophrenia-like behaviour at 45 postnatal days associated with the increase of NLRP3 inflammasome expression and IL-1ß levels on 7, 14 and 45 postnatal days. CONCLUSION: This study shows that MIA may be associated with a schizophrenia-like behaviour. This behaviour can be induced to a neuroinflammatory profile in the brain. These evidences may base future studies on the relationship between neuroinflammation and psychiatric disorders.

Five direct behavior rating multi-item scales: Sensitivity to the effects of classroom interventions.

Direct Behavior Rating (DBR) is a tool designed for the assessment of behavioral changes over time. Unlike methods for summative evaluations, the development of progress monitoring tools requires evaluation of sensitivity to change. The present study aimed to evaluate this psychometric feature of five newly developed DBR Multi-Item Scales (DBR-MIS). Teachers identified students with behaviors interfering with their learning or the learning of others and implemented a Daily Report Card (DRC) intervention in the classroom settings for two months. The analyses were performed on 31 AB single case studies. Change metrics were calculated at an individual level by using Tau-UA vs. B + trend B and Hedges' g and at a scale-level by using Mixed Effect Meta-Analysis, Hierarchical Linear Models (HLMs), and Between-Case Standardized Mean Difference (BC-SMD). HLMs were estimated considering both fixed and random effects of intervention and linear trend within the intervention phase. The results supported sensitivity to change for three DBR-MIS (i.e., Academic Engagement, Organizational Skills, and Disruptive Behavior), and the relative magnitudes were consistent across the metrics. Sensitivity to change of DBR-MIS Interpersonal Skills received moderate support. Conversely, empirical evidence was not provided for sensitivity to change of DBR-MIS Oppositional Behavior. Particular emphasis was placed on the intervention trend in that responses to behavioral interventions might occur gradually or require consistency over time in order to be observed by raters. Implications for the use of the new DBR-MIS in the context of progress monitoring of social-emotional behaviors are discussed.

Behavior test for seven-week old puppies (Canis familiaris): Inter-rater reliability and factors associated with test performance.

Behavioral development in domestic dogs has been investigated for predicting suitability for service dog work or for matching with the "right" families as well as for identifying predispositions to behavioral problems. Findings from the scientific literature seem to confirm that conducting behavioral tests at 7 weeks of age is too early to reliably predict the temperament and personality of a dog. However, this period for domestic dogs is sensitive for early life learning and conditions during this time could have important consequences in adulthood. The aims of this study were to evaluate inter-rater reliability of a simple standardized test and to investigate which factors influence the behavioral reaction of puppies. 105 seven-week old puppies were exposed to five subtests: social attraction, following, retrieving, sudden appearance, noise. During each task, the behaviour of each pup was scored on a 3-5 point scale that reflected the suitability of the pup's reaction to the task. Scores were evaluated for a single subtest and for two aggregate indicators (i.e. response to a person: social attraction subtest and following subtest and response to object and noise: retrieving subtest, sudden appearance subtest and noise subtest). Three assessors independently scored the dogs' reactions for each task. Inter-rater reliability of the three assessors were analyzed with Fleiss' Kappa and Kendall's coefficient, which showed a high inter-rater reliability in 4 of 5 tasks. The ordered logistic regression was carried out to obtain a proportional odds model that was used to model the relationship between sex, litter size, stimulating environment, parity of mother, adequate maternal behavior and high scores. Litter size and maternal parity were associated with test performance in response to a person. The variance of effect of litter was high in response to object and noise. Taken together, our results suggest that using this scoring system there is sufficient inter-rater reliability in the test and litter size and mother experience influences task performances related to dog-human interaction.

Between-teacher variance of students' teacher-rated risk for emotional, behavioral, and adaptive functioning.

As schools increasingly adopt universal social, emotional, and behavioral screening, more research is needed to examine the effects of between-teacher differences due to error and bias on students' teacher-rated screening scores. The current study examined predictors of between-teacher differences in students' teacher-rated risk across one global and three narrow domains of behavioral functioning. Participants included 2450 students (52.1% male, 54.2% White) and 160 teachers (92.1% female, 80.3% White) from four elementary schools in one Southeastern U.S. school district. Teachers rated student behavior on the Behavior Assessment System for Children (Third Edition) Behavioral and Emotional Screening System (BESS)-Teacher Form and completed a survey about their training and perspectives of common behavior problems. Results of multilevel linear regression found between-teacher effects to be greater for internalizing risk scores (intraclass correlation = 0.23) than for externalizing risk scores (intraclass correlation = 0.12) or adaptive behavior scores (intraclass correlation = 0.14). Statistically significant student predictors in most models included student grade, gender, race and/or ethnicity, office discipline referrals, and course grades. We also detected effects of several teacher-level variables in one or more of the models, including teacher gender, teacher ratings of problem severity and concern for hypothetical children displaying behavior problems, and the covariance of random teacher intercept and teacher random slopes for students' office discipline referrals. Although these factors explained some teacher-level variance in students' risk scores, a notable amount of variance between teachers remains unexplained. Future research is needed to fully understand, reduce, and account for differences between teacher ratings due to error and bias.

Recent Developments in Treatment Outcome Measures for Young Children With Autism Spectrum Disorder (ASD).

Significant advancements have been made in early intervention programs for children with Autism spectrum disorder (ASD). However, measuring treatment response for children with ASD is difficult due to the heterogeneity of changes in symptoms, which can be subtle, especially over a short period of time. Here we outline the challenge of evaluating treatment response with currently available measures as well as newly developed or refined measures that may be useful in clinical trials for young children with ASD. Continued development of treatment outcome measures will help the field identify and compare efficacious interventions and tailor treatments for children with ASD.

Development of the Childhood Nonverbal Communication Scale.

The aim of this study was to develop and validate the Childhood Nonverbal Communication Scale (CNCS) to assess nonverbal communication skills in children from birth to 18 months old. An extensive review of existing research provided evidence used to generate items representative of nonverbal communication behaviors. The final version of the CNCS includes 37 items divided in two dimensions (CNCS-1 and CNCS-2) showing high content validity (item-rated content validity index ≥ 0.75). The scale was administered to 428 Iranian Persian-speaking children 3 to 18 months old with normal development. According to the findings, the CNCS showed strong internal consistency (KR-20 = 0.965). Further, it had good convergent validity based on a significant correlation between total scores and the results of the Persian version of the Production of Infant Scale Evaluation (PRISE-P) (r = 0.5, P < 0.01). Therefore, the CNCS is a promising tool for measuring nonverbal communication in Iranian children from birth to 18 months of age.

Reliability and validity of Persian version of Brief Self-Control Scale (BSCS) in motorcyclists.

Objective: The present study aimed to investigate the validity and reliability of the Persian version of brief self-control scale (BSCS) in Iranian motorcyclists.Methods: The original English questionnaire of BSCS has been translated into Persian using the direct-reverse approach. A total of 130 motorcyclists aged 18-65 years old in Iran-Kashan completed the questionnaire. Validity was determined by content validity methods, structural validity through factor analysis, and also the convergence and divergence validity using Spearman correlation coefficient. The intra class correlation coefficient (ICC) was calculated to estimate the reliability of the self-control tool. Reliability was calculated using Cronbach's alpha.Results: The mean and standard deviation of the age at the time of study was 38.5 ± 13.5 years old and all of the subjects were male. Cronbach's alpha coefficient of the whole questionnaire (BSCS) was 0.81, which was good in this regard. The ICC coefficient was 0.88 with confidence interval of (0.8-0.93), which confirmed the repeatability of this tool. Exploratory factor analysis (EFA) yielded a two-factor solution accounted for 42% of the observed variance.Conclusion: This study showed that Persian version of BSCS has a good reliability and validity for self-control in the Persian language community.Key pointsThe Brief Self-Control Scale (BSCS) has good internal consistency.The Brief Self-Control Scale (BSCS) has acceptable reliability.Brief Self-control Scale (BSCS) has acceptable validity and reliability in the population studies.