The Development of a New Pediatric Measure of Instrumental Activities of Daily Living Using the interRAI Child and Youth Mental Health Assessment-to-Intervention System

AIMS: Among pediatric populations, instrumental activities of daily living (IADL) are essential for establishing autonomy. The purpose of this research was to test the plausibility and applicability of developing and validating an additive versus hierarchical IADL scale for children and youth using the interRAI Child and Youth Mental Health (ChYMH) system. METHODS: A retrospective cross-sectional study was conducted using interRAI ChYMH and ChYMH - Developmental Disability (ChYMH-DD) assessment data of children and youth (4-18 years). IADL indicator item distributions were assessed using means and standard deviations. Inter-item correlations and reliability testing were completed. Off-diagonal placements based on the Guttman approach were used to explore the plausibility of a hierarchical IADL structure. RESULTS: Children and youth with developmental disabilities required more assistance to complete IADLs than their counterparts. IADL indicators on the ChYMH and ChYMH-DD grouped by age (4-11 years and 12-18 years) showed strong reliability. Analyses identified no hierarchical structure of IADL performance. CONCLUSIONS: Two IADL additive summary scales for children and youth were developed to assess their IADL functioning. Widespread implementation of the interRAI child and youth IADL scales offers clinical, policy, and research utility by assessing, monitoring, and understanding IADL functioning across populations, service sectors, and geographic regions.