Kang Lin-Ju, Yen Chia-Feng, Bedell Gary, Simeonsson Rune J, Liou Tsan-Hon, Chi Wen-Chou, Liu Shu-Wen, Liao Hua-Fang, Hwang Ai-Wen
Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
Department of Public Health, Tzu Chi University, Hualien, Taiwan.
Res Dev Disabil. 2015 Mar;38:64-74. doi: 10.1016/j.ridd.2014.12.019. Epub 2014 Dec 26.
Measurement of children's participation and environmental factors is a key component of the assessment in the new Disability Evaluation System (DES) in Taiwan. The Child and Adolescent Scale of Environment (CASE) was translated into Traditional Chinese (CASE-C) and used for assessing environmental factors affecting the participation of children and youth with disabilities in the DES. The aim of this study was to validate the CASE-C. Participants were 614 children and youth aged 6.0-17.9 years with disabilities, with the largest condition group comprised of children with intellectual disability (61%). Internal structure, internal consistency, test-retest reliability, convergent validity, and discriminant (known group) validity were examined using exploratory factor analyses, Cronbach's α coefficient, intra-class correlation coefficients (ICC), correlation analyses, and univariate ANOVAs. A three-factor structure (Family/Community Resources, Assistance/Attitude Supports, and Physical Design Access) of the CASE-C was produced with 38% variance explained. The CASE-C had adequate internal consistency (Cronbach's α=.74-.86) and test-retest reliability (ICCs=.73-.90). Children and youth with disabilities who had higher levels of severity of impairment encountered more environmental barriers and those experiencing more environmental problems also had greater restrictions in participation. The CASE-C scores were found to distinguish children on the basis of disability condition and impairment severity, but not on the basis of age or sex. The CASE-C is valid for assessing environmental problems experienced by children and youth with disabilities in Taiwan.
儿童参与度和环境因素的测量是台湾新残疾评估系统（DES）评估的关键组成部分。儿童与青少年环境量表（CASE）被翻译成繁体中文（CASE-C），并用于评估影响残疾儿童和青少年在DES中参与度的环境因素。本研究的目的是验证CASE-C。参与者为614名年龄在6.0至17.9岁之间的残疾儿童和青少年，其中最大的疾病组是智力残疾儿童（61%）。使用探索性因素分析、克朗巴哈α系数、组内相关系数（ICC）、相关分析和单因素方差分析来检验内部结构、内部一致性、重测信度、收敛效度和区分（已知组）效度。CASE-C产生了一个三因素结构（家庭/社区资源、援助/态度支持和物理设计可达性），解释了38%的方差。CASE-C具有足够的内部一致性（克朗巴哈α系数=0.74-0.86）和重测信度（ICC=0.73-0.90）。残疾程度较高的儿童和青少年遇到的环境障碍更多，而那些经历更多环境问题的人在参与方面也受到更大限制。发现CASE-C分数能够根据残疾状况和损伤严重程度区分儿童，但不能根据年龄或性别区分。CASE-C对于评估台湾残疾儿童和青少年所经历的环境问题是有效的。
