Time for time : Assessment of time processing ability and daily time management in children with and without disabilities

Detta är en avhandling från Stockholm : Karolinska Institutet, Department of Neurobiology, Care Sciences and Society

Sammanfattning: The focus of this thesis was further development of instruments for assessing Time Processing Ability (TPA) and daily Time Management (TM) in children, focusing on the constructs measured and investigating differences in TPA and daily TM between children with and without cognitive disabilities. Participants were 5-11 year-old TD children (n=144) and children with disabilities: Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorders (ASD), mild or moderate intellectual disabilities, or with neurological disease such as CP or MMC (n=118). Data was collected with: Kit for assessing Time processing ability (KaTid), a Parent scale for daily time management and a Self-rating scale of autonomy. Data was analysed using a person-oriented approach in all four studies; Rasch models (Study I, II, IV), cluster analysis (study III) and variable based methods; correlation and regression analysis. The results of Studies I and II showed that the KaTid demonstrated acceptable internal scale validity, person response validity and person separation reliability. The internal scale validity and the PCA analysis statistically support a potential unidimensional construct. In this thesis the theoretical base for each item was presented and the hierarchy of the items was in line with previous literature, indicating that the construct measured is TPA. Thus, the items in KaTid, initially defined as time perception, time orientation and time management are suggested to be unidimensional. The results of Study II demonstrate a moderate significant relation between the parents ratings of daily TM and the TPA of the children (r= .513, p<.001), and between the self-rating of autonomy and TPA (r= .306, p<.001). There was also a significant relation between self-ratings of autonomy and the parents rating of the children s daily TM (r= .366, p<.001). Parents ratings of their children s daily TM could explain 25%, and the children s age 22%, of the variation in TPA. The results indicate the viability of the instrument for assessing TPA also in children with disabilities, and that some factors relevant for daily time management are the ability measured by KaTid and the chronological age of the child, together with others not included in this analysis. The results of Study III indicated that four of the five clusters differed mainly in chronological age and in levels of TPA. Children within the same diagnostic category do not share membership in a subgroup with a specific pattern of TPA. Daily TM as estimated by the parents and self-rated autonomy differs between clusters and were related to the profile and level of TPA. Overall the level of TPA seems to be a more valid base for predicting the functioning of daily TM than the type of diagnosis. Study IV investigated if there were differences between the response patterns of children with and without disabilities, indicating bias/differential functioning in items. Data of TD children (n=115) and of children with disabilities (n=144) was analysed with differential item functioning (DIF) and Standardized z-comparison. The DIF analysis revealed a relative item challenge in 15 items, most of them in time perception and time orientation, perhaps due to disability/diagnosis (possibly ASD). The following analysis resulted in a trivial degree of differential functioning at individual level, indicating that the instrument can be used for children with or without disabilities. This thesis has contributed a new model for assessing TPA and daily TM. The instrument KaTid can be used for assessment of the individual level of TPA, for children with or without cognitive disability. The three instruments KaTid, Parent Scale and the Self-rating scale complement each other, underlining the advantages of collecting information from all these sources, in order to help professionals to structure the intervention planning process for children with difficulties in daily TM. There is a need to examine the utility of the KaTid and the Parent scale in planning and documenting the effectiveness of interventions for children with difficulties in daily TM, both in research and in clinical practice. Finally, this thesis informs our practitioners of the importance of addressing the issue of TPA and daily TM, aiming at increasing daily TM and autonomy in children with cognitive disabilities. It is time for time!

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