Development of the PedsADAPSS: A Measure of Disability Appraisals in Youth with Spinal Cord Injury.

Abstract

To develop and provide evidence supporting content validity for the Pediatric Appraisals of Disability Primary and Secondary Scale (PedsADAPSS), a self-report measure designed to assess appraisals of disability related to spinal cord injury (SCI) in children and adolescents. A mixed-methods, multi-phase instrument development study guided by the Stress, Appraisal, and Coping (SAC) framework. Pediatric rehabilitation hospitals and outpatient settings in the United States. A multidisciplinary expert panel, an international sample of 72 SCI clinicians/researchers, and 15 caregiver-youth dyads of children and adolescents with SCI aged 9-17 years. Not applicable. Item clarity, relevance, and developmental appropriateness as determined by structured expert review, modified Delphi consensus (≥90%), and iterative cognitive interviews. Item generation drew from 42 measures and the adult ADAPSS. Through a binning and winnowing process and expert review, a refined item pool underwent a modified Delphi survey. Cognitive interviews with caregiver-youth dyads informed three waves of item revision. The finalized PedsADAPSS comprises 37 items across four domains: Harm/Loss, Threat, Challenge, and Coping Potential. The PedsADAPSS was developed using a rigorous, stakeholder-informed process to assess appraisals of disability in youth with SCI. This tool fills a critical gap in pediatric rehabilitation by offering a developmentally appropriate measure that can support early identification of at-risk youth and inform targeted psychological interventions to improve long-term outcomes.