Sonja Mensch

146 Chapter 8 Chapter 3. Design and content validity of a new instrument to evaluate motor abilities of children with severe multiple disabilities: Movakic With an expert group consisting of six physiotherapists and one occupational therapist, working in intellectual disability care, all of them with over 15 years of experience with the target group, a new instrument for the evaluation of motor abilities at the level of ‘activities’ was systematically developed. The procedure included the following steps: 1. Formulating relevant criteria for an instrument in the target group, 2. Making a list of relevant motor abilities, 3. Designing the instrument’s structure and lay-out and 4. Performing a pilot to ascertain applicability. The expert group decided that the instrument should be a questionnaire, to be completed by the child’s physiotherapist, and based upon his/her knowledge of the child’smotor abilities over a longer time frame, insteadof – as is the current approach– an observation test of the child’s performance at a certain moment. The result was Movakic ( mo tor e v aluation of ki ds with multiple and c omplex disabilities), a questionnaire with 12 situations/groups, each consisting of multiple sub-questions. The structure of Movakic is shown in the following table: Positions Lying Sitting Standing Situations → Grouping of motor abilities ↓ 1 Supine 2 Supine with device* 3 Prone 4 Prone with device 5 Side 6 Side with device 7 Flat surface 8 Dangling legs 9 Chair/ sitting device 10 Feet on subsurface 11 Without device 12 With device Maintaining position Items with questions on 1 Intensity manual or support by device 2 Activity of the child 3 Intensity of manual facilitation/ stimulation Activities Changing body position Moving around *Device: Assistive devices such as prostheses, ortheses and specialized tools and aids for personal mobility such as canes, walkers and wheelchairs. Because the children have different capabilities to begin with, only situations that are relevant to the child are scored. After a 4-hour training, 26 physiotherapists who had not been members of the expert group, participated in the pilot study. They completed the questionnaire for 53 children in total and 15 adults. All participating physiotherapists judged the content and relevance of the items to be good, some items were found difficult to understand.