Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD): First psychometric evaluation of a new child and parenting assessment tool for children with a developmental disability

https://doi.org/10.1016/j.ridd.2015.09.006Get rights and content

Highlights

  • We examined the psychometric properties of a newly developed instrument for assessing child adjustment in children with developmental disabilities.

  • Factor analyses supported a three factor model describing emotional and behavioral problems as well as prosocial behavior.

  • An additional scale assessing parenting self-efficacy was found to be reliable and valid.

  • The scales were found to have good to very good internal consistency as well as convergent and predictive validity.

Abstract

This study examined the psychometric properties of the Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD), a brief inventory for assessing emotional and behavioral problems of children with developmental disabilities aged 2- to 16-years, as well as caregivers’ self-efficacy in managing these problems. A sample of 636 parents participated in the study. Children's ages ranged from 2 to 15. Exploratory and confirmatory factor analyses supported a 21-item, three-factor model of CAPES-DD child adjustment with 13 items describing behavioral (10 items) and emotional (3 items) problems and 8 items describing prosocial behavior. Three additional items were included due to their clinical usefulness and contributed to a Total Problem Score. Factor analyses also supported a 16-item, one factor model of CAPES-DD self-efficacy. Psychometric evaluation of the CAPES-DD revealed scales had satisfactory to very good internal consistency, as well as very good convergent and predictive validity. The instrument is to be in the public domain and free for practitioners and researchers to use. Potential uses of the measure and implications for future validation studies are discussed.

Introduction

Developmental disability (DD) is a term that describes a group of rather heterogeneous and diverse conditions. They range from intellectual (e.g., autism spectrum disorder) to physical (e.g., cerebral palsy) impairments and can be of genetic, environmental or trauma-related origin. The impairments must affect at least three major areas of life activities, such as communication, living independently, self-care, mobility or learning (United States of America Developmental Disabilities Act of 1984). With an overall prevalence rate of about 14% for children aged of 3- to 17-years they concern a significant number of families (Boyle et al., 2011).

Children with a DD have an approximately three to four times elevated risk of presenting with behavioral and emotional problems, not uncommonly resulting in serious psychiatric disorders (Einfeld and Tonge, 1996, Emerson, 2003b). Furthermore, Einfeld et al. (2006) found that these problems tend to persist into adulthood. As these problems increase the risk for parental stress, they not only have an impact on the wellbeing and life of the child, but are a burden for the whole family (Roberts, Mazzucchelli, Taylor, & Reid, 2003). It is therefore important to provide parents with useful parenting tools and advice as well as to support them in handling these problems. Parenting programmes such as Stepping Stones Triple P (SSTP; Mazzucchelli and Sanders, 2011, Sanders et al., 2004) represent useful methods for doing this. However, it is not sufficient to restrict these interventions to clinical settings, instead it is necessary to provide wide reaching evidence-based support to every family in need.

In order to offer the most appropriate support and to evaluate the usefulness of such support, it is necessary to assess child behavior problems in a reliable and valid way. At present there are several instruments which are commonly used for the assessment of emotional and behavioral problems of children with DD such as the Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2001), the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997), and the Developmental Behaviour Checklist (DBC; Einfeld & Tonge, 2002). However, these measures show several weaknesses in assessing child adjustment, particularly in the context of DDs. The CBCL, for example, is a very long and time-consuming instrument, which can be burdensome for parents and caregivers to complete (Goodman & Scott, 1999). It also incurs a fee, which can make it problematic to use for large population studies. Furthermore, the CBCL does not provide any norms regarding children with a DD. The SDQ correlates highly with the CBCL (Goodman & Scott, 1999) and is significantly shorter with only 25 items. In spite of this, it shows some weaknesses regarding the internal consistency of individual subscales (Smedje, Broman, Hetta, & Von Knorring, 1999), and its online use is restricted. In addition, the SDQ was developed for typically developing children and there has been limited research regarding its suitability for children with a disability. The DBC has sound psychometric properties, but was specifically developed for children with an ID and consequently may lack applicability for children having just a DD. The DBC must be purchased for use and is not very change sensitive. Thus, an economical instrument for the assessment of emotional and behavioral problems of children with a DD that is in the public domain, change sensitive, and has good psychometric properties is still needed.

Additionally, increasing research is emerging regarding the construct of parental self-efficacy (PSE) that “can be broadly defined as the expectation caregivers hold about their ability to parent successfully” (Jones & Prinz, 2005, p. 342). PSE is very important in the context of parenting and parenting interventions. In their review, Coleman and Karraker (1998) link maternal self-efficacy to more adaptive parenting strategies, to parental adjustment as well as to child difficulties. The Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD; Mazzucchelli, Sanders, & Morawska, 2011) being evaluated in the present study provides a newly developed scale measuring PSE in relation to the parallel assessed emotional and behavioral problems presented by the children. This not only establishes a direct link between the efficacy beliefs of the parents and the specific demands claimed by their children but also decreases the assessment burden on families by only using one instrument instead of two.

The CAPES-DD was developed to assess different behavior domains (i.e., externalizing, internalizing and prosocial) in children with a DD, and to also assess parental confidence in handling those problems. The authors wanted it to be suitable for children aged 2- to 16-years and to be appropriate for a range of respondents (e.g., parents, carers, teachers). Furthermore it was desired to be relatively brief (a maximum of 30 items), change sensitive, and in the public domain. In correspondence to the already developed Child Adjustment and Parent Efficacy Scale (CAPES; Morawska & Sanders, 2010), Sanders and Mazzucchelli adopted the same structure regarding the number of items, response format and scales, namely an Intensity scale measuring child adjustment and a Self-Efficacy scale measuring PSE. The CAPES-DD items were selected in a way so that they reflect the full range of behaviors that a child with a disability might present, including problems and strengths. These items were generated based on the authors’ own experience as well as by considering items from existing scales such as: Aberrant Behavior Checklist – Community (Aman & Singh, 1994), the Maladaptive Behavior Scale of the Scales of Independent Behavior-R (Bruininks, Woodcock, Weatherman, & Hill, 1984) and the DBC (Einfeld & Tonge, 2002).

This study is the first to examine the psychometric properties of the newly developed CAPES-DD. Specifically, it aimed to investigate: (a) the item properties, (b) the construct validity with a focus on the exploration of the dimensional structure of the Intensity scale, (c) the concurrent validity, (d) the predictive validity as well as (e) the reliability of the instrument.

Section snippets

Participants

The participants consisted of parents and carers recruited for two different projects. The first project, conducted in 2012 at Curtin University, recruited parents (n = 77) of a child with a DD from several Australian states and territories (Western Australia, Northern Territory, South Australia, Australian Capital Territory, and Tasmania). Disability agencies as well as education support schools and centres were contacted and asked to forward information about the project to their clients. The

Intensity scale

First, the analysis of the item properties was done based on the model suggested by the authors that intended to reverse the positively formulated items asking about strengths and to include them into two subscales describing externalizing and internalizing problems. But as factor analyses of the Intensity scale revealed a different structure (namely a three factor structure with one subscale assessing behavioral problems, one assessing emotional problems, and one assessing prosocial skills)

Discussion

The present study established that the CAPES-DD shows a three-factor structure assessing emotional and behavioral problems as well as prosocial skills. The Total Problems scale, Behavioural Problems and Emotional Problems subscales, Prosocial Behaviour scale, and the Self-Efficacy scale all turned out to have very good convergent and predictive validity as well as satisfactory to good internal consistency. Thorough and explicit analyses were also performed in order to establish construct

Conclusions

This first psychometric evaluation of the CAPES-DD provides substantial support for the reliability and validity of the instrument. With its very economical length of now 24 items, the CAPES-DD has advantages for parents to complete and for its administration in large population studies. The addition of a factor that assesses prosocial behavior and skills improves the ability of the CAPES-DD in providing a comprehensive picture of the assessed child. The Self-Efficacy scale assessing a

Conflict of interest

The Triple P-Positive Parenting Program is owned by The University of Queensland. The University, through its technology transfer company Uniquest Pty Ltd., has licensed Triple P International Pty Ltd to disseminate the program worldwide. Royalties stemming from this dissemination work are distributed to the Faculty of Health and Behavioural Sciences, the School of Psychology, Parenting and Family Support Centre, and contributory authors in accordance with the University's intellectual property

Acknowledgements

We wish to acknowledge funding support from the Australian Government's National Health and Medical Research Council as the major funding body, whose support made this research possible. This research was also funded in part by a grant of the Faculty of Health Sciences funded through the Dean of Research and School of Psychology and Speech Pathology, Curtin University. We thank Associate Professor Kate Sofronoff, Dr. Julie Hodges, and Ms. Martha Schoch who lead and coordinate the Stepping

References (49)

  • C.A. Boyle et al.

    Trends in the prevalence of developmental disabilities in US children, 1997–2008

    Pediatrics

    (2011)
  • M.W. Browne et al.

    Alternative ways of assessing model fit

    Sociological Methods and Research

    (1992)
  • R.H. Bruininks et al.

    Scales of independent behavior

    (1984)
  • B.M. Byrne

    Structural equation modeling with Mplus: Basic concepts, applications, and programming

    (2012)
  • R.B. Cattell

    The scree test for the number of factors

    Multivariate Behavioral Research

    (1966)
  • O. Christ et al.

    Strukturgleichungsmodelle mit Mplus, eine praktische Einführung

    (2012)
  • J.M. Cortina

    What is coefficient alpha? An examination of theory and applications

    Journal of Applied Psychology

    (1993)
  • S.L. Einfeld et al.

    Population prevalence of psychopathology in children and adolescents with intellectual disability. II: Epidemiological findings

    Journal of Intellectual Disability Research

    (1996)
  • S.L. Einfeld et al.

    Manual for the Developmental Behaviour Checklist: Primary Carer Version (DBC-P) & Teacher Version (DBC-T)

    (2002)
  • S.L. Einfeld et al.

    Psychopathology in young people with intellectual disability

    The Journal of the American Medical Association

    (2006)
  • S.L. Einfeld et al.

    Behavior problems increase costs of care of children with intellectual disabilities

    Journal of Mental Health Research in Intellectual Disabilities

    (2010)
  • E. Emerson

    Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability

    Journal of Intellectual Disability Research

    (2003)
  • C.K. Enders

    A primer on maximum likelihood algorithms available for use with missing data. Teacher's Corner

    Structural Equation Modeling

    (2001)
  • L.R. Fabrigar et al.

    Evaluating the use of exploratory factor analysis in psychological research

    Psychological Methods

    (1999)
  • Cited by (26)

    • Predicting positive outcomes and successful completion in an online parenting program for parents of children with disruptive behavior: An integrated data analysis

      2021, Behaviour Research and Therapy
      Citation Excerpt :

      This allowed us to harmonize variables meaningfully using data from multiple trials. Table 2 provides an overview of the outcome measures available in each study under the following five key domains: 1) Disruptive child behavior: Eyberg Child Behavior Inventory (ECBI; Eyberg & Pincus, 1999), Strengths and Difficulties Questionnaire (SDQ; Goodman, 1999), Conners Early Childhood Behavior Scale (Conners & Goldstein, 2009), Child Adjustment and Parent Efficacy Scale (CAPES; Morawska, Sanders, Haslam, Filus, & Fletcher, 2014), and an adaptation of the CAPES for parents of children with a disability (CAPES-DD; Emser, Mazzucchelli, Christiansen, & Sanders, 2016); 2) Ineffective or dysfunctional parenting: Parenting Scale (PS; Arnold, O'Leary, Wolff, & Acker, 1993), Parenting and Family Adjustment Scales (PAFAS; Sanders, Morawska, Haslam, Filus, & Fletcher, 2014); 3) Parent confidence or self-efficacy: Parenting Tasks Checklist (PTC; Sanders & Woolley, 2005), CAPES, CAPES-DD, Parenting Sense of Competence scales (PSOC; Johnston & Mash, 1989); 4) Parental adjustment: Depression, Anxiety and Stress Scales (DASS; Lovibond & Lovibond, 1996), PAFAS; and 5) Inter-parental conflict: Parent Problem Checklist (PPC; Dadds & Powell, 1991), PAFAS. Information regarding the validity and internal consistency of these measures is provided in each of the original studies.

    • Development and testing of the Nature Connectedness Parental Self-Efficacy (NCPSE) scale

      2021, Urban Forestry and Urban Greening
      Citation Excerpt :

      This is perhaps why those who felt more efficacious in overcoming barriers tended to visit nature more frequently either by themselves or together with their families. Therefore, similar to other parental self-efficacy measures (Emser et al., 2016), our scale offers a degree of specificity that will enable researchers to understand the challenges faced by parents towards nature and perhaps act as a potential mechanism for behaviour change (Byrne et al., 2015) and for promoting healthy functioning of parents and their children (Albanese et al., 2019). Significant positive relationships were also found to exist between NCPSE and the NCI as expected, suggesting that greater NCPSE is related to a greater nature connectedness.

    View all citing articles on Scopus
    View full text