ABSTRACT
OBJECTIVES: To develop a tool to assess pre-writing skills of 2-5 y old children in India. METHODS: The tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10th, 25th, 50th, 75th, 90th). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10th-90th age-percentile bars. RESULTS: The final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings. CONCLUSIONS: A 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established.
