Objective: To evaluate the readability, comprehension and response processes of test items designed to measure activity performance and participation by children with spinal cord injury (SCI). Methods: Eleven parents and 33 children participated. Descriptive statistics were used to calculate frequency of problems based on age, grade, domain and response scale. Agreement was evaluated by weighted kappa coefficient values. Results: Most (54%) of the problems were due to reading/comprehension, with the majority by children 8 years of age or younger (56%) who had not completed 2nd grade (51%). Agreement between child-parent reports ranged from poor-good, with strongest agreement for mobility items and weak agreement for chores, self-care and participation. Conclusion: Children with SCI 8 years of age and older who have competed 2nd grade are able to read, understand and respond to items associated with activity performance and participation.
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