Development and Validation of an Assessment Tool Grounded in Occupational Adaptation Theory

The purpose of this instrument development and quantitative study was to construct the Measurement of Adaptive Capacity (MAC) tool based on occupational adaptation (OA) theory for use with children and adolescents with developmental disabilities. The psychometric properties were examined for implementation of the MAC tool in occupational therapy practice via a three-phase instrument development design. Phase 1 involved the development of the MAC assessment grounded in OA theory based on the literature review results. In Phase 2, the modified Delphi process was conducted with subject matter experts. Following the Phase 2 Delphi process, revisions were made to the final version of the MAC assessment tool to improve its content validity with OA theory for items that did not meet the predefined 80% subject matter expert consensus rule. Once the revisions were made to strengthen the assessment’s measurement of OA theory constructs, Phase 3 involved a cross-sectional and repeated measures design with 17 occupational therapy practitioners completing the MAC assessment tool during the first administration. Two weeks later, in a second administration of the MAC tool, 10 occupational therapy practitioners participated. Interrater reliability among the first administration’s 17 occupational therapy practitioners was achieved as excellent with an ICC of .915, where F (24, 384) = 12.411, p < 0.001, and 95% C.I. [0.858, 0.956]. Intra-rater reliability among the 10 matched pairs of occupational therapy practitioners who completed both administrations of the MAC tool approached excellent, with an ICC of 0.894, where F (9, 9) = 17.889, p < 0.001, and 95% C.I. [0.651, 0.972]. Finally, all 27 completed MAC tools generated data suggesting occupational therapy practitioners in both administrations perceived the MAC assessment tool as easily understood (52%) and easy to score (52%). A total of 82% of the 27 responses generated during both MAC tool administrations reported strongly agree (41%) and somewhat agree (41%) that the MAC assessment tool is relevant. The findings of the Delphi process with subject matter experts and quantitative results with the sample of practitioners demonstrated that the newly designed MAC assessment tool has content validity and usability. Recommendations are provided in the final chapter.

Name thesis:degree_name

Doctor of Philosophy

Discipline thesis:degree_discipline

Occupational Therapy

Grantor

Texas Woman's University

Year dc:date.issued

2025

Author dc:creator

• Rupp-Blanchard, Sarah

Advisor dc:contributor.advisor

• Baxter, Mary F

Committee members dc:contributor.committeemember

• Evetts, Cynthia L.
• Mitchell, Katy

• Occupational adaptation
• Children and adolescents
• Measurement of adaptive capacity

Language dc:language.iso

English

Handle dc:identifier.uri

https://hdl.handle.net/11274/17302

OAI identifier oai:identifier

oai:twu-ir.tdl.org:11274/17302