The Quick Measure of Cognitive Status: Assessment of Children with Post-Traumatic Brain Injury

Abstract

Initial pilot analyses examined the psychometric properties and underlying component structure of a recently developed instrument, the Quick Measure of Cognitive Status (QMOCS), for the assessment of children with post-traumatic brain injury (TBI). The initial component structure of QMOCS was explored within a sample of 63 children. Principal component analysis (PCA) found that four cognitive items (`language,' processing,' 'attention/concentration,' and 'memory') loaded highly on a single principal component, and these items were used to form a total score on a cognitive subscale.;Reliability of the cognitive subscale with standardized items was assessed with Cronbach alpha (alpha): Time 1, alpha = .91; Time 2, alpha = .85. Test-Retest reliability from Time 1 to Time 2 was assessed with the intraclass correlation coefficient (ICC) using the coefficient for absolute agreement, based on a two-way random effects model, and it was found to be .41, p = .002.;Given these results, the primary aims of the present study were to 1) extend to a larger sample of children the findings that established the cognitive measure of the QMOCS by means of principal component and reliability analyses, and 2) to explore the convergent validity of the QMOCS with respect to the Functional Independence Measure for Children-II (WeeFIM) cognitive subscale.;Results were consistent with findings from the pilot investigation. A cognitive subscale within the QMOCS was identified, comprised of the original four items and, in addition, 'orientation' confirmed. Reliability of the cognitive subscale yielded high internal consistency: Cronbach alpha = .90 at both Time 1 and Time 2. Test-Retest reliability, from Time 1 to Time 2, assessed with the ICC, was found to be 0.53, p < .01, indicating moderate reliability and adequate stability over time.;Convergent validity with the WeeFIM yielded no correlations at admission and moderate correlations at the other time points. The QMOCS was a sensitive measure of cognitive status over time. The sample size of raters did not allow for examination of interrater agreement. These results are preliminary and indicate the value of furthering the development of the QMOCS as a psychometrically sound and clinically useful assessment measure.