Source:http://linkedlifedata.com/resource/pubmed/id/11997585
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
1
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pubmed:dateCreated |
2002-5-8
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pubmed:abstractText |
Classification of Mental Retardation (MR) into severe and profound is based on IQ threshold (<35 and 20% respectively) and on quite generic descriptions of deficits in adaptive behavior. The LAPMER scale (after Level of Activity in Profound/severe Mental Retardation) was developed as a measure of severity through observed behavior in adult patients. The Rasch analysis (RA, in its rating scale model) was adopted as a guide for selection of items, conceptualization of item levels, and validation of the overall instrument. The RA provides estimates on a continuum measure corresponding to the discrete cumulative score. A model prescribes the expected scores on each subject-item interaction. Discrepancies between observed and expected scores allow diagnostic procedures on coherence (fit) of both subjects and items. The final version included 8 items: Feeding, Sphincters, Communication, Manipulation, Dressing, Locomotion, Spatial Orientation and Praxiae, scored 0/1 or 0/1/2 (cumulative range for the total set of items was 0-13) the higher the score, the better the performance. The test can be administered in 15 minutes through observation or inquiry from proxies and personnel. A psychologist rated 146 permanent hosts of a large Institute for mentally retarded adults (51 profound and 95 severe, 91 male, age 18-63, median 36). Median score was 6/13, IQR 1-9, range 0-12, 19% of cases scored 0. Cronbach a for internal consistency was 0.90. Fifty-seven patients were also independently scored by another psychologist. Between-rater Cohen's k reliability index ranged from 0.77-0.96 across items. Median raw scores were 1 and 8 in profound and severe cases, respectively (p<0.001). Rasch person reliability coefficient, a 0 to 1 index of internal consistency analogous to Crohnbach a, was 0.92. For each item the standardized differences between observed and model-expected scores (residuals) were c2 tested (a level 0.05) across sub-groups of patients. These were: profound vs. severe cases, and classes of motor impairment (tetra-,hemi-,para-plegic and unimpaired), matched for overall ability measure. For 6 items some residuals were found to be statistically significant. Absolute differences ranged from 0 to 0.7 raw score points, with no systematic patterns. Gender, age group and rater did not bias the measure. Residuals did not correlate meaningfully across pairs of items (r<(0.5)), further supporting the unidimensionality of the measure. The scale seems a valid tool for classification of adult severe and profound MR cases.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:issn |
1529-7713
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
3
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
50-84
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pubmed:dateRevised |
2011-11-17
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pubmed:meshHeading |
pubmed-meshheading:11997585-Activities of Daily Living,
pubmed-meshheading:11997585-Adolescent,
pubmed-meshheading:11997585-Adult,
pubmed-meshheading:11997585-Disability Evaluation,
pubmed-meshheading:11997585-Female,
pubmed-meshheading:11997585-Humans,
pubmed-meshheading:11997585-Intellectual Disability,
pubmed-meshheading:11997585-Male,
pubmed-meshheading:11997585-Middle Aged,
pubmed-meshheading:11997585-Models, Statistical,
pubmed-meshheading:11997585-Motor Activity,
pubmed-meshheading:11997585-Psychometrics,
pubmed-meshheading:11997585-Reproducibility of Results
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pubmed:year |
2002
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pubmed:articleTitle |
Level of Activity in Profound/Severe Mental Retardation (LAPMER): a Rasch-derived scale of disability.
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pubmed:affiliation |
Divisione di Recupero e Rieducazione Funzionale, Fondazione Salvatore Maugeri, Via A.Ferrata, 8, 27100 Pavia, Italy. ltesio@fsm.it
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pubmed:publicationType |
Journal Article
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