The Content Validity and Clinical Utility of the Kindergarten Readiness Inventory (K-READI): A Screening Tool of School Readiness for Children on the Autism Spectrum

Abstract

ABSTRACT There is currently a gap in available assessments for evaluating school readiness in children with Autism Spectrum Disorder (ASD). The Kindergarten Readiness Inventory (K-READI) is a non-standardized screener for basic kindergarten readiness skills of children with autism. The K-READI includes five subscales to assess overall school readiness, which include: (1) school activities of daily living, (2) school-related activities, (3) basic school concepts, (4) social participation, and (5) school behavior. The K-READI is proposed as a screener for collaborative treatment planning and further evaluation. The purpose of this study was to determine the content validity and clinical utility of the K-READI. To determine the content validity of the K-READI, the researchers recruited seven participants who were identified as pediatric occupational therapy practitioners or autism experts to review the K-READI. Item level content validity index (I-CVI) and scale level validity (S-CVI) were calculated, as well as modified kappa indices to reduce probability of chance agreement. The K-READI was then revised based on feedback from the content experts. To determine clinical utility of the K-READI, the researchers recruited 16 pediatric occupational therapists to assess the clinical usage of the revised version of the tool. Responses were thematized and analyzed as collective case studies. The content experts agreed that 17 of the 19 items in the K-READI are essential items to screen for kindergarten readiness. Two of the scale items (Cleans Up and Eye Contact) were removed from the K-READI. The other 17 items and scales were also revised and refined for clarity based on feedback. Modified kappa indices showed excellent level of agreement between raters supporting validity of the I-CVI and S-CVI findings. Clinician reviewers found that the K-READI is a potentially useful tool in practice. Four themes emerged from the analysis of clinical utility responses: The K-READI is (1) a thorough assessment of school readiness skills, (2) generally easy to use, (3) may have potential challenges in administration in different settings, and (4) assesses real life school occupations as a reflection of ecological validity. The K-READI shows initial content validity and potential usefulness in clinical practice. Future research directions include the need to establish construct validity and test reliability of the tool.