Validity of the AMPS for children and adolescents

1996 Fall.Includes bibliographical references.A vast number of assessments are available for occupational therapists to measure the functional independence of their clients, however, the majority were developed primarily for use with adults and older persons. A scarcity exists of reliable and valid functional assessments of personal activities of daily living (PADL) and instrumental activities of daily living (IADL) for testing children and adolescents. As a result, PADL or IADL assessments designed for use with adults have been applied to the pediatric population, often without being reevaluated for validity or reliability. Unlike most existing tests of PADL or IADL, the Assessment of Motor and Process Skills (AMPS) is unique in that it was designed to be used with school-age children, adolescents, adults, and older persons. The AMPS is a standardized IADL assessment tool used to evaluate a person's functional performance in terms of both motor IADL and process IADL ability. The AMPS was used to evaluate a sample of 162 school-age children and adolescents who had no known diagnosis. Subject goodness-of-fit statistics, generated by the many-faceted Rasch analysis, were examined to determine whether children and adolescents fit the many-faceted Rasch measurement model defined by the AMPS adult calibration sample. Overall findings suggest that school-age children and adolescents demonstrated subject goodness-of-fit to the AMPS process scale, but failed to demonstrate acceptable subject goodness-of-fit to the AMPS motor scale. These findings were supplemented with an analysis of the proportion of individual item ratings that were unexpected or misfit. On both scales, the proportion met our criterion, which was based on a previous analysis of adult well and older well subjects. In addition, we divided the sample into two groups based on age. The comparison of the two groups revealed that for the AMPS motor scale, 88% of misfitting subjects were 8 years of age or younger. This suggests that subjects 8 years of age or younger were more likely to misfit than were subjects 9 years of age or older. Of the 16 AMPS motor skill items only one item, Lifts, was significantly different for children and adolescents than for the AMPS adult calibration sample. However, no meaningful difference was found in young children's subject ability measure, regardless whether the item Lifts was included in the analysis. The results of this study support the use of the AMPS with school-age children and adolescents, although it is important for occupational therapists to be aware that young children may tend to misfit on the AMPS motor scale. In addition, recognizing the lack of valid and reliable assessments of IADL available for children and adolescents, the AMPS meets the need for a standardized evaluation for this population

EAACI position paper: Influence of dietary fatty acids on asthma, food allergy, and atopic dermatitis

The prevalence of allergic diseases such as allergic rhinitis, asthma, food allergy, and atopic dermatitis has increased dramatically during the last decades, which is associated with altered environmental exposures and lifestyle practices. The purpose of this review was to highlight the potential role for dietary fatty acids, in the prevention and management of these disorders. In addition to their nutritive value, fatty acids have important immunoregulatory effects. Fatty acid-associated biological mechanisms, human epidemiology, and intervention studies are summarized in this review. The influence of genetics and the microbiome on fatty acid metabolism is also discussed. Despite critical gaps in our current knowledge, it is increasingly apparent that dietary intake of fatty acids may influence the development of inflammatory and tolerogenic immune responses. However, the lack of standardized formats (ie, food versus supplement) and standardized doses, and frequently a lack of prestudy serum fatty acid level assessments in clinical studies significantly limit our ability to compare allergy outcomes across studies and to provide clear recommendations at this time. Future studies must address these limitations and individualized medical approaches should consider the inclusion of specific dietary factors for the prevention and management of asthma, food allergy, and atopic dermatitis.</p