Occupational Therapy Program Student Theses, Dissertations and Capstones

Document Type



Validity of the newly translated and culturally-adapted Spanish version of the children's assessment of participation and enjoyment & preferences for activities of children

Degree Name

Doctor of Philosophy (PhD) in Occupational Therapy

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College of Health Care Sciences – Occupational Therapy Department

Publication Date / Copyright Date



Nova Southeastern University


Currently there are no standardized Spanish tools to assess leisure and recreation participation of Spanish-speaking children. Occupational therapists face the challenge of implementing valid assessments to develop culturally-sensitive intervention plans to obtain meaningful participation outcomes for Spanish-speaking children. The purpose of this study was to develop a Spanish version of the Children's Assessment of Participation and Enjoyment & Preferences for Activities of Children (CAPE/PAC) for children living in Puerto Rico, and to assess its validity and reliability.

A back translation and a cultural adaptation process, which included a focus group, and qualitative and quantitative exercises by subject-matter-experts (SMEs), were used to develop the Evaluación de Participación y Disfrute de los Niños & Preferencias de las Actividades de los Niños (EPDN/PAN). A sample of 20 children with and without disabilities and their parents was used to pilot-test the new instrument, and a sample of 249 children was used for the field-test.

Validity evidence based on test content, structure, and relationships with other variables were sought through descriptive statistics, factor analysis, known group comparisons, and reliability coefficients.

The results document strong support of validity evidence based on test content; the translation, cultural adaptation, and pilot-testing processes yielded the evidence to support the validity of the EPDN/PAN construction process. The EPDN dimension test scores were related to external variables such as age and disability, but were not statistically significant for gender. Younger children and children with disabilities exhibited more restricted participation than older children and children without a disability (p < .05).

Adequate internal consistency was found for the PAN scales (.92 - .70) and for the Overall and Informal Intensity scales (.85 and .84). Evidence was found to support test-retest reliability for the PAN and the Diversity and Intensity EPDN (.60 - .81). Further examination of the test-retest reliability of the scales is recommended with a larger sample.

In conclusion, initial evidence of validity and reliability was found to support the use of the EPDN/PAN with Puerto Rican children to assess various dimensions of their leisure participation, an important occupational performance area.


Occupational Therapy


Health and environmental sciences, Education, Children's Assessment of Participation and Enjoyment, Occupational therapy, Participation, Preferences for Activities of Children, Spanish assessment, Validity

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