Internal Psychometric Properties of the Children with Special Health Care Needs Screener

Abstract 

Objective

Insufficient research has established the measurement properties of the Children with Special Health Care Needs (CSHCN) Screener. This leaves unclear whether CSHCN Screener–based estimates reliably identify CSHCN. We used classical and modern test theory to establish the CSHCN Screener’s internal psychometric properties.

Methods

Data came from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN), a nationally representative survey of US children (N = 359 154).

Results

Cronbach’s α, a measure of internal reliability, equaled .76. Confirmatory factor analysis for ordered-categorical measures indicated that a single underlying trait that we label health-condition-complexity underlies CSHCN Screener responses. Item response theory showed that responses provide particularly precise measurement among children experiencing elevated health-condition-complexity trait levels.

Conclusions

Findings demonstrate that responses to the CSHCN Screener as used in the NS-CSHCN have good internal psychometric properties and include minimal random measurement error. Epidemiologists, clinicians and others can rely on CSHCN Screener responses to reliably identify CSHCN experiencing 1 or more of the 5 consequences included on the CSHCN Screener.

Keywords: children with special health care needs, confirmatory factor analysis, item response theory, psychometrics, reliability