Children's Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC)

Full Name of Assessment:		CAPE/PAC (Children’s Assessment of Participation and Enjoyment/Preferences for Activities of Children)
Author, Publisher, Date:		King, G. et al., Pearson, Inc., 2004
Source:		Pearson	Pricing: $129.00
Brief description (purpose, domains, subscales, time to administer, space/equipment needs): Purpose:  The CAPE is a measure designed to document a child’s participation in day-today activities outside of mandated school activities.  The PAC asses a child’s preferences for the same set of activities.  Service providers and researchers can use the measure to assess a child’s participation diversity, intensity, and enjoyment of these activities; with who and where a child participates, and his or her preferences.  These measures can also be used as outcome measures to assess the effectiveness of interventions designed to enhance a child’s participation and to answer basic questions about the nature of the participation of children with or without disabilities.  Age Range:  6-21 years Domains: Informal (Item #s 1-15 and 31-55) and Formal (Item #s 16-30) for both CAPE and PAC Subscales: CAPE:  Diversity, Intensity, With Whom, Where, and Enjoyment; PAC: Preference Scores (1 = would not like to do at all, 2 = would sort of like to do, 3= would really like to do) Time to Administer:  CAPE:  30-45 min., PAC: 15-20min. Space/Equipment Needs: The CAPE/PAC manual and booklet. The CAPE/PAC scoring sheets and record form. The practitioner needs an instrument to record their findings and documentation. The practitioner will also need the activity cards, CAPE category cards, visual response pages, and administration questionnaire.
Scoring: For each dimension of participation that the CAPE and PAC measures, scores can be obtained to cover various levels of interest to the user. For the CAPE, the administer scores five different subscales including: diversity, intensity, with whom, where, and enjoyment. Diversity: There is an overall diversity score ranging from 0-55 (due to the 55 total items), a range for the informal diversity score is 0-40 (due to the 40 informal items) and a range for the formal diversity score is 0-15 (due to 15 formal items). This subscale scale is scored individually 0 (meaning the child has not performed this activity) or 1 (meaning the child has participated in this type of activity). All the “1” scores are then added in the “scoring calculations” section to give you an overall range score from 0-55. Intensity: refers to how often the child participates in the activity ranging from 1 (1 time in the past four months) to 7 (1 or more times a day.) There are 7 scoring options here. Each item is scored from 1-7 and added up to get a subtotal for items 1-21. There is a second subtotal for items 22-55. The two subtotals are added together to get a total score for intensity, this is then divided by 55 (due to the total number of items being scored) to give you an overall intensity score. For example items 1-21 are scored to 37, items 22-55 are scored to 45. These two numbers summed equals 82, which is then divided by 55 (82/55) = 1.5 overall intensity score. With Whom: There are five responses options for with whom dimension on the CAPE: (1) alone, (2) with family, (3) with other relatives, (4) with friends, and (5) with others. The with whom score is calculated by adding together the with whom ratings of those items that the child does and dividing the number of items that the child does. The possible range of scores for this dimension is 1.0-5.0. There is a subtotal score items 1-21 and a subtotal score for items 22-55. For example subtotal score for items 1-21 is 25 and subtotal score for items 22-55 is 17. These two numbers summed is 42 and this is divided by the total number of items that child participates in (17), therefore 42/17 = 2.5 overall with whom score. Where: There are six responses for this category, therefore each item is scored from 1-6. The scoring options for the where dimension on the CAPE: (1) at home, (2) at a relative’s home, (3) in your neighborhood, (4) at school, (5) in your community, and (6) beyond your community. This score is calculated by adding together the where ratings of those items that the child participates in and dividing by the total number of items. The possible range of scores for this dimension are 1.0-6.0. For example, 14 (subtotal for items 1-21) + 24 (subtotal for items 22-55) = 38/17 (total number of items) = 2.2 overall where score. Enjoyment: There are five responses for this category, therefore each item is scored from 1-5. The scoring options for the enjoyment dimension of the CAPE: (1) not at all, (2) somewhat; sort of, (3) pretty much, (4) very much, and (5) love it. The enjoyment score is calculated by adding the enjoyment ratings of those items the child participates in and dividing it by the total number of items that the child completes. The overall score range for this dimension is from 1.0-5.0. Example, 37 (subtotal for items 1-21) + 27 (subtotal for items 22-55) = 64/17 (total number of activities) = 3.8 overall enjoyment score. The same 55 activities are then used in the PAC. The PAC breaks the items into five categories including: recreational activities, physical activities, social activities, skill-based activities, and self-improvement activities. Every PAC item IS scored based on preference. Preference: The three responses include: (1) I would not like to do it all, (2) I would sort of like to do it, and (3) I would really like to do it. The preference score is calculated by summing the preference ratings and dividing by the total number of items. The divisor number depends on the number of items under each category (for example the recreational activity category has 12 items, so total score /12 = the preference score for rec. activities.). The overall preference score ranges from 1.0-3.0. So each category is scored like the example above and the scores for all the five categories are added up to a total that is divided by the total number of items on the PAC (55). This gives the administer an overall PAC score.
Psychometric properties (describe briefly; e.g. reliability, validity, sensitivity, specificity, etc): Reliability: This assessment uses internal consistency and test-retest reliability. The internal consistency is calculated using a Cronbach’s Alpha which compares each item to the overall score and the other individual items. This assessment was completed on both the PAC and CAPE. The PAC scored better for the formal and informal domains. The overall PAC scores were .76 (formal) and .84(informal). The overall CAPE scores were .42 (formal) and .76 (informal).  The test-retest scores were administered to three CAPE subscales including the diversity, intensity and enjoyment subscales. These scores were scored for overall participation in the three categories and then compared to the PAC scores for each of the five categories. The scores for diversity, intensity, and enjoyment ranged from .64-.86 indicating sufficient test-retest reliability. Validity: The validity is related to test content and is based on the degree to which the items represent and relate to the construct being measured. For the CAPE, the correlations among activity types are low, ranging from .22 to .44. This means that the CAPE doesn’t have strong validity. For the PAC preference scores the range was low from .27-.55, with the highest found between skill-based activities and self-improvement activities at .55. This makes sense as self-development activities usually entail skill development. The CAPE/PAC are not looking to rule in or out conditions/diagnoses, therefore sensitivity and specificity are not available.
Citations/References (source at least 2 articles that use the tool or reports on psychometrics): Imms, C. (2008). Review of the Children's Assessment of Participation and Enjoyment and the Preferences for Activity of Children. Physical & occupational therapy in pediatrics, 28(4), 389-404. King, G. A. (2004). CAPE/PAC Manual: Children's Assessment of Participation and Enjoyment & Preferences for Activities of Children. PsychCorp. King, G. A., Law, M., King, S., Hurley, P., Hanna, S., Kertoy, M., & Rosenbaum, P. (2006). Measuring children’s participation in recreation and leisure activities: construct validation of the CAPE and PAC. Child: care, health and development, 33(1), 28-39.
Comments/critique (include application to practice – settings, needs, populations): The CAPE and PAC are designed to be user friendly for children and their parents or caregivers. The CAPE / PAC provide a way to measure several dimensions of participation from a client-centered perspective. This assessment can be used on both children with and without disabilities. This allows the CAPE / PAC to be an engaging tool to use with all types of clients. This tool can be used any OT practice setting designed to provide interventions for children. I think the scoring is slightly limited for some categories and the categories could be more detailed to provide clearer evidence if the child really likes participating in activities or not.
Training or certification requirements:	No additional training is required. The administer should have high skill levels for interviewing children and the ability to establish a rapport with children and parents or caregivers. The administer should have extensive knowledge of the manual and score sheet to administer the CAPE and PAC.