776 A New Outcome Metric for Young Children with Burns: Item Pool Development for the Preschool Life Impact Burn Recovery Evaluation (LIBRE) Computer Adaptive Test (CAT) Profile

Abstract Introduction The assessment of recovery from burn injury is critical to improving pediatric health. However, there is a lack of brief, burn-specific measures to assess preschool-aged burn survivors’ health outcomes. We developed items pools for a new, parent-reported computer adaptive test based assessment of preschool-aged children’s burn outcomes. Methods Initial item pools were informed by the Preschool LIBRE Conceptual Model based on the International Classification for Children (ICF) and the Burn Outcomes Questionnaires (BOQ 0–5) and generated from a review of existing instruments assessing health and developmental outcomes in children 1–5 years. Candidate items underwent a review process to bin items together based on the underlying construct they assessed. Items were then winnowed down and further refined based on clinical expert consensus meetings. The winnowing process focused on ensuring items assessed abilities and behaviors that could be reliably determined by parent report, were age-relevant, and focused on health and developmental concepts that are important in the assessment of children’s burn recovery. To ensure item quality, we conducted parent cognitive interviews. In final reviews, we standardized item recall periods, response options, verb tense, and literacy demands. Results A total of 9,509 items were identified and extracted. Four item pool domains were established: communication and language development (42 items), physical functioning (53 items), psychological functioning (56 items), and social functioning (37 items). The respective item pools aim to assess: children’s ability to receive meaning and produce language; children’s gross and fine motor abilities; children’s emotions and behavior (internalizing and externalizing behaviors, dysregulation, toileting, response to trauma and resilience); and children’s social participation and abilities. Recall period and response options were refined for consistency for all 188 final items. Conclusions Four item pools were developed assessing four domains 1) communication and language development, 2) physical functioning, 3) psychological functioning and 4) social functioning for preschool-aged children. The item pools are currently being field-tested for the calibration and validation of the Preschool LIBRE CAT Profile. Applicability of Research to Practice This work is relevant to researchers and practitioners evaluating the effects of burn injury on preschool-aged children’s health and developmental outcomes.