School Function Assessment (SFA)
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Supplemental: Cerebral Palsy (CP)
|Short Description of Instrument||
The School Function Assessment (SFA) evaluates a child's performance in functional tasks necessary for participation in academic and social activities in elementary school. The entire SFA (Coster et al., 1998) is not strictly a measure of participation. It is a generic tool developed for use with children with and without disabilities for elementary aged school children aged 5 to 12 years. It has three sections: participation, task supports, and activity performance – all related to school (Coster et al, 1998). The participation section measures the child's level of participation in six school settings: general or social education classroom; playground; transportation to and from school; bathroom; transitions to and from class; and mealtimes. Each item is rated based on the extent to which the child participates in the tasks and activity in comparison with peers in the same grade. All 6 of these items map to the participation domain of ICF-CY (Chien et al., 2014). The task support section measures assistance given and adaptations made which contribute to the child's school related functions. These functions include physical tasks and cognitive/behavioral tasks. Finally, the performance section measures performance in more detail in school related functional tasks such as using school material, following school rules and communicating needs.
Numerous studies have examined the content and construct validity of the SFA. Evidence for content validity is supported through use of expert panels (Davies et al., 2004; Sakzewski et al., 2007) and for construct validity in cohorts of children with and without disability (Davies et al., 2004; Sakzewski et al., 2007). Internal consistency has been reported as excellent (0.92–0.98) (Davies et al., 2004; Hwang et al., 2009), inter rater reliability as adequate (ICC 0.68–0.73) (Davies et al., 2004), and test retest reliability as excellent (ICC 0.82–0.98) (Davies et al., 2004; Chien et al., 2014).
Part 1 Participation 6-point scale in 6 major school settings (i.e., score is 6 to 36). Part 2 Task supports (adaptations and assistance for physical and cognitive/hehavioural tasks) 4 point scale. Part 3 Activity performance (physical and cognitive/Behavioural tasks) 4 point scale.
This assessment has been widely used for children with a range of disabilities, not specifically cerebral palsy.
Coster W, Deeney T, Haltiwanger J, Haley S. School Function Assessment (SFA) San Antonio, TX: Pearson; 1998 [cited 2016 05 Jan]. Available from: http://www.pearsonclinical.com/therapy/products/100000547/school-function-assessment-sfa.html.
Chien CW, Rodger S, Copley J, McLaren C. Measures of participation outcomes related to hand use for 2- to 12-year-old children with disabilities: a systematic review. Child Care Health Dev. 2014;40(4):458–471.
Davies PL, Soon PL, Young M, Clausen-Yamaki A. Validity and reliability of the school function assessment in elementary school students with disabilities. Phys Occup Ther Pediatr. 2004;24(3):23–43.
Sakzewski L, Boyd R, Ziviani J. Clinimetric properties of participation measures for 5- to 13-year-old children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2007;49(3):232–240.
Hwang JL, Davies PL. Rasch analysis of the School Function Assessment provides additional evidence for the internal validity of the activity performance scales. Am J Occup Ther. 2009;63(3):369–373.
Chien CW, Rodger S, Copley J, Skorka K. Comparative content review of children's participation measures using the International Classification of Functioning, Disability and Health-Children and Youth. Arch Phys Med Rehabil. 2014;95(1):141–152.