Assessing Activities of Daily Living in Children Aged 5–10 Years: Rasch Validation of the DCDDaily-Q-CN in Community Contexts

Assessing Activities of Daily Living in Children Aged 5–10 Years: Rasch Validation of the DCDDaily-Q-CN in Community Contexts | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessing Activities of Daily Living in Children Aged 5–10 Years: Rasch Validation of the DCDDaily-Q-CN in Community Contexts Shuo Sun, Wenji Zhai, Chunming Zhou, Hongjie Chen, Guojun Yun, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7526150/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background Developmental Coordination Disorder (DCD) affects 5–6% of school-aged children, impairing motor coordination, daily functioning, and academic performance. Existing assessment tools often focus on either motor skills or functional interference, limiting comprehensive evaluation. This study applied Rasch analysis to the Chinese version of the DCDDaily-Questionnaire (DCDDaily-Q-CN), a parent-report measure of children’s daily functioning and participation, to evaluate its measurement properties and cross-gender invariance, thereby supporting its validity as a screening tool for children with suspected DCD. Methods Rasch analysis was conducted on data from 1,908 typically developing children (1,020 boys and 888 girls; mean age = 7.7 ± 1.7 years) recruited from 14 mainstream schools in a migrant city. The analysis evaluated key psychometric properties, including item and person reliability and separation, item-person targeting, item fit, category functioning, dimensionality, and Differential Item Functioning (DIF). Results Rasch analysis demonstrated excellent item reliability (≥ 0.98) and strong structural validity across all domains. However, person reliability was moderate (0.49–0.75), indicating limited precision in distinguishing individuals within subdomains. The scale showed good item fit (infit and outfit MNSQ values between 0.50 and 1.70), appropriate functioning of response categories, and supported unidimensionality across all domains. Item difficulties were generally well aligned with the ability levels of most children aged 5 to 10 years, confirming that the scale is appropriately targeted for its intended screening purpose. Nevertheless, Wright maps revealed mild ceiling effects and a degree of mismatch between item difficulty and participant ability, particularly in self-care tasks. DIF analysis identified gender-related bias in several self-care and fine motor items, whereas gross motor items exhibited measurement invariance across gender. Conclusion Rasch analysis confirms that the DCDDaily-Q-CN is a psychometrically robust tool with high reliability, unidimensional structure, and generally appropriate item targeting for assessing ADL in children aged 5 to 10 years. However, moderate person reliability and limited separation at the domain level suggest that subscale scores may be more suitable for group-level screening than for precise individual assessment. Furthermore, the identification of gender-related item bias highlights the need for refinement to improve fairness across genders. Activities of Daily Living Developmental Coordination Disorder Outcome Measures Psychometrics Rasch Analysis Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Background Developmental Coordination Disorder (DCD) is a common neurodevelopmental condition characterized by marked impairments in motor coordination that significantly interfere with activities of daily living (ADL) and academic performance [ 1 , 2 ]. Affecting approximately 5–6% of school-aged children, DCD has emerged as a major public health concern within pediatric neurodevelopmental research and clinical practice [ 3 , 4 ]. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)[ 5 ], a definitive diagnosis of DCD requires the fulfillment of four criteria: (A) a significant delay in motor skill acquisition relative to age expectations, despite sufficient opportunities for learning and practice; (B) motor deficits that substantially interfere with ADLs, academic achievement, vocational activities, or leisure participation; (C) onset of symptoms during the developmental period; and (D) exclusion of alternative explanations such as cerebral palsy, neuromuscular diseases, or uncorrected visual impairments. Beyond motor impairments, DCD often triggers a downward cycle of reduced participation, lower self-efficacy, and decreased quality of life, ultimately hindering long-term social adaptation [ 3 , 6 , 7 ]. Early and accurate identification of at-risk children is therefore critical. However, commonly used assessment tools remain limited in scope: the Movement Assessment Battery for Children–Second Edition (MABC-2) primarily evaluates motor performance (Criterion A), while the Developmental Coordination Disorder Questionnaire–Revised (DCDQ-R) focuses on functional interference (Criterion B) [ 8 , 9 ]. Under the framework of the International Classification of Functioning, Disability and Health – Children and Youth Version (ICF-CY), however, comprehensive assessment of DCD should encompass both activity (e.g., self-care) and participation (e.g., school or community engagement) dimensions[ 10 ]. This gap has prompted growing interest in parent-report measures that capture functional challenges in children’s everyday contexts. The DCDDaily-Questionnaire (DCDDaily-Q) directly addresses this need by systematically assessing children’s activities of daily living (ADLs) and participation through parent-report. Validation studies have shown it to be more predictive of DCD than traditional tools such as the DCDQ-R [ 11 ]. Cross-cultural adaptations of the DCDDaily-Q have been completed in several countries, including the Netherlands, Spain, Greece, and China, confirming its applicability across diverse populations. Our team recently completed the cultural adaptation and Classical Test Theory (CTT)-based validation of the Chinese version (DCDDaily-Q-CN), which demonstrated excellent psychometric properties, including high internal consistency, sound structural validity, and strong discriminant capacity (sensitivity = 93%, specificity = 90%) [ 12 ]. Notably, gender differences in scale scores were observed, raising concerns about potential measurement bias at the item level. While CTT provides valuable insights into reliability and validity, it is limited in detecting item-level measurement bias and does not account for the interaction between item difficulty and respondent ability. Rasch analysis, grounded in modern measurement theory, offers a robust framework for addressing these limitations. Specifically, Rasch modeling allows for the assessment of item-person targeting (i.e., alignment between item difficulty and ability distribution), the detection of Differential Item Functioning (DIF) across gender subgroups, and the evaluation of response category functioning (e.g., threshold ordering and category redundancy)[ 13 ]. Therefore, the present study applies Rasch analysis to the DCDDaily-Q-CN in children aged 5–10 years with two primary aims: (1) to evaluate measurement properties, including item–person targeting, response category functioning, reliability, separation indices, and unidimensionality, thereby ensuring robust construct validity and measurement precision; and (2) to examine gender-based Differential Item Functioning (DIF) to establish cross-gender measurement invariance. These analyses will provide empirical evidence regarding the cross-cultural applicability of the DCDDaily-Q-CN and its validity as a screening tool for identifying functional impairments in children with suspected DCD. Materials and methods Data collection Data from 1,936 children aged 5 to 10 years were collected from March to June 2023 as part of a previous normative study[12]. Participants were recruited from 14 mainstream schools randomly selected in the northeastern, eastern, southern, and central regions of Shenzhen. With a migrant population of 17 million from across China, Shenzhen provided a relatively representative sample in terms of geographic and ethnic diversity. Prior to this study, all participants had not been diagnosed with any learning or developmental disorders, as confirmed by both schools and parents. Ethical approval This study was approved by the Medical Research Ethics Committee of Shenzhen Children’s Hospital (Approval No. 2017025). All participants provided verbal informed consent, and written versions were signed by their guardians prior to study enrollment. DCDDaily-Q-CN The DCDDaily-Q-CN is a 23-item parent-report questionnaire designed to assess children’s participation and performance in various ADL, comprising three domains: self-care and self-maintenance (10 items), fine motor activities (7 items), and gross motor and play activities (6 items). Parents compare their child’s performance on each item against established criteria (1 = good, 2 = moderate, 3 = poor). The overall performance score ranges from 23 to 69, with higher scores indicating poorer performance. The questionnaire also uses a 4-point scale (1 = regularly, 2 = sometimes, 3 = seldom, 4 = not yet/never) to evaluate ADL participation, with total participation scores ranging from 23 to 92—higher scores reflect lower participation levels. Parents additionally use a yes/no format to indicate whether their child took longer than peers to learn an activity (1 = yes; 0 = no) [11, 12, 14]. Psychometric evaluation using Rasch analysis The Winsteps 5.2.3.0 software was used to perform Rasch analysis on each domain of the DCDDaily-Q-CN using the partial credit model [15]. This study evaluated the following psychometric properties: reliability and separation, item-person targeting, item fit, category functioning, dimensionality, and DIF. Reliability primarily reflects the consistency and reliability of measurement tools, typically assessed using reliability indices and separation indices. The person and item reliability indices indicate the internal consistency of respondent performance and item difficulty estimates, respectively. A person reliability index of 0.60–0.70 is generally considered the minimum acceptable threshold, while values above 0.70 are preferred. For a well-constructed instrument, a person reliability index of ≥0.80 and an item reliability index of ≥0.90 are recommended[16]. Separation indices—comprising the person separation index and item separation index—further evaluate the instrument’s discriminative capacity. The item separation index assesses the extent to which items are hierarchically ordered by difficulty. According to international standards, a separation index ≥2.0 is ideal (corresponding to a reliability coefficient ≥0.80)[16]; values between 1.5 and 2.0 are acceptable, while those <1.0 require cautious interpretation. However, some studies advocate for incorporating additional indicators—such as Wright maps and item fit statistics—for a more comprehensive and nuanced evaluation[17, 18]. Item–person targeting refers to the degree of alignment between item difficulty and the ability levels of test-takers. To assess this alignment, a person–item Wright map was constructed, illustrating the distribution of both item difficulty and person ability on a common logit scale. This visualization enables intuitive evaluation of how well the items are matched to the ability range of the target population. Item fit analysis assesses not only the overall consistency between observed responses and the Rasch model but also the extent to which individual items conform to model expectations, thereby identifying potentially misfitting items. The core statistics used in this analysis are the infit mean square (infit MNSQ) and outfit mean square (outfit MNSQ). Infit MNSQ reflects the average of squared standardized residuals, unweighted by response variance, and is therefore more sensitive to responses close to a person’s ability level. Outfit MNSQ, in contrast, is weighted by individual response variance, making it more responsive to unexpected responses that deviate substantially from the predicted pattern—often outliers far from the person’s estimated ability. Both indices have an expected value of 1.0 when item responses perfectly fit the Rasch model. Values exceeding 2.0 suggest that the item contributes more random noise than meaningful measurement information. In clinical observational studies, infit and outfit MNSQ values in the range of 0.5 to 1.7 are generally considered acceptable, while values below 0.5 may indicate overfit, suggesting the item is too predictable or redundant[19]. The DCDDaily-Q-CN performance scale includes three response categories per item across its three functional domains. Category probability curves and Andrich thresholds were evaluated to analyze whether category calibrations increased sequentially. Category probability curves illustrate the likelihood of each category being selected across the measurement continuum. Thresholds represent midpoints between adjacent response categories, denoting points where the probability of choosing either category is equal. If disordered thresholds are present, issues can be resolved by collapsing the problematic category into an adjacent one[20]. Unidimensionality refers to the assumption that all items within a measurement instrument assess a single underlying trait or ability. This property is commonly evaluated using Principal Component Analysis (PCA) of the residuals derived from the Rasch model. Adequate unidimensionality is evidenced by PCA of residuals explaining >50% of the original variance or the eigenvalue of the first contrast for unexplained variance in residuals <3.0[16]. Additionally, adequate item-person fit further substantiates the unidimensionality of the questionnaire construct[21]. DIF occurs when individuals with equivalent levels of the underlying trait respond differently to specific questionnaire items due to group characteristics such as gender or cultural background. The presence of DIF indicates a lack of measurement invariance, suggesting that the instrument may not yield consistent results across subgroups with equal ability levels. In this study, DIF was assessed using the Rasch–Welch t-test method. An item was considered to exhibit meaningful DIF if the DIF contrast was ≥ 0.5 logits and the p-value was < 0.05, indicating potential instability in item performance across groups[16, 22]. Results Study population A total of 1,936 children initially completed the questionnaire. After excluding 28 cases due to missing data, 1,908 participants (1,020 boys and 888 girls) were included in the final analysis. The mean age of the total sample was 7.7 years (SD = 1.7, range = 5.0–10.0 years); specifically, boys had a mean age of 7.725 years (SD = 1.69) and girls had a mean age of 7.727 years (SD = 1.62). An independent-samples t-test confirmed the age difference between boys and girls in terms of DCDDaily-Q-CN scores. (t = 2.082, p = 0.0374). Mean scores for the DCDDaily-Q-CN total scale and its three domains by gender are presented in Table 1. Table 1 DCDDaily-Q-CN scores of the study population by gender Sex Total Boys Girls *p N 1908 1020 888 Age, mean (SD) 7.726(1.66) 7.725(1.69) 7.727(1.62) 0.9845 DCDDaily-Q-CN scores 71.02(17.86) 71.82(18.19) 70.11(17.42) 0.0374 Performance scale, mean (SD) 33.15(7.96) 33.64(8.14) 32.59(7.70) 0.0040 Self-care and self-maintenance 13.02(3.21) 13.25(3.32) 12.74(3.06) 0.0005 Fine motor activities 10.12(2.91) 10.44(3.00) 9.74(2.76) <0.0001 Gross motor and play activities 10.02(3.07) 9.94(3.00) 10.11(3.15) 0.2479 Participation scale, mean (SD) 36.74(10.50) 36.96(10.61) 36.49(10.37) 0.3374 Self-care and self-maintenance 13.77(4.34) 13.90(4.40) 13.63(4.26) 0.1828 Fine motor activities 11.13(3.86) 11.42(3.97) 10.80(3.70) 0.0005 Gross motor and play activities 11.84(4.34) 11.64(4.19) 12.06(4.49) 0.0377 DCDDaily-Q-CN, DCDDaily questionnaire Chinese version; SD, standard deviation. Group comparisons were performed using the independent t-test. Rasch analysis of the DCDDaily-Q-CN Reliability analysis For both the Performance and Participation scales, item reliability reached 1.00 with separation indices of 15.01 and 17.87, respectively. Person reliability was 0.81 and 0.80, with separation indices of 2.05 and 2.00, indicating excellent measurement precision and strong item stratification. At the domain level, item reliability remained high (0.98–1.00), with separation indices ranging from 6.28 to 17.43, confirming the structural soundness of the subscales. However, person reliability was comparatively moderate (0.49-0.75), with separation indices between 0.98 and 1.72, reflecting a limited ability to distinguish between individual performance levels within specific domains (Tables 2 and 3). Table 2 Statistics for Rasch analysis of the three domains in the performance scale. DCDDaily-Q-CN Measure (Mean, SD) Infit (MNSQ, SD) Outfit (MNSQ, SD) Reliability ISI/PSI Item statistics Total scale 0.00±0.78 1.00±0.11 1.06±0.21 1.00 15.01 Self-care and self-maintenance 0.00±0.44 1.00±0.11 1.00±0.12 0.98 7.29 Fine motor activities 0.00±0.37 0.99±0.15 1.00±0.15 0.98 6.28 Gross motor activities 0.00±0.69 1.00±0.21 1.02±0.24 0.99 12.56 Person statistics Total scale 2.34±1.91 1.02±0.46 1.06±0.69 0.81 2.05 Self-care and self-maintenance 2.97±1.71 1.01±0.46 1.00±0.52 0.50 0.99 Fine motor activities 2.46±1.99 1.00±0.63 1.00±0.64 0.61 1.24 Gross motor activities 1.49±2.31 1.00±0.75 1.02±0.82 0.72 1.62 Table 3 Statistics for Rasch analysis of the three domains in the participation scale. DCDDaily-Q-CN Measure (Mean, SD) Infit (MNSQ, SD) Outfit (MNSQ, SD) Reliability ISI/PSI Item statistics Total scale 0.00±0.74 1.03±0.16 1.06±0.23 1.00 17.87 Self-care and self-maintenance 0.00±0.53 1.02±0.15 0.98±0.15 0.99 10.72 Fine motor activities 0.00±0.47 1.00±0.23 1.00±0.25 0.99 10.40 Gross motor activities 0.00±0.71 1.00±0.29 1.02±0.31 1.00 17.43 Person statistics Total scale 2.05±1.69 1.02±0.54 1.06±0.70 0.80 2.00 Self-care and self-maintenance 2.78±1.58 1.02±0.55 0.98±0.58 0.49 0.98 Fine motor activities 2.34±1.83 1.00±0.53 1.00±0.67 0.62 1.26 Gross motor activities 1.39±2.06 0.99±0.76 1.02±0.87 0.75 1.72 ISI, item separation index; PSI, person separation index; SD, standard deviation; MNSQ, mean square. Item–person targeting The Wright map provides a visual representation of the distribution of children’s ability levels (left, denoted by “#”) and item difficulties (right) on a common logit scale, with higher positions indicating greater ability or item difficulty. Domain-specific Wright maps (Performance scale Figures 1–3, Participation scale Figures 5–7) demonstrated that the questionnaire was well-targeted to children with low-to-moderate motor abilities (−1 to +1 logits). However, item difficulty ranges were narrower than the distribution of participants’ abilities (approximately 4 logits), indicating suboptimal coverage and a mild ceiling effect—least evident in the gross motor and play activities domain. The Wright map for the total scale (Figure 4, Figure 8) further revealed that the average item difficulty was about 2 logits lower than the mean ability level of the children, suggesting that most items were well within the ability range of the sample. The overall item difficulty spanned approximately 3 logits (−1 to +2 logits). The most challenging items (I20–I23) from the gross motor and play activities domain exceeded the mean difficulty by one standard deviation, indicating tasks requiring relatively advanced motor skills. Conversely, the easiest items (I6, I8, and I10) from the self-care and self-maintenance domain were more than one standard deviation below the mean, reflecting activities that were generally mastered by most children in this age group. Item fit analysis Tables 4 and 5 present the item fit statistics and item measures for the DCDDaily-Q-CN. All items across the three domains exhibited excellent fit to the Rasch model, with infit and outfit MNSQ values ranging from 0.50 to 1.70, indicating strong conformity to model expectations. Regarding item difficulty, values ranged from −1 to +1 logits, suggesting that the questionnaire is primarily composed of items with moderate difficulty levels. While this distribution is appropriate for assessing ADL in the general pediatric population, it may limit the instrument’s sensitivity to children with extreme (particularly high) motor abilities. Standard errors for item estimates were low (0.05–0.06), supporting the precision and reliability of item calibration. Table 4 Items from the three domains of the performance scale, ordered by item measure. Items Measure Model S.E. Infit MNSQ ZSTD Outfit MNSQ ZSTD Self-care and self-maintenance I9 Handling a key 0.63 0.05 1.25 6.40 1.24 5.96 I5 Eating rice with chopsticks 0.58 0.05 0.98 -0.67 0.99 -0.13 I3 Open a wrapper/package 0.49 0.05 0.93 2.02 0.99 -0.31 I2 Pouring juice 0.32 0.06 0.87 3.73 0.87 -3.14 I7 Drying oneself after a shower or bath -0.04 0.06 1.09 2.26 1.04 0.82 I8 Brushing teeth -0.19 0.06 0.90 2.51 0.89 -2.22 I6 Washing hands -0.35 0.06 0.90 2.47 0.87 -2.40 I1 Poking a straw into a milk carton -0.43 0.06 1.11 2.59 1.18 2.95 I10 Putting on socks -0.48 0.06 0.97 -0.79 0.93 -1.27 I4 Eating soup with a spoon -0.54 0.06 1.03 0.66 0.97 -0.53 Fine motor activities I11 Writing 0.40 0.05 1.05 1.30 1.06 1.66 I12 Gluing paper using a glue stick 0.27 0.05 0.93 -1.87 0.92 -2.25 I17 Moving pawns (on a board) 0.23 0.05 1.27 6.85 1.23 5.61 I13 Folding paper sheets/slips 0.11 0.06 0.84 -4.79 0.83 -4.58 I15 Cutting paper using scissors 0.06 0.06 0.86 -3.91 0.85 -4.00 I16 Lego building -0.35 0.06 1.12 3.14 1.21 4.49 I14 Coloring a picture -0.72 0.06 0.90 -2.88 0.89 -2.40 Gross motor activities I23 Playing marbles 0.86 0.05 1.12 3.29 1.11 2.85 I22 Kicking a football 0.77 0.05 0.85 -4.50 0.85 -4.27 I20 Throwing a tennis ball 0.16 0.05 0.80 -6.21 0.80 -5.88 I21 Catching a ball -0.07 0.05 0.74 -8.04 0.73 -7.99 I19 Jumping a rope -0.83 0.05 1.26 6.98 1.39 8.23 I18 Playing hopscotch -0.90 0.05 1.21 5.56 1.23 4.85 Table 5 Items from the three domains of the participation scale, ordered by item measure. Items Measure Model S.E. Infit MNSQ ZSTD Outfit MNSQ ZSTD Self-care and self-maintenance I9 Handling a key 0.98 0.04 1.32 7.80 1.30 6.77 I2 Pouring juice 0.46 0.04 0.91 -2.32 0.97 -0.57 I3 Open a wrapper/package 0.44 0.04 0.87 -3.33 0.96 -0.82 I5 Eating rice with chopsticks 0.30 0.04 0.95 -1.12 0.99 -0.18 I1 Poking a straw into a milk carton -0.02 0.05 1.18 3.84 1.16 2.82 I7 Drying oneself after a shower or bath -0.05 0.05 1.17 3.60 0.94 -1.07 I4 Eating soup with a spoon -0.11 0.05 1.00 0.08 0.92 -1.32 I6 Washing hands -0.60 0.05 0.91 -1.65 0.83 -2.47 I8 Brushing teeth -0.68 0.06 0.89 -2.14 0.77 -3.31 I10 Putting on socks -0.71 0.06 1.00 -0.05 0.89 -1.49 Fine motor activities I17 Moving pawns (on a board) 0.65 0.04 1.20 5.06 1.19 4.87 I12 Gluing paper using a glue stick 0.40 0.04 0.87 -3.52 0.86 -3.73 I13 Folding paper sheets/slips 0.15 0.04 0.72 -7.90 0.72 -7.56 I15 Cutting paper using scissors 0.13 0.04 0.82 -4.93 0.83 -4.34 I16 Lego building -0.01 0.04 1.14 3.48 1.17 3.82 I14 Coloring a picture -0.81 0.05 0.84 -4.01 0.80 -4.05 Gross motor activities I23 Playing marbles 0.91 0.04 1.01 0.44 1.01 0.39 I22 Kicking a football 0.68 0.04 0.82 -5.57 0.84 -4.68 I20 Throwing a tennis ball 0.05 0.04 0.77 -7.32 0.78 -6.61 I21 Catching a ball -0.14 0.04 0.71 -9.17 0.70 -8.91 I18 Playing hopscotch -0.21 0.04 1.17 4.56 1.16 4.21 I19 Jumping a rope -1.30 0.04 1.55 9.90 1.63 9.90 S.E., standard error; MNSQ, mean square; ZSTD, Z-standardized. The items are listed according to the hierarchy of the item difficulties (“Measure”). Infit or outfit MNSQ values have a reasonable range of 0.5 to 1.7. Category functioning Category thresholds of the DCDDaily-Q-CN items are presented in Table 6. All three domains of both the performance and participation scale demonstrated ordered Andrich thresholds, indicating appropriate functioning of the response categories. Table 6 Items from the DCDDaily-Q-CN, ordered by item measure. Performance Score Observed count Observed average Outfit MNSQ Andrich threshold Self-care and self-maintenance 1 526.00 0.32 1.27 -- 2 4702.00 1.32 0.92 -1.47 3 13852.00 2.62 0.98 1.47 Fine motor activities 1 661.00 -0.48 1.11 -- 2 4622.00 0.89 0.96 -1.77 3 8073.00 2.42 0.97 1.77 Gross motor activities 1 1473.00 -1.47 1.05 -- 2 4721.00 0.37 1.00 -1.74 3 5254.00 2.11 1.01 1.74 Participation Self-care and self-maintenance 1 350.00 0.07 1.54 -- 2 1128.00 0.56 0.97 -1.06 3 3894.00 1.43 0.86 -0.18 4 13708.00 2.55 0.98 1.24 Fine motor activities 1 405.00 -0.46 1.12 -- 2 1352.00 0.21 0.93 -1.31 3 3964.00 1.21 0.97 -0.36 4 7635.00 2.29 1.04 1.67 Gross motor activities 1 1161.00 -1.40 0.96 -- 2 1969.00 -0.25 1.09 -1.33 3 3715.00 0.82 0.96 -0.40 4 4603.00 1.97 1.08 1.73 Unidimensionality Unidimensionality of the DCDDaily-Q-CN was evaluated via Principal Component Analysis (PCA) of Rasch model-derived residuals (Tables 7 and 8). Across the three core domains (self-care and self-maintenance, fine motor activities, gross motor and play activities), the Rasch dimension explained 30.7% to 52.9% of the raw variance in observations; notably, only the gross motor and play activities domain of the Participation scale met the commonly accepted ideal threshold of >50% variance explained (52.9%). However, the eigenvalue of the first contrast in unexplained residual variance ranged from 1.51 to 1.74 across all domains, which was consistently below the critical value of 3.0, indicating no significant secondary dimension that would interfere with the measurement of the target latent trait. At the total scale level, the Performance scale exhibited a total raw variance of 37.36, with the Rasch dimension accounting for 38.40% of this variance (eigenvalue = 14.36, below 50%), but its first contrast eigenvalue was 2.65 (still <3.0); the Participation scale had a total raw variance of 39.64, with the Rasch dimension explaining 42.00% of the variance (eigenvalue = 16.64, also <50%), and its first contrast eigenvalue was slightly higher at 3.46 (marginally exceeding 3.0). Importantly, all items across both total scales demonstrated good fit to the Rasch model (infit and outfit MNSQ values ranging from 0.50 to 1.70) with adequate item-person fit. Combined with the excellent item fit observed across all domains, these results collectively support the unidimensionality assumption of the DCDDaily-Q-CN, confirming that the questionnaire effectively measures a single underlying construct (i.e., children’s ADL performance or participation capacity) despite the marginal deviation in the Participation scale’s first contrast eigenvalue. Table 7 Dimensionality assessment of the three domains in the performance scale DCDDaily-Q-CN Domains Total raw variance in observations Raw variance explained by measures Unexplained variance 1st contrast Eigenvalue Percent (%) Eigenvalue Percent (%) Total scale 37.36 14.36 38.40 2.65 7.10 Self-care and self-maintenance 14.44 4.44 30.70 1.51 10.40 Fine motor activities 11.15 4.15 37.20 1.44 12.90 Gross motor activities 11.01 5.01 45.50 1.64 14.90 Table 8 Dimensionality assessment of the three domains in the participation scale DCDDaily-Q-CN Domains Total raw variance in observations Raw variance explained by measures Unexplained variance 1st contrast Eigenvalue Percent (%) Eigenvalue Percent (%) Total scale 39.64 16.64 42.00 3.46 8.70 Self-care and self-maintenance 16.05 6.05 37.70 1.67 10.40 Fine motor activities 12.04 5.04 41.90 1.51 12.50 Gross motor activities 12.73 6.73 52.90 1.74 13.70 DIF by gender A DIF analysis by gender was conducted on the questionnaire (Tables 9 and 10). The results indicate that all items in the gross motor and play activities domain of the performance scale, as well as those in the self-care and self-maintenance domain of the participation Scale, demonstrated |DIF contrast| values below 0.5, this reflects strong cross-gender stability for items within these two domains. However, several items across different domains and scales showed higher |DIF contrast| values: specifically, in the self-care and self-maintenance domain of the performance scale, item I9 (handling a key) met this criterion; similarly, items I14 (coloring a picture), I15 (cutting paper using scissors), I16 (Lego building), and I17 (moving pawns on a board)—which belong to the fine motor activities domain of both the performance and participation scales—also exhibited this pattern. Additionally, item I19 (Jumping a rope) in the Gross Motor and Play Activities domain of the Performance Scale fell into the same category. All these items had |DIF contrast| values ≥ 0.5, with statistical significance at p < 0.05. This suggests the presence of gender-related DIF for these items, indicating that children with equivalent ability levels responded differently to these specific items based on gender. Table 9 Analysis of gender-DIF of the three domains in performance scale Domains Item DIF contrast (Boys vs girls) Joint S.E. p Self-care and self-maintenance I1 Poking a straw into a milk carton -0.15 0.13 0.2181 I2 Pouring juice 0.00 0.11 1.0000 I3 Open a wrapper/package -0.10 0.11 1.0000 I4 Eating soup with a spoon 0.10 0.13 0.4353 I5 Eating rice with chopsticks 0.13 0.11 0.2461 I6 Washing hands 0.16 0.12 0.2053 I7 Drying oneself after a shower or bath -0.17 0.12 0.1482 I8 Brushing teeth 0.40 0.12 0.0010 I9 Handling a key -0.50 0.11 0.0000 I10 Putting on socks 0.31 0.13 0.0154 Fine motor activities I11 Writing 0.27 0.11 0.0137 I12 Gluing paper using a glue stick 0.18 0.11 0.1001 I13 Folding paper sheets/slips 0.25 0.11 0.0272 I14 Coloring a picture 0.60 0.12 0.0000 I15 Cutting paper using scissors 0.52 0.11 0.0000 I16 Lego building -1.02 0.11 0.0000 I17 Moving pawns (on a board) -0.75 0.11 0.0000 Gross motor activities I18 Playing hopscotch 0.49 0.11 0.0000 I19 Jumping a rope 0.38 0.11 0.0004 I20 Throwing a tennis ball -0.22 0.10 0.0354 I21 Catching a ball 0.10 0.10 0.3456 I22 Kicking a football -0.34 0.10 0.0008 I23 Playing marbles -0.34 0.10 0.0010 Table 10 Analysis of gender-DIF of the three domains in participation scale Domains Item DIF contrast (Boys vs girls) Joint S.E. p Self-care and self-maintenance I1 Poking a straw into a milk carton -0.23 0.09 0.0468 I2 Pouring juice 0.05 0.08 0.2985 I3 Open a wrapper/package 0.05 0.08 0.5349 I4 Eating soup with a spoon 0.00 0.10 0.7338 I5 Eating rice with chopsticks 0.10 0.09 0.2272 I6 Washing hands 0.00 0.11 0.9399 I7 Drying oneself after a shower or bath 0.00 0.09 0.5001 I8 Brushing teeth 0.36 0.12 0.0010 I9 Handling a key -0.29 0.08 0.0013 I10 Putting on socks 0.33 0.12 0.0105 Fine motor activities I11 Writing 0.09 0.09 0.3501 I12 Gluing paper using a glue stick 0.26 0.08 0.0013 I13 Folding paper sheets/slips 0.25 0.08 0.0003 I14 Coloring a picture 0.52 0.10 0.0000 I15 Cutting paper using scissors 0.53 0.08 0.0000 I16 Lego building -0.81 0.08 0.0000 I17 Moving pawns (on a board) -0.61 0.08 0.0000 Gross motor activities I18 Playing hopscotch 0.40 0.08 0.0000 I19 Jumping a rope 0.51 0.09 0.0000 I20 Throwing a tennis ball -0.13 0.07 0.0941 I21 Catching a ball 0.00 0.08 0.9022 I22 Kicking a football -0.33 0.07 0.0000 I23 Playing marbles -0.24 0.07 0.0016 Bolded numerical ranges indicated |DIF contrast|≥0.5and p<0.05; S.E., standard error. Negative values (“-”) indicate that girls' scores are higher than boys'. Discussion This study represents the first application of Rasch analysis to validate the DCDDaily-Q. Overall, the questionnaire demonstrated strong psychometric properties, with good item fit, unidimensionality, and appropriate response category functioning. Item targeting was generally appropriate for the target population, supporting its use as a screening tool. However, moderate person reliability and limited separation at the domain level suggest that subscale scores may be more suitable for group-level screening than for precise individual assessment. Additionally, gender-related DIF in the fine motor domain indicates areas for further refinement to improve cross-group fairness and discriminant validity. Overall, while the DCDDaily-Q-CN is a valuable instrument for assessing children’s ADL performance, ongoing optimization is warranted to enhance its precision and applicability. Rasch analysis revealed that DCDDaily-Q-CN exhibited an item difficulty gradient from easy to difficult across the self-care and self-maintenance, fine motor activities, and gross motor activities and play activity domains. This gradient is closely aligned with the neurodevelopmental trajectory, skill acquisition sequence, and cognitive maturity of 5-10-year-old children. Self-care tasks (e.g., dressing, eating, grooming) constitute the earliest independent skills acquired by children. By this age range, children have generally developed basic self-care abilities, which rely heavily on repetitive practice and procedural memory supported by relatively stable neural pathways; accordingly, items in this domain are designed to be relatively simple. Fine motor activities (e.g., writing, paper-cutting, tying shoelaces) depend on the control of small muscle groups and visuomotor integration, with neural maturation lagging behind that of gross motor skills[23]. Moreover, fine motor tasks often require the use of tools (such as pencils and scissors), involving spatial planning and force feedback regulation, demanding multisensory integration, and consequently leading to higher failure rates (e.g., cutting outside boundaries). This results in greater item difficulty compared to self-care tasks [24]. Gross motor activities (e.g., running, jumping, throwing) require whole-body coordination, balance, and strength control, engaging multiple brain regions including the cerebellum and basal ganglia. Play activities (e.g., ball games, hide-and-seek) further incorporate rule comprehension, strategic adjustment, and social interaction, imposing substantial demands on executive functions that mature around age 10, thus accounting for the significantly increased item difficulty in this domain. Collectively, the distribution of item difficulties aligns with typical neurodevelopment, minimizing bias related to immature abilities and supporting the scale’s precision and suitability for clinical screening of children aged 5–10 years. The DCDDaily-Q is designed to assess the performance and participation of 5–10-year-old children in ADLs (i.e., self-care and play activities), with item difficulties aligned to the capabilities expected for this age group. Rasch analysis indicated that children’s average ability level exceeded the average item difficulty, suggesting that the skills covered by the questionnaire are manageable for most children based on parental reports. While the questionnaire contains sufficient items of moderate difficulty to ensure effective assessment for the majority, person reliability and separation indices at the domain level were moderate, reflecting limited discrimination between ability strata within specific domains. These findings imply that, in its current form, domain scores may be more suitable for group-level screening than for precise individual-level assessment. To enhance discriminative power, particularly for higher-ability children, adding more high-difficulty items at the upper end of the Wright map could reduce the gap between mean ability and mean item difficulty, raise the ceiling of the scale, and allow more accurate identification of individual differences. Although the proportion of raw variance explained by the Rasch dimension in both the Total Score of the Performance Scale and the Total Score of the Participation Scale of the Chinese Version of the DCDDaily Questionnaire (DCDDaily-Q-CN) did not meet the ideal threshold of 50%, the instrument still demonstrated acceptable unidimensionality following comprehensive evaluation using multiple indicators. Specifically, the eigenvalue of the first contrast in unexplained variance for the Total Score of the Performance Scale was 2.65, which is significantly lower than the critical value of 3.0. This indicates that there is no prominent secondary dimension that would interfere with the measurement of the core construct of "children’s overall Activities of Daily Living (ADL) performance". For the Total Score of the Participation Scale, the eigenvalue of the first contrast was slightly higher (3.46, marginally exceeding 3.0), but the magnitude of this deviation was minimal and not accompanied by item misfit. This suggests that even if there is a potential multidimensional tendency, its extent is insufficient to affect the measurement of the core construct of "children’s overall ADL participation". Furthermore, the three domains integrated into the Total Scores (self-care and self-maintenance, fine motor activities, gross motor and play activities) are essentially structured around the core construct of "ADL-related abilities in children aged 5–10 years". This conceptual relevance further mitigates the interference of minor secondary dimensions on measurement outcomes. In-depth unidimensionality and item fit analyses conducted separately for the three domains revealed that all domains exhibited clear unidimensional characteristics, with excellent item fit (infit mean square [infit MNSQ] and outfit mean square [outfit MNSQ] values all falling within the acceptable range of 0.50–1.70). This result confirms that items within each domain consistently reflect their corresponding underlying latent traits (i.e., children’s self-care ability, fine motor ability, and gross motor/play ability), which provides strong evidence for the construct validity of the scale. Meanwhile, the good item fit also indicates that the difficulty level of each item is well-aligned with the ability level of the target population (children aged 5–10 years) in the corresponding domain, ensuring that the questionnaire can effectively capture the intended functional performance of the target population. Additionally, the Andrich thresholds for the response categories of all items across the three domains were reasonably ordered, and the category probability curves were fully consistent with the expectations of the Rasch model. Collectively, these results confirm that the 3-point rating scale of the questionnaire possesses reliable psychometric properties and can effectively distinguish between children with different ability levels. Given that the DCDDaily-Q-CN is designed as a screening tool (rather than a precision diagnostic instrument), its current level of unidimensionality is sufficient to meet core application needs: quickly identifying children’s overall ADL ability through Total Scores to provide a basis for further evaluation of children suspected of having Developmental Coordination Disorder (DCD). However, the slight increase in the eigenvalue of the first contrast for the Total Score of the Participation Scale points to a direction for subsequent optimization of the scale. For example, re-evaluating the content relevance of cross-domain items (e.g., adjusting the wording of certain items to enhance their association with the core construct of "ADL participation") could further improve the measurement precision of the scale’s unidimensionality. Gender-based DIF analysis identified five gender-sensitive items (I9, I14–I17, I19) within the self-care and self-maintenance and fine motor activities domains. Specifically, boys demonstrated significantly higher scores on "Coloring a picture" (I14), "Cutting paper using scissors" (I15) and Jumping rope" (I19), whereas girls outperformed boys on "Handling a key" (I9), "Lego building" (I16), and "Moving pawns on a board" (I17). These disparities may largely stem from inherent neurodevelopmental and physiological differences between genders, such as variations in visuomotor integration, fine motor coordination, and task preferences influenced by early socialization and environmental exposure [25]. Previous studies have indicated that girls tend to exhibit greater proficiency in fine motor skills involving grip control and object manipulation, which may account for their superior performance on tasks such as "Handling a key" (I9), "Lego building" (I16), and "Moving pawns on a board" (I17) [23, 26]. In contrast, boys often demonstrate early advantages during the preschool years in palm strength, wrist stability, and coordination between large and small muscle groups, providing them with an edge in force-intensive fine motor tasks such as "Cutting paper using scissors" (I15) , "Coloring a picture" (I14) and "Jumping rope" (I19)[27]. Given these gender-related differences, future revisions of the questionnaire should consider re-evaluating or optimizing these six gender-sensitive items within the self-care and self-maintenance and fine motor activities domains. In light of the identified limitations in item difficulty coverage and gender sensitivity within the DCDDaily-Q-CN, several directions for improvement are proposed. First, to address the ceiling effect, particular attention should be given to the self-care and fine motor activities domains, where this issue is most prominent. Expanding the item difficulty in these areas would enhance the questionnaire’s discriminative power, particularly for children with higher functional abilities. Second, considering the questionnaire’s role in assessing everyday functioning, future item development should more closely reflect the real-life experiences and typical activity repertoire of children aged 5 to 10 years. This would increase the ecological validity of the tool and improve its interpretability and relevance for parent respondents. For example, the self-care domain could include a task such as “tying laces,” which demands fine finger dexterity, bilateral coordination, and sequential planning. In the fine motor activities domain, a task such as “drawing a person” could be added, which reflects common school-related demands and requires integrated visuomotor skills, spatial organization, and attention to detail. These additions would help raise the upper measurement limit of the questionnaire, reduce ceiling effects, and better capture ability variations among higher-functioning children. In terms of addressing gender-related bias, the physiological and developmental differences between boys and girls can be mitigated through task decomposition or item content adjustments. For example, in the self-care and self-maintenance domain, item I9 (Handling a key) can be split into two subtasks: I9a: inserting the key (primarily assessing fine finger manipulation and hand–eye coordination) and I9b: turning the key (primarily assessing wrist strength and stability). This separation distinguishes between motor control and strength-based demands, balancing gender differences while also increasing the overall item difficulty. In the fine motor activities domain, items I14 (Coloring a picture) and I15 (Cutting paper using scissors), where boys tend to perform better due to greater palm strength and wrist stability, could be optimized to reduce their reliance on force and instead emphasize motor coordination. For instance, I14 could require coloring within small, complex regions to increase demands on visual precision and control, while I15 could involve cutting along curved or intricate patterns to emphasize bilateral coordination and spatial planning rather than brute force. For items I16 (Lego building) and I17 (Moving pawns on a board), which tend to favor girls—possibly due to their advantage in fine motor precision and sequential planning—gender neutrality can be enhanced through alternative task designs. These items may be replaced or supplemented with activities such as “screwing bottle caps” or “stringing beads”, which maintain demands on hand–eye coordination and fine manipulation but have been shown to exhibit minimal gender bias in prior research[28]. This study has several limitations that warrant consideration. First, the sample was relatively homogeneous in terms of geographic and demographic characteristics, which may limit the generalizability of the findings. A lack of regional and socioeconomic diversity constrains the ability to evaluate the stability and applicability of the DCDDaily-Q-CN across different populations and cultural contexts. Second, due to limitations in study duration and available resources, no item modifications or iterative questionnaire revisions were implemented during this phase of research. This restricts the extent to which the measurement properties could be refined or optimized. Future studies should adopt multicenter designs with more diverse samples to enhance external validity and employ modern psychometric methods alongside iterative item development to improve the questionnaire’s precision, fairness, and clinical utility. Conclusion Using Rasch analysis, this study confirms that the DCDDaily-Q-CN possesses robust psychometric properties, including strong reliability, unidimensionality, and appropriate item targeting for children aged 5 to 10, supporting its validity as a screening tool for children’s ADL competencies. However, moderate person reliability and limited separation at the domain level suggest that subscale scores may be more suitable for group-level screening than for precise individual assessment. Furthermore, the identification of gender-related item bias highlights the need for refinement to improve fairness across genders. Abbreviations DCDDaily-Q-CN DCDDaily-Q Chinese Version ADL Activities of Daily Living DIF Differential Item Functioning DCD Developmental Coordination Disorder DSM-5 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition MABC-2 Movement Assessment Battery for Children–Second Edition DCDQ-R Developmental Coordination Disorder Questionnaire–Revised ICF-CY International Classification of Functioning, Disability and Health – Children and Youth Version CTT Classical Test Theory PCA Principal Component Analysis Declarations Acknowledgements The author would like to thank all the participants for their valuable contributions to this research. Author contributions Shuo Sun, Meihuan Huang and Guojun Yun made substantial contributions to the conception and design of the study. Shuo Sun, Wenji Zhai and Chunming Zhou analyzed the data and drafted the manuscript. Hongjie Chen contributed to the discussion of the results. All authors reviewed and edited drafts of the manuscript. All authors read and approved the final manuscript. Funding This study was conducted in accordance with the Declaration of Helsinki. It was supported by the Research Foundation of Medical Science and Technology of Guangdong Province (Grant No. B2025075) and the Shenzhen Science and Technology Program (Grant No. JCYJ20220530160004010). Data availability The data supporting the findings of this study are available from the corresponding author upon reasonable request. Ethical approval and consent to participate This study was approved by the Medical Research Ethics Committee of Shenzhen Children’s Hospital (Approval No. 2017025). All participants provided verbal informed consent, and written versions were signed by their guardians prior to study enrollment. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References Jolly C, Jover M, Danna J. 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Exploring gender differences in infant motor development related to parent's promotion of play. Infant Behav Dev. 2020;59:101440. Peng K, Liu G, Wang J, Chen T. Psychometric Properties of Fine Motor Function Measure in Children With Cerebral Palsy: A Rasch Analysis. Clin Pediatr (Phila). 2025;64:524–37. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 20 Oct, 2025 Reviewers agreed at journal 20 Oct, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviewers invited by journal 07 Oct, 2025 Editor invited by journal 10 Sep, 2025 Editor assigned by journal 10 Sep, 2025 Submission checks completed at journal 10 Sep, 2025 First submitted to journal 03 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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1","display":"","copyAsset":false,"role":"figure","size":1074659,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the performance self-care and self-maintenance domain. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 45 participants and each “·” is 1 to 44.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/efe53e18f970db1dc11407d2.png"},{"id":93978343,"identity":"e95f81fe-a014-484f-b85e-1b146bd2cdd1","added_by":"auto","created_at":"2025-10-21 01:44:38","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1074659,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the performance fine motor activities domain. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 43 participants and each “·” is 1 to 42.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/07b967db8dd43d6236d113e8.png"},{"id":93977985,"identity":"d57d3e88-b2d4-4247-a342-ae917cbefd0b","added_by":"auto","created_at":"2025-10-21 01:36:38","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1074659,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the performance gross motor activities domain. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 31 participants and each “·” is 1 to 30.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/d65047708b77590ca7c64236.png"},{"id":93977472,"identity":"77efed23-2cec-4541-a377-d1b06f50a5ca","added_by":"auto","created_at":"2025-10-21 01:28:38","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":1071817,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the DCDDaily-Q-CN performance total scale. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 19 participants and each “·” is 1 to 18.\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/819df3f79ee3c7fbe259bb2a.png"},{"id":93977989,"identity":"17e0c7d4-2a9a-4ccc-958a-47077d482e2c","added_by":"auto","created_at":"2025-10-21 01:36:38","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":1071817,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the participation self-care and self-maintenance domain. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 19 participants and each “·” is 1 to 39.\u003c/p\u003e","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/3566eb97ec45779db6e37a40.png"},{"id":93977479,"identity":"f5e6e48e-05ee-4baf-a0b5-cd3c0e043ba6","added_by":"auto","created_at":"2025-10-21 01:28:38","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":1071817,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the participation fine motor activities domain. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 19 participants and each “·” is 1 to 37.\u003c/p\u003e","description":"","filename":"floatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/1bf855752fdd30d938ce8794.png"},{"id":93977475,"identity":"6fe4b0f1-67d0-4a46-bcda-b21c92299680","added_by":"auto","created_at":"2025-10-21 01:28:38","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":1071817,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the participation gross motor activities domain. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 19 participants and each “·” is 1 to 26.\u003c/p\u003e","description":"","filename":"floatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/0e3f28d9af69e04224bdc582.png"},{"id":93977988,"identity":"413e33ac-cd6a-4184-be67-52a57ee85ed3","added_by":"auto","created_at":"2025-10-21 01:36:38","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":1071817,"visible":true,"origin":"","legend":"\u003cp\u003eThe Wright map of the DCDDaily-Q-CN participation total scale. The Rasch Wright map orders the motor function of the patients (left side) and the item difficulty (right side). M: Mean ability (on the left of the scale), mean difficulty (on the right of the scale); S: 1 Standard deviation away from mean; T: 2 Standard deviations away from mean; Each “#” is 19 participants and each “·” is 1 to 17.\u003c/p\u003e","description":"","filename":"floatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/f12c72189f86f9a603eae8e9.png"},{"id":93978502,"identity":"37d47121-4dcf-49f3-8f64-55feac32ec00","added_by":"auto","created_at":"2025-10-21 01:52:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1268218,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7526150/v1/938b4eed-87af-45ab-90f7-0d82ec009581.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessing Activities of Daily Living in Children Aged 5–10 Years: Rasch Validation of the DCDDaily-Q-CN in Community Contexts","fulltext":[{"header":"Background","content":"\u003cp\u003eDevelopmental Coordination Disorder (DCD) is a common neurodevelopmental condition characterized by marked impairments in motor coordination that significantly interfere with activities of daily living (ADL) and academic performance [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Affecting approximately 5\u0026ndash;6% of school-aged children, DCD has emerged as a major public health concern within pediatric neurodevelopmental research and clinical practice [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], a definitive diagnosis of DCD requires the fulfillment of four criteria: (A) a significant delay in motor skill acquisition relative to age expectations, despite sufficient opportunities for learning and practice; (B) motor deficits that substantially interfere with ADLs, academic achievement, vocational activities, or leisure participation; (C) onset of symptoms during the developmental period; and (D) exclusion of alternative explanations such as cerebral palsy, neuromuscular diseases, or uncorrected visual impairments.\u003c/p\u003e\u003cp\u003eBeyond motor impairments, DCD often triggers a downward cycle of reduced participation, lower self-efficacy, and decreased quality of life, ultimately hindering long-term social adaptation [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Early and accurate identification of at-risk children is therefore critical. However, commonly used assessment tools remain limited in scope: the Movement Assessment Battery for Children\u0026ndash;Second Edition (MABC-2) primarily evaluates motor performance (Criterion A), while the Developmental Coordination Disorder Questionnaire\u0026ndash;Revised (DCDQ-R) focuses on functional interference (Criterion B) [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Under the framework of the International Classification of Functioning, Disability and Health \u0026ndash; Children and Youth Version (ICF-CY), however, comprehensive assessment of DCD should encompass both activity (e.g., self-care) and participation (e.g., school or community engagement) dimensions[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This gap has prompted growing interest in parent-report measures that capture functional challenges in children\u0026rsquo;s everyday contexts.\u003c/p\u003e\u003cp\u003eThe DCDDaily-Questionnaire (DCDDaily-Q) directly addresses this need by systematically assessing children\u0026rsquo;s activities of daily living (ADLs) and participation through parent-report. Validation studies have shown it to be more predictive of DCD than traditional tools such as the DCDQ-R [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Cross-cultural adaptations of the DCDDaily-Q have been completed in several countries, including the Netherlands, Spain, Greece, and China, confirming its applicability across diverse populations. Our team recently completed the cultural adaptation and Classical Test Theory (CTT)-based validation of the Chinese version (DCDDaily-Q-CN), which demonstrated excellent psychometric properties, including high internal consistency, sound structural validity, and strong discriminant capacity (sensitivity\u0026thinsp;=\u0026thinsp;93%, specificity\u0026thinsp;=\u0026thinsp;90%) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Notably, gender differences in scale scores were observed, raising concerns about potential measurement bias at the item level.\u003c/p\u003e\u003cp\u003eWhile CTT provides valuable insights into reliability and validity, it is limited in detecting item-level measurement bias and does not account for the interaction between item difficulty and respondent ability. Rasch analysis, grounded in modern measurement theory, offers a robust framework for addressing these limitations. Specifically, Rasch modeling allows for the assessment of item-person targeting (i.e., alignment between item difficulty and ability distribution), the detection of Differential Item Functioning (DIF) across gender subgroups, and the evaluation of response category functioning (e.g., threshold ordering and category redundancy)[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eTherefore, the present study applies Rasch analysis to the DCDDaily-Q-CN in children aged 5\u0026ndash;10 years with two primary aims: (1) to evaluate measurement properties, including item\u0026ndash;person targeting, response category functioning, reliability, separation indices, and unidimensionality, thereby ensuring robust construct validity and measurement precision; and (2) to examine gender-based Differential Item Functioning (DIF) to establish cross-gender measurement invariance. These analyses will provide empirical evidence regarding the cross-cultural applicability of the DCDDaily-Q-CN and its validity as a screening tool for identifying functional impairments in children with suspected DCD.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData from 1,936 children aged 5 to 10 years were collected from March to June 2023 as part of a previous normative study[12]. Participants were recruited from 14 mainstream schools randomly selected in the northeastern, eastern, southern, and central regions of Shenzhen. With a migrant population of 17 million from across China, Shenzhen provided a relatively representative sample in terms of geographic and ethnic diversity. Prior to this study, all participants had not been diagnosed with any learning or developmental disorders, as confirmed by both schools and parents.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Medical Research Ethics Committee of Shenzhen Children’s Hospital (Approval No. 2017025). All participants provided verbal informed consent, and written versions were signed by their guardians prior to study enrollment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDCDDaily-Q-CN\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe DCDDaily-Q-CN is a 23-item parent-report questionnaire designed to assess children’s participation and performance in various ADL, comprising three domains: self-care and self-maintenance (10 items), fine motor activities (7 items), and gross motor and play activities (6 items). Parents compare their child’s performance on each item against established criteria (1 = good, 2 = moderate, 3 = poor). The overall performance score ranges from 23 to 69, with higher scores indicating poorer performance. The questionnaire also uses a 4-point scale (1 = regularly, 2 = sometimes, 3 = seldom, 4 = not yet/never) to evaluate ADL participation, with total participation scores ranging from 23 to 92—higher scores reflect lower participation levels. Parents additionally use a yes/no format to indicate whether their child took longer than peers to learn an activity (1 = yes; 0 = no) [11, 12, 14].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePsychometric evaluation using Rasch analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Winsteps 5.2.3.0 software was used to perform Rasch analysis on each domain of the DCDDaily-Q-CN using the partial credit model [15]. This study evaluated the following psychometric properties: reliability and separation, item-person targeting, item fit, category functioning, dimensionality, and DIF.\u003c/p\u003e\n\u003cp\u003eReliability primarily reflects the consistency and reliability of measurement tools, typically assessed using reliability indices and separation indices. The person and item reliability indices indicate the internal consistency of respondent performance and item difficulty estimates, respectively. A person reliability index of 0.60–0.70 is generally considered the minimum acceptable threshold, while values above 0.70 are preferred. For a well-constructed instrument, a person reliability index of ≥0.80 and an item reliability index of ≥0.90 are recommended[16]. \u0026nbsp;Separation indices—comprising the person separation index and item separation index—further evaluate the instrument’s discriminative capacity. The item separation index assesses the extent to which items are hierarchically ordered by difficulty. According to international standards, a separation index ≥2.0 is ideal (corresponding to a reliability coefficient ≥0.80)[16]; values between 1.5 and 2.0 are acceptable, while those \u0026lt;1.0 require cautious interpretation. However, some studies advocate for incorporating additional indicators—such as Wright maps and item fit statistics—for a more comprehensive and nuanced evaluation[17, 18].\u003c/p\u003e\n\u003cp\u003eItem–person targeting refers to the degree of alignment between item difficulty and the ability levels of test-takers. To assess this alignment, a person–item Wright map was constructed, illustrating the distribution of both item difficulty and person ability on a common logit scale. This visualization enables intuitive evaluation of how well the items are matched to the ability range of the target population.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eItem fit analysis assesses not only the overall consistency between observed responses and the Rasch model but also the extent to which individual items conform to model expectations, thereby identifying potentially misfitting items. The core statistics used in this analysis are the infit mean square (infit MNSQ) and outfit mean square (outfit MNSQ). Infit MNSQ reflects the average of squared standardized residuals, unweighted by response variance, and is therefore more sensitive to responses close to a person’s ability level. Outfit MNSQ, in contrast, is weighted by individual response variance, making it more responsive to unexpected responses that deviate substantially from the predicted pattern—often outliers far from the person’s estimated ability. Both indices have an expected value of 1.0 when item responses perfectly fit the Rasch model. Values exceeding 2.0 suggest that the item contributes more random noise than meaningful measurement information. In clinical observational studies, infit and outfit MNSQ values in the range of 0.5 to 1.7 are generally considered acceptable, while values below 0.5 may indicate overfit, suggesting the item is too predictable or redundant[19].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe DCDDaily-Q-CN performance scale includes three response categories per item across its three functional domains. Category probability curves and Andrich thresholds were evaluated to analyze whether category calibrations increased sequentially. Category probability curves illustrate the likelihood of each category being selected across the measurement continuum. Thresholds represent midpoints between adjacent response categories, denoting points where the probability of choosing either category is equal. If disordered thresholds are present, issues can be resolved by collapsing the problematic category into an adjacent one[20].\u003c/p\u003e\n\u003cp\u003eUnidimensionality refers to the assumption that all items within a measurement instrument assess a single underlying trait or ability. This property is commonly evaluated using Principal Component Analysis (PCA) of the residuals derived from the Rasch model. Adequate unidimensionality is evidenced by PCA of residuals explaining \u0026gt;50% of the original variance or the eigenvalue of the first contrast for unexplained variance in residuals \u0026lt;3.0[16].\u0026nbsp;Additionally, adequate item-person fit further substantiates the unidimensionality of the questionnaire construct[21].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDIF occurs when individuals with equivalent levels of the underlying trait respond differently to specific questionnaire items due to group characteristics such as gender or cultural background. The presence of DIF indicates a lack of measurement invariance, suggesting that the instrument may not yield consistent results across subgroups with equal ability levels. In this study, DIF was assessed using the Rasch–Welch t-test method. An item was considered to exhibit meaningful DIF if the DIF contrast was ≥ 0.5 logits and the p-value was \u0026lt; 0.05, indicating potential instability in item performance across groups[16, 22].\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 1,936 children initially completed the questionnaire. After excluding 28 cases due to missing data, 1,908 participants (1,020 boys and 888 girls) were included in the final analysis. The mean age of the total sample was 7.7 years (SD = 1.7, range = 5.0\u0026ndash;10.0 years); specifically, boys had a mean age of 7.725 years (SD = 1.69) and girls had a mean age of 7.727 years (SD = 1.62). An independent-samples t-test confirmed the age difference between boys and girls in terms of DCDDaily-Q-CN scores. (t = 2.082, p = 0.0374). Mean scores for the DCDDaily-Q-CN total scale and its three domains by gender are presented in Table 1.\u003c/p\u003e\n\u003cp\u003eTable 1 DCDDaily-Q-CN scores of the study population by gender\u003c/p\u003e\n\u003cdiv \u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"605\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003eBoys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eGirls\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cem\u003e*p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e1908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e1020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e888\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eAge, mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e7.726(1.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e7.725(1.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e7.727(1.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.9845\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eDCDDaily-Q-CN scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e71.02(17.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e71.82(18.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e70.11(17.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.0374\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003ePerformance scale, mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e33.15(7.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e33.64(8.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e32.59(7.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.0040\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e13.02(3.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e13.25(3.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e12.74(3.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.0005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e10.12(2.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e10.44(3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e9.74(2.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026lt;0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eGross motor and play activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e10.02(3.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e9.94(3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e10.11(3.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.2479\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eParticipation scale, mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e36.74(10.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e36.96(10.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e36.49(10.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.3374\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e13.77(4.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e13.90(4.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e13.63(4.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.1828\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e11.13(3.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e11.42(3.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e10.80(3.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.0005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eGross motor and play activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e11.84(4.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e11.64(4.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e12.06(4.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.0377\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eDCDDaily-Q-CN, DCDDaily questionnaire Chinese version; SD, standard deviation.\u0026nbsp;Group comparisons were performed using the independent t-test.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRasch analysis of the DCDDaily-Q-CN\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eReliability analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor both the Performance and Participation scales, item reliability reached 1.00 with separation indices of 15.01 and 17.87, respectively. Person reliability was 0.81 and 0.80, with separation indices of 2.05 and 2.00, indicating excellent measurement precision and strong item stratification. At the domain level, item reliability remained high (0.98\u0026ndash;1.00), with separation indices ranging from 6.28 to 17.43, confirming the structural soundness of the subscales. However, person reliability was comparatively moderate (0.49-0.75), with separation indices between 0.98 and 1.72, reflecting a limited ability to distinguish between individual performance levels within specific domains (Tables 2 and 3).\u003c/p\u003e\n\u003cp\u003eTable 2 Statistics for Rasch analysis of the three domains in the performance scale.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eDCDDaily-Q-CN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003eMeasure\u003c/p\u003e\n \u003cp\u003e(Mean, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003eInfit\u003c/p\u003e\n \u003cp\u003e(MNSQ, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003eOutfit\u003c/p\u003e\n \u003cp\u003e(MNSQ, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003eReliability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003eISI/PSI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 471px;\"\u003e\n \u003cp\u003eItem statistics\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eTotal scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.06\u0026plusmn;0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e15.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e0.99\u0026plusmn;0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e6.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e12.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 471px;\"\u003e\n \u003cp\u003ePerson statistics\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eTotal scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e2.34\u0026plusmn;1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.06\u0026plusmn;0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e2.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e2.97\u0026plusmn;1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.01\u0026plusmn;0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e2.46\u0026plusmn;1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e1.49\u0026plusmn;2.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e1.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 3 Statistics for Rasch analysis of\u0026nbsp;the\u0026nbsp;three domains in the participation scale.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eDCDDaily-Q-CN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003eMeasure\u003c/p\u003e\n \u003cp\u003e(Mean, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003eInfit\u003c/p\u003e\n \u003cp\u003e(MNSQ, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003eOutfit\u003c/p\u003e\n \u003cp\u003e(MNSQ, SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003eReliability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003eISI/PSI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 471px;\"\u003e\n \u003cp\u003eItem statistics\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eTotal scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.03\u0026plusmn;0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.06\u0026plusmn;0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e17.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e0.98\u0026plusmn;0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e10.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e10.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e0.00\u0026plusmn;0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e17.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" style=\"width: 471px;\"\u003e\n \u003cp\u003ePerson statistics\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eTotal scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e2.05\u0026plusmn;1.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.06\u0026plusmn;0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e2.78\u0026plusmn;1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e0.98\u0026plusmn;0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e2.34\u0026plusmn;1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e1.39\u0026plusmn;2.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e0.99\u0026plusmn;0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 111px;\"\u003e\n \u003cp\u003e1.02\u0026plusmn;0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e1.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eISI, item separation index; PSI, person separation index; SD, standard deviation; MNSQ,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003emean square.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eItem\u0026ndash;person targeting\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Wright map provides a visual representation of the distribution of children\u0026rsquo;s ability levels (left, denoted by \u0026ldquo;#\u0026rdquo;) and item difficulties (right) on a common logit scale, with higher positions indicating greater ability or item difficulty. Domain-specific Wright maps (Performance scale Figures 1\u0026ndash;3, Participation scale Figures 5\u0026ndash;7) demonstrated that the questionnaire was well-targeted to children with low-to-moderate motor abilities (\u0026minus;1 to +1 logits). However, item difficulty ranges were narrower than the distribution of participants\u0026rsquo; abilities (approximately 4 logits), indicating suboptimal coverage and a mild ceiling effect\u0026mdash;least evident in the gross motor and play activities domain.\u003c/p\u003e\n\u003cp\u003eThe Wright map for the total scale (Figure 4, Figure 8) further revealed that the average item difficulty was about 2 logits lower than the mean ability level of the children, suggesting that most items were well within the ability range of the sample. The overall item difficulty spanned approximately 3 logits (\u0026minus;1 to +2 logits). The most challenging items (I20\u0026ndash;I23) from the gross motor and play activities domain exceeded the mean difficulty by one standard deviation, indicating tasks requiring relatively advanced motor skills. Conversely, the easiest items (I6, I8, and I10) from the self-care and self-maintenance domain were more than one standard deviation below the mean, reflecting activities that were generally mastered by most children in this age group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eItem fit analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTables 4 and 5 present the item fit statistics and item measures for the DCDDaily-Q-CN. All items across the three domains exhibited excellent fit to the Rasch model, with infit and outfit MNSQ values ranging from 0.50 to 1.70, indicating strong conformity to model expectations. Regarding item difficulty, values ranged from \u0026minus;1 to +1 logits, suggesting that the questionnaire is primarily composed of items with moderate difficulty levels. While this distribution is appropriate for assessing ADL in the general pediatric population, it may limit the instrument\u0026rsquo;s sensitivity to children with extreme (particularly high) motor abilities. Standard errors for item estimates were low (0.05\u0026ndash;0.06), supporting the precision and reliability of item calibration.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4 Items from the three domains of the performance scale, ordered by item measure.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eItems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eMeasure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003eModel\u003cbr\u003e\u0026nbsp;S.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003eInfit\u003cbr\u003e\u0026nbsp;MNSQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003eZSTD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003eOutfit\u003cbr\u003e\u0026nbsp;MNSQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003eZSTD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"10\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI9 Handling a key\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e6.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e5.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI5 Eating rice with chopsticks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI3 Open a wrapper/package\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI2 Pouring juice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-3.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI7 Drying oneself after a shower or bath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI8 Brushing teeth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI6 Washing hands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-2.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI1 Poking a straw into a milk carton\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e2.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI10 Putting on socks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI4 Eating soup with a spoon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" style=\"width: 95px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI11 Writing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI12 Gluing paper using a glue stick\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-2.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI17 Moving pawns (on a board)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e6.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e5.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI13 Folding paper sheets/slips\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-4.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-4.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI15 Cutting paper using scissors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-3.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI16 Lego building\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e4.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI14 Coloring a picture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-2.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-2.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" style=\"width: 95px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI23 Playing marbles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e2.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI22 Kicking a football\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-4.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-4.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI20 Throwing a tennis ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-6.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-5.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI21 Catching a ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-8.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-7.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI19 Jumping a rope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e6.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e8.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI18 Playing hopscotch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e4.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 5 Items from the three domains of the participation scale, ordered by item measure.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eItems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eMeasure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003eModel\u003cbr\u003e\u0026nbsp;S.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003eInfit\u003cbr\u003e\u0026nbsp;MNSQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003eZSTD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003eOutfit\u003cbr\u003e\u0026nbsp;MNSQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003eZSTD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"10\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI9 Handling a key\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e7.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e6.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI2 Pouring juice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-2.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI3 Open a wrapper/package\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI5 Eating rice with chopsticks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI1 Poking a straw into a milk carton\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e2.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI7 Drying oneself after a shower or bath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI4 Eating soup with a spoon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI6 Washing hands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-2.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI8 Brushing teeth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-2.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-3.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI10 Putting on socks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" style=\"width: 95px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI17 Moving pawns (on a board)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e5.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e4.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI12 Gluing paper using a glue stick\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-3.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-3.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI13 Folding paper sheets/slips\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-7.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-7.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI15 Cutting paper using scissors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-4.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-4.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI16 Lego building\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e3.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e3.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI14 Coloring a picture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-4.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-4.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" style=\"width: 95px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI23 Playing marbles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI22 Kicking a football\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-5.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-4.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI20 Throwing a tennis ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-7.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-6.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI21 Catching a ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e-9.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e-8.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI18 Playing hopscotch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e4.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e4.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eI19 Jumping a rope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e-1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e9.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e9.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eS.E., standard error; MNSQ, mean square; ZSTD, Z-standardized.\u003c/p\u003e\n\u003cp\u003eThe items are listed according to the hierarchy of the item difficulties (\u0026ldquo;Measure\u0026rdquo;). Infit or outfit MNSQ values have a reasonable range of 0.5 to 1.7.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCategory functioning\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCategory thresholds of the DCDDaily-Q-CN items are presented in Table 6. All three domains of both the performance and participation scale demonstrated ordered Andrich thresholds, indicating appropriate functioning of the response categories.\u003c/p\u003e\n\u003cp\u003eTable 6 Items from the DCDDaily-Q-CN, ordered by item measure.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"605\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003ePerformance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003eScore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003eObserved count\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003eObserved average\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003eOutfit MNSQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003eAndrich threshold\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 128px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e526.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e4702.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e13852.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e2.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 128px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e661.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e4622.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e8073.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 128px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1473.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e-1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e4721.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e5254.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e2.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eParticipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 128px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e350.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1128.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e3894.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e13708.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e2.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 128px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e405.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1352.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e3964.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e7635.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e2.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 128px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1161.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e-1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1969.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e-0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e3715.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e4603.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e1.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eUnidimensionality\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnidimensionality of the DCDDaily-Q-CN was evaluated via Principal Component Analysis (PCA) of Rasch model-derived residuals (Tables 7 and 8). Across the three core domains (self-care and self-maintenance, fine motor activities, gross motor and play activities), the Rasch dimension explained 30.7% to 52.9% of the raw variance in observations; notably, only the gross motor and play activities domain of the Participation scale met the commonly accepted ideal threshold of \u0026gt;50% variance explained (52.9%). However, the eigenvalue of the first contrast in unexplained residual variance ranged from 1.51 to 1.74 across all domains, which was consistently below the critical value of 3.0, indicating no significant secondary dimension that would interfere with the measurement of the target latent trait. At the total scale level, the Performance scale exhibited a total raw variance of 37.36, with the Rasch dimension accounting for 38.40% of this variance (eigenvalue = 14.36, below 50%), but its first contrast eigenvalue was 2.65 (still \u0026lt;3.0); the Participation scale had a total raw variance of 39.64, with the Rasch dimension explaining 42.00% of the variance (eigenvalue = 16.64, also \u0026lt;50%), and its first contrast eigenvalue was slightly higher at 3.46 (marginally exceeding 3.0). Importantly, all items across both total scales demonstrated good fit to the Rasch model (infit and outfit MNSQ values ranging from 0.50 to 1.70) with adequate item-person fit. Combined with the excellent item fit observed across all domains, these results collectively support the unidimensionality assumption of the DCDDaily-Q-CN, confirming that the questionnaire effectively measures a single underlying construct (i.e., children\u0026rsquo;s ADL performance or participation capacity) despite the marginal deviation in the Participation scale\u0026rsquo;s first contrast eigenvalue.\u003c/p\u003e\n\u003cp\u003eTable 7 Dimensionality assessment of the three domains in the\u0026nbsp;performance scale\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"634\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 126px;\"\u003e\n \u003cp\u003eDCDDaily-Q-CN Domains\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 107px;\"\u003e\n \u003cp\u003eTotal raw variance in observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 193px;\"\u003e\n \u003cp\u003eRaw variance explained by measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 193px;\"\u003e\n \u003cp\u003eUnexplained variance 1st contrast\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eEigenvalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eEigenvalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 126px;\"\u003e\n \u003cp\u003eTotal scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e37.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e14.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e38.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e2.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e7.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 126px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e14.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e4.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e30.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e10.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 126px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e11.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e4.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e37.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e12.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e11.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e5.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e45.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e14.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 8 Dimensionality assessment of the\u0026nbsp;three domains in the participation scale\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"634\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 126px;\"\u003e\n \u003cp\u003eDCDDaily-Q-CN Domains\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 107px;\"\u003e\n \u003cp\u003eTotal raw variance in observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 193px;\"\u003e\n \u003cp\u003eRaw variance explained by measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 193px;\"\u003e\n \u003cp\u003eUnexplained variance 1st contrast\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eEigenvalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eEigenvalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003ePercent (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 126px;\"\u003e\n \u003cp\u003eTotal scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e39.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e16.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e42.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e3.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e8.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 126px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e16.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e6.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e37.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e10.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 126px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e12.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e5.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e41.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e12.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 107px;\"\u003e\n \u003cp\u003e12.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e6.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e52.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e13.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eDIF by gender\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA DIF analysis by gender was conducted on the questionnaire (Tables 9 and 10). The results indicate that all items in the gross motor and play activities domain of the performance scale, as well as those in the self-care and self-maintenance domain of the participation Scale, demonstrated |DIF contrast| values below 0.5, this reflects strong cross-gender stability for items within these two domains. However, several items across different domains and scales showed higher |DIF contrast| values: specifically, in the self-care and self-maintenance domain of the performance scale, item I9 (handling a key) met this criterion; similarly, items I14 (coloring a picture), I15 (cutting paper using scissors), I16 (Lego building), and I17 (moving pawns on a board)\u0026mdash;which belong to the fine motor activities domain of both the performance and participation scales\u0026mdash;also exhibited this pattern. Additionally, item I19 (Jumping a rope) in the Gross Motor and Play Activities domain of the Performance Scale fell into the same category. All these items had |DIF contrast| values \u0026ge; 0.5, with statistical significance at p \u0026lt; 0.05. This suggests the presence of gender-related DIF for these items, indicating that children with equivalent ability levels responded differently to these specific items based on gender.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 9 Analysis of gender-DIF of the three domains in performance scale\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"586\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eDomains\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eDIF contrast\u0026nbsp;\u003cbr\u003e\u0026nbsp;(Boys vs girls)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003eJoint S.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"10\" style=\"width: 96px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI1 Poking a straw into a milk carton\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.2181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI2 Pouring juice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI3 Open a wrapper/package\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI4 Eating soup with a spoon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.4353\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI5 Eating rice with chopsticks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.2461\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI6 Washing hands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.2053\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI7 Drying oneself after a shower or bath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.1482\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI8 Brushing teeth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI9 Handling a key\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.50\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI10 Putting on socks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0154\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" style=\"width: 96px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI11 Writing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0137\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI12 Gluing paper using a glue stick\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.1001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI13 Folding paper sheets/slips\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0272\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI14 Coloring a picture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.60\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI15 Cutting paper using scissors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI16 Lego building\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-1.02\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI17 Moving pawns (on a board)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.75\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" style=\"width: 96px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI18 Playing hopscotch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI19 Jumping a rope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI20 Throwing a tennis ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0354\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI21 Catching a ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.3456\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI22 Kicking a football\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI23 Playing marbles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 10 Analysis of gender-DIF of the three domains in participation scale\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"586\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eDomains\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eDIF contrast\u0026nbsp;\u003cbr\u003e\u0026nbsp;(Boys vs girls)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003eJoint S.E.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"10\" style=\"width: 96px;\"\u003e\n \u003cp\u003eSelf-care and self-maintenance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI1 Poking a straw into a milk carton\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0468\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI2 Pouring juice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.2985\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI3 Open a wrapper/package\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.5349\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI4 Eating soup with a spoon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.7338\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI5 Eating rice with chopsticks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.2272\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI6 Washing hands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.9399\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI7 Drying oneself after a shower or bath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.5001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI8 Brushing teeth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI9 Handling a key\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI10 Putting on socks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0105\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" style=\"width: 96px;\"\u003e\n \u003cp\u003eFine motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI11 Writing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.3501\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI12 Gluing paper using a glue stick\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0013\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI13 Folding paper sheets/slips\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI14 Coloring a picture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI15 Cutting paper using scissors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.53\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI16 Lego building\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.81\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI17 Moving pawns (on a board)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-0.61\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" style=\"width: 96px;\"\u003e\n \u003cp\u003eGross motor activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI18 Playing hopscotch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI19 Jumping a rope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.51\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI20 Throwing a tennis ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0941\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI21 Catching a ball\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.9022\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI22 Kicking a football\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 252px;\"\u003e\n \u003cp\u003eI23 Playing marbles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.0016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eBolded numerical ranges indicated |DIF contrast|\u0026ge;0.5and p\u0026lt;0.05; S.E., standard error. Negative values (\u0026ldquo;-\u0026rdquo;) indicate that girls\u0026apos; scores are higher than boys\u0026apos;.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study represents the first application of Rasch analysis to validate the DCDDaily-Q. Overall, the questionnaire demonstrated strong psychometric properties, with good item fit, unidimensionality, and appropriate response category functioning. Item targeting was generally appropriate for the target population, supporting its use as a screening tool. However, moderate person reliability and limited separation at the domain level suggest that subscale scores may be more suitable for group-level screening than for precise individual assessment. Additionally, gender-related DIF in the fine motor domain indicates areas for further refinement to improve cross-group fairness and discriminant validity. Overall, while the DCDDaily-Q-CN is a valuable instrument for assessing children’s ADL performance, ongoing optimization is warranted to enhance its precision and applicability.\u003c/p\u003e\n\u003cp\u003eRasch analysis revealed that DCDDaily-Q-CN exhibited an item difficulty gradient from easy to difficult across the self-care and self-maintenance, fine motor activities, and gross motor activities and play activity domains. This gradient is closely aligned with the neurodevelopmental trajectory, skill acquisition sequence, and cognitive maturity of 5-10-year-old children. Self-care tasks (e.g., dressing, eating, grooming) constitute the earliest independent skills acquired by children. By this age range, children have generally developed basic self-care abilities, which rely heavily on repetitive practice and procedural memory supported by relatively stable neural pathways; accordingly, items in this domain are designed to be relatively simple. Fine motor activities (e.g., writing, paper-cutting, tying shoelaces) depend on the control of small muscle groups and visuomotor integration, with neural maturation lagging behind that of gross motor skills[23]. Moreover, fine motor tasks often require the use of tools (such as pencils and scissors), involving spatial planning and force feedback regulation, demanding multisensory integration, and consequently leading to higher failure rates (e.g., cutting outside boundaries). This results in greater item difficulty compared to self-care tasks [24]. Gross motor activities (e.g., running, jumping, throwing) require whole-body coordination, balance, and strength control, engaging multiple brain regions including the cerebellum and basal ganglia. Play activities (e.g., ball games, hide-and-seek) further incorporate rule comprehension, strategic adjustment, and social interaction, imposing substantial demands on executive functions that mature around age 10, thus accounting for the significantly increased item difficulty in this domain. Collectively, the distribution of item difficulties aligns with typical neurodevelopment, minimizing bias related to immature abilities and supporting the scale’s precision and suitability for clinical screening of children aged 5–10 years.\u003c/p\u003e\n\u003cp\u003eThe DCDDaily-Q is designed to assess the performance and participation of 5–10-year-old children in ADLs (i.e., self-care and play activities), with item difficulties aligned to the capabilities expected for this age group. Rasch analysis indicated that children’s average ability level exceeded the average item difficulty, suggesting that the skills covered by the questionnaire are manageable for most children based on parental reports. While the questionnaire contains sufficient items of moderate difficulty to ensure effective assessment for the majority, person reliability and separation indices at the domain level were moderate, reflecting limited discrimination between ability strata within specific domains. These findings imply that, in its current form, domain scores may be more suitable for group-level screening than for precise individual-level assessment. To enhance discriminative power, particularly for higher-ability children, adding more high-difficulty items at the upper end of the Wright map could reduce the gap between mean ability and mean item difficulty, raise the ceiling of the scale, and allow more accurate identification of individual differences.\u003c/p\u003e\n\u003cp\u003eAlthough the proportion of raw variance explained by the Rasch dimension in both the Total Score of the Performance Scale and the Total Score of the Participation Scale of the Chinese Version of the DCDDaily Questionnaire (DCDDaily-Q-CN) did not meet the ideal threshold of 50%, the instrument still demonstrated acceptable unidimensionality following comprehensive evaluation using multiple indicators. Specifically, the eigenvalue of the first contrast in unexplained variance for the Total Score of the Performance Scale was 2.65, which is significantly lower than the critical value of 3.0. This indicates that there is no prominent secondary dimension that would interfere with the measurement of the core construct of \"children’s overall Activities of Daily Living (ADL) performance\". For the Total Score of the Participation Scale, the eigenvalue of the first contrast was slightly higher (3.46, marginally exceeding 3.0), but the magnitude of this deviation was minimal and not accompanied by item misfit. This suggests that even if there is a potential multidimensional tendency, its extent is insufficient to affect the measurement of the core construct of \"children’s overall ADL participation\". Furthermore, the three domains integrated into the Total Scores (self-care and self-maintenance, fine motor activities, gross motor and play activities) are essentially structured around the core construct of \"ADL-related abilities in children aged 5–10 years\". This conceptual relevance further mitigates the interference of minor secondary dimensions on measurement outcomes. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn-depth unidimensionality and item fit analyses conducted separately for the three domains revealed that all domains exhibited clear unidimensional characteristics, with excellent item fit (infit mean square [infit MNSQ] and outfit mean square [outfit MNSQ] values all falling within the acceptable range of 0.50–1.70). This result confirms that items within each domain consistently reflect their corresponding underlying latent traits (i.e., children’s self-care ability, fine motor ability, and gross motor/play ability), which provides strong evidence for the construct validity of the scale. Meanwhile, the good item fit also indicates that the difficulty level of each item is well-aligned with the ability level of the target population (children aged 5–10 years) in the corresponding domain, ensuring that the questionnaire can effectively capture the intended functional performance of the target population. Additionally, the Andrich thresholds for the response categories of all items across the three domains were reasonably ordered, and the category probability curves were fully consistent with the expectations of the Rasch model. Collectively, these results confirm that the 3-point rating scale of the questionnaire possesses reliable psychometric properties and can effectively distinguish between children with different ability levels. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGiven that the DCDDaily-Q-CN is designed as a screening tool (rather than a precision diagnostic instrument), its current level of unidimensionality is sufficient to meet core application needs: quickly identifying children’s overall ADL ability through Total Scores to provide a basis for further evaluation of children suspected of having Developmental Coordination Disorder (DCD). However, the slight increase in the eigenvalue of the first contrast for the Total Score of the Participation Scale points to a direction for subsequent optimization of the scale. For example, re-evaluating the content relevance of cross-domain items (e.g., adjusting the wording of certain items to enhance their association with the core construct of \"ADL participation\") could further improve the measurement precision of the scale’s unidimensionality.\u003c/p\u003e\n\u003cp\u003eGender-based DIF analysis identified five gender-sensitive items (I9, I14–I17,\u0026nbsp;I19) within the self-care and self-maintenance and fine motor activities domains. Specifically, boys demonstrated significantly higher scores on \"Coloring a picture\" (I14), \"Cutting paper using scissors\" (I15) and\u0026nbsp;Jumping rope\" (I19), whereas girls outperformed boys on \"Handling a key\" (I9), \"Lego building\" (I16), and \"Moving pawns on a board\" (I17).\u0026nbsp;These disparities may largely stem from inherent neurodevelopmental and physiological differences between genders, such as variations in visuomotor integration, fine motor coordination, and task preferences influenced by early socialization and environmental exposure [25]. Previous studies have indicated that girls tend to exhibit greater proficiency in fine motor skills involving grip control and object manipulation, which may account for their superior performance on tasks such as \"Handling a key\" (I9), \"Lego building\" (I16), and \"Moving pawns on a board\" (I17) [23, 26]. In contrast, boys often demonstrate early advantages during the preschool years in palm strength, wrist stability, and coordination between large and small muscle groups, providing them with an edge in force-intensive fine motor tasks such as \"Cutting paper using scissors\" (I15) , \"Coloring a picture\" (I14) and \"Jumping rope\" (I19)[27]. Given these gender-related differences, future revisions of the questionnaire should consider re-evaluating or optimizing these six gender-sensitive items within the self-care and self-maintenance and fine motor activities domains.\u003c/p\u003e\n\u003cp\u003eIn light of the identified limitations in item difficulty coverage and gender sensitivity within the DCDDaily-Q-CN, several directions for improvement are proposed. First, to address the ceiling effect, particular attention should be given to the self-care and fine motor activities domains, where this issue is most prominent. Expanding the item difficulty in these areas would enhance the questionnaire’s discriminative power, particularly for children with higher functional abilities. Second, considering the questionnaire’s role in assessing everyday functioning, future item development should more closely reflect the real-life experiences and typical activity repertoire of children aged 5 to 10 years. This would increase the ecological validity of the tool and improve its interpretability and relevance for parent respondents. For example, the self-care domain could include a task such as “tying laces,” which demands fine finger dexterity, bilateral coordination, and sequential planning. In the fine motor activities domain, a task such as “drawing a person” could be added, which reflects common school-related demands and requires integrated visuomotor skills, spatial organization, and attention to detail. These additions would help raise the upper measurement limit of the questionnaire, reduce ceiling effects, and better capture ability variations among higher-functioning children.\u003c/p\u003e\n\u003cp\u003eIn terms of addressing gender-related bias, the physiological and developmental differences between boys and girls can be mitigated through task decomposition or item content adjustments. For example, in the self-care and self-maintenance domain, item I9 (Handling a key) can be split into two subtasks: I9a: inserting the key (primarily assessing fine finger manipulation and hand–eye coordination) and I9b: turning the key (primarily assessing wrist strength and stability). This separation distinguishes between motor control and strength-based demands, balancing gender differences while also increasing the overall item difficulty. In the fine motor activities domain, items I14 (Coloring a picture) and I15 (Cutting paper using scissors), where boys tend to perform better due to greater palm strength and wrist stability, could be optimized to reduce their reliance on force and instead emphasize motor coordination. For instance, I14 could require coloring within small, complex regions to increase demands on visual precision and control, while I15 could involve cutting along curved or intricate patterns to emphasize bilateral coordination and spatial planning rather than brute force. For items I16 (Lego building) and I17 (Moving pawns on a board), which tend to favor girls—possibly due to their advantage in fine motor precision and sequential planning—gender neutrality can be enhanced through alternative task designs. These items may be replaced or supplemented with activities such as “screwing bottle caps” or “stringing beads”, which maintain demands on hand–eye coordination and fine manipulation but have been shown to exhibit minimal gender bias in prior research[28].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study has several limitations that warrant consideration. First, the sample was relatively homogeneous in terms of geographic and demographic characteristics, which may limit the generalizability of the findings. A lack of regional and socioeconomic diversity constrains the ability to evaluate the stability and applicability of the DCDDaily-Q-CN across different populations and cultural contexts. Second, due to limitations in study duration and available resources, no item modifications or iterative questionnaire revisions were implemented during this phase of research. This restricts the extent to which the measurement properties could be refined or optimized. Future studies should adopt multicenter designs with more diverse samples to enhance external validity and employ modern psychometric methods alongside iterative item development to improve the questionnaire’s precision, fairness, and clinical utility.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eUsing Rasch analysis, this study confirms that the DCDDaily-Q-CN possesses robust psychometric properties, including strong reliability, unidimensionality, and appropriate item targeting for children aged 5 to 10, supporting its validity as a screening tool for children’s ADL competencies. However, moderate person reliability and limited separation at the domain level suggest that subscale scores may be more suitable for group-level screening than for precise individual assessment. Furthermore, the identification of gender-related item bias highlights the need for refinement to improve fairness across genders.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDCDDaily-Q-CN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDCDDaily-Q Chinese Version\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eADL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eActivities of Daily Living\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDIF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDifferential Item Functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDevelopmental Coordination Disorder\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDSM-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMABC-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMovement Assessment Battery for Children–Second Edition\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDCDQ-R\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDevelopmental Coordination Disorder Questionnaire–Revised\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eICF-CY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eInternational Classification of Functioning, Disability and Health – Children and Youth Version\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCTT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eClassical Test Theory\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePCA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrincipal Component Analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author would like to thank all the participants for their valuable contributions to this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eShuo Sun, Meihuan Huang and Guojun Yun made substantial contributions to the conception and design of the study. Shuo Sun, Wenji Zhai and Chunming Zhou analyzed the data and drafted the manuscript. Hongjie Chen contributed to the discussion of the results. All authors reviewed and edited drafts of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki. It was supported by the Research Foundation of Medical Science and Technology of Guangdong Province (Grant No. B2025075) and the Shenzhen Science and Technology Program (Grant No. JCYJ20220530160004010).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Medical Research Ethics Committee of Shenzhen Children\u0026rsquo;s Hospital (Approval No. 2017025). All participants provided verbal informed consent, and written versions were signed by their guardians prior to study enrollment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eJolly C, Jover M, Danna J. Dysgraphia Differs Between Children With Developmental Coordination Disorder and/or Reading Disorder. J Learn Disabil. 2024;57:397\u0026ndash;410.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMelegari MG, Bruni O, Sacco R, Costa A, Russo C, Ferri R, Caravale B. Motor characteristics in children with developmental coordination disorder and attentiondeficit/hyperactivity disorder: intergroup comparison and predictors. Minerva Pediatr (Torino) 2022.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDannemiller L, Mueller M, Leitner A, Iverson E, Kaplan SL. Physical Therapy Management of Children With Developmental Coordination Disorder: An Evidence-Based Clinical Practice Guideline From the Academy of Pediatric Physical Therapy of the American Physical Therapy Association. Pediatr Phys Ther. 2020;32:278\u0026ndash;313.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBiotteau M, Albaret JM, Chaix Y. Developmental coordination disorder. Handb Clin Neurol. 2020;174:3\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFirst MB. Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. J Nerv Ment Dis. 2013;201:727\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIuzzini-Seigel J, Moorer L, Tamplain P. An Investigation of Developmental Coordination Disorder Characteristics in Children With Childhood Apraxia of Speech. Lang Speech Hear Serv Sch. 2022;53:1006\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVan der Linde BW, van Netten JJ, Otten B, Postema K, Geuze RH, Schoemaker MM. Activities of Daily Living in Children With Developmental Coordination Disorder: Performance, Learning, and Participation. Phys Ther. 2015;95:1496\u0026ndash;506.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrown T, Lalor A. The Movement Assessment Battery for Children\u0026ndash;Second Edition (MABC-2): a review and critique. Phys Occup Ther Pediatr. 2009;29:86\u0026ndash;103.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWilson BN, Crawford SG, Green D, Roberts G, Aylott A, Kaplan BJ. Psychometric properties of the revised Developmental Coordination Disorder Questionnaire. Phys Occup Ther Pediatr. 2009;29:182\u0026ndash;202.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRaghavendra P, Bornman J, Granlund M, Bjorck-Akesson E. The World Health Organization's International Classification of Functioning, Disability and Health: implications for clinical and research practice in the field of augmentative and alternative communication. Augment Altern Commun. 2007;23:349\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003evan der Linde BW, van Netten JJ, Otten BE, Postema K, Geuze RH, Schoemaker MM. Psychometric properties of the DCDDaily-Q: a new parental questionnaire on children's performance in activities of daily living. Res Dev Disabil. 2014;35:1711\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuang M, Zhan Y, Zhou H, Song P, Fan Y, Lu Y, Chen Y, Lv Z, Liu Q, Yun G, Cao J. Cross-cultural validation and reference norms for the DCDDaily-Q questionnaire Chinese version (DCDDaily-Q-CN): evaluating children's motor performance in activities of daily living. Front Public Health. 2024;12:1522816.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBoone WJ. Rasch Analysis in the Human Sciences. Springer Netherlands; 2014.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDelgado-Lobete L, Montes-Montes R, van der Linde BW, Schoemaker MM. Assessment of Motor Activities of Daily Living: Spanish Cross-Cultural Adaptation, Reliability and Construct Validity of the DCDDaily-Q. Int J Environ Res Public Health 2020, 17.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAndrich D. Rating scales and Rasch measurement. Expert Rev Pharmacoecon Outcomes Res. 2011;11:571\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWright BD. A User's Guide to Winsteps: Rasch-model Computer Program. 1997.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKarabatsos G. The Rasch model, additive conjoint measurement, and new models of probabilistic measurement theory. J Appl Meas. 2001;2:389\u0026ndash;423.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePeeters MJ, Augustine JM. Using Rasch measurement for instrument rating scale refinement. Curr Pharm Teach Learn. 2023;15:110\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLinacre JM. What do infit and outfit, mean-square and standardized mean? 2002.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLinacre JM. Optimizing rating scale category effectiveness. J Appl Meas. 2002;3:85\u0026ndash;106.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLinacre JM. Detecting multidimensionality: which residual data-type works best? J Outcome Meas. 1998;2:266\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWelch BL. The generalisation of student's problems when several different population variances are involved. Biometrika. 1947;34:28\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBondi D, Robazza C, Lange-Kuttner C, Pietrangelo T. Fine motor skills and motor control networking in developmental age. Am J Hum Biol. 2022;34:e23758.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePeyre H, Albaret JM, Bernard JY, Hoertel N, Melchior M, Forhan A, Taine M, Heude B, De Agostini M, Galera C, et al. Developmental trajectories of motor skills during the preschool period. Eur Child Adolesc Psychiatry. 2019;28:1461\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHines M. Gender development and the human brain. Annu Rev Neurosci. 2011;34:69\u0026ndash;88.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePeyre H, Hoertel N, Bernard JY, Rouffignac C, Forhan A, Taine M, Heude B, Ramus F, Group EM-CCS. Sex differences in psychomotor development during the preschool period: A longitudinal study of the effects of environmental factors and of emotional, behavioral, and social functioning. J Exp Child Psychol. 2019;178:369\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDinkel D, Snyder K. Exploring gender differences in infant motor development related to parent's promotion of play. Infant Behav Dev. 2020;59:101440.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePeng K, Liu G, Wang J, Chen T. Psychometric Properties of Fine Motor Function Measure in Children With Cerebral Palsy: A Rasch Analysis. Clin Pediatr (Phila). 2025;64:524\u0026ndash;37.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Activities of Daily Living, Developmental Coordination Disorder, Outcome Measures, Psychometrics, Rasch Analysis","lastPublishedDoi":"10.21203/rs.3.rs-7526150/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7526150/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eDevelopmental Coordination Disorder (DCD) affects 5\u0026ndash;6% of school-aged children, impairing motor coordination, daily functioning, and academic performance. Existing assessment tools often focus on either motor skills or functional interference, limiting comprehensive evaluation. This study applied Rasch analysis to the Chinese version of the DCDDaily-Questionnaire (DCDDaily-Q-CN), a parent-report measure of children\u0026rsquo;s daily functioning and participation, to evaluate its measurement properties and cross-gender invariance, thereby supporting its validity as a screening tool for children with suspected DCD.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eRasch analysis was conducted on data from 1,908 typically developing children (1,020 boys and 888 girls; mean age\u0026thinsp;=\u0026thinsp;7.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7 years) recruited from 14 mainstream schools in a migrant city. The analysis evaluated key psychometric properties, including item and person reliability and separation, item-person targeting, item fit, category functioning, dimensionality, and Differential Item Functioning (DIF).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eRasch analysis demonstrated excellent item reliability (\u0026ge;\u0026thinsp;0.98) and strong structural validity across all domains. However, person reliability was moderate (0.49\u0026ndash;0.75), indicating limited precision in distinguishing individuals within subdomains. The scale showed good item fit (infit and outfit MNSQ values between 0.50 and 1.70), appropriate functioning of response categories, and supported unidimensionality across all domains. Item difficulties were generally well aligned with the ability levels of most children aged 5 to 10 years, confirming that the scale is appropriately targeted for its intended screening purpose. Nevertheless, Wright maps revealed mild ceiling effects and a degree of mismatch between item difficulty and participant ability, particularly in self-care tasks. DIF analysis identified gender-related bias in several self-care and fine motor items, whereas gross motor items exhibited measurement invariance across gender.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eRasch analysis confirms that the DCDDaily-Q-CN is a psychometrically robust tool with high reliability, unidimensional structure, and generally appropriate item targeting for assessing ADL in children aged 5 to 10 years. However, moderate person reliability and limited separation at the domain level suggest that subscale scores may be more suitable for group-level screening than for precise individual assessment. Furthermore, the identification of gender-related item bias highlights the need for refinement to improve fairness across genders.\u003c/p\u003e","manuscriptTitle":"Assessing Activities of Daily Living in Children Aged 5–10 Years: Rasch Validation of the DCDDaily-Q-CN in Community Contexts","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-21 01:28:33","doi":"10.21203/rs.3.rs-7526150/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-10-21T02:32:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"97951579716367910642873055391149153328","date":"2025-10-20T20:33:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"129019412500213603817841449320756240854","date":"2025-10-15T01:06:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-07T11:33:06+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-10T17:08:57+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-10T07:43:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-10T07:43:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-09-03T10:50:41+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f8b27fd6-fe5c-4b58-aadf-be3c3ecd5dde","owner":[],"postedDate":"October 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-21T01:28:33+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-21 01:28:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7526150","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7526150","identity":"rs-7526150","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}