Network analysis of the participation and activity inventory for children and youth (PAI-CY) 7–12 years with visual impairment

Ellen B.M. Elsman, Carel F.W. Peeters, Ruth M.A. van Nispen, Ger H.M.B. van Rens

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Purpose: Children with visual impairment often experience more difficulties regarding participation compared to sighted peers. The Participation and Activity Inventory for Children and Youth (PAI-CY) has recently been developed to assess their participation needs. A novel application in the field of questionnaires is the use of network analysis to explore interrelations between items in order to capture their complex interactions as a reflection of the overall construct of measurement. This study aimed to apply network modeling for the PAI-CY 7–12 from the perspectives of children and their parents. Methods: Children and their parents (n = 195) completed the 55-item PAI-CY via face-to-face interviews and a web-based survey, respectively. Internal consistency, test-retest reliability, and concordance between children and parents were investigated. Two networks were created, along with visualizations of shared and differential connections between children and parents. Results: Eight items were deleted. Network structures were dissimilar; for children, connections evolved around social contacts and school items, whereas for parents, mobility, leisure time, acceptance, self-reliance, and communication items prevailed. In the children’s network, playing imaginary games, inviting a friend to play at home, and estimating the distance from others were most connected to other items. Conclusions: This study uniquely identifies connections between items of the PAI-CY 7–12, highlighting the different perspectives parents and children have on what defines participation, possibly implying that they perceive the relevance of various rehabilitation programs differently. Translational Relevance: Rehabilitation programs aimed at improving the most connected items might positively affect other items in the network, possibly improving children’s participation.

Original languageEnglish
Article number19
Pages (from-to)1-15
Number of pages15
JournalTranslational Vision Science and Technology
Issue number6
Publication statusPublished - May 2020


  • Children
  • Low vision
  • Network analysis
  • Participation
  • Questionnaire development

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