第九屆 The Infant/Toddler Home Observation for Measurement of the Environment Inventory

(IT-HOME-C):
Measurement Properties, Predictabilities, and Cross-Culture Comparison

Ai-Wen Hwanga Pau-Chung Chenb Hua-Fang Liao a,c Wu-Shiun Hsiehd

a) School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
b) Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University
c) Physical Therapy Center, National Taiwan University Hospital, College of Medicine, National Taiwan University
d) Department of Pediatrics, National Taiwan University Hospital


Corresponding author：
Associate Professor Hua-Fang Liao
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3rd floor, No.17, Xuzhou Rd., Zhongzheng District, Taipei City 100, Taiwan (R.O.C.)

Abstract
Background: Evidence has indicated that home environment in early life plays a central role in children's development. The Infant/Toddler Home Observation for Measurement of the Environment Inventory (IT-HOME)[1], administered via semi-structured interview at home settings for children aged 0-3 years, has been reported as a sensitive predictor of child development in western countries[2-5]. The goals of this study were threefold: (1) to investigate the measurement properties (reliability, stability, and validity), (2) to examine the predictability of the Chinese translated IT-HOME (IT-HOME-C) for developmental outcomes, and (3) to compare the mean IT-HOME-C scores with groups of different cultural background reported in the literature.

Methods: The IT-HOME-C contains 45 binary-choice items clustered into six domains: Responsivity, Acceptance, Organization, Learning Materials, Involvement, and Variety. The present study sample came from the Taipei Birth Panel Study which followed 486 children from birth to 3 years. Of all the participants, 166 and 261 families were willing to be interviewed at their homes when their children were in infancy (mean age = 6.0 ± 0.4 months) and at toddler age (mean age = 28.0 ± 2.5 months) respectively. Besides, 148 families were successfully followed up at both ages. For investigating the inter-observer reliability of IT-HOME-C, two interviewers concurrently rated the randomly selected families at infant (n = 32) and toddler (n = 16) follow-up periods. Along with the home visits, the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) were conducted to measure the developmental outcomes. For testing the reliability, the internal consistency and interobserver reliability were examined with Kuder-Richardson formula 20 (KR-20) and Intraclass correlation coefficients (ICC (2, 1) ) respectively. The convergent validity with family background variables, the stability from infancy to toddler, and the correlations between IT-HOME-C scores and developmental outcomes was examined with Spearman's rank correlation coefficients (ρ).

Results: The inter-observer reliability (ICCs = .64~.97, p < .001) was adequate to excellent for two age groups. The internal consistency were acceptable (KR-20 > .70). The stability of the scores from infant to toddler was significantly low to moderate (ρ = .19~.44, p<.05) except for Responsivity subscale (ρ = .01, ns). Significantly but minimal correlations were observed between IT-HOME-C and specific family background variables (ρ=-.28~.30, p<.05), and between IT-HOME-C and children's developmental outcomes (ρ=.17~.29, p<.05). The IT-HOME-C scores rated for families from northern Taiwan appeared to be relatively higher compared with the normative groups reported in other countries.

Conclusion: The IT-HOME-C presented acceptable reliability for clinical use. Minimal stability implies the early environment would change with age. The content of IT-HOME may represent different aspects from family background in measuring child's early environment. Specific subscales of IT-HOME-C had significant but weak correlation with children's developmental outcomes in Taiwan. The higher IT-HOME scores in northern Taiwan than that in other countries may due to the sampling bias. A Taiwan's norm is needed for better clinic use of IT-HOME-C.

Key words: IT-HOME, reliability, validity, stability, cross-culture comparison


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