Psychometric Evaluation of the Cross-Culturally Adapted Dutch-Language Version of the Participation and Environment Measure for Children and Youth (PEM-CY)

Abstract

BackgroundParticipation in meaningful activities is essential for children ' s development and well-being, making it a key focus of rehabilitation outcomes. The PEM-CY assesses participation frequency, involvement, and environmental support in home, school, and community settings. While it has been validated in several languages, its psychometric properties have not yet been evaluated in the Dutch context.ObjectivesTherefore, the aim of our study is to assess the internal consistency, test-retest reliability, and construct validity of the Dutch PEM-CY including its ability to differentiate between children with and without disabilities and to examine associations between environmental supportiveness, participation, and parental satisfaction.MethodsA cross-sectional study involving parents of 161 Dutch children 5-17 years old with and without disabilities was conducted to psychometrically evaluate the Dutch PEM-CY in the Netherlands. Internal consistency was evaluated using Cronbach ' s alpha, test-retest reliability with intraclass correlation coefficients (ICCs), and construct validity through known-group comparisons and correlations between environmental supportiveness, participation outcomes, and parental desire for change.ResultsThe Dutch PEM-CY demonstrated acceptable to good internal consistency (alpha = 0.54-0.68) and good to very good test-retest reliability (ICC = 0.60-0.80). Known-group comparisons revealed significant differences between children with and without disabilities, particularly in involvement and environmental barriers. In addition, higher perceived environmental support was significantly associated with greater involvement and less parental desire for change, but not with participation frequency. These findings support the Dutch PEM-CY ' s reliability and validity in assessing participation and environmental influences among Dutch children aged 5-17 years old.ConclusionThe Dutch PEM-CY is a reliable and valid instrument for assessing participation and environmental influences among Dutch children aged 5-17 years. Its ability to identify both group differences and associations with environmental support underscores its value for guiding tailored occupational therapy interventions and informing inclusive policy development.