Psychometric properties of the cognitive and linguistic scale: A follow-up study

Objective: In a pediatric rehabilitation setting, monitoring recovery of cognitive skills is challenging due todiversity in age and brain injury severity. The Cognitive and Linguistic Scale (CALS) is a measure withpromising psychometric properties that was designed for inpatient pediatric rehabilitation care. This studyre-examines the reliability and validity of the CALS in a larger, independent sample. Method: Two hundredfifty-eight children (2-21 years) who were consecutively admitted to an inpatient brain injury facility between2008 and 2014 for a first inpatient rehabilitation admission following a traumatic or acquired brain injury wereincluded. Both CALS and Functional Independence Measure for Children (WeeFIM) were examined atadmission and discharge. CALS scores by age groups (preschool-aged, school-aged, adolescents, or youngadults), gender, and etiology (acquired vs. traumatic brain injury) and in two subgroups. Results: The internalconsistency of the CALS was high. Total CALS score and individual item scores improved significantlybetween admission and discharge for children of all age groups, both genders, both traumatic and acquiredetiologies, and in subgroups with limited responsiveness and no change on the WeeFIM cognitive domain. Noage group had a floor or ceiling effect. Correlations with the WeeFIM were high. Factor analysis revealed 2factors (basic responding and higher-level cognitive skills). Conclusions: The CALS has strong psychometricproperties across a wide range of ages, brain injury etiologies, and cognitive severity. The CALS can be usedto track cognitive and linguistic recovery in children, adolescents, and young adults with brain injury duringinpatient rehabilitation.