Internal psychometric properties of the Children with Special Health Care Needs Screener

Acad Pediatr. 2011 Mar-Apr;11(2):128-35. doi: 10.1016/j.acap.2009.11.006. Epub 2010 Mar 15.


Objective: Insufficient research has established the measurement properties of the Children with Special Health Care Needs (CSHCN) Screener. This leaves unclear whether CSHCN Screener-based estimates reliably identify CSHCN. We used classical and modern test theory to establish the CSHCN Screener's internal psychometric properties.

Methods: Data came from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN), a nationally representative survey of US children (N = 359,154).

Results: Cronbach's α, a measure of internal reliability, equaled .76. Confirmatory factor analysis for ordered-categorical measures indicated that a single underlying trait that we label health-condition-complexity underlies CSHCN Screener responses. Item response theory showed that responses provide particularly precise measurement among children experiencing elevated health-condition-complexity trait levels.

Conclusions: Findings demonstrate that responses to the CSHCN Screener as used in the NS-CSHCN have good internal psychometric properties and include minimal random measurement error. Epidemiologists, clinicians and others can rely on CSHCN Screener responses to reliably identify CSHCN experiencing 1 or more of the 5 consequences included on the CSHCN Screener.

MeSH terms

  • Child
  • Chronic Disease / classification*
  • Chronic Disease / epidemiology
  • Disability Evaluation*
  • Disabled Children / classification*
  • Disabled Children / statistics & numerical data
  • Factor Analysis, Statistical
  • Humans
  • Mass Screening / methods
  • Psychometrics*
  • Reproducibility of Results
  • United States / epidemiology