Psychometric study of the Assessment of Communication and Interaction Skills---Chinese version (ACIS-C)

Abstract

Background：There is a lack of standardized social skill assessments which are developed based on occupational therapy theories with good psychometric properties in Taiwan. The Assessment of Communication and Interaction Skills (ACIS) is an observational rating scale with acceptable construct validity, discriminative validity and reliability. However, the psychometric properties of the Chinese version are unclear.

Objective：The purpose of this study is to examine the reliability and validity of the Assessment Communication and Interaction Skills---Chinese version (ACIS-C) with psychiatric patients in Taiwan. Methods：The subjects were recruited from 3 day care wards in northern and eastern Taiwan. The minimal educational level is elementary school. Exclusion criteria for the subjects included diagnoses of organic brain injury and substance abuse. We recruited 101 patients. After explaining the process and purpose of the study to patients and obtaining their informed consent, each subject was tested on the Mini-Mental State Examination (MMSE). Only patients whose scores on MMSE were equal or larger than 24 were recruited. After securing the permission of the patient and ward staff, the researcher observed subjects’ performance during group session and a simulated social situation. The ACIS-C was used to assess the communication and interaction skills of the patients. Construct and discriminative validity as well as test-retest reliability were examined through Rasch measurement model and related inferential statistics.

Results: The mean age of the subjects are 38.6 years (SD=11.5years). 55.4% are female and 44.6% are male. The majority of the subjects are diagnosed as schizophrenia (77.2%). 70.3% of the patients were unmarried. Most of the educational level is at college or above. 97% of the subjects were unemployed. The results of the Rasch analysis showed that the items of the ACIS-C form a unidimensional construct except for one item (item 7). The test retest reliability is good (ICC=.93). The internal consistency of the scale is .96. The ACIS-C is a sensitive scale which could be used to differentiate social skills among psychiatric patients. The easiest item is ”ask” and the hardest item is”relate”.

Discussion：The ACIS was translated into Chinese through careful two stage translation process. The ACIS-C has acceptable construct validity, discriminative validity and test-retest reliability. The reason for misfit item could be attributed to side effect of psychotropic medications. Therapists can utilize the level of difficulties of ACIS-C items from the study to design matching training programs. For example, a therapist could start the training focus from easier item such as body movement, then progress to harder items such as relates and respects. The results of the study also showed that the severity of symptoms did not influence the patients’ social skills. Future study needs to emphasize inter-rater and intra-rater reliability of the ACIS-C as well as ACIS-C’s validity in different context.

References:

Hsu, W. L. (2007). Psychometric study of the Assessment of Communication and Interaction Skills---Chinese version (ACIS-C). Unpublished master’s thesis, National Taiwan University, Taipei.

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