Psychometric properties of the Proxy-reported Activities-specific Balance Confidence (ABC-P) Scale among Individuals with Intellectual Disability

Background: The fear of falling impairs mobility and independence among individuals with intellectual disability. Little is known about the domain of fear of falling, and the lack of studies addressing proxy-reported fear of... [ view full abstract ]

Background:
The fear of falling impairs mobility and independence among individuals with intellectual disability. Little is known about the domain of fear of falling, and the lack of studies addressing proxy-reported fear of falling is often attributed to the unavailability of valid and reliable assessment tools that are specific to individuals with intellectual disability.
Method:
We assessed the validity and reliability of the proxy-reported Activities-specific Balance Confidence Scale (ABC-P) for determining balance issues related to the fear of falling among individuals with intellectual disability attending an Employment Development Centre at "Movement for the Intellectually Disabled of Singapore (MINDS)", Singapore. Training officers of 42 participants assessed the fear of falling using the ABC-P. Therapist-assessed balance using the Berg Balance Scale, functional mobility using the Timed Up and Go Scale and functional independence using the modified Barthel Index and the Lawton's Score of Instrumental Activities of Daily Living were recorded.
Results:
Good concurrent validity was observed between the ABC-P and participants’ balance (r=0.316; Significance =0.021). The ABC-P had excellent validity for predicting falls (r= -0.72; Significance=0.0001) among individuals with intellectual disability. The inter-rater (ICC=0.973) and test-retest reliabilities (ICC=0.976) between training officers were excellent.
Conclusion:
Thus, the ABC-P is a valid and reliable tool for assessing the fear of falling among individuals with intellectual disability.
Application to Practice:
Proxy-reported fear of falling is reliably assessed through ABC-P. Its periodic administration among individuals with intellectual disability could reliably predict falls and functional deterioration.