The Child-Focused Injury Risk Screening Tool (ChildFIRST) Demonstrates Greater Reliability When Using a Dichotomous Scale vs. a Seven-Point Likert Scale, and Is Preferred by Raters

The Child-Focused Injury Risk Screening Tool (ChildFIRST) assesses movement competence in children and currently uses a dichotomous scoring scale, which, while simple and practical, may lack the precision needed for nuanced movement skill analysis. This study compared the inter- and intra-rater reliability of the ChildFIRST when scored using a dichotomous scale versus a seven-point Likert scale. Fourteen trained raters evaluated video recordings of eight children performing ten standardized movement tasks using both scales across two sessions. Reliability was assessed using intraclass correlation coefficients (ICCs). The dichotomous scale demonstrated moderate to excellent inter-rater reliability (ICC = 0.50–1.00) and good to excellent intra-rater reliability (ICC = 0.75–1.00). The seven-point scale showed similar inter-rater reliability but generally lower intra-rater reliability (ICC = 0.50–1.00). In addition, raters preferred the dichotomous scale in terms of practicality (91.6%), feasibility (75%), and overall usability (66.6%). These findings suggest that while both scales provide comparable inter-rater agreement, the dichotomous format offers greater consistency across repeated ratings and is more favorably received by users. The dichotomous scoring system is therefore recommended for continued use in field-based screening and future applications of the ChildFIRST.