KaTid materials; KaTid-Child, Time-P, Time-S
The instrument Kit for assessing TPA [KaTid]
The KaTid has a detailed manual describing how to proceed with assessment, exactly how to
pose each question/each item and how to score. Adaptations that might be needed are
described e.g. for children with physical disability. The unique features in this new instrument
are a) the items in time perception, aimed at measuring the duration of daily activities and b)
that the instrument includes items in time management for children and c) that the instrument
includes items from at least three different constructs of time. It was validated and reliability
tested with classical statistical methods on 6 year-old TD children (n=61) (1). The results
indicated no differences in gender, as well as acceptable validity, reliability and significant
correlation between KaTid – the Parent scale and the self-rating of autonomy. From August
2004, the development of this instrument and of increased knowledge was continued within a
research project supported by the National Health Care Sciences Postgraduate School,
resulting in this thesis.
The multi-disciplinary KaTid instrument is used to assess TPA among the
participants in this thesis. The instrument was developed to cover the three earlier described
aspects of TPA: time perception (P), time orientation (O) and time management (M). If a
child is reported to have problems in everyday situations identified as potentially related to
TPA, KaTid may be used for further exploration and investigation of time processing skills.
The aim is to define/clarify or interpret the causes, or rather one potential cause, of problems
of occupational performance in daily life.
The KaTid was primarily aimed for being used for children with disabilities and
therefore contains picture support to make it more easily available and accessible (1). Using
pictures as support is a way of making information less abstract for children with or without
cognitive disabilities (2, 3), thus facilitating assessments of those young children who have
not learned to read or who have communication problems. KaTid included 61 items in the
form of tabletop activities. Most of the items were presented in a flip-booklet with 2 or 3
pictures on one side of the flipbook for the child to see, and the question to pose visible only
to the professional. The child can point to the picture or answer verbally. KaTid has
dichotomous response alternatives (can/cannot) in most items, but five items are scored on a
three point rating scale.
A. Time perception
The subcategory P=time perception, contained 16 items, P1 – P16. The items P1 – P14 are
aimed at measuring if the child knows which activities take a long time/short time to do, i.e.
the perceived duration of daily activities (4). One item, P15 is aimed at measuring the
subjective perception of time passing, a so-called prospective time judgement task (5), using a
stopwatch with a yellow dot at 10 seconds. First the child is instructed to watch the hand of
the stopwatch as it moves to the yellow dot. Then the child is told that the stopwatch will be
restarted out of sight, by the child’s ear and s/he is told to say stop when s/he thinks the hand
has reached the yellow dot. This item is an adapted version of a task used and recommended
by Friedman (6). In this instrument a shorter time interval is used, ten seconds, bearing in
mind that the KaTid aims at children with disabilities. In item, P16, the child is to identify
which activity s/he does often, from two given examples.
B. Time orientation/concepts
In the subcategory of O=time orientation; there were 35 items, O1 – O35. In the items O2 -
O4, the child is asked to place a picture sequence of a daily activity in temporal order. For
example, O3 is a sequence of a girl performing a morning routine in 5 pictures. In this
instrument the time concepts of sequence, (a) location, (b) frequency and (c) units are
included, mostly concepts of “educated time” (7). Examples of items in (a) location in time:
O14 (“Which season is it now?”) is sometimes easy enough, if you can look through the
window and see yellow leaves on a tree. For orientation within the week, O5 asks “What day
is it today?”, and O8 “Which day was it yesterday?” (Figure 2). An example of (b) frequency
concepts: O1 “Which do you do more seldom, brush your teeth or go to the dentist?”
Examples of items in (c) units: O10 “Which days are you free from school?” and O7 “Say the
names of all the days of the week in the right order”.
The item O19, putting digits on the right place on a clock face, is an adaptation
of a frequently used item, drawing a clock (8), here using self-adhesive digits.
C. Time orientation/objective time
Items O20 – O27 are about telling time from a clock with increasing levels of difficulty. This
type of item is the traditional way of measuring time ability included in instruments like
Griffiths Mental Developmental scale (9). Item O28 includes objective time in duration, and a
similar item is seen in LOTCA (8). When starting the assessment a timer is set for 15
minutes, without telling the child. This kind of item aims to measure the subjective time in
passing retrospectively (5). Items O29 - O35 are about time quantity with questions like O29
“How many minutes are there in quarter of an hour?”, O31, the number of days in a week (9,
10) and O32, the number of days in a month (11).
D. Time management
In subcategory M= time management, M1 - M10, the items are based on questions about (a)
what one would have time to do in a set amount of time, (b) when to do it and (c) for how
long to do it (12). In items about (a) -what one would have time to do in a set amount of timethe
skill of reading the clock is combined with the duration of activities. For example, M3 “If
the hands on the clock are like this, and a TV program you want to see starts at six o’clock,
what would you have time to do? Make a sandwich or eat dinner?” Items about (b) – when -
and (c) -for how long to do it- includes calculation. For example, item M5 “If it takes 10
minutes to go to the dentist and you should be there by 20 past eleven, when will you have to
During the studies included in thesis, the analyses have yielded some changes of
the instrument. In the earliest data collection there was only one item in the subcategory of
time management, as there was no evidence that children at this early age might manage their
time at all. In the preliminary analysis of the 6 year olds, this item turned out to be very easy
for the sample. Thus another two items were added in the following data collection with 5
year olds. The next analysis indicated a need for even more, and more difficult, items in time
management, so another seven were added. Due to this, the subcategory of time management
was imputed for some children in order to obtain more data for Study III. In the other studies,
using Rasch analysis, the missing values in time management are not as crucial. In the other
subcategories there are very few missing data.
In the first study, 61 items were included in KaTid. The step-by–step process of
omitting items resulted in 51 items with acceptable goodness-of-fit. Those 51 items are used
in studies II - IV.
Time- P, Parent scale
Information about the children’s daily TM was obtained with a Parent scale, created by the
first author and a colleague, and designed to collect information about the children’s everyday
functioning in situations possibly affected by difficulties in TPA. Items were generated from
previous knowledge of the limitations in everyday situations that were often demonstrated by
children with difficulties in time perception. For example, it has been suggested that
difficulties in time perception in children with ASD are related to limitations in daily
rhythm/sleeping problems (13), leading to the statement “My child has a stable sleep-wake
cycle...”. It is also suggested that children with ASD have difficulties with variability in daily
routines (14), thus generating item 2. Difficulties in time perception were assumed to be
connected to difficulties in adjusting activity level to the specific context (e.g. problems with
waiting) (15, 16), thus generating items 6 and 11. Many activities in daily living are done in a
temporal sequence, e.g. making a snack, and managing such activities is part of learning time
management (12, 17) (item 3). One statement was added to acquire information on whether
the child shows proof of understanding time concepts in everyday situations (item 5) (5).
Time perspective, hindsight and forethought are aspects of psychological time (16, 18), and
generated item 9. The Time-Parent scale has a Likert agreement scale with four response
The Time-P 5-10 was created for parent rating ocf children aged 5-10. It was validated with
Rasch analysis and was found to have good psychometric properties. Time-P 10 – 17 is newly
created, validation ongoing.
Time-S, Self-rating scale of daily time management
The Time-S was created for self-rating of daily time management. Validation in children aged
10 – 15 is ongoing.
Validity and reliability of KaTid and Time-P, see summary of thesis on p 4-5 (19)
TIME for TIME - in time! Assessment of time processing ability (TPA) and daily
time management in children with disabilities
The overall aim of the thesis is improving a method for supporting children with difficulties in
their daily time management by operationalizing the concepts of time in ICF-CY into an
assessment of time for clinic and research and to contribute to the body of knowledge in
children with or without time processing difficulties.
Study I: Development of a new assessment of time processing ability for children, using Rasch
The purpose of this study was to examine aspects of construct validity of a new instrument,
for assessing time processing ability (TPA) in typically developing (TD) children. Data from
144, 5-10 year-old TD children, was collected with a multi diciplinary instrument: Kit for
assessing Time processing ability (KaTid), a Parent scale for daily time management and
Self-rating of autonomy. Data was analyzed using modern test statistics; Rasch models. A
step-by-step procedure was carried out, omitting items that did not fit the model. 51 items in
KaTid demonstrated acceptable goodness-of-fit to a Rasch model indicating evidence of
internal scale validity. The performances of the children in KaTid demonstrated acceptable
goodness-of-fit to the Rasch model indicating evidence of validity in response processes. The
items in KaTid separate the children into four different levels of TPA. Relationships between
the KaTid measures and the parents’ estimations of the child’s daily time management
indicated further evidence of construct validity. The results from this study indicate that the
items in KaTid, initially defined as time perception, time orientation and time management,
all demonstrate acceptable internal scale validity, based on the actual goodness-of-fit statistics
used in the analysis and all 51 items support a potential unidimensional construct, here named
TPA. In this unidimensional construct time perceptions, time orientation and time
management can be seen as different levels of complexity in time processing ability rather
than as separate constructs. There is a need for further research in children with disability and
Study II: Measurement of time processing ability and daily time management in children with
disabilities (accepted for publication)
The aim of the second study was to empirically investigate the hypothesized relation between
children’s TPA, daily time management (TM) and self-rated autonomy. Participants were
children aged 6 – 11 years with disabilities: Attention Deficit Hyperactivity Disorder
(ADHD), autism/ Asperger syndrome, mild or moderate intellectual disabilities, or with
neurological disease like CP or MMC (n=118). TPA was measured with the instrument
KaTid, daily TM with a parent scale and Self-rating of autonomy with a short version of a
validated scale of autonomy. All data were transformed to interval measures using
applications of Rasch models and then further analysed with correlation and regression
analysis. The results demonstrate a moderate significant relation between the parents’ ratings
of daily TM and the TPA of the children, and between the self-rating of autonomy and TPA.
There was also a significant relation between self-ratings of autonomy and the parents’ rating
of the children’s daily TM. Parents’ ratings of their children’s daily TM could explain 25% of
the variation in TPA, age of the children explains 22%, whilst the child’s self-rating of
autonomy can explain 9% of the variation in TPA. The three variables together explain 38%
of the variation in TPA. The results indicate the viability of the instrument for assessing TPA
also in children with disabilities, and that the ability measured by KaTid is relevant for daily
Study III: Patterns of Time Processing Ability in children with and without Disability
Children with cognitive disabilities, e.g. ID or autism are reported to have problems in time
perception, time orientation or time management, i.e. time processing ability (TPA). It is not
known whether the problems described are diagnosis specific or reflect differences in age or
in level of TPA. The aim of study III was to investigate if there were different patterns in TPA
in children with disabilities and TD children, if there are individual differences in patterns and if
such differences were related to type of diagnosis using a person-oriented approach. With a
cluster analysis, this study investigated if there were different patterns in TPA in 5 – 10 yearold
children with (n=77) and without disabilities (n=89) and whether differences were related
to type of diagnosis or chronological age. The results indicated that four of the five clusters
differed mainly in chronological age and in levels of TPA. Children within the same
diagnostic category do not share membership in a subgroup with specific pattern of TPA.
Daily time management as estimated by the parents and self-rated autonomy differs between
clusters and was related to the TPA. Overall the level of TPA seems to be a more valid base
for planning interventions in daily time management than type of diagnosis. More research is
needed to examine the differences between children with and without disability.
StudyIV: Comparing time processing ability in children with or without disability.
(Manuscript in progress)
The aim of study IV was to further investigate if there was a difference between the response
patterns of children with disability compared to TD children that might indicate
bias/differential functioning in items or scale. Participants were children with disabilities,
same criteria as in earlier studies (n=144) and TD children (n=115) totally 259 5 – 10 year old
children. Data was analysed with Rasch analysis models for differential item functioning
(DIF) and Standardized z-comparison. The DIF analysis demonstrated that the two samples
responded similarly in 37 of the 51 items (72.5%) in KaTid indicating stability across the
samples in these items. The first analysis revealed a difference in challenge in some specific
items in KaTid between children with or without disabilities; most of them in the
subcategories time perception and time orientation. However, the Standardized z-comparison
resulted in a trivial degree of differential functioning at scale level. There were no discernible
patterns connected to diagnoses. This study provides evidence of further validity of the
There is now a validated instrument that can be used for assessment of a child’s individual
level of TPA, also change over time, for children with or without disability complemented by
the Parent scale for valid assessment of a child’s daily TM, useful in clinic and in research.
The results of this attempt of operationalizing the concepts of time in ICF-CY indicated that
TPA might be one construct, meaning that the skills of time perception – time orientation and
time management are different levels of complexity in TPA rather than separate constructs.
This conclusion and the evaluated instruments i.e. this thesis, contribute to clarifying the
construct and the concepts used, making it possible to unify the language. This can contribute
to improve communication used in between the parents and between parents, professionals
and significant others. Everybody using the same concepts of time (ICF-CY), opens up for
describing present skills in TPA and the daily TM of the child, to set concrete and reachable
goals and discuss how to reach the goals, all beneficial for the child, the family and the
1. Alderman I, Janeslätt G. Utveckling av instrument för kartläggning av tidsuppfattning
hos sexåringar [Development of a tool for assessing of Time Processing Ability in sixyear-
old children] [Master]. Västerås, Sweden: Mälardalen University, Department of
Social Sciences; 2004.
2. Wing L. Autistic spectrum disorders. British Medical Journal1996;312(7027):327-8.
3. Sturgess J, Rodger S, Ozanne A. A review of the use of self-report assessment with
young children. British Journal of Occupational Therapy2002;65:108-15.
4. Grondin S. From physical time to the first and second moments of psychological time.
5. Friedman WJ. Children's Representations of the Pattern of Daily Activities. Child
Development1990 Oct;61 (5):1399-412.
6. Friedman ER. Judgements of time interval by young children. Perceptual and Motor
7. Nelson K. Language in Cognitive Development: The Emergence of the Mediated
Mind. Cambridge: Cambridge University Press; 2002.
8. Katz N, Itzkovich M, Averbuch S, Elazar B. Loewenstein Occupational Therapy
Cognitive Assessment (LOTCA) battery for brain-injured patients: reliability and
validity. American Journal of Occupational Therapy1989;43(3):184-92.
9. Alin-Åkerman B, Nordberg L. Griffiths' utvecklingsskalor I och II: manual för
administrering och utvärdering [Griffiths Developmental Scale I and II]. Eskilstuna,
Sweden: Psykologiförlaget ab 1980.
10. Wechsler D. WIPPSI-R; Wechsler Preschool and Primary Scale of Intelligencerevised,
Manual [Swedish version]. Stockholm: Psykologiförlaget AB; 1999.
11. Wechsler D. WISC-III; Wechsler Intelligence Scale for children. Manual [Swedish
version]. 3 ed. Stockholm: Psykologiförlaget AB,; 1999.
12. Davies DK, Stock SE, Wehmeyer ML. Enhancing Independent Time-Management
Skills of Individuals With Mental Retardation Using a Palmtop Personal Computer.
13. Wimpory D, Nicholas B, Nash S. Social timing, clock genes and autism: a new
hypothesis. Journal of Intellectual Disability Research2002;46(part 4):352-8.
14. Hollander E, Phillips AT, Yeh C-C. Targeted treatments for symptom domains in
child and adolescent autism. The Lancet2003;362(9385):732-4.
15. Segal R, Frank G. The Extraordinary Construction of Ordinary Experience:
Scheduling Daily Life in Families with Children with Attention Deficit Hyperactivity
Disorder. Scandinavian Journal of Occupational Therapy1998;5(3):141-7.
16. Barkley RA. Attention-deficit/hyperactivity disorder, self-regulation, and time: toward
a more comprehensive theory. Journal of Developmental and Behavioral
17. Bambara LM, Ager C. Using self-scheduling to promote self-directed leisure activity
in home and community settings. Journal of the Association for Persons with Severe
18. Melges FT. Identity and Temporal Perspective. In: Block RA, editor. Cognitive
models of psychological time. Hillsdale, NJ: Lawrence Erlbaum; 1990. p. 255-85.
19. Janeslätt G. TIME FOR TIME; Assessment of time processing ability and daily time
management in children with and without disabilities [Doctoral]. Stockholm:
Karolinska Institutet; 2009.
Abstract of doctoral thesis “Time for time” presenting the validation of the material