Greek Translation and Preliminary Test-Retest Reliability of the AQUA CHILD Questionnaire in Children With Developmental Disabilities.

Abstract

Background and purpose: AQUA CHILD is a parent-proxy questionnaire for pre-aquatic assessment. This study describes its Greek translation and examines preliminary test-retest agreement, with explicit verification of response coding and the limits of score interpretation.

Methods: In a methodological repeated-measures study, 47 parents completed the questionnaire 7 days apart. The retained electronic paired files contained 99 of the 102 numbered items on the supplied forms. Swimming responses were analysed categorically; 20 non-swimming domain summaries were analysed as exploratory raw-code sums, excluding non-applicable responses and using complete domain pairs (n = 43-47). Intraclass correlation coefficients for absolute agreement, ICC(A, 1), and 95% confidence intervals (CIs), systematic differences, measurement-error estimates, and participant-level Bland-Altman analyses were calculated. No overall score was retained.

Results: Swimming-item exact agreement was 91.5%-97.9% (unweighted kappa, 0.899-0.974). Non-swimming ICCs ranged from 0.878 to 0.968, with lower 95% CI limits of 0.786-0.942. Only undertaking a single task retained a mean retest increase after Holm adjustment: 0.22 raw-code points (95% CI, 0.09-0.34; adjusted p = 0.019). Baseline domain alpha coefficients ranged from -0.375 to 0.329. At T2, 41 non-swimming responses from 24 of 47 participants were 'not relevant', all 'not capable' at T1; none were 'not relevant' at T1. Two domain analyses used incomplete item sets. Normal-theory limits of agreement were sensitive to the discrete, zero-heavy differences.

Discussion: These estimates describe the retained electronic records. The original paper questionnaires are no longer available, so the accuracy and origin of the 41 transitions could not be independently verified; this unresolved data-quality issue may bias reliability estimates. Unconfirmed clinical stability, incomplete adaptation records, and missing items further limit inference. The findings do not establish validated domain scales, diagnosis-specific reliability, or an overall score. Prospective validation with independent source-data verification remains necessary before individual treatment decisions.