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A Preliminary Validation Study of the Korean Version of the Minnesota Self-Determination Scales for Adults With Intellectual Disabilities:

A Preliminary Validation Study of the Korean Version of the Minnesota Self-Determination Scales... The Minnesota Self-Determination Scale (MSDS) was translated into Korean. The Korean version was then validated using a sample of 40 individuals with intellectual disabilities between the ages of 19 and 45 years, the legal age of adults in South Korea. The evidence of the reliability and validity was examined. The test–retest was good (.84-.94). The internal consistency was excellent (.96-.99). The construct validity with other Korean translated self-determination measure (K-SDS) was acceptable (.50-.51). The findings indicated that the K-MSDS was an appropriate measure with acceptable psychometric properties. The Korean version was the first self-determination measure for adults with disabilities. Keywords special education, education, social sciences, intellectual and developmental disabilities, rehabilitation, self-determination, measurement Recently, there has been considerable emphasis placed on are parents, siblings, and service providers of the individuals. the role of environmental supports in defining the concept of Abery and Stancliffe (Stancliffe, 1997; Stancliffe & Abery, disability. The International Classification of Functioning, 1997; Stancliffe, Abery, & Smith, 2000) closely examined Disability, and Health (ICF) defines disability as the com- the relationship between individual levels of self-determina- plex outcome between a person’s health condition and envi- tion and residential environment occurring at the micro-sys- ronmental factors, which include social, physical, and policy tem levels of the ecological perspective. The residential supports (Schneidert, Hurst, Miller, & Üstün, 2003). This environment examined in those studies included staff emphasis on the role of environment corresponds to the arrangement, residence size, number of residents, and resi- socio-ecological perspective of Bronfenbrenner (1979), who dence location. Another study by Wehmeyer and Bolding views human development as the evolving interaction (2001) examined the effects that transitioning from institu- between the person and environment (recited in Berry, 1995). tionalization to community residences had on self-determi- The socio-ecological perspective holds that successful out- nation in adults with severe intellectual disabilities. The comes in human functioning may depend more on the match results of this study were consistent with those of the previ- between individuals and their environments than on individ- ous study by Stancliffe and Abery (1997). They found sig- ual personal characteristics alone (Thompson, Tasse, & nificant improvement in the areas of self-determination, McLaughlin, 2008). As such, a disability is heavily influ- autonomy, and choice-making in adults with severe intellec- enced not only by internal traits but also by the varied sup- tual disabilities after they moved from more restrictive resi- ports that enable an individual to function in the environment dential institutions to less restrictive community residences. (Claes, Van Hove, Vandevelde, Loon, & Schalock, 2012). Stancliffe, Abery, Springborg, and Elkin (2000) also exam- Environmental support in this context is defined as the over- ined the effect of substitute decision-making (e.g., a legal riding “resources and strategies that aim to promote the guardianship or conservatorship) on the personal control of development, education, interests, and personal wellbeing of adults with intellectual disabilities at the macro-system level. a person and that enhance individual functioning” (Luckasson et al., 2002, p.145). Obtaining information about the indi- Chonbuk National University, Jeonju City, South Korea vidual and the environment is a critical starting point which Corresponding Author: enables the individual to benefit from socio-ecological per- Jaehyun Cho, PhD, Dept. of Education, Chonbuk National University, spective, because of the inability and limitation the individ- Baekjedaero 567, Jeonju City, 561-756, South Korea. ual has. The primary sources of these environmental supports Email: saehim1@gmail.com 2 SAGE Open The results demonstrated that adults without any substitute with severe disabilities. Notably, the Korean version of the decision makers exercised significantly higher levels of per- Minnesota Self-Determination Scale (K-MSDS) was the first sonal control than those with a conservator or a guardian. instrument designed to assess self-determination of Korean However, there was no assessment conducted to systemi- adults through the socio-ecological perspective. cally identify which facilitators and barriers existed, and examined how they influenced the individuals with disabili- The Purpose of the Study ties either at the micro- or at the macro-system levels in South Korea (Cho, 2009). The purpose of this study was to examine whether a trans- lated Korean version of the MSDS, the K-MSDS, might be valid when applied to a Korean population. The original Problems scales were invented to measure adults with developmental Since 2000, significant efforts have been made in South disabilities (Abery, Stancliffe, Smith, Elkin, & Springborg, Korea toward the development of self-determination skills in 2000a). The measures were incorporated from the construct individuals with disabilities have. These efforts have included of an ecological model of self-determination (Abery & development of interventional programs (Bang, 2000; Stancliffe, 2003). H. O. Park, 2006; Rhyou, 2003), and examination of out- comes related to an individual’s self-determination level after Research Questions participating in these programs (E. Kim & Kim, 2005, 2006; S. W. Park & Kim, 2004). Shogren et al. (2008) asserted that Research Question 1: Does the K-MSDS yield adequate self-determination measures should be used to develop, test–retest reliability correlations in an adult sample from implement, and evaluate the effect of self-determination three Korean group homes and a residential institution at interventions on individuals with disabilities. Unfortunately, two different points in time? the development of norm-referenced and standardized mea- Research Question 2: Does the K-MSDS yield accept- sures of self-determination for individuals with disabilities able internal consistency coefficients in an adult sample which report acceptable psychometric properties has been from three Korean group homes and a residential very limited in South Korea. Since 2000, three self-determi- institution? nation measures have been translated into Korean (Cho, Research Question 3: To what extent is there correlation 2009). However, only one of these measures included discus- between the K-MSDS and the K-Arc’s SDS (K-SDS) in sion of psychometric properties and contained a standardized constructing self-determination? sample that matched the recent South Korea census in terms of gender, age, family socio-economic status, and regional Method representation (J. K. Kim, Cho, Moon, & Kim, 2001). The second problem identified was the lack of self-deter- Participants and Setting mination measures developed for adults in South Korea. Most measures privileged the evaluation of self-determina- Participants included 40 adults with intellectual disabilities tion of secondary students with intellectual disabilities, and residing in three group homes and one residential institution focused less on the importance of promoting and measuring in an urban area of South Korea. The gender breakdown of self-determination in both young children and adults (Lee & this sample was 24 males (60%) and 16 females (40%). The Wehmeyer, 2003). However, the ultimate goal of special age of participants was restricted to 19 or over, because the education in South Korea is to promote the full inclusion of MSDS was originally developed for use with adults. Mean students with disabilities (Korean Department of Education age was 31.5 years (SD = 6.36, range = 20-42). The ethnicity & Human Resources, 2003). Considering that self-determi- of the participants was Pacific Islander (Koreans). Of the nation is a developmental process intended to increase participants, 28 were recruited from one residential institu- autonomy over the course of one’s life span (Abery & tion and 12 were recruited from three group homes the direc- Stancliffe, 2003; Wehmeyer, 1998), it was valuable for any tors of which agreed to participate in the study. self-determination measure to account for the changes that Participants lived in three different residential settings: adults undergo as they age. (a) group homes, (b) pre-group homes, and (c) a residential The final problem pertained to the limited perspectives of institution. Twelve (n = 12) participants resided in three existing measures of self-determination of individuals with dis- group homes that provided semi-independent living services abilities. There were no self-determination measures represent- in integrated community settings. Unmarried participants ing the socio-ecological perspective. Considering that the shared a room with two to three other residents. Married par- nature of disability can be understood as an intersection ticipants lived with their own family members in the group between a person’s capacities and the context in which that per- homes. Twelve (n = 12) participants lived in “pre-group son lives, it was valuable to explore the role of environmental home buildings” located within the residential institution, supports in improving the self-determination of individuals but segregated from the community. The “pre-group home Cho 3 Table 1. Characteristics of Persons Assessed. the primary causal agent in his or her life. The primary causal agent was based on four functional characters of behavior: Demographic variables % (a) autonomy, (b) self-regulation, (c) self-realization, and Gender (d) psychological empowerment. Thus, the model developed Male 60 by Wehmeyer et al. (1996) was called the functional model. Female 40 The measure assesses these four self-determination areas. Age Abery and Stancliffe (2003) proposed an ecological 40< 10 model of self-determination based on the work of 31-40 58 Bronfenbrenner (1979). They defined self-determination as 21-30 32 the degree of personal control which one wishes to exercise <19 0 over those areas he or she considers important. They present IQ range personal control as heavily influenced by the interaction 51-75 60 between individuals and their environments. Thus, the role 40-50 27 of environmental supports was emphasized in the ecological <40 3 model. Abery and Stancliffe’s (2003) measure assesses the Missing data 10 eight environmental support areas. Some examples of these Adaptive Behavior Deficit supports include home, leisure activities, friends, health, and 16-20 63 work (Abery et al., 2000a). 11-15 6-10 17 <6 10 Measures Missing data 10 The Arc’s Self-Determination Scale (SDS; Wehmeyer & Disability category Kelchner, 1995) was developed to measure the self-determi- ID only nation of both secondary students and adults. This measure Other disabilities to ID 100 was comprised of two forms: an adult and an adolescent Language disorder 30 Physical disability 20 form, both of which share the same content. The adult form Psychiatric disorder 50 was adapted from the adolescent form (Wehmeyer, 1996). Ethnicity The internal consistency coefficient (Cronbach’s α) was .90. Pacific Islander (Koreans) 100 The Korean version of Arc’s Self-Determination Adolescent Living arrangement Scale (K-SDS) was developed by Kim, Cho, Moon, and Kim Group-home 5 (2001). The K-SDS was normed on 710 Korean adolescents Pre-group-home 53 with and without disabilities. The internal consistency was .95 Residential institution 42 in the Cronbach’s α (J. K. Kim et al., 2001). Primary employment Construct validity was established through a confirmatory Competitive 5 factor analysis which identified the consistent factors between Supported 53 K-SDS (J. K. Kim et al., 2001) and the SDS measure Sheltered 42 (Wehmeyer & Kelchner, 1995). The psychometric properties Unemployed 0 of the measure were established by administering it to sec- ondary students with intellectual disabilities. The internal ID = Individual disability. Physical disability = Cerebral palsy. consistency (Cronbach’s α) ranged between .92 and .95 across Psychiatric disorder = Epilepsy. the four Korean studies. The K-SDS was used for this study. The MSDS (Abery et al., 2000a) were invented to measure self-determination of an adult in light of the effects of certain buildings” were created to prepare individuals for the transi- environmental factors. The MSDS consisted of three sub- tion to living in an integrated community. Sixteen (n = 16) scales. These subscales included (a) Exercise of Control, participants resided in one residential institution which pro- (b) Decision-Maker Preference, and (c) Importance of Control. vided 24-hr supervised services. These individuals lived in Each subscale included 90 items, grouped into eight domains, four-person rooms segregated from the community. Table 1 which used a 3-point scale system to evaluate the levels of provides additional demographic information regarding the self-determination of the individual. Item questionnaires for participants in this study. the three scales shared the same content, with variation occur- ring only in initial statements, such as “How much do you care Structure of Self-Determination Construct about . . .” on the Important scale, “Who decides . . .” on the Exercise Control scale, and “Who do you want to decide . . .” Wehmeyer, Kelchner, and Richards (1996) proposed a func- on the Decision-Preference scale. The MSDS included both a tional model of self-determination. They defined self-determi- self-reporting adult form and a proxy reporting residential nation as the attitudes and abilities of the individual to act as 4 SAGE Open staff form, which share the same content. The proxy forms Nine culturally inappropriate items were identified by the were used for this study (Abery et al., 2000a). The test–retest panel on the first translated version and replaced with modi- (Pearson’s r) ranged between .74 and .87. The internal consis- fied items applicable to Korean institutions serving individu- tency coefficient (Cronbach’s α) ranged between .88 and .92 als with intellectual disabilities. for the self-reporting scales (Elkin, 2007). Changes in the questionnaires were identically applied to the three subscales, as they shared the same content. The con- tent replaced on the questionnaires was comprised of five Procedures items pertaining to the Plans domain, two items from the The investigator obtained two types of consents; a signed Support Money domain, and two items from the Support Staff and an oral consent form. Signed consent forms were domain. For example, the phrase transition planning meeting obtained from directors of the residential institution and in the Plans domain was replaced with “a personal discussion three group homes, and legal guardians of the participants with peer or family member,” as transition planning meetings who did not have families and relatives. Oral consent forms did not occur in South Korea. The phrase “hiring or paying were obtained from participants (i.e., residents with intellec- the service staff” in the Support Staff domain was replaced tual disabilities). Written consent was waived for participants with “saving money for necessity” and “buying something for who were not able to read the forms. The consent document the necessity” in the K-MSDS, as individuals who resided in was communicated orally by a member of the research team. the group homes and residential institution were not able to Each participant was informed that participation in the study hire or pay the service staff in South Korea. Table 2 provides was voluntary and could be terminated at any time. sample updated items recommended by the panel. Both the first and second translated Korean versions were pretested with five individuals with intellectual disabilities. Translation and Back Translation The individuals better understood questionnaires in the sec- The translation–back translation technique (also known as ond translated version. The second translated Korean version retranslation) was used to ensure equivalence on the scale was used for this study between different cultures (Brislin, 1986; Brislin & Thorndike, 1972). The investigator of this study, who was fluent in both Administrations Korean and English, translated the MSDS into Korean. The Korean version was then retranslated into English by a Korean Interviews were administered by six volunteers enrolled in an doctoral student majoring in English Literature at the graduate undergraduate special education program in South Korea. school level, and fluent in both Korean and English. The two The interviewers completed a one-day training workshop versions were compared by translation checkers—two other (6 hr) to acquire specific information regarding the protection doctoral students in English literature programs at the same of participants’ privacy, practices and policies in the institu- school—who were also fluent in both Korean and English. tions, and procedures for administering the measures used in These checkers were asked to rate how well the items on the the study. Each of the interviewers had an opportunity to prac- two versions of the MSDS aligned to the following criteria: tice the interviewing process through role-playing various (a) linguistic likeness (e.g., word-to-word correspondence case studies. In addition, the investigator of this study leaded between English and Korean) and (b) content agreement (e.g., two discussion sessions with interviewers to assess their com- delivery of the meanings from English to Korean. The trans- petence regarding the process of data collecting activities. The lated-retranslated items were rated using a 5-point Likert-type discussion sessions each lasted for 2 hr and were first held scale (1-5 points). The items that received ratings equal or immediately after participants began to conduct interviews greater than a point of 4 on both criteria were retained. Items and, again, later on in the process of conducting interviews. that received ratings equal to or lower than a point of 3 on both criteria were discarded for later retranslations. Results Procedure Test-Retest and Internal Consistency Face validity of the second Korean version of the MSDS was Test–retest reliability (Pearson’s r) was computed between rated by a Korean panel of three residential staff members the first and second administrations of the K-MSDS by the who served individuals with intellectual disabilities. Among same interviewers with the same respondents. The time panel participants, the mean number of years serving intel- interval between the two administrations was approximately lectual disabilities was 14 (SD = 6.36, range = 7-21). All par- 2 weeks (M = 14 days, SD = 2 days). Test–retest reliability ticipants were certificated social workers. The panel members coefficients were (r = .94) for the Preference, (r = .89) for the were asked to rate how well the translated Korean items cor- Importance and (r = .84) for the Personal Control Scales. All responded to institutional policies and practices in group scale scores on the three scales were significant at the homes for adults with intellectual disabilities in South Korea. p < .001 levels (two-tailed). Test–retest reliability analyses Cho 5 Table 2. Comparisons of the Original Items and Modified Items of the K-MSDS. Domain Item no. Content Plan 01 A. Who do you want to decide which people attend the meeting? B. Who do you want to decide whom do you want to discuss your dream or life goals? C. There is no transitional plan meeting to discuss individual’s dreams or goals in South Korea. 07 A. Who do you want to decide to hire the staff members that work with you at home? B. Who do you want to save money for something necessary for you at home? C. It is impossible for the individuals to hire the staff in Korean institutions. 08 A. Who do you want to decide how much your staff is paid? B. Who do you want to buy something necessary for you at home? C. It is impossible for the individuals to hire or to pay for service providers in Korean institutions? Staff 01 A. Who do you want to decide if your staff is doing a good job? B. Who do you want to decide if your staff benefits your life at home? C. It is very seldom for the individuals to assess the service quality of their staff in Korean institutions. 02 A. Who do you want to decide what to do when your staff is NOT doing a good job? B. Who do you want to decide whether you are satisfied with staff’s support? C. It is very seldom for the individuals to assess the service quality of their staff in Korean institutions. Note. K-MSDS = Korean Version of the Minnesota Self-Determination Scale; A = original statement; B = modified statement; C = brief reasons. Table 3. Reliability Coefficients (Pearson’s r) and Internal were also conducted for the domain scores. Test–retest coef- Consistency (Cronbach’s α) Across Domains in the K-MSDS. ficients were strong between domain scores with the excep- tion of two domains. K-MSDS The internal consistency was analyzed for each of the Preference Importance Personal Control Preference, Importance, and Personal Scales using Cronbach’s α (Cronbach, 1951). Each of these scales demon- Domains r α r α r α strated a strong internal consistency: Preference (.99), Importance (.99), and Personal control (.96) scales. The Home .97 .97 .96 .95 .95 .95 internal consistency was also analyzed for the domains Leisure .84 .90 .61 .86 .78 .88 within the three scales. Test–retest and internal consistency Friends .61 .90 .59 .86 .68 .89 correlations of K-MSDS are presented in Table 3. Health .91 .96 .68 .96 .87 .93 At work .88 .96 .85 .95 .31 .73 Plan .84 .96 .87 .97 .77 .89 Convergent Validity Money .91 .97 .93 .96 .72 .72 Criterion-related concurrent validity of the K-MSDS was Staff .80 .97 .83 .97 .34 .66 examined using K-SDS (Kim, Cho, Moon, & Kim, 2001) as a Total .94 .99 .89 .99 .84 .98 criterion measure. Pearson correlations (Pearson’s r) were Note. K-MSDS = Korean Version of the Minnesota Self-Determination computed between scores on the K-MSDS and on the K-SDS. Scale; α = Cronbach’s α (Cronbach, 1951). The K-MSDS and the K-SDS appear to assess similar con- **Correlation is significant at the .01 level (two-tailed). structs. Preference (r = .53), Importance (r = .52), and Personal Control (r = .51) Scales were correlated with the K-SDS. Scores on the K-MSDS also significantly correlated with Table 4. Descriptive Statistics and Correlation Matrix for K-SDS scores on the K-SMS, (Social Maturity Scale; S. Kim & Kim, and K-MSDS. 1998), an adaptive behavior scale (p < .001, two-tailed). Personal Preference (r = .53), Importance (r = .52), and Personal Control Scales M SD Preference Importance control (r = .53) scales were correlated with the K-SMS. Pearson’s K-SDS 82.1 14.9 .51** .51** .51** correlations between the K-MSDS and K-SDS are shown in Preference 188.7 39.1 — .97** .92** Table 3. Also, correlations between K-SDS and K-MSDS Importance 190.3 37.7 — — .92** including the subscales are presented in Tables 4 to 7. Personal control 182.3 22.3 — — — Discussion Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination One of the aims of this study was to examine the reliability Scale. **Correlation is significant at the .01 level (two-tailed). and validity of a Korean K-MSDS. Overall, the results 6 SAGE Open Table 5. Descriptive Statistics and Correlations for the Sub-Scales on K-SDS and for the Domains on Preference Scale. Subscales M SD 2 3 4 5 6 7 8 9 10 11 1. AUT (K-SDS) 53.2 10.5 .51** .66** .57** .60** .60** .60** .55** .56** .52** .51** 2. PSYE (K-SDS) 3.2 1.0 — .50** .34* .41** .44** .40** .40** .32 .36 .39** 3. SREA (K-SDS) 25.6 5.0 — — .19 .21 .29 .17 .14 .15 .11 .12 4. Home (K-MSDS) 39.7 8.0 — — — .92** .86** .90** .88** .94** .95** .94** 5. Leisure (K-MSDS) 23.1 3.7 — — — — .91** .83** .85** .91** .89** .92** 6. Friend (K-MSDS) 23.3 4.2 — — — — — .74** .75** .84** .81** .82** 7. Health (K-MSDS) 21.7 4.4 — — — — — .— .91** .93** .92** .89** 8. Work (K-MSDS) 21.0 4.6 — — — — — — — .87** .86** .86** 9. Plan (K-MSDS) 20.2 5.2 — — — — — — — — .97** .96** 10. Money (K-MSDS) 17.6 6.3 — — — — — — — — — .96** 11. Staff (K-MSDS) 21.9 4.4 — — — — — — — — — — Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination Scale; AUT = Autonomy; PSYE = Psychological Empowerment; SREA = Self-Realization as measured by K-SDS. **Correlation is significant at the .01 level (two-tailed). Table 6. Descriptive Statistics and Correlations for the Sub-Scales on K-SDS and for the Domains on Importance Scale. Subscales M SD 2 3 4 5 6 7 8 9 10 11 1. AUT (K-SDS) 53.2 10.5 .51** .66** .57** .56** .62** .62** .46** .52** .59** .48** 2. PSYE (K-SDS) 3.2 1.0 — .51** .33* .41** .48** .44** .40** .44** .42** .42** 3. SREA (K-SDS) 25.6 5.0 — — .15 .17 .39** .26 .15 .21 .23 .10 4. Home (K-MSDS) 39.6 6.9 — — — .83** .73** .93** .92** .91** .93** .86** 5. Leisure (K-MSDS) 22.9 3.5 — — — — .78** .84** .84** .88** .87** .87** 6. Friend (K-MSDS) 23.2 3.8 — — — — — .70** .73** .73** .73** .71** 7. Health (K-MSDS) 22.3 4.5 — — — — — — .92** .94** .96** .89** 8. Work (K-MSDS) 21.0 4.1 — — — — — — —. .94** .95** .91** 9. Plan (K-MSDS) 20.7 5.5 — — — — — — — — .97** .95** 10. Money (K-MSDS) 18.3 6.6 — — — — — — — — — .94** 11. Staff (K-MSDS) 21.8 5.1 — — — — — — — — — — Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination Scale; AUT = Autonomy; PSYE = Psychological empowerment; SREA = Self-realization as measured by K-SDS. **Correlation is significant at the .01 level (two-tailed). Table 7. Descriptive Statistics and Correlations for the Sub-Scales on K-SDS and for the Domains on Personal Control Scale. Subscales M SD 2 3 4 5 6 7 8 9 10 11 1. AUT (K-SDS) 53.2 10.5 .51** .66** .62** .60** .59** .58** .03 .35 .38 −.13 2. PSYE (K-SDS) 3.2 1.0 — .50** .41** .35 .38** .26 .18 .48** .31 −.23 3. SREA (K-SDS) 25.6 5.0 — — .24 .18 .29 .26 −.03 .19 .20 −.27 4. Home (K-MSDS) 39.9 7.0 — — — .88** .81** .82** .25 .66** .51** −.13 5. Leisure (K-MSDS) 23.0 3.6 — — — — .82** .71** .23 .57** .48** .11 6. Friend (K-MSDS) 23.4 4.0 — — — — —. .71** .30 .65** .61** .11 7. Health (K-MSDS) 21.2 3.3 — — — — — — .35 .73** .63** −.03 8. Work (K-MSDS) 18.2 2.8 — — — — — — —. .63** .67** .15 9. Plan (K-MSDS) 18.3 3.3 — — — — — — — — .78** −.10 10. Money (K-MSDS) 19.7 2.4 — — — — — — — — — .10 11. Staff (K-MSDS) 18.6 2.2 — — — — — — — — — — Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination Scale; AUT = Autonomy; PSYE = Psychological empowerment; SREA = Self-realization as measured by K-SDS. **Correlation is significant at the .01 level (two-tailed). Cho 7 demonstrated that the K-MSDS had good psychometric to different cultures. Asian cultures, such as those in Korea properties for validity, internal consistency, and test–retest and Japan, emphasize family values and relationships reliability. However, this study did not further explore the among community members differently from Anglo- possible effects of environmental characteristics—residence European cultures that value individualism (Zhang, 2005). size and type, guardianship status of adults with intellectual Because of existing cultural norms, it could be difficult for disabilities, and the characteristics of staff who serve in com- individuals to request a change in their scheduled lunch munity-based settings—combined with MSDS, examined in time or to express preferences for certain types of work. previous studies (Stancliffe, Abery, & Smith, 2000; They may express hesitancy communicating their own Stancliffe, Abery, Springborg, & Elkin, 2000). Also, because opinions on first or second responding, as they fear break- adults with intellectual disabilities do not retain any legal ing agency policy or losing better benefits by challenging rights as independent decision makers in South Korea, we collective decisions. were not able to examine the effects of possible substitute Internal consistency for the K-MSDS ranged from .96 to decisions made by these adults, and, therefore, could not .99. These results were corroborated by the previous results make comparisons with previous studies. for the original MSDS administered by Elkin (2007), which The items on the MSDS were adapted from the Institute ranged from .88 to .92. These results indicated that K-MSDS on Community Integration Self-Determination Opportunities was an internally consistent measure across all the three and Exercise Scale (ICI-SDOES; Abery, McGrew, & Smith, scales. However, we did not conduct a study examining how 1994, as cited by Abery & Stancliffe, 2003). Family, teach- well the original MSDS scales were translated to other lan- ers, and staff who served children with disabilities were guages and cultures. Thus, we could not compare the inter- involved as members of an advisory panel during the devel- nal consistency values of this study with those of other opment of the MSDS. In contrast, only the staff serving foreign language and culture-based translated versions of adults with intellectual disabilities participated as panel the MSDS. An additional concern involved the use of the members of the K-MSDS. Thus, items on the K-MSDS were coefficient—as the number of items increased, Cronbach’s restricted to reflect the opinions of the individuals with dis- alpha tended to inflate (Netemeyer, Bearden, & Sharma, abilities and their residential service providers. For a wider 2003). application of the K-MSDS beyond individuals with intel- The criterion-related validity of the K-MSDS was evalu- lectual disabilities who lived in community-segregated resi- ated by examining the relationship between the K-MSDS dential settings, more stake-holders such as family, teachers, and K-SDS. The associations between the two measures and service providers in community-inclusive settings are were moderate. The validity coefficients were .50, .50, and recommended to participate as panel members. .51 for the three scales of the K-MSDS and the K-SDS. The test–retest coefficients ranged from .84 to .94 for These results provided preliminary support for the use of the the K-MSDS scales. The test–retest intervals (M = 14 days, measures with Korean individuals. These two measures of SD = 2 days) were similar to those (M = 16 days, SD = 6 self-determination provided different theoretical perspec- days) of the original study (Elkin, 2007). The test–retest tives; the K-MSDS relied on the ecological perspective intervals administered to individuals with intellectual dis- (Abery & Stancliffe, 2003), whereas the K-SDS is based on abilities in two cross-cultural studies examined varied 1 to the functional perspective (Wehmeyer, 1996). Therefore, the 3 weeks (Gonzalez-Gordon, Salvador-Carulla, Romero, criterion-related concurrent validity was anticipated as Gonzalez-Saiz, & Romero, 2002; Morin & Cobigo, 2009). related, but may not actually be as high because those scales So a 2-week interval for the study is acceptable. The might measure the different self-determination characteris- K-MSDS showed higher test–retest estimates than the tics of the same individual. MSDS data. These findings provided preliminary support Scores on the K-MSDS (r = .51-.53) were also signifi- for the reliability of the K-MSDS applied to Korean indi- cant predictors of individuals’ scores on the adaptive behav- viduals. The test–retest coefficients were particularly low ior scale (K-SMS). These results validated the previous for the At Work domain, (r = .31). One possible explana- study by Abery, Rudrud, and Arndt (1995) indicating that tion for this, is that participants did not have an opportu- adaptive behavior is closely related to self-determination in nity to use employee’s benefits—such as paid vacations, a individuals with intellectual disabilities (e.g., r = .86-. 89). day off, or task training for new employees—as most indi- Weller, Watteyne, and Herbert (1994) explained that adap- viduals with intellectual disabilities were unemployed tive behavior and self-determination might share common (81.6%; Employment Development of Korean Institute, characteristics, such as making choices without being 2010). Individuals who had been employed were consid- forced, emphasizing individuals’ interests, and modifying ered under-employed compared with those with non- environments based on individual judgments and percep- intellectual disabilities or those without disabilities tions of specific encounters. This study indicated that the (Employment Development of Korean Institute, 2010). K-MSDS was a valid and reliable self-determination mea- Another explanation for this result relates to the difficul- sure when applied to Korean adults with intellectual ties inherent in applying the concept of self-determination disabilities. 8 SAGE Open interventions as stated by Shogren et al. (2008). There was Limitation no self-determination intervention program for adults with This study used a convenient sample consisting of 40 adult disabilities in South Korea. Future studies should focus on individuals who participated voluntarily. This sample was the development of intervention programs for enhancing not representative of all individuals with intellectual disabili- self-determination in Korean adults. The data from the cur- ties in South Korea. Interpretation of results should be rent study identify the needs of individuals who are placed in restricted to this study as generalization to other populations Korean group homes and residential institutions, and sug- cannot be made. Future studies to examine the technical ade- gests the need for designing and implementing intervention quacy of the K-MSDS should extend the sample size of par- programs. ticipants to individuals from a wider variety of age ranges, Additional studies should include the administration of intellectual levels, and residential settings both community- the K-MSDS combined with the Environment Scale (Abery, inclusive and segregated. Stancliffe, Smith, Elkin, & Springborg, 2000b). The The use of the K-SDS adolescent form as the criterion Environment scale was developed for use in combination measure was a limitation of the study. There was no measure with one of the MSDS. Its purpose is to identify environmen- to assess self-determination of adults in South Korea. Even tal features in which the individual lives. This scale was not though there was considerable similarity between the Arc’s included in this study. Use of the Environment scale will pro- SDS, adolescent, and adult forms (Wehmeyer & Kelchner, vide individualized information pertaining to what environ- 1995), there was no Korean study to support the similarity mental features enhance self-determination, which barriers between both adolescent and adult forms of the K-SDS. exist, and how they influence the individuals with The study requires the application of sophisticated statis- disabilities. tical techniques to clarify which environmental variables Future studies will include the exploratory factor analysis, existed and how much they contributed to enhanced levels of given the availability of a larger sample population. This individuals’ self-determination. Stancliffe, Abery, and Smith methodological approach will be more effective for detect- (2000) used path analysis to examine whether there was a ing factor structure and relationships among the factors direct relationship between levels of self-determination and within the theoretically based-measures (i.e., the K-MSDS, various expected environmental predictors. They found four K-SDS). prominent environmental predictors: self-determination skills, autonomy, individualization, and a discretionary use Declaration of Conflicting Interests of money. Another study (Stancliffe, Abery, Springborg, & The author(s) declared no potential conflicts of interest with respect Elkin, 2000) analyzed self-determination scores combined to the research, authorship, and/or publication of this article. with adaptive behavior skills and IQ tests to examine the influences of different substitute decision-making statuses Funding on individuals’ levels of self-determination. This method The author(s) received no financial support for the research and/or was effective for controlling the compound effects because authorship of this article. adaptive behavior and IQ were identified as strongly related to levels of self-determination. These studies provided con- References sistent support for the ecological perspective. Future studies Abery, B. H., McGrew, K., & Smith, J. (1994). ICI Self- propose that the results of this study will be more convincing Determination Opportunities and Exercise Scale. Minneapolis: when combined with the Environment Scale (Abery, University of Minnesota, Research and Training Center on Stancliffe, Smith, Elkin, & Springborg, 2000b). The purpose Community Living and Institute on Community Integration. of the Environment Scale is to identify the environmental Abery, B. H., Rudrud, L., & Arndt, K. (1995). Evaluating a mul- features in which an individual lives. ticomponent program for enhancing the self-determination of Scale brevity may be a concern (Netemeyer et al., 2003). youth with disabilities. Intervention in School and Clinic, 30, The study used relatively long interview protocols with indi- 170-179. Abery, B. H., & Stancliffe, R. J. (2003). An ecological theory of self- viduals with intellectual disabilities. The K-MSDS includes determination: Theoretical foundation. In M. L. Wehmeyer, 270 items and requires approximately 3 hr to be completed. B. H. Abery, D. E. Mithaug & R. J. Stancliffe (Eds.), Theory Participants became less enthusiastic in the interviews as in self-determination: Foundations for educational practices time progressed. It is suggested that low levels of participant (pp. 25-42). Springfield, IL: Charles C Thomas. enthusiasm influenced the results of the study. A shorter Abery, B. H., Stancliffe, R. J., Smith, J. G., Elkin, S. V., & interview period may increase the test–retest reliability. Springborg, H. L. (2000a). Minnesota Self-Determination Scales–Adult Edition. Minneapolis: University of Minnesota, Research and Training Center on Community Living and Implications for Future Studies Institute on Community Integration. Self-determination measures are used for developing, imple- Abery, B. H., Stancliffe, R. J., Smith, J. G., Elkin, S. V., & Springborg, H. L. (2000b). Minnesota Self-Determination menting, and evaluating the effect of self-determination Cho 9 Scales: Self-Determination—Environment Scale. Minneapolis: Korean Department of Education & Human Resources University of Minnesota, Research and Training Center on Development. (2003). Korean special education development Community Living and Institute on Community Integration. planning for five years (2003-2007). Seoul, South Korea. Bang, M. Y. (2000). Instruction on self-determination skills as Lee, S. H., & Wehmeyer, M. L. (2003). A review of the Korean transition support strategies for students with disabilities. The literature related to self-determination: Future directions and Korean Journal of Special Education, 34(3), 27-48. practices for promoting the self-determination of students with Berry, O. (1995). Families and deinstitutionalization: An applica- disabilities. The Korean Journal of Special Education, 38, tion of Bronfenbrenner’s social ecological model. Journal of 369-390. Counseling & Development, 73, 379-384. Luckasson, R., Bothwick-Duffy, S., Buntinx, W., Coulter, D., Crag, Brislin, R. W. (1986). The wording and translation of research E., . . . Tassé, M. (2002). Mental retardation: Definition, clas- instruments. In W. J. Lonner & J. W. Berry (Eds.), Field meth- sification, and systems of supports (10th ed.). Washington, DC: ods in cross-cultural research (pp. 137-164). Beverly Hills, American Association on Mental Retardation. CA: SAGE. Morin, D., & Cobigo, V. (2009). Reliability of the Support Brislin, R. W., Lonner, W. J., & Thorndike, R. M. (1973). Cross Intensity Scale (French version). Intellectual & Developmental cultural research methods: Comparative studies in behavioral Disabilities, 47, 24-30. sciences. New York, NY: A Wiley-Intersection Publication. Netemeyer, R. G., Bearden, W. O., & Sharma, S. (2003). Scaling Bronfenbrenner, U. (1979). The ecology of human development: procedure. Thousand Oaks, CA: SAGE. Experiments by nature and design. Cambridge, MA: Harvard Park, H. O. (2006). The effect of decision-making program on the University Press. self-assertion and self-determination skills of students with Cho, J. (2009). A validation study of the Korean Version of the developmental disabilities. The Korean Journal of Special Minnesota Self-Determination Scales (K-MSDS) for adults Education & Rehabilitation Science, 45(1), 41-57. with intellectual disabilities (Unpublished doctoral thesis). Park, S. W., & Kim, Y. W. (2004).The comparison of self-deter- University of Minnesota, Minneapolis. mination and quality of life on type of disability and age of Claes, C., Van Hove, G., Vandevelde, S., Loon, J., & Schalock, students with special learning needs. The Korean Journal of R. (2012). The influence of supports strategies, environmental Special Education: Theory and Practices, 5(4), 251-270. factors, and client characteristics on quality of life-related per- Rhyou, S. R. (2003). Development of a program for self-deter- sonal outcomes. Research in Developmental Disabilities, 33, mination activity and effects of the program on the level of 96-103. self-determination for students with mild disabilities in transi- Cronbach, L. J. (1951). Coefficient alpha and the internal structure tion period. The Korean Journal of Special Education, 38(1), of tests. Psychometrika, 31, 93-96. 161-181. Elkin, S. V. (2007). Investigation of the Minnesota self-determi- Schneidert, M., Hurst, R., Miller, J., & Üstün, B. (2003). The role of nation index for use with adults with intellectual disabilities: environment in the International Classification of Functioning, Support for the tripartite ecological model of self-determina- Disability and Health (ICF). Disability and Rehabilitation, 25, tion (Unpublished doctoral thesis). University of Minnesota, 588-595. Minneapolis. Shogren, K. A., Wehmeyer, M. L., Palmer, S. B., Soukup, J. H., Employment Development of Korean Institute. (2010). The Panel Little, T. D., Garner, N., & Lawrence, M. (2008). Understanding Survey of Employment for the Disabled (2008). Kyunggi-Do, the construct of self-determination, Examining the relationship South Korea. between the Arc’s Self-Determination Scale and the American Gonzalez-Gordon, R. G., Salvador-Carulla, L., Romero, C., institutes for research self-determination scale. Assessment for Gonzalez-Saiz, F., & Romero, D. (2002). Feasibility, reliability Effective Intervention, 33, 94-107. and validity of the Spanish version of psychiatric assessment Stancliffe, R. J. (1997). Community living-unit size, staff pres- schedule for adults with developmental disabilities: A struc- ence, and residents’ choice-making. Mental Retardation, 35, tured psychiatric interview for intellectual disability. Journal 1-9. of Intellectual Disability Research, 46, 209-217. Stancliffe, R. J., & Abery, B. H. (1997). Longitudinal study of Kim, E., & Kim, D. (2005).The effect of self-determination on grad- deinstitutionalization and the exercise of choice. Mental uation and employment outcome for the high school students Retardation, 35, 159-169. with disabilities. The Korean Journal of Special Education, Stancliffe, R. J., Abery, B. H., & Smith, J. (2000). Personal control 39(4), 25-41. and the ecology of community living settings: Beyond living- Kim, E., & Kim, D. (2006).The effect of self-determination on the unit size and type. American Journal on Mental Retardation, transition outcomes and the career decision of the special class 105, 431-454. students with disabilities in regular high schools. The Korean Stancliffe, R. J., Abery, B. H., Springborg, H., & Elkin, S. (2000). Journal of Special Education, 41(1), 283-306. Substitute decision-making and personal control: Implications Kim, J. K., Cho, I. S., Moon, T. H., & Kim, H. K. (2001). for self-determination. Mental Retardation, 38, 407-421. Korean Version of Self-Determination Scale. Daegu, South Thompson, J. R., Tasse, M. L., & McLaughlin, C. A. (2008). Inter- Korea: Rehabilitation Science Research Center of Daegu rater reliability of the Support Intensity Scale (SIS). American University. Journal on Mental Retardation, 113, 231-237. Kim, S., & Kim, O. (1998). The Korean Social Maturity Scale. Wehmeyer, M. L. (1996). Student self-report measure of self-deter- Seoul, South Korea: Joong-AngJok Song Publishing. mination for students with intellectual disabilities. Education 10 SAGE Open and Training in Mental Retardation and Developmental mental retardation and developmental disabilities. American Disabilities, 31, 282-293. Journal on Mental Retardation, 100, 632-642. Wehmeyer, M. L. (1998). Self-determination and individuals with Weller, C., Watteyne, L., & Herbert, M. (1994).Adaptive behavior significant disabilities: Examining meanings and misinter- of adults and young adults with learning disabilities. Learning pretations. Research and Practices for Persons With Severe Disability Quarterly, 17, 282-295. Disabilities, 23, 5-16. Zhang, D. (2005). Parent practices in facilitating self-determination Wehmeyer, M. L., & Bolding, N. (2001). Enhanced self-determination skills: The influences of culture, socioeconomic status, and of adults with intellectual disability as an outcome of moving children’s special education status. Research & Practices for to community-based work or living environments. Journal of Persons With Severe Disabilities, 30, 154-162. Intellectual Disability Research, 45, 371-383. Wehmeyer, M. L., & Kelchner, K. (1995).The Arc’s Self- Author Biography Determination Scale. Arlington, TX: Arc National Headquarters. Wehmeyer, M. L., Kelchner, K., & Richards, S. (1996).Essential Jaehyun Cho, PhD, is an Instructor in Department of Education, characteristics of self-determined behaviors of individuals with Chonbuk National University. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png SAGE Open SAGE

A Preliminary Validation Study of the Korean Version of the Minnesota Self-Determination Scales for Adults With Intellectual Disabilities:

Cho, Jaehyun
SAGE Open , Volume 4 (1): 1 – Jan 30, 2014
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Abstract

The Minnesota Self-Determination Scale (MSDS) was translated into Korean. The Korean version was then validated using a sample of 40 individuals with intellectual disabilities between the ages of 19 and 45 years, the legal age of adults in South Korea. The evidence of the reliability and validity was examined. The test–retest was good (.84-.94). The internal consistency was excellent (.96-.99). The construct validity with other Korean translated self-determination measure (K-SDS) was acceptable (.50-.51). The findings indicated that the K-MSDS was an appropriate measure with acceptable psychometric properties. The Korean version was the first self-determination measure for adults with disabilities. Keywords special education, education, social sciences, intellectual and developmental disabilities, rehabilitation, self-determination, measurement Recently, there has been considerable emphasis placed on are parents, siblings, and service providers of the individuals. the role of environmental supports in defining the concept of Abery and Stancliffe (Stancliffe, 1997; Stancliffe & Abery, disability. The International Classification of Functioning, 1997; Stancliffe, Abery, & Smith, 2000) closely examined Disability, and Health (ICF) defines disability as the com- the relationship between individual levels of self-determina- plex outcome between a person’s health condition and envi- tion and residential environment occurring at the micro-sys- ronmental factors, which include social, physical, and policy tem levels of the ecological perspective. The residential supports (Schneidert, Hurst, Miller, & Üstün, 2003). This environment examined in those studies included staff emphasis on the role of environment corresponds to the arrangement, residence size, number of residents, and resi- socio-ecological perspective of Bronfenbrenner (1979), who dence location. Another study by Wehmeyer and Bolding views human development as the evolving interaction (2001) examined the effects that transitioning from institu- between the person and environment (recited in Berry, 1995). tionalization to community residences had on self-determi- The socio-ecological perspective holds that successful out- nation in adults with severe intellectual disabilities. The comes in human functioning may depend more on the match results of this study were consistent with those of the previ- between individuals and their environments than on individ- ous study by Stancliffe and Abery (1997). They found sig- ual personal characteristics alone (Thompson, Tasse, & nificant improvement in the areas of self-determination, McLaughlin, 2008). As such, a disability is heavily influ- autonomy, and choice-making in adults with severe intellec- enced not only by internal traits but also by the varied sup- tual disabilities after they moved from more restrictive resi- ports that enable an individual to function in the environment dential institutions to less restrictive community residences. (Claes, Van Hove, Vandevelde, Loon, & Schalock, 2012). Stancliffe, Abery, Springborg, and Elkin (2000) also exam- Environmental support in this context is defined as the over- ined the effect of substitute decision-making (e.g., a legal riding “resources and strategies that aim to promote the guardianship or conservatorship) on the personal control of development, education, interests, and personal wellbeing of adults with intellectual disabilities at the macro-system level. a person and that enhance individual functioning” (Luckasson et al., 2002, p.145). Obtaining information about the indi- Chonbuk National University, Jeonju City, South Korea vidual and the environment is a critical starting point which Corresponding Author: enables the individual to benefit from socio-ecological per- Jaehyun Cho, PhD, Dept. of Education, Chonbuk National University, spective, because of the inability and limitation the individ- Baekjedaero 567, Jeonju City, 561-756, South Korea. ual has. The primary sources of these environmental supports Email: saehim1@gmail.com 2 SAGE Open The results demonstrated that adults without any substitute with severe disabilities. Notably, the Korean version of the decision makers exercised significantly higher levels of per- Minnesota Self-Determination Scale (K-MSDS) was the first sonal control than those with a conservator or a guardian. instrument designed to assess self-determination of Korean However, there was no assessment conducted to systemi- adults through the socio-ecological perspective. cally identify which facilitators and barriers existed, and examined how they influenced the individuals with disabili- The Purpose of the Study ties either at the micro- or at the macro-system levels in South Korea (Cho, 2009). The purpose of this study was to examine whether a trans- lated Korean version of the MSDS, the K-MSDS, might be valid when applied to a Korean population. The original Problems scales were invented to measure adults with developmental Since 2000, significant efforts have been made in South disabilities (Abery, Stancliffe, Smith, Elkin, & Springborg, Korea toward the development of self-determination skills in 2000a). The measures were incorporated from the construct individuals with disabilities have. These efforts have included of an ecological model of self-determination (Abery & development of interventional programs (Bang, 2000; Stancliffe, 2003). H. O. Park, 2006; Rhyou, 2003), and examination of out- comes related to an individual’s self-determination level after Research Questions participating in these programs (E. Kim & Kim, 2005, 2006; S. W. Park & Kim, 2004). Shogren et al. (2008) asserted that Research Question 1: Does the K-MSDS yield adequate self-determination measures should be used to develop, test–retest reliability correlations in an adult sample from implement, and evaluate the effect of self-determination three Korean group homes and a residential institution at interventions on individuals with disabilities. Unfortunately, two different points in time? the development of norm-referenced and standardized mea- Research Question 2: Does the K-MSDS yield accept- sures of self-determination for individuals with disabilities able internal consistency coefficients in an adult sample which report acceptable psychometric properties has been from three Korean group homes and a residential very limited in South Korea. Since 2000, three self-determi- institution? nation measures have been translated into Korean (Cho, Research Question 3: To what extent is there correlation 2009). However, only one of these measures included discus- between the K-MSDS and the K-Arc’s SDS (K-SDS) in sion of psychometric properties and contained a standardized constructing self-determination? sample that matched the recent South Korea census in terms of gender, age, family socio-economic status, and regional Method representation (J. K. Kim, Cho, Moon, & Kim, 2001). The second problem identified was the lack of self-deter- Participants and Setting mination measures developed for adults in South Korea. Most measures privileged the evaluation of self-determina- Participants included 40 adults with intellectual disabilities tion of secondary students with intellectual disabilities, and residing in three group homes and one residential institution focused less on the importance of promoting and measuring in an urban area of South Korea. The gender breakdown of self-determination in both young children and adults (Lee & this sample was 24 males (60%) and 16 females (40%). The Wehmeyer, 2003). However, the ultimate goal of special age of participants was restricted to 19 or over, because the education in South Korea is to promote the full inclusion of MSDS was originally developed for use with adults. Mean students with disabilities (Korean Department of Education age was 31.5 years (SD = 6.36, range = 20-42). The ethnicity & Human Resources, 2003). Considering that self-determi- of the participants was Pacific Islander (Koreans). Of the nation is a developmental process intended to increase participants, 28 were recruited from one residential institu- autonomy over the course of one’s life span (Abery & tion and 12 were recruited from three group homes the direc- Stancliffe, 2003; Wehmeyer, 1998), it was valuable for any tors of which agreed to participate in the study. self-determination measure to account for the changes that Participants lived in three different residential settings: adults undergo as they age. (a) group homes, (b) pre-group homes, and (c) a residential The final problem pertained to the limited perspectives of institution. Twelve (n = 12) participants resided in three existing measures of self-determination of individuals with dis- group homes that provided semi-independent living services abilities. There were no self-determination measures represent- in integrated community settings. Unmarried participants ing the socio-ecological perspective. Considering that the shared a room with two to three other residents. Married par- nature of disability can be understood as an intersection ticipants lived with their own family members in the group between a person’s capacities and the context in which that per- homes. Twelve (n = 12) participants lived in “pre-group son lives, it was valuable to explore the role of environmental home buildings” located within the residential institution, supports in improving the self-determination of individuals but segregated from the community. The “pre-group home Cho 3 Table 1. Characteristics of Persons Assessed. the primary causal agent in his or her life. The primary causal agent was based on four functional characters of behavior: Demographic variables % (a) autonomy, (b) self-regulation, (c) self-realization, and Gender (d) psychological empowerment. Thus, the model developed Male 60 by Wehmeyer et al. (1996) was called the functional model. Female 40 The measure assesses these four self-determination areas. Age Abery and Stancliffe (2003) proposed an ecological 40< 10 model of self-determination based on the work of 31-40 58 Bronfenbrenner (1979). They defined self-determination as 21-30 32 the degree of personal control which one wishes to exercise <19 0 over those areas he or she considers important. They present IQ range personal control as heavily influenced by the interaction 51-75 60 between individuals and their environments. Thus, the role 40-50 27 of environmental supports was emphasized in the ecological <40 3 model. Abery and Stancliffe’s (2003) measure assesses the Missing data 10 eight environmental support areas. Some examples of these Adaptive Behavior Deficit supports include home, leisure activities, friends, health, and 16-20 63 work (Abery et al., 2000a). 11-15 6-10 17 <6 10 Measures Missing data 10 The Arc’s Self-Determination Scale (SDS; Wehmeyer & Disability category Kelchner, 1995) was developed to measure the self-determi- ID only nation of both secondary students and adults. This measure Other disabilities to ID 100 was comprised of two forms: an adult and an adolescent Language disorder 30 Physical disability 20 form, both of which share the same content. The adult form Psychiatric disorder 50 was adapted from the adolescent form (Wehmeyer, 1996). Ethnicity The internal consistency coefficient (Cronbach’s α) was .90. Pacific Islander (Koreans) 100 The Korean version of Arc’s Self-Determination Adolescent Living arrangement Scale (K-SDS) was developed by Kim, Cho, Moon, and Kim Group-home 5 (2001). The K-SDS was normed on 710 Korean adolescents Pre-group-home 53 with and without disabilities. The internal consistency was .95 Residential institution 42 in the Cronbach’s α (J. K. Kim et al., 2001). Primary employment Construct validity was established through a confirmatory Competitive 5 factor analysis which identified the consistent factors between Supported 53 K-SDS (J. K. Kim et al., 2001) and the SDS measure Sheltered 42 (Wehmeyer & Kelchner, 1995). The psychometric properties Unemployed 0 of the measure were established by administering it to sec- ondary students with intellectual disabilities. The internal ID = Individual disability. Physical disability = Cerebral palsy. consistency (Cronbach’s α) ranged between .92 and .95 across Psychiatric disorder = Epilepsy. the four Korean studies. The K-SDS was used for this study. The MSDS (Abery et al., 2000a) were invented to measure self-determination of an adult in light of the effects of certain buildings” were created to prepare individuals for the transi- environmental factors. The MSDS consisted of three sub- tion to living in an integrated community. Sixteen (n = 16) scales. These subscales included (a) Exercise of Control, participants resided in one residential institution which pro- (b) Decision-Maker Preference, and (c) Importance of Control. vided 24-hr supervised services. These individuals lived in Each subscale included 90 items, grouped into eight domains, four-person rooms segregated from the community. Table 1 which used a 3-point scale system to evaluate the levels of provides additional demographic information regarding the self-determination of the individual. Item questionnaires for participants in this study. the three scales shared the same content, with variation occur- ring only in initial statements, such as “How much do you care Structure of Self-Determination Construct about . . .” on the Important scale, “Who decides . . .” on the Exercise Control scale, and “Who do you want to decide . . .” Wehmeyer, Kelchner, and Richards (1996) proposed a func- on the Decision-Preference scale. The MSDS included both a tional model of self-determination. They defined self-determi- self-reporting adult form and a proxy reporting residential nation as the attitudes and abilities of the individual to act as 4 SAGE Open staff form, which share the same content. The proxy forms Nine culturally inappropriate items were identified by the were used for this study (Abery et al., 2000a). The test–retest panel on the first translated version and replaced with modi- (Pearson’s r) ranged between .74 and .87. The internal consis- fied items applicable to Korean institutions serving individu- tency coefficient (Cronbach’s α) ranged between .88 and .92 als with intellectual disabilities. for the self-reporting scales (Elkin, 2007). Changes in the questionnaires were identically applied to the three subscales, as they shared the same content. The con- tent replaced on the questionnaires was comprised of five Procedures items pertaining to the Plans domain, two items from the The investigator obtained two types of consents; a signed Support Money domain, and two items from the Support Staff and an oral consent form. Signed consent forms were domain. For example, the phrase transition planning meeting obtained from directors of the residential institution and in the Plans domain was replaced with “a personal discussion three group homes, and legal guardians of the participants with peer or family member,” as transition planning meetings who did not have families and relatives. Oral consent forms did not occur in South Korea. The phrase “hiring or paying were obtained from participants (i.e., residents with intellec- the service staff” in the Support Staff domain was replaced tual disabilities). Written consent was waived for participants with “saving money for necessity” and “buying something for who were not able to read the forms. The consent document the necessity” in the K-MSDS, as individuals who resided in was communicated orally by a member of the research team. the group homes and residential institution were not able to Each participant was informed that participation in the study hire or pay the service staff in South Korea. Table 2 provides was voluntary and could be terminated at any time. sample updated items recommended by the panel. Both the first and second translated Korean versions were pretested with five individuals with intellectual disabilities. Translation and Back Translation The individuals better understood questionnaires in the sec- The translation–back translation technique (also known as ond translated version. The second translated Korean version retranslation) was used to ensure equivalence on the scale was used for this study between different cultures (Brislin, 1986; Brislin & Thorndike, 1972). The investigator of this study, who was fluent in both Administrations Korean and English, translated the MSDS into Korean. The Korean version was then retranslated into English by a Korean Interviews were administered by six volunteers enrolled in an doctoral student majoring in English Literature at the graduate undergraduate special education program in South Korea. school level, and fluent in both Korean and English. The two The interviewers completed a one-day training workshop versions were compared by translation checkers—two other (6 hr) to acquire specific information regarding the protection doctoral students in English literature programs at the same of participants’ privacy, practices and policies in the institu- school—who were also fluent in both Korean and English. tions, and procedures for administering the measures used in These checkers were asked to rate how well the items on the the study. Each of the interviewers had an opportunity to prac- two versions of the MSDS aligned to the following criteria: tice the interviewing process through role-playing various (a) linguistic likeness (e.g., word-to-word correspondence case studies. In addition, the investigator of this study leaded between English and Korean) and (b) content agreement (e.g., two discussion sessions with interviewers to assess their com- delivery of the meanings from English to Korean. The trans- petence regarding the process of data collecting activities. The lated-retranslated items were rated using a 5-point Likert-type discussion sessions each lasted for 2 hr and were first held scale (1-5 points). The items that received ratings equal or immediately after participants began to conduct interviews greater than a point of 4 on both criteria were retained. Items and, again, later on in the process of conducting interviews. that received ratings equal to or lower than a point of 3 on both criteria were discarded for later retranslations. Results Procedure Test-Retest and Internal Consistency Face validity of the second Korean version of the MSDS was Test–retest reliability (Pearson’s r) was computed between rated by a Korean panel of three residential staff members the first and second administrations of the K-MSDS by the who served individuals with intellectual disabilities. Among same interviewers with the same respondents. The time panel participants, the mean number of years serving intel- interval between the two administrations was approximately lectual disabilities was 14 (SD = 6.36, range = 7-21). All par- 2 weeks (M = 14 days, SD = 2 days). Test–retest reliability ticipants were certificated social workers. The panel members coefficients were (r = .94) for the Preference, (r = .89) for the were asked to rate how well the translated Korean items cor- Importance and (r = .84) for the Personal Control Scales. All responded to institutional policies and practices in group scale scores on the three scales were significant at the homes for adults with intellectual disabilities in South Korea. p < .001 levels (two-tailed). Test–retest reliability analyses Cho 5 Table 2. Comparisons of the Original Items and Modified Items of the K-MSDS. Domain Item no. Content Plan 01 A. Who do you want to decide which people attend the meeting? B. Who do you want to decide whom do you want to discuss your dream or life goals? C. There is no transitional plan meeting to discuss individual’s dreams or goals in South Korea. 07 A. Who do you want to decide to hire the staff members that work with you at home? B. Who do you want to save money for something necessary for you at home? C. It is impossible for the individuals to hire the staff in Korean institutions. 08 A. Who do you want to decide how much your staff is paid? B. Who do you want to buy something necessary for you at home? C. It is impossible for the individuals to hire or to pay for service providers in Korean institutions? Staff 01 A. Who do you want to decide if your staff is doing a good job? B. Who do you want to decide if your staff benefits your life at home? C. It is very seldom for the individuals to assess the service quality of their staff in Korean institutions. 02 A. Who do you want to decide what to do when your staff is NOT doing a good job? B. Who do you want to decide whether you are satisfied with staff’s support? C. It is very seldom for the individuals to assess the service quality of their staff in Korean institutions. Note. K-MSDS = Korean Version of the Minnesota Self-Determination Scale; A = original statement; B = modified statement; C = brief reasons. Table 3. Reliability Coefficients (Pearson’s r) and Internal were also conducted for the domain scores. Test–retest coef- Consistency (Cronbach’s α) Across Domains in the K-MSDS. ficients were strong between domain scores with the excep- tion of two domains. K-MSDS The internal consistency was analyzed for each of the Preference Importance Personal Control Preference, Importance, and Personal Scales using Cronbach’s α (Cronbach, 1951). Each of these scales demon- Domains r α r α r α strated a strong internal consistency: Preference (.99), Importance (.99), and Personal control (.96) scales. The Home .97 .97 .96 .95 .95 .95 internal consistency was also analyzed for the domains Leisure .84 .90 .61 .86 .78 .88 within the three scales. Test–retest and internal consistency Friends .61 .90 .59 .86 .68 .89 correlations of K-MSDS are presented in Table 3. Health .91 .96 .68 .96 .87 .93 At work .88 .96 .85 .95 .31 .73 Plan .84 .96 .87 .97 .77 .89 Convergent Validity Money .91 .97 .93 .96 .72 .72 Criterion-related concurrent validity of the K-MSDS was Staff .80 .97 .83 .97 .34 .66 examined using K-SDS (Kim, Cho, Moon, & Kim, 2001) as a Total .94 .99 .89 .99 .84 .98 criterion measure. Pearson correlations (Pearson’s r) were Note. K-MSDS = Korean Version of the Minnesota Self-Determination computed between scores on the K-MSDS and on the K-SDS. Scale; α = Cronbach’s α (Cronbach, 1951). The K-MSDS and the K-SDS appear to assess similar con- **Correlation is significant at the .01 level (two-tailed). structs. Preference (r = .53), Importance (r = .52), and Personal Control (r = .51) Scales were correlated with the K-SDS. Scores on the K-MSDS also significantly correlated with Table 4. Descriptive Statistics and Correlation Matrix for K-SDS scores on the K-SMS, (Social Maturity Scale; S. Kim & Kim, and K-MSDS. 1998), an adaptive behavior scale (p < .001, two-tailed). Personal Preference (r = .53), Importance (r = .52), and Personal Control Scales M SD Preference Importance control (r = .53) scales were correlated with the K-SMS. Pearson’s K-SDS 82.1 14.9 .51** .51** .51** correlations between the K-MSDS and K-SDS are shown in Preference 188.7 39.1 — .97** .92** Table 3. Also, correlations between K-SDS and K-MSDS Importance 190.3 37.7 — — .92** including the subscales are presented in Tables 4 to 7. Personal control 182.3 22.3 — — — Discussion Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination One of the aims of this study was to examine the reliability Scale. **Correlation is significant at the .01 level (two-tailed). and validity of a Korean K-MSDS. Overall, the results 6 SAGE Open Table 5. Descriptive Statistics and Correlations for the Sub-Scales on K-SDS and for the Domains on Preference Scale. Subscales M SD 2 3 4 5 6 7 8 9 10 11 1. AUT (K-SDS) 53.2 10.5 .51** .66** .57** .60** .60** .60** .55** .56** .52** .51** 2. PSYE (K-SDS) 3.2 1.0 — .50** .34* .41** .44** .40** .40** .32 .36 .39** 3. SREA (K-SDS) 25.6 5.0 — — .19 .21 .29 .17 .14 .15 .11 .12 4. Home (K-MSDS) 39.7 8.0 — — — .92** .86** .90** .88** .94** .95** .94** 5. Leisure (K-MSDS) 23.1 3.7 — — — — .91** .83** .85** .91** .89** .92** 6. Friend (K-MSDS) 23.3 4.2 — — — — — .74** .75** .84** .81** .82** 7. Health (K-MSDS) 21.7 4.4 — — — — — .— .91** .93** .92** .89** 8. Work (K-MSDS) 21.0 4.6 — — — — — — — .87** .86** .86** 9. Plan (K-MSDS) 20.2 5.2 — — — — — — — — .97** .96** 10. Money (K-MSDS) 17.6 6.3 — — — — — — — — — .96** 11. Staff (K-MSDS) 21.9 4.4 — — — — — — — — — — Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination Scale; AUT = Autonomy; PSYE = Psychological Empowerment; SREA = Self-Realization as measured by K-SDS. **Correlation is significant at the .01 level (two-tailed). Table 6. Descriptive Statistics and Correlations for the Sub-Scales on K-SDS and for the Domains on Importance Scale. Subscales M SD 2 3 4 5 6 7 8 9 10 11 1. AUT (K-SDS) 53.2 10.5 .51** .66** .57** .56** .62** .62** .46** .52** .59** .48** 2. PSYE (K-SDS) 3.2 1.0 — .51** .33* .41** .48** .44** .40** .44** .42** .42** 3. SREA (K-SDS) 25.6 5.0 — — .15 .17 .39** .26 .15 .21 .23 .10 4. Home (K-MSDS) 39.6 6.9 — — — .83** .73** .93** .92** .91** .93** .86** 5. Leisure (K-MSDS) 22.9 3.5 — — — — .78** .84** .84** .88** .87** .87** 6. Friend (K-MSDS) 23.2 3.8 — — — — — .70** .73** .73** .73** .71** 7. Health (K-MSDS) 22.3 4.5 — — — — — — .92** .94** .96** .89** 8. Work (K-MSDS) 21.0 4.1 — — — — — — —. .94** .95** .91** 9. Plan (K-MSDS) 20.7 5.5 — — — — — — — — .97** .95** 10. Money (K-MSDS) 18.3 6.6 — — — — — — — — — .94** 11. Staff (K-MSDS) 21.8 5.1 — — — — — — — — — — Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination Scale; AUT = Autonomy; PSYE = Psychological empowerment; SREA = Self-realization as measured by K-SDS. **Correlation is significant at the .01 level (two-tailed). Table 7. Descriptive Statistics and Correlations for the Sub-Scales on K-SDS and for the Domains on Personal Control Scale. Subscales M SD 2 3 4 5 6 7 8 9 10 11 1. AUT (K-SDS) 53.2 10.5 .51** .66** .62** .60** .59** .58** .03 .35 .38 −.13 2. PSYE (K-SDS) 3.2 1.0 — .50** .41** .35 .38** .26 .18 .48** .31 −.23 3. SREA (K-SDS) 25.6 5.0 — — .24 .18 .29 .26 −.03 .19 .20 −.27 4. Home (K-MSDS) 39.9 7.0 — — — .88** .81** .82** .25 .66** .51** −.13 5. Leisure (K-MSDS) 23.0 3.6 — — — — .82** .71** .23 .57** .48** .11 6. Friend (K-MSDS) 23.4 4.0 — — — — —. .71** .30 .65** .61** .11 7. Health (K-MSDS) 21.2 3.3 — — — — — — .35 .73** .63** −.03 8. Work (K-MSDS) 18.2 2.8 — — — — — — —. .63** .67** .15 9. Plan (K-MSDS) 18.3 3.3 — — — — — — — — .78** −.10 10. Money (K-MSDS) 19.7 2.4 — — — — — — — — — .10 11. Staff (K-MSDS) 18.6 2.2 — — — — — — — — — — Note. K-SDS = Korean version of Arc’s Self-Determination Adolescent Scale; K-MSDS = Korean Version of the Minnesota Self-Determination Scale; AUT = Autonomy; PSYE = Psychological empowerment; SREA = Self-realization as measured by K-SDS. **Correlation is significant at the .01 level (two-tailed). Cho 7 demonstrated that the K-MSDS had good psychometric to different cultures. Asian cultures, such as those in Korea properties for validity, internal consistency, and test–retest and Japan, emphasize family values and relationships reliability. However, this study did not further explore the among community members differently from Anglo- possible effects of environmental characteristics—residence European cultures that value individualism (Zhang, 2005). size and type, guardianship status of adults with intellectual Because of existing cultural norms, it could be difficult for disabilities, and the characteristics of staff who serve in com- individuals to request a change in their scheduled lunch munity-based settings—combined with MSDS, examined in time or to express preferences for certain types of work. previous studies (Stancliffe, Abery, & Smith, 2000; They may express hesitancy communicating their own Stancliffe, Abery, Springborg, & Elkin, 2000). Also, because opinions on first or second responding, as they fear break- adults with intellectual disabilities do not retain any legal ing agency policy or losing better benefits by challenging rights as independent decision makers in South Korea, we collective decisions. were not able to examine the effects of possible substitute Internal consistency for the K-MSDS ranged from .96 to decisions made by these adults, and, therefore, could not .99. These results were corroborated by the previous results make comparisons with previous studies. for the original MSDS administered by Elkin (2007), which The items on the MSDS were adapted from the Institute ranged from .88 to .92. These results indicated that K-MSDS on Community Integration Self-Determination Opportunities was an internally consistent measure across all the three and Exercise Scale (ICI-SDOES; Abery, McGrew, & Smith, scales. However, we did not conduct a study examining how 1994, as cited by Abery & Stancliffe, 2003). Family, teach- well the original MSDS scales were translated to other lan- ers, and staff who served children with disabilities were guages and cultures. Thus, we could not compare the inter- involved as members of an advisory panel during the devel- nal consistency values of this study with those of other opment of the MSDS. In contrast, only the staff serving foreign language and culture-based translated versions of adults with intellectual disabilities participated as panel the MSDS. An additional concern involved the use of the members of the K-MSDS. Thus, items on the K-MSDS were coefficient—as the number of items increased, Cronbach’s restricted to reflect the opinions of the individuals with dis- alpha tended to inflate (Netemeyer, Bearden, & Sharma, abilities and their residential service providers. For a wider 2003). application of the K-MSDS beyond individuals with intel- The criterion-related validity of the K-MSDS was evalu- lectual disabilities who lived in community-segregated resi- ated by examining the relationship between the K-MSDS dential settings, more stake-holders such as family, teachers, and K-SDS. The associations between the two measures and service providers in community-inclusive settings are were moderate. The validity coefficients were .50, .50, and recommended to participate as panel members. .51 for the three scales of the K-MSDS and the K-SDS. The test–retest coefficients ranged from .84 to .94 for These results provided preliminary support for the use of the the K-MSDS scales. The test–retest intervals (M = 14 days, measures with Korean individuals. These two measures of SD = 2 days) were similar to those (M = 16 days, SD = 6 self-determination provided different theoretical perspec- days) of the original study (Elkin, 2007). The test–retest tives; the K-MSDS relied on the ecological perspective intervals administered to individuals with intellectual dis- (Abery & Stancliffe, 2003), whereas the K-SDS is based on abilities in two cross-cultural studies examined varied 1 to the functional perspective (Wehmeyer, 1996). Therefore, the 3 weeks (Gonzalez-Gordon, Salvador-Carulla, Romero, criterion-related concurrent validity was anticipated as Gonzalez-Saiz, & Romero, 2002; Morin & Cobigo, 2009). related, but may not actually be as high because those scales So a 2-week interval for the study is acceptable. The might measure the different self-determination characteris- K-MSDS showed higher test–retest estimates than the tics of the same individual. MSDS data. These findings provided preliminary support Scores on the K-MSDS (r = .51-.53) were also signifi- for the reliability of the K-MSDS applied to Korean indi- cant predictors of individuals’ scores on the adaptive behav- viduals. The test–retest coefficients were particularly low ior scale (K-SMS). These results validated the previous for the At Work domain, (r = .31). One possible explana- study by Abery, Rudrud, and Arndt (1995) indicating that tion for this, is that participants did not have an opportu- adaptive behavior is closely related to self-determination in nity to use employee’s benefits—such as paid vacations, a individuals with intellectual disabilities (e.g., r = .86-. 89). day off, or task training for new employees—as most indi- Weller, Watteyne, and Herbert (1994) explained that adap- viduals with intellectual disabilities were unemployed tive behavior and self-determination might share common (81.6%; Employment Development of Korean Institute, characteristics, such as making choices without being 2010). Individuals who had been employed were consid- forced, emphasizing individuals’ interests, and modifying ered under-employed compared with those with non- environments based on individual judgments and percep- intellectual disabilities or those without disabilities tions of specific encounters. This study indicated that the (Employment Development of Korean Institute, 2010). K-MSDS was a valid and reliable self-determination mea- Another explanation for this result relates to the difficul- sure when applied to Korean adults with intellectual ties inherent in applying the concept of self-determination disabilities. 8 SAGE Open interventions as stated by Shogren et al. (2008). There was Limitation no self-determination intervention program for adults with This study used a convenient sample consisting of 40 adult disabilities in South Korea. Future studies should focus on individuals who participated voluntarily. This sample was the development of intervention programs for enhancing not representative of all individuals with intellectual disabili- self-determination in Korean adults. The data from the cur- ties in South Korea. Interpretation of results should be rent study identify the needs of individuals who are placed in restricted to this study as generalization to other populations Korean group homes and residential institutions, and sug- cannot be made. Future studies to examine the technical ade- gests the need for designing and implementing intervention quacy of the K-MSDS should extend the sample size of par- programs. ticipants to individuals from a wider variety of age ranges, Additional studies should include the administration of intellectual levels, and residential settings both community- the K-MSDS combined with the Environment Scale (Abery, inclusive and segregated. Stancliffe, Smith, Elkin, & Springborg, 2000b). The The use of the K-SDS adolescent form as the criterion Environment scale was developed for use in combination measure was a limitation of the study. There was no measure with one of the MSDS. Its purpose is to identify environmen- to assess self-determination of adults in South Korea. Even tal features in which the individual lives. This scale was not though there was considerable similarity between the Arc’s included in this study. Use of the Environment scale will pro- SDS, adolescent, and adult forms (Wehmeyer & Kelchner, vide individualized information pertaining to what environ- 1995), there was no Korean study to support the similarity mental features enhance self-determination, which barriers between both adolescent and adult forms of the K-SDS. exist, and how they influence the individuals with The study requires the application of sophisticated statis- disabilities. tical techniques to clarify which environmental variables Future studies will include the exploratory factor analysis, existed and how much they contributed to enhanced levels of given the availability of a larger sample population. This individuals’ self-determination. Stancliffe, Abery, and Smith methodological approach will be more effective for detect- (2000) used path analysis to examine whether there was a ing factor structure and relationships among the factors direct relationship between levels of self-determination and within the theoretically based-measures (i.e., the K-MSDS, various expected environmental predictors. They found four K-SDS). prominent environmental predictors: self-determination skills, autonomy, individualization, and a discretionary use Declaration of Conflicting Interests of money. Another study (Stancliffe, Abery, Springborg, & The author(s) declared no potential conflicts of interest with respect Elkin, 2000) analyzed self-determination scores combined to the research, authorship, and/or publication of this article. with adaptive behavior skills and IQ tests to examine the influences of different substitute decision-making statuses Funding on individuals’ levels of self-determination. 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Journal

SAGE Open – SAGE

Published: Jan 30, 2014

Keywords: special education; education; social sciences; intellectual and developmental disabilities; rehabilitation; self-determination; measurement

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