As occupational therapists become increasingly concerned with accountability, the paucity of adequate instrumentation available for documenting therapeutic effectiveness surfaces as a major problem. Therapists will need to construct new or refine existing instruments to satisfy the requirements of third-party payment. The purpose of this paper is to illustrate how a new instrument is planned, developed, and validated. A sequential step-by-step process is illustrated with a flowchart and applied in the hypothetical construction of an attitude scale to assess school administrators' valuing of the role of occupational therapists in the schools. This example is provided to show how general psychometric principles are applied within an occupational therapy context.

What would a strong program of construct validation look like for the concept of test anxiety? What are the components of strong validation programs? In particular, how does structural equation modeling fit into such a program?

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The purpose of the study was to examine the effect of item phrasing on the validity of a Likert-type attitude scale. Three content similar scales were composed of 15 items, either all positive, all negative, or a mixture of positive and negative items. Five hundred twenty-two students in grades 4-6 responded to one of the three forms. Results from the all positive and negative forms indicated that item means, variances, and factor structures differed significantly. Inspection of item means suggested that it was difficult for the students to indicate agreement by disagreeing with a negative statement. Analyses of the mixed phrasing form indicated factors based upon item phrasing, not item content. Taken together, the results suggest that the technique of balancing item phrasing when used with elementary students appears to affect adversely the validity of attitude measurement.