| Résumé: | Attention-Deficit Hyperactivity Disorder (ADHD) poses unique challenges for children
and their parents, impacting various aspects of daily life, including the establishment of
consistent oral hygiene practices. Given the complexity of managing ADHD-related
behaviours, effective assessment tools are needed to evaluate parental experiences and
child behaviours related to toothbrushing. This study aimed to assess the validity and
reliability of the M-PACTA in evaluating behaviours of children with ADHD, along with
parental strategies, knowledge, and attitudes regarding toothbrushing. The 77-item MPACTA
questionnaire was adapted to the context of children with ADHD through a twophase
process. Phase I focused on content and face validity, where five specialists from
various departments reviewed the questionnaire to ensure its relevance and clarity. This
was followed by cognitive debriefing with ten parents of children with ADHD to evaluate
the readability, formatting, and language clarity of the revised questionnaire. Phase II
encompassed comprehensive psychometric assessments, including detailed analyses of
construct validity and reliability. The study recruited 42 parents of children aged 6-12
years diagnosed with ADHD, who were receiving care at Departments of Paediatrics and
Psychiatry, Universiti Malaya Medical Centre (UMMC) from March to June 2024, using
universal sampling. Expert evaluation showed excellent content and face validity for
relevance and clarity, with CVI scores from 0.75 to 1.00 and Kappa values from 0.72 to
1.00, except for five items. One item was deleted due to low relevance, and four items
were modified for clarity based on experts' recommendations. Exploratory factor analysis
identified distinct factor structures for the four scales: Child Behaviour (two factors),
Parental Strategies (five factors), Parental Attitude (four factors), and Parental
Knowledge (two factors). Five items were dropped due to cross-loadings, negative
loadings, and no loadings. Reliability analysis showed moderate to strong internal
consistency (Cronbach's alpha 0.616 to 0.938) and test-retest reliability (ICC values 0.657 to 0.957). The final questionnaire had 71 items, specifically tailored for ADHD children.
In conclusion, the adapted M-PACTA for children with ADHD demonstrated satisfactory
construct validity and reliability in assessing children's behaviours, parental strategies,
knowledge, and attitudes towards toothbrushing among children with ADHD at UMMC.
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