Factor structure of the HoNOS-LD: Further evidence of its validity and use as a generic outcome measure

Abstract

The HoNOS-LD seems reliable and sensitve to change when used as a team generic outcomes measure. In this paper we examine the factor structure of HoNOS-LDs administered at the end of assessment and prior to intervention (N=155). Four hypothesised factors were proposed as externalising behaviour problems, internalising behaviour problems, loss of skills, and loss of community presence. Factor analysis with Varimax rotation yielded four sizaeble factors accounting for 48 per cent of the variance. However, the hypothesised factors were only partly identified. The actual factors meeting Eigenvalue >1 were described as: (1) communicative-cognitive competence; (2) behaviour disturbance incorporating relationship breakdown; (3) loss of adaptive behaviour incorporating acute physical illness; and (4) internal dysregulation. The implications for more specific and partial analysis of HoNOS-LD ratings are briefly discussed.

An investigation into the factor structure of the Health of the Nation Outcome Scales for People with Learning Disabilities

“…2018) or as five separate ratings, resulting in the measure being reported as having 22 items (e.g. Skelly and D'Antonio 2008; Turton, 2020). Harris et al .…”

“…Tenneij et al 2009;Esteba-Castillo et al 2018) or as five separate ratings, resulting in the measure being reported as having 22 items (e.g. Skelly and D'Antonio 2008;Turton, 2020). Harris et al (2018) described a systematic review of the HoNOS family of measure and proposes a seven-factor structure that incorporates a single rating for item 3.…”

“…Esteba-Castillo et al (2018) analysed data for 111 people with intellectual disabilities using a Spanish translation of the HoNOS-LD and reported a single latent variable containing all 18 items derived from a combined parallel analysis and theoretical inclusion criteria; however, several items had a poor fit to the unidimensional model. Skelly and D'Antonio (2008) analysed 155 clinical records using principal components analysis to identify four scales that include all but four items. The four components included items that loaded at or above an absolute value of 0.50 and the authors labelled the factors as 'cognitive and communicative competence', 'functional behaviour and attachment disturbance', 'loss of functioning and community presence' and 'internal dysregulation'.…”