Hi Marie!
All great questions.
1. You could look at it either way. As long as you identify that there was an increase in score, that’s the important thing.
2. Correct, the score is reliable, but still does not exceed the threshold for test error. The CI and SEM need to both be taken into account when you are looking at everything and making decisions about change scores.
3. Correct!
4. For this one, the 2008 article was the one we intended to reference. The 2009 article can be a helpful resource, too. If you do consider the 2009 article, you see that a decline in skills for children in GMFCS level III occurs around 7 years, 11 months. The child in this case is 9 years old and is still making improvements in score and percentile. It is trending in the right direction even though we can’t say it is real change. The next score, if he returns to clinic, will be the most telling to determine if he continues to trend in a positive direction or if his scores start to plateau. For this one you are picking the best answer and identifying the positive trajectory in score.