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Child Health Questionnaire (CHQ)
Availability
Please visit this website for more information about the instrument: Child Health Questionnaire website
Classification
Supplemental – Highly Recommended: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
 
Supplemental: Epilepsy, Pediatric Neuromuscular Disease (NMD) and Spinal Cord Injury (SCI)-Pediatric
 
Exploratory: Cerebral Palsy (CP)
Short Description of Instrument
Description: This is a comprehensive quality of life scale that was developed in 1996 to be used across a diverse group of children and health conditions.
 
There are two major summary scores: Physical Well-Being and Psychosocial Well- Being. Concept areas measured are: Physical Functioning (PF), Role/Social Physical (RP), General Health Perceptions (GH), Bodily Pain (BP), Parental Impact-Time (PT), Parental Impact-Emotional (PE), Role/Social Emotional, Role/Social Behavioral, Self- Esteem (SE), Mental Health (MH), General Behavior (BE), Family Activities (FA), Family Cohesion (FC), and Change in Health (CH). There are three parent-completed versions for children as young as 5 years (PF98 items, PF50 items, and PF28 items) and one version for children ages 10 years and older to complete (CF87 items). Parents and children respond to items based on the past four weeks. Scores for each subscale are converted to a 0 to 100 scale with higher scores reflecting better functioning.
 
Particular Features: There are norms for general population children and a manual is available that contains a disc to use for scoring.
 
Psychometric Properties:
 
Reliability: Internal consistency reliabilities for epilepsy samples were > 0.70 for scales with the exception of general health and parent impact-time scales. Higher retest scores with small effect sizes were found on test-retest reliability.
 
Validity: Discriminant validity results reported in the manual show subscale scores were correlated with similar scales on other quality of life scales in populations with epilepsy.
 
Sensitivity to Change: Findings with test-retest reliability make these findings difficult to interpret.
 
Relationships to other variables: Children with idiopathic syndromes had higher scores on the majority of CHQ subscales than children with symptomatic syndromes.
 
ME/CFS specific:
Internal consistency reliability coefficients are good for the CHQ (0.84 for the child form; ranging from 0.80 to 0.88 for the parent form, depending upon the parents’ SES). Furthermore, the CHQ evidences acceptable validity. Discriminant validity of the subscales is excellent, as the scales can discriminate children with clinically defined conditions from a control sample (Landgraf et al., 1996). Finally, there are parent and child rated norms available for each subscale, and the CHQ has been found reliable down to age 5 (Drotar et al., 2006).
 
Strengths and Weaknesses:
 
Strengths: This general health-related quality of life scale has been tested in children with a variety of chronic conditions including 31 children with epilepsy. The PF50 and PF28 scales have been translated in to more than 60 languages and the CF87 scale has been translated into more than 20 languages. There are self-report versions as well as an interview scripts available to be used.
 
Weakness: The ceiling effects found for four subscales and the test-retest reliability problems found for five subscales limits its use for testing effects of interventions. There are no items specific to epilepsy.
References
Landgraf, JM. (2014). Child Health Questionnaire (CHQ). In Michalos AC (Ed.), Encyclopedia of Quality of Life and Well-Being Research. New York: Springer Dordrecht Heidelberg, 2014, pp. 698–702.
 
Landgraf JM, Abetz L, Ware, JE. The CHQ: A User's Manual (First Edition). Boston, MA: The Health Institute, 1996.
 
Landgraf JM, Abetz L, Ware JE. The CHQ: A User's Manual (2nd printing). Boston, MA: The Health Institute, 1999.
 
Landgraf JM, Abetz L, Ware JE. (2013). HealthActCHQ (2013) CHQ Scoring and Interpretation Manual. Retrieved from Boston, MA: https://www.healthactchq.com/chq.php
 
Raat H, Landgraf JM, Bonsel GJ, Gemke RJ, Essink-Bot ML. Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population. Qual Life Res. 2002;11(6):575–581.
 
Epilepsy-Specific References:
Gilliam F, Wyllie E, Kashden J, Faught E, Kotagal P, Bebin M, Wise M, Comair Y, Morawetz R, Kuzniecky R. Epilepsy surgery outcome: comprehensive assessment in children. Neurology. 1997;48(5):1368–1374.
 
Sabaz M, Lawson JA, Cairns DR, Duchowny MS, Resnick TJ, Dean PM, Bye AM. Validation of the quality of life in childhood epilepsy questionnaire in American epilepsy patients. Epilepsy Behav. 2003;4(6):680–691.
 
Sabaz M, Cairns DR, Bleasel AF, Lawson JA, Grinton B, Scheffer IE, Bye AM. The health- related quality of life of childhood epilepsy syndromes. J Paediatr Child Health. 2003;39(9):690–696.
 
ME/CFS-Specific References:
Drotar D, Schwartz L, Palermo TM, Burant C. Factor structure of the child health questionnaire-parent form in pediatric populations. J Pediatr Psychol. 2006;31(2):127–138
Recommended Instrument for
CP, Epilepsy, Pediatric NMD and SCI-Pediatric
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