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Children’s Assessment of Participation and Enjoyment Scale (CAPE) / Preferences for Activities of Children (PAC)
Please visit this website for more information about the instrument: Children’s Assessment of Participation/Preferences for Activities of Children.
Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
Children’s Assessment of Participation (CAPE) measures participation in informal and formal everyday activities outside school (in the dimensions of participation recreational, active physical, social, skill based, and self-improvement) (King et al., 2004; 2007, Imms, 2008) for children and young people, with and without disabilities, aged 6 years to 21 years. For each of the 55 activities listed in the CAPE, 5 questions are asked to identify whether i) the activity was undertaken in the previous month (to identify diversity of participation), ii) how often they did it (to measure intensity of participation), iii) with whom, iv) where, and v) level of enjoyment. Preferences for Activities of Children (PAC) measures activity preference for these 55 activities and therefore can explore whether participation relates to personal choice or to other barriers to participation. The two measures are designed to be used together, and CAPE should be used first. (King et al., 2004; 2007, Imms, 2008). Fifty-three percent of items are considered to assess participation according to ICF, 38% activity, with the remainder ambiguous (Chien et al., 2014b). Validation of the CAPE is based on expert review, literature and factor analytic studies.
Comments/Special Instructions
CAPE/PAC is a questionnaire that can be completed by child self-report or interview. They are not appropriate for proxy report as child’s own enjoyment and preferences are sought and they are not appropriate for children who are unable to respond (Imms, 2008). The CAPE provides pictures for each question and rating response in order to enhance children’s understanding. Administration can be modified to enable children to respond using their own communication style. Mail out is possible but often results in the need to follow up to seek answers to questions which have not been answered (Imms, 2008).
Scoring the CAPE results in 5 scores; overall diversity score, overall intensity score, overall with whom score, overall where score and overall enjoyment score.
Although not specifically developed for children with CP, the CAPE/PAV has been  used extensively in the assessment of participation in children with CP (Bjornson et al., 2013; Bult et al., 2013; Engel-Yeger et al., 2009; Imms et al., 2008; Imms et al., 2009; Kang et al., 2010; Kangs et al., 2012; Majnemer et al., 2008; Orlin et al., 2010; Palisano et al., 2009, 2011) and is considered a thorough measure of different aspects of participation outside school. It is relatively inexpensive to purchase but time consuming to complete and score. Would be appropriate for research which needs a tool to guide and measure the impact of a participation intervention.
King G, Law M, King S, Hurley P, Rosenbaum P, Hanna S, Kertoy M, Young N. Children's Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) (CAPE/PAC): Pearson; 2004 [cited 2015 24 Nov]. Available from: http://www.pearsonclinical.com/therapy/products/100000481/childrens-assessment-of-participation-and-enjoyment-cape-and-preferences-for-activities-of-children-pac-cape-pac.html.
King GA, Law M, King S, Hurley P, Hanna S, Kertoy M, Rosenbaum P. Measuring children's participation in recreation and leisure activities: construct validation of the CAPE and PAC. Child Care Health Dev. 2007;33(1):28–39.
Imms C. Review of the Children's Assessment of Participation and Enjoyment and the Preferences for Activity of Children. Phys Occup Ther Pediatr. 2008;28(4):389–404.
Sakzewski L, Boyd R, Ziviani J. Clinimetric properties of participation measures for 5- to 13-year-old children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2007;49(3):232–240.
Other References:
Bult MK, Verschuren O, Lindeman E, Jongmans MJ, Westers P, Claassen A, Ketelaar M. Predicting leisure participation of school-aged children with cerebral palsy: longitudinal evidence of child, family and environmental factors. Child Care Health Dev. 2013;39(3):374–380.
Chien CW, Rodger S, Copley J, McLaren C. Measures of participation outcomes related to hand use for 2- to 12-year-old children with disabilities: a systematic review. Child Care Health Dev. 2014a;40(4):458–471.
Chien CW, Rodger S, Copley J, Skorka K. Comparative content review of children's participation measures using the International Classification of Functioning, Disability and Health-Children and Youth. Arch Phys Med Rehabil. 2014b;95(1):141–152.
Engel-Yeger B, Jarus T, Anaby D, Law M. Differences in patterns of participation between youths with cerebral palsy and typically developing peers. Am J Occup Ther. 2009;63(1):96–104.
Imms C, Reilly S, Carlin J, Dodd KJ. Characteristics influencing participation of Australian children with cerebral palsy. Disab Rehabil. 2009;31(26):2204–2215.
Imms C, Reilly S, Carlin J, Dodd K. Diversity of participation in children with cerebral palsy. Dev Med Child Neurol. 2008;50(5):363–369.
Kang LJ, Palisano RJ, King GA, Chiarello LA, Orlin MN, Polansky M. Social participation of youths with cerebral palsy differed based on their self-perceived competence as a friend. Child Care Health Dev. 2012;38(1):117–127.  
Kang LJ, Palisano RJ, Orlin MN, Chiarello LA, King GA, Polansky M. Determinants of social participation--with friends and others who are not family members--for youths with cerebral palsy. Phys Ther. 2010;90(12):1743–1757.
Majnemer A, Shevell M, Law M, Birnbaum R, Chilingaryan G, Rosenbaum P, Poulin C. Participation and enjoyment of leisure activities in school-aged children with cerebral palsy. Dev Med Child Neurol. 2008;50(10):751–758.
Orlin MN, Palisano RJ, Chiarello LA, Kang LJ, Polansky M, Almasri N, Maggs J. Participation in home, extracurricular, and community activities among children and young people with cerebral palsy. Dev Med Child Neurol. 2010;52(2):160–166.
Palisano RJ, Chiarello LA, Orlin M, Oeffinger D, Polansky M, Maggs J, Bagley A, Gorton G. Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy. Dev Med Child Neurol. 2011;53(2):142–149.
Palisano RJ, Kang LJ, Chiarello LA, Orlin M, Oeffinger D, Maggs J. Social and community participation of children and youth with cerebral palsy is associated with age and gross motor function classification. Phys Ther. 2009;89(12):1304–1314.
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