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DSQ-Pediatric Screening Questionnaire (DSQ-PSQ)
Please visit this website for more information about the instrument: The DSQ-Pediatric Screening Questionnaire can be downloaded from the REDCap shared library.
Please email the author for information about obtaining the instrument: Dr. Leonard Jason, ljason@depaul.edu
Supplemental: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Short Description of Instrument
The DSQ-PSQ can be used  to screen for ME/CFS-like profiles among children and adolescents. This screening questionnaire consists of three parts. First, there are questions designed to determine if any of the children or teenagers (aged 5–17 years) in the household are experiencing significant fatigue. The second part assesses whether any of the children are experiencing disruption in their school activities or performance due to fatigue or cognitive difficulties. These initial questions are broad in order to cast a wide net to increase sensitivity and detect all possible cases of ME/CFS. The third part of the questionnaire presents a list of ME/CFS-related symptoms in children proposed by Bell (1995), Jason et al. (2006), and others (Fukuda et al., 1994; Institute of Medicine, 2015; Carruthers et al., 2003; Jason et al., 2010).
Comments/Special Instructions
Ages: 5-17 (Completed by the child’s parent)
Time to Complete: Approximately 3-5 minutes per child
The parent responds “Yes” or “No” to indicate whether the child has experienced each symptom over the past 3-6 months. Frequency and severity ratings are requested for all symptoms endorsed, “Yes.” Participants rate the symptom’s frequency on the following 5-point likert scale: 0=none of the time, 1=a little of the time, 2=about half the time, 3=most of the time, and 4=all of the time.  Participants rate the symptom’s severity on the following 5-point likert scale: 0=symptom not present, 1=mild, 2=moderate, 3=severe, 4=very severe.
The following criteria are used to determine whether a child screens positive (i.e., the child experiences ME/CFS-like symptoms that warrant further medical evaluation)
Screen Positive Criteria:
       1. At least 1 of the following symptoms:
                  a. Fatigue (frequency and severity ? 2)
                  b. Missing activities because too sick/tired (“Yes”)
                  c. Poor school attendance (“Yes”)
                  d. Unable/Unwilling to go to school (“Yes”)
                  e. School learning/memory problems (“Yes”)
Response of “Yes” to at least 4 of the remaining symptoms
The DSQ-PSQ has been utilized in two, large-scale epidemiological studies of pediatric ME/CFS (Jordan et al., 2006; Jason, Katz, et al., 2017). Preliminary psychometric analyses demonstrated good internal reliability (? = .83).
Bell DS. Diagnosis of Chronic Fatigue Syndrome in children and adolescents: Special considerations. J Chronic Fatigue Syndr.1995;1(3/4):29–66.
Carruthers BM, Jain AK, DeMeirleir KL. Myalgic encephalomyelitis/chronic fatigue syndrome: Clinical working case definition, diagnostic and treatments protocols. J Chronic Fatigue Syndr. 2003;11: 7–115.
Fukuda K, Straus SE, Hickie I. The chronic fatigue syndrome: A comprehensive approach to its definition and study. Ann Intern Med. 1994;121(12):953–959.
Institute of Medicine. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: Redefining an illness. Washington, DC: The National Academies Press, 2015.
Jason LA, Bell DS, Rowe K. A pediatric case definition for ME/CFS. J Chronic Fatigue Syndr. 2006;13:1–44.
Jason LA, Katz BZ, et al. Issues in estimating rates of pediatric chronic fatigue syndrome and myalgic encephalomyelitis in a community-based sample. Avicenna J Neuropsychophysiol. 2017;2(4).
Jason L, Porter N, Shelleby E, et al. Examining criteria to diagnose ME/CFS in pediatric samples. J Behav Health  Med. 2010;3:186–195.
Jordan KM., et al. Prevalence of pediatric chronic fatigue syndrome in a community-based sample. J Chronic Fatigue Syndr. 2006;13(2-3):75-78.
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