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Exploratory: Spinal Cord Injury (SCI)-Pediatric
Short Description of Instrument
The CALI is a subjective, validated, and reliable measure of functional impairment due to pain in children and adolescents with recurrent chronic pain (Palermo, et al., 2004). The CALI is comprised of 21 items: two items that capture the concept of sleep and rest; one item that refers to eating; three school-related items; three items that deal with ambulation; two items that refer to mobility; two work-related items; and 8 items that access physical, social and recreational interactions.
A 9-item version of the CALI (CALI-9) is also available (Lewandowski et al., 2018).
Comments/Special Instructions
Administration:  The CALI is administered via individual interviews with children and parents. Time to administer is approximately 5–7 minutes.
Age range: 8-18 y
Scoring: Each respondent is read the 21-item activity list and asked to choose the eight activities that are most difficult or bothersome due to recurrent pain. Importance of each activity is rated on a 5-point scale from (0) 'not important' to (4) 'extremely important'. The primary score is derived from the difficulty ratings which are obtained on a 5-point scale: (0) 'not difficult' to (4) 'extremely difficult'. Difficulty ratings are summed and the total score ranges from 0 to 32, with higher scores indicating greater levels of difficulty (Palermo et al., 2004).
"The CALI demonstrates internal consistency (alpha=0.88, child version; alpha=0.95, parent version); and reliability, (one-month test-retest reliability (r = 0.33, child report) and cross-informant reliability (r = 0.43) were moderate)" (Palermo et al., 2004).
The CALI is appropriate for diverse pediatric pain populations, and suitable for retrospective and prospective daily assessment (Hainsworth, et al., 2007; Palermo, et al., 2008). However, it has not been validated in pediatric SCI and has not been used to date.
Key reference:
Palermo TM, Witherspoon D, Valenzuela D, Drotar DD. Development and validation of the Child Activity Limitations Interview: a measure of pain-related functional impairment in school-age children and adolescents. Pain. 2004;109(3):461-470.
Additional references:
Hainsworth KR, Davies WH, Khan KA, Weisman SJ. Development and preliminary validation of the child activity limitations questionnaire: flexible and efficient assessment of pain-related functional disability. J Pain. 2007;8(9):746-752.
Holley AL, Zhou C, Wilson AC, Hainsworth K, Palermo TM. The CALI-9: A brief measure for assessing activity limitations in children and adolescents with chronic pain. Pain. 2018;159(1):48-56.
Palermo TM, Lewandowski AS, Long AC, Burant CJ. Validation of a self-report questionnaire version of the Child Activity Limitations Interview (CALI): The CALI-21. Pain. 2008;139(3):644-652.