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Child and Adolescent Scale of Environment (CASE)
Please visit this website for more information about the instrument: Child and Adolescent Scale of Environment
Please email the author for information about obtaining the instrument: Dr. Gary Bedell,
Supplemental: Cerebral Palsy (CP), Mitochondrial Disease (Mito) and Traumatic Brain Injury (TBI)
Exploratory: Sport-Related Concussion (SRC) Subacute (after 72 hours to 3 months) and Persistent/Chronic (3 months and greater post concussion)
Short Description of Instrument
The Child and Adolescent Scale for Environment (CASE) consists of 18 items that measure environmental problems that might hinder a child's participation at home, school, and in the community. These problems may be physical, social, or attitudinal problems in the community, including lack of resources, crime, and negative perceptions of others. Parents/guardians rate the impact of these problems - no problem, little problem, big problem. The scale is an adaptation of the Craig Hospital Inventory of Environment Factors (CHIEF). The CASE is completed by the parent/guardian and can be administered in about 5 minutes.
Scoring and Psychometric Properties
Scoring: Scores range from 0 to 100, with higher scores reflecting more environment problems and/or a greater impact of problems.
Psychometric Properties: Test re-test reliability (Intraclass Correlation Coefficient = .75) and internal consistency (alpha = 0.91; Bedell, 2004; alpha =0.84, recent 9 analyses) and construct/ discriminant validity (Bedell, 2004).
Strengths: CASE can be self-administered or interviewer- administered.
"The CASE is a developing instrument with evidence of reliability and validity and has been used in a number of studies with children and youth with traumatic and other acquired brain injuries. The CASE was selected over the CHIEF because the CASE has been used in a number of studies specific to children and youth with TBI and acquired brain injury." - McCauley et al. 2012
Sport-Related Concussion-Specific:
Weaknesses: CASE has mostly been evaluated in white English- speaking families, more testing is necessary in diverse populations. Only captures the perspectives of parent/guardians.
Age Range: 5 to 17
Key References:
Bedell, G. (2011). The Child and Adolescent Scale of Environment (CASE): Administration and scoring guidelines.  
Bedell, G. (2016). The Child and Adolescent Scale of Environment (CASE): Administration and scoring guidelines. Available online at:
Additional References:
Bedell G. Further validation of the Child and Adolescent Scale of Participation (CASP). Dev Neuro Rehabil. 2009;12(5):342-51.
Bedell GM. Developing a follow-up survey focused on participation of children and youth with acquired brain injuries after discharge from inpatient rehabilitation. NeuroRehabilitation. 2004;19(3):191-205.
Bedell GM, Dumas HM. Social participation of children and youth with acquired brain injuries discharged from inpatient rehabilitation: a follow-up study. Brain Inj. 2004 Jan;18(1):65-82.
Bedell G, McDougall J. The Child and Adolescent Scale of Environment (CASE): Further validation with youth who have chronic conditions. Dev Neurorehabil. 2015;18(6):375-82.
Galvin J, Froude EH, McAleer J. Children's participation in home, school and community life after acquired brain injury. Aus Occup Ther J. 2010 Apr;57(2):118-26.
McCauley SR, Wilde EA, Anderson VA, Bedell G, Beers SR, Campbell TF, Chapman SB, Ewing-Cobbs L, Gerring JP, Gioia GA, Levin HS, Michaud LJ, Prasad MR, Swaine BR, Turkstra LS, Wade SL, Yeates KO; Pediatric TBI Outcomes Workgroup. Recommendations for the use of common outcome measures in pediatric traumatic brain injury research. J Neurotrauma. 2012 Mar 1;29(4):678-705.
Wells R, Minnes P, Phillips M. Predicting social and functional outcomes for individuals sustaining paediatric traumatic brain injury. Dev Neurorehabil. 2009 Feb;12(1):12-23.
Whiteneck GG, Harrison-Felix CL, Mellick DC, Brooks CA, Charlifue SB, Gerhart KA. Quantifying environmental factors: a measure of physical, attitudinal, service, productivity, and policy barriers. Arch Phys Med Rehabil. 2004 Aug;85(8):1324-35.
Ziviani J, Desha L, Feeney R, Boyd R. Measures of Participation Outcomes and Environmental Considerations for Children With Acquired Brain Injury: A Systematic Review. Brain Impair. 2010 Sep;11(2):93-112.
Document last updated March 2024