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Rehab Measures Database

Children's Leisure Assessment Scale

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Purpose

Children’s Leisure Assessment Scale (CLASS) is a self-report, multidimensional questionnaire developed to examine school aged (10-18 years) children’s engagement of leisure activities.

Acronym CLASS

Area of Assessment

Behavior
Infant & Child Development
Life Participation
Patient Satisfaction
Quality of Life
Social Relationships
Social Support

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

CDE Status

Not a CDE – last searched 6/21/2023 

Key Descriptions

  • 40 items, patient reported
  • Minimum score = 0; Maximum score = 760
  • The child scores each item in four categories based on (1) marking 0 or 1 for whether or not they do the activity, (2) rating from 1-4 how frequently they do the activity, (3) rating from 1-4 the sociability of each occupation, and (4) rating from 1-10 how much they like the activity.
  • The assessment can be administered online or in person using a paper and pencil. The assessor instructs the child to rate each item based on the categories listed above.
  • The manual emphasizes that “use of the scoring system may be beneficial for assessing intervention effectiveness by comparing score pre and post intervention. However, in clinical practice the dialogue that formulates following completion of the CLASS should be emphasized…clinicians should endeavor to deepen understanding of the individual child’s leisure characteristics.”

Number of Items

40

Equipment Required

  • Paper and pencil or online access

Time to Administer

Approximately 30 minutes

Required Training

No Training

Age Ranges

School-age children

10 - 18

years

Instrument Reviewers

Hannah Stice, Helena Shaw, Atlas Nelson, and Nicole Banuelos (Master of Occupational Therapy students) with faculty mentor: Danbi Lee, PhD, OTD, OTR/L, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
Participation & Activities
Emotion

Professional Association Recommendation

No Professional Association recommendations found – last searched 6/21/2023

Considerations

  • The CLASS assessment was originally developed to be a tool that is culturally sensitive to the multi-cultural groups in Israel.
  • Available languages: Hebrew and English
  • There is an adapted assessment for preschool-aged children (ages 3-6)

 

Non-Specific Patient Population

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Normative Data

Typically Developing Children (Rosenblum et al., 2010; n = 249 (54% female); mean age = 13.91 (2.08) years; age range = 10-18)

Comparison between boys and girls across the four factors and dimensions of the Children’s Leisure Assessment Scale (mean (Std. Dev))


Factor and Dimension

Male

(n = 114)

Female

(n = 114)

Instrumental Indoor Activities

?Variety

0.74 (0.17)

0.84 (0.16)

?Frequency

2.17 (0.82)

2.39 (0.99)

?Sociability

1.75 (0.59)

1.85 (0.57)

?Preference

6.83 (1.47)

7.46 (1.38)

Outdoor Activities

?Variety

0.67 (0.25)

0.73 (0.24)

?Frequency

1.42 (1.42)

1.61 (0.64)

?Sociability

2.80 (0.63)

2.76 (0.61)

?Preference

6.96 (2.09)

7.90 (1.71)

Self-Enrichment Activities

?Variety

0.32 (0.18)

0.47 (0.24)

?Frequency

0.74 (0.46)

1.15 (0.64)

?Sociability

2.68 (1.04)

2.81 (0.84)

?Preference

6.59 (2.68)

7.69 (2.14)

Games and Sports Activities

?Variety

0.69 (0.26)

0.53 (0.30)

?Frequency

1.91 (0.39)

1.22 (0.80)

?Sociability

2.64 (0.94)

2.04 (1.10)

?Preference

6.83 (1.47)

7.49 (1.35)

 

Typically Developing Children (Brown & Thyer, 2020; n = 40, mean age = 9.2 (2.01) years; 60% female; Australian sample)

Children’s Leisure Assessment Scale (CLASS) mean, standard deviation, range and percentile scores by subscale

CLASS subscale

Instrumental Indoor: Variety

Instrumental Indoor: Frequency

Instrumental Indoor: Sociability

Instrumental Indoor: Preference

Mean

0.839

2.496

1.784

7.191

SD

0.1026

0.4304

0.3015

1.2504

Range

0.4

1.3

1.2

5.4

25th percentile

0.75

2.00

1.60

6.86

50th percentile

0.88

2.50

1.86

7.33

75th percentile

0.88

2.75

2.00

7.71

Children’s Leisure Assessment Scale (CLASS) mean, standard deviation, range and percentile scores by subscale (cont.)

 

CLASS subscale

Outdoor Activity: Variety

Outdoor Activity: Frequency

Outdoor Activity: Sociability

Outdoor Activity: Preference

Mean

0.728

1.275

2.173

8.487

SD

0.139

0.5318

0.2152

1.2263

Range

0.4

1.7

0.7

4.0

25th percentile

0.56

0.78

2.00

7.50

50th percentile

0.67

1.22

2.13

8.60

75th percentile

0.89

1.67

2.38

9.40

Children’s Leisure Assessment Scale (CLASS) mean, standard deviation, range and percentile scores by subscale (cont.)

 

CLASS

Subscale

Self-Enrichment Activities: Variety

Self-Enrichment Activities: Frequency

Self-Enrichment Activities: Sociability

Self-Enrichment Activities: Preference

Mean

798

2.075

1.990

7.692

SD

2041

.6510

.4239

1.1615

Range

0.9

2.9

2.0

4.6

25th percentile

0.75

1.75

1.71

7.14

50th percentile

0.75

2.00

2.00

8.00

75th percentile

1.00

2.50

2.13

8.50

Children’s Leisure Assessment Scale (CLASS) mean, standard deviation, range and percentile scores by subscale (cont.)

CLASS

Subscale

Games and Sports: Variety

Games and Sports: Frequency

Games and Sports: Sociability

Games and Sports: Preference

Mean

0.916

2.642

2.298

8.268

SD

0.1385

0.6203

0.4084

1.3685

Range

0.4

2.2

1.3

4.5

25th percentile

.80

2.40

2.00

7.60

50th percentile

1.00

2.60

2.20

8.20

75th percentile

1.00

3.40

2.60

9.75

 

Internal Consistency

Typically Developing Children: (Rosenblum et al., 2010)

  • Adequate: Cronbach’s alpha = 0.71 across all items
  • Poor to excellent: Cronbach’s alpha ranged from 0.57-0.83 for the four principal factors resulting from an analysis of the frequency domain.

 

Construct Validity

 

Convergent validity:

Typically Developing Children (Brown & Thyer, 2020)

  • Excellent convergent validity between CLASS outdoor activity preference score and Children’s Assessment of Participation and Enjoyment (CAPE) informal enjoyment subscale score (r?=?0.726)
  • Adequate to excellent convergent validity between CLASS outdoor activities preference and the Preferences for activities of children (PAC) recreational, physical, formal, informal and overall performance scores (r?=?0.47-0.77).
  • Excellent convergent validity between CLASS games and sport activities preferences and the PAC physical subscale (r?=?0.65)

Content Validity

Content validity of the CLASS assessment was determined by five expert consultants and five experienced pediatric occupational therapists. The results from this panel showed that this assessment has “adequately reflected the instruments prescribed objectives and were consistent with the establishment of content validity” (Rosenblum et al., 2010). 

Face Validity

Face validity of CLASS was determined by five parents of school-aged children. Each of the parents “performed a secondary qualitative evaluation process and reported that the items were clearly written” (Rosenblum et al., 2010). 

Pediatric Disorders

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Normative Data

Physical Disabilities: (Schreuer et al., 2014; n = 294, children without disabilities n = 213,  mean age = 13.90 (2.17); children with disabilities n = 81, mean age = 13.22 (3.04); Hebrew speaking sample)

Scores on the Children Leisure Activity Scale by dimension and presence of disabilities (mean (std. dev.))

 

Dimension

Children with disabilities

Children without disabilities

Preference

7.46 (1.45)

7.30 (1.65)

Variety

20.90 (7.07)

23.51 (5.63)

Frequency

2.77 (0.38)

1.47 (0.39)

Sociability

1.99 (0.29)

2.16 (0.26)

 

Internal Consistency

Celiac Disease: (Meyer & Rosenblum, 2016; n = 68, children ages 8-15 with celiac disease n = 34, mean age = 10.5 (2.4) years; parents n = 34; matched control group of children without celiac disease n = 34, mean age = 10.6 (2.3) years; 73.5% female) 

  • Poor for food-related activities: Cronbach’s alpha = 0.60

Construct Validity

Convergent validity:

Celiac Disease: (Meyer & Rosenblum, 2016)

  • Adequate correlation between CLASS sociability dimension of the food-related activities factor and the Celiac Disease DUX (CDDUX) total score (r = .465) and three subscales (Diet scale, Having CD scale, Communication scale) (r = 0.355-0.421)

Discriminant validity:

Physical Disabilities: (Schreuer et al., 2014)

  • Significant differences in the CLASS variety, frequency, and sociability scales between children with and without disabilities (p < 0.01)
    • Children with disabilities participate in a smaller variety of activities, more frequently, and with less social interactions with their peers than children without disabilities

Bibliography

Brown, T. & Thyer, L. (2020) The convergent validity of the Children's Leisure Assessment Scale (CLASS) and Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC). Scandinavian Journal of Occupational Therapy, 27(5), 349-363. DOI:10.1080/11038128.2019.1672784 

Chi-Wen, C., Rodger, S., Copley, J. & Skorka, K. (2014) Comparative content review of children’s participation measures using the International Classification of Functioning, Disability and Health--children and youth. Archives of Physical Medicine and Rehabilitation, 95(1), 141-152. DOI:10.1016/j.apmr.2013.06.027 

Meyer, S., & Rosenblum, S. (2016). Children with celiac disease: Health-related quality of life and leisure participation. American Journal of Occupational Therapy, 70, 7006220010p1-7006220010p8. DOI: 10.5014/ajot.2016.020594 

Rosenblum, S., Sachs, D., & Schreuer, N. (2010). Reliability and validity of the Children's Leisure Assessment Scale. The American Journal of Occupational Therapy, 64(4), 633–641.

Schreuer, N., Sachs, D., & Rosenblum, S. (2014). Participation in leisure activities: Differences between children with and without physical disabilities. Research in Developmental Disabilities, 35(1), 223-233.