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Rehab Measures Database

Pediatric Quality of Life (PedsQL) Inventory Generic Core Scales 4.0

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Purpose

The Pediatric Quality of Life (PedsQL) Measurement Model is a modular approach to measuring health-related quality of life (HRQOL) in healthy children and adolescents and those with acute and chronic health conditions.

Link to Instrument

Acronym PedsQL

Area of Assessment

Quality of Life
Life Participation
Social Relationships
Mental Health

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$0.00

Cost Description

Free for not funded academic research.
Not free for funded academic research, large non-commercial organization research & evaluation (i.e., states, hospitals or healthcare systems), or commercial use.
Cost varies depending on use type. Full cost structure can be found here: https://www.pedsql.org/PedsQL-CostStructure.pdf.

CDE Status

NINDS CDE Notice of Copyright

PedsQL *Searched on 8/13/2022

Availability

Please visit these websites for more information about the instrument: or

Classification

NeuroRehab Core: Pediatric (ages 2-18)

Supplemental - Highly Recommended: Mitochondrial Disease (Mito) and Sport-Related Concussion (SRC) Subacute (after 72 hours to 3 months)

Supplemental: Cerebral Palsy (CP), Duchenne Muscular Dystrophy (DMD), Friedreich's Ataxia (FA), Headache, Spinal Muscular Atrophy (SMA), SRC Acute (time of injury until 72 hours) and Persistent/Chronic (3 months and greater post concussion), Stroke, Acute, Moderate and Mild Traumatic Brain Injury (TBI), and Epidemiology TBI

Exploratory: Myotonic Dystrophy (DM)

 

NINDS CDE Highlight Summaries (searched on 8/9/2023)

NeuroRehab

  • Outcomes and Endpoints/Pediatric: NeuroRehab Core

 

Spinal Muscular Atrophy (SMA)

  • Outcomes and Endpoints/Quality of Life: Supplemental

 

Myotonic Dystrophy

  • Outcomes and Endpoints/Pediatric: Exploratory

 

Duchenne Muscular Dystrophy (DMD)/Becker Muscular Dystrophy (BMD)

  • Outcomes and Endpoints/Quality of Life: Supplemental

 

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

  • Outcomes and Endpoints/Fatigue: Supplemental

 

Mitochondrial Disease

  • Supplemental – Highly Recommended

 

Headache Version 2.0

  • Outcomes and Endpoints/Quality of Life: Supplemental

 

Friedreich’s Ataxia (FA)

  • Outcomes and Endpoints/Quality of Life: Supplemental

 

Stroke

  • Outcomes and Endpoints/Pediatric: Supplemental

Key Descriptions

  • PedsQL is a 23-item measurement tool designed to measure health-related quality of life for pediatric patients, via a self-report and a parent proxy report.
  • A 5-point response scale is used across the child self-report (for ages 8 to 18) and parent proxy-report (0 = never a problem; 1 = almost never a problem; 2 = sometimes a problem; 3 = often a problem; 4 = almost always a problem). A 3-point scale is used for the young child self-report (ages 5 to 7) (0 = not at all a problem; 2 = sometimes a problem; 4 = a lot of a problem).
  • Items are reverse-scored and linearly transformed to a 0–100 scale (0 = 100, 1 = 75, 2 = 50, 3= 25, 4 = 0), so that higher scores indicate better HRQOL. This instrument yields a Total score, Physical Health Summary score (8 items, equivalent to the Physical Functioning subscale) and Psychosocial Health Summary score (15 items, based on the Emotional Functioning subscale [5 items], Social Functioning subscale [5 items], and School Functioning subscale [5 items]).
  • The instrument is self-administered unless a child’s age/cognitive abilities require an administrator to read the items aloud.

Number of Items

23 items total
- Physical Functioning (8 items)
- Emotional Functioning (5 items)
- Social Functioning (5 items)
- School Functioning (5 items)

Equipment Required

  • Pen or Pencil
  • Solid writing surface or clipboard.

Time to Administer

Approximately 5 minutes

Required Training

No Training

Age Ranges

Preschool Children

2 - 5

years

Children

6 - 12

years

Adolescents

13 - 17

years

Instrument Reviewers

Mica Benner-Kenagy, Tori Bishop, Christel Gunterman, Lizzie Willsmore-Finkle, (Master of Occupational Therapy Students) and Danbi Lee, PhD, OTD, OTR/L (faculty mentor), Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle.

ICF Domain

Activity
Participation

Measurement Domain

Emotion
General Health

Professional Association Recommendation

No Professional Association recommendations found – last searched 8/9/2023.

Considerations

“The PedsQL4.0 Generic Core Scales have consistently demonstrated on over 25,000 children and their parents in over 75 peer-reviewed journal publications in numerous pediatric chronic health conditions the feasibility, reliability, validity, sensitivity and responsiveness required for a patient-reported outcome for pediatric clinical trials in child self-report ages 5-18 years and parent proxy report for ages 2-18 years.” (Varni, 2005)

“The PedsQL4.0 is the only empirically validated generic pediatric health-related quality of life measurement instrument available to span this broad age range for child self-report and parent proxy report while maintaining item and scale construct consistency.” (Varni, 2005)

“Low scores on the PedsQL would suggest the need for more in-depth neurocognitive testing.” (Varni, 2019)

“PedsQL is an easy to administer and score, reliable and valid generic (non disease-specific) measure of perceived cognitive functioning.” (Varni, 2019)

The PedsQL 4.0 Generic Core Scales have been translated into over 60 languages.,List of available translations can be found here:

Pediatric Disorders

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Minimally Clinically Important Difference (MCID)

Epilepsy: (Varni et al., 2019; pediatric patients: n = 221, mean age = 11.93 (3.77), age range = 5-18 years; parents of patients ages 2-18: n = 336)

  • MCID for patient self-report = 8.80
  • MCID for parent-proxy report = 5.92

Normative Data

Epilepsy: (Varni et al., 2019)

Mean and Standard Deviation for the PedsQL 4.0 Generic Core Scales in pediatric patients with epilepsy by report type

PedsQL 4.0 Generic Core Scales

Patient Self-Report

        Mean (SD)

Parent Proxy-Report

        Mean (SD)

Total Scale Score

      73.95 (16.99)

      72.90 (20.53)

Interrater/Intrarater Reliability

Epilepsy: (Varni et al., 2019)

  • Poor interrater reliability between youth with epilepsy and their parents on the Cognitive Functioning Scale (ICC = 0.38)
  • Adequate interrater reliability between patient self-report and parent proxy report (r = 0.46-0.74)

Internal Consistency

Epilepsy: (Varni et al., 2019)

  • Excellent: Cronbach's alpha range from 0.88-0.96
    • Patients self-report Cronbach’s alpha = 0.88
    • Parent Proxy-Report Cronbach's alpha = 0.96

Floor/Ceiling Effects

Epilepsy: (Varni et al., 2019)

  • Patient self-report: adequate floor effects (0.5%, lower scores demonstrate worse cognitive functioning) and ceiling effects (10.9%, higher scores demonstrate better cognitive functioning)
  • Parent proxy-report: adequate floor effects (5.1%) and ceiling effects (12.8%)

Cerebral Palsy

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Minimally Clinically Important Difference (MCID)

Cerebral Palsy: (Oeffinger et al., 2008; n = 381, mean age = 11.0 (SD = 4.4); Gross Motor Function Classification System (GMFCS) Levels I-III)

 

Minimum change scores needed for Minimum Clinically Important Difference (MCID) of medium effect size by PedsQL subscale

 

 

PedsQL Subscale

Overall (n = 292)

GMFCS I,II,II

MCID medium effect size (0.5)

Parent PedsQL Emotional Functioning

                      6.5

Parent PedsQL Physical Functioning

                      7.9

Parent PedsQL School Functioning

                      7.7

Parent PedsQL Social Functioning

                      8.0

Child PedsQL Emotional Functioning

                    12.1

Child PedsQL Physical Functioning

                      8.8

Child PedsQL School Functioning

                    11.4

Child PedsQL Social Functioning

                    10.5

Normative Data

Mean and Standard Deviation on PedsQL for non-surgical group (n = 292) by PedsQL Scale and GMFCS level

 

PedsQL Scale

Level I

n = 141

Mean (SD)

Level II

n = 96

Mean (SD)

Level III

n = 55

Mean (SD)

Parent PedsQL Emotional Functioning

2.2 (15.6)

0.4 (13.8)

-2.4 (14.7)

Parent PedsQL Physical Functioning

-0.4 (16.5)

1.8 (16.9)

-0.7 (18.9)

Parent PedsQL School Functioning

1.3 (16.5)

-1.6 (16.7)

-1.4 (19.6)

Parent PedsQL Social Functioning

2.4 (15.8)

4.1 (17.3)

3.8 (15.2)

Child PedsQL Emotional Functioning

4.0 (21.5)

0.7 (22.4)

-0.3 (18.9)

Child PedsQL Physical Functioning

0.1 (16.9)

-0.9 (19.4)

-1.1 (18.8)

Child PedsQL School Functioning

3.5 (24.2)

0.7 (17.0)

0.2 (16.7)

Child PedsQL Social Functioning

2.1 (20.8)

2.9 (20.6)

-0.9 (19.5)

 

Mean and Standard Deviation on PedsQL for Surgical group (n = 87) by PedsQL Scale and GMFCS level*

 

PedsQL Scale

Level I

n = 32

Mean (SD)

Level II

n = 35

Mean (SD)

Level III

n = 20

Mean (SD)

Parent PedsQL Emotional Functioning

0.8 (17.8)

3.2 (14.2)

0.3 (11.5)

Parent PedsQL Physical Functioning

7.1 (19.5)

2.9 (14.9)

5.6 (17.2)

Parent PedsQL School Functioning

0.3 (15.7)

1.5 (15.9)

7.3 (15.6)

Parent PedsQL Social Functioning

4.4 (19.6)

-0.6 (20.0)

8.0 (13.3)

*Note: Insufficient numbers per group for Child PedsQL.

Responsiveness

Cerebral Palsy: (Oeffinger et al., 2008; at baseline and follow-up an average of 1 year 5 months after surgical intervention)

  • Significant mean change score of 8.6 (14.6) for improved group on Parent PedsQL Physical exceeds MCID scores for medium effect sizes, p < 0.02
  • Significant mean change score of -7.9 (12.5) for declined group on Parent PedsQL Physical exceeds MCID scores for medium effect sizes, p < 0.04

Diabetes

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Minimally Clinically Important Difference (MCID)

Diabetes: (Hillard et al., 2013, children n = 4,582, parent n = 4,444; mean age 12.5 (4.7) years; Type 1 and Type 2 Diabetes; PedsQL Generic Core)

  • Type 1 Diabetes
    • MCID for Parents of children with Type 1 Diabetes = 4.88
    • MCID for Youth with Type 1 Diabetes  = 4.72
  • Type 2 Diabetes
    • MCID for parents of children with Type 2 Diabetes = 6.27
    • MCID for youth with Type 2 Diabetes = 5.41

Normative Data

Diabetes: (Hilliard et al., 2013)

Mean and Standard Deviation for Total Score on the PedsQL Generic Core by Report Type

Report Type

Mean

SD

PedsQL Generic Core - Youth Report Total Score (n = 4,582)

79.9

13.4

PedsQL Generic Core - Parent Report Total Score (n = 4,444)

77.5

14.9

Internal Consistency

Diabetes: (Hilliard et al., 2013)

  • Adequate internal consistency of PedsQL total scores on youth report: Cronbach's alpha = 0.87
  • Adequate internal consistency of PedsQL total scores on parent report: Cronbach's alpha = 0.88 

Responsiveness

Diabetes: (Hilliard et al., 2013)

  • Significant, positive changes in baseline scores for Youth and Parent reports on both the PedsQL Generic Core and Diabetes Module were found (p = <0.0001)

Cancer

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Standard Error of Measurement (SEM)

Cancer: (Varni et al., 1999; children n = 281, mean age = 11.78 years; parents n = 283; calculated SEM)

  • SEM for self-report: 0.18
  • SEM for Parent proxy: 0.17

Minimal Detectable Change (MDC)

Cancer: (Varni et al., 1999; calculated MDC)

  • MDC for self-report: 0.50
  • MDC for parent proxy: 0.48

Internal Consistency

Cancer: (Varni et al., 1999)

  • Excellent internal consistency for patient report (Cronbach’s alpha = 0.93)
  • Excellent internal consistency for parent report (Cronbach’s alpha = 0.93)

Construct Validity

Convergent validity:

Cancer: (Varni et al., 1999)

  • Adequate to Excellent convergent validity between Patient Report PedsQL Core Scales for Psychological and Social functioning and standardized psychosocial instruments (ICC = 0.32 – 0.63)

 

Discriminant validity:

Cancer: (Varni et al., 1999)

  • Excellent discriminant validity between Patient Report PedsQL Physical functioning scale and standardized psychosocial instruments (ICC = 0.05 – 0.12)

Content Validity

Content validity supported through the development process. Supplied-response and generated-responses (open-ended) items were created based on an extensive search of the relevant literature, open-ended interviews with patients and their families, and discussions with pediatric healthcare professionals. The item pool was examined and further refined based on interviews with a new pool of patients, families, and healthcare professionals. (Varni et al., 1999)

Floor/Ceiling Effects

Cancer: (Varni et al., 1999)

  • Adequate: ceiling effects for PedsQL Core Total = 2.3-3.1%
  • Excellent: No floor effects for PedsQL Core Total

Pulmonary Diseases

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Standard Error of Measurement (SEM)

Asthma: (Seid et al., 2010; Child Self-Report: healthy n = 245, asthma n = 198, mild asthma n = 56, moderate asthma n = 79, severe asthma n = 63; Parent Proxy Report: healthy n = 460, asthma n = 252, mild asthma n = 68, moderate asthma n = 103, severe asthma n = 81)

  • SEM for Child self-report total: 6.12
  • SEM for Parent proxy-report total: 5.84

Minimal Detectable Change (MDC)

Asthma: (Seid et al., 2010; calculated MDC)

  • MDC for Child self-report: 16.93
  • MDC for Parent proxy-report: 16.18

Normative Data

Asthma: (Seid et al., 2010)

  • Healthy sample total score mean (SD): 80.39 (15.44)
  • Asthma sample total score mean (SD): 71.81 (15.27)
  • Asthma mild total score mean (SD): 77.64 (12.61)
  • Asthma moderate total score mean (SD): 71.29 (14.54)
  • Asthma severe total score mean (SD): 67.30 (16.80)

Internal Consistency

Asthma: (Seid et al., 2010)

  • Excellent internal consistency for child self-report (Cronbach’s alpha = 0.84)
  • Excellent internal consistency for parent proxy-report (Cronbach’s alpha = 0.82)

Construct Validity

Convergent validity:

Asthma: (Seid et al., 2010)

  • Adequate convergent validity between total scores on parent-proxy report and child self-report: (ICC = 0.47, p < 0.001)

 

Discriminant validity:

Asthma: (Seid et al., 2010)

  • Discriminant validity total score child self-report:
    • Significant difference between asthma and healthy (p < .001, independent-sample t test)
    • Significant difference between mild and severe (p < .01, ANOVA with Tukey post hoc tests)
    • Significant difference between mild and moderate (p < .05, ANOVA with Tukey post hoc tests)
  • Discriminant validity total score parent-proxy report:
    • Significant difference between asthma and healthy (p < .001, independent-sample t test)
    • Significant difference between mild and severe (p < .01, ANOVA with Tukey post hoc tests)

Responsiveness

Asthma: (Seid et al., 2010)

  • Effect sizes for patients who improved after 3 months (p < .001)
    • Large change for total child self-report: 0.58
    • Large change for total parent-proxy report: 0.62
  • Effect sizes for patients who remained stable after 3 months (p < .001)
    • Large change for total child self-report: 0.75
    • Large change for total parent-proxy report: 0.71

Mixed Populations

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Standard Error of Measurement (SEM)

Healthy Children and Children with Chronic Conditions: (Varni et al., 2003; Children n = 5,991; mean age = 7.9 (4.0), Parents n = 10,241)

  • SEM for child self-report total score: 4.36
  • SEM for parent proxy-report total score: 4.50

Minimal Detectable Change (MDC)

Healthy Children and Children with Chronic Conditions: (Varni et al., 2003; calculated MDC)

  • MDC for child self-report total score: 12.09
  • MDC for parent proxy-report total score: 12.47

Minimally Clinically Important Difference (MCID)

Healthy Children and Children with Chronic Conditions: (Varni et al., 2003)

  • MCID for child self-report total score: 4.36 score units
  • MCID for parent proxy-report total score: 4.50 score units

Cut-Off Scores

Healthy Children and Children with Chronic Conditions: (Varni et al., 2003)

  • Child self-report cut-off score = 69.7
  • Parent proxy-report cut-off score = 65.4
  • One SD below population mean = potential at risk status for impaired HRQOL (similar to children with a severe chronic health condition)

Normative Data

Psychiatric Disorders, Cancer, Diabetes: (Limbers et al., 2011; Healthy n = 1,453, mean age = 9.21 (4.46) years; ADHD and comorbid disorder n = 181, mean age = 11.08 (3.70) years; pediatric cancer n = 182, mean age = 8.22 (4.83) years; type 1 diabetes n = 320, mean age = 12.34 (3.94) years)

Mean (SD) of Total Score on PedsQL 4.0 Generic Core Scale by Report Type for Pediatric Patients with ADHD/Comorbid Psychiatric Disorders, Pediatric Cancer Patients on Treatment, and Pediatric Patients with Type 1 Diabetes

Report Type

ADHD/Comorbid Psychiatric

Healthy

Cancer (on treatment)

Type 1 Diabetes

Child self-report

67.00 (15.80)

85.86 (11.76)

68.92 (15.97)

80.79 (12.78)

Parent proxy-report

58.38 (18.04)

86.04 (12.72)

66.95 (19.85)

77.48 (14.33)

 

Healthy, Acutely and Chronically Ill Children: (Varni et al., 2001; children n = 963; mean age = 9.3 (4.37) years; parents n = 1,629)

Mean (SD) for Total Score on PedsQL by report type and illness level

Illness Level

Child Self-report

Parent Proxy-report

Chronically ill

77.19 (15.53)

74.22 (18.40)

Acutely ill

78.70 (14.03)

80.42 (15.26)

Healthy

83.00 (14.79)

87.61 (12.33)

 

Healthy UK and US Toddlers: (Buck, 2012; n = 256 (UK sample); mean age = 38 (10) months; age range = 2.0 to 4 years, 11 months; Toddler version of PedsQL)

Mean (SD) for parent proxy-report total score on PedsQL by sample type

Sample type

Mean (SD) for PedsQL Total Score

UK sample - males

                    87.6 (9.2)

UK sample – females

                    88.0 (8.0)

UK sample of healthy 2-4-yr-olds

                    87.8 (8.7)

US sample of healthy 2-4-yr-olds

                    87.8 (12.1)

 

 

Healthy and Chronically Ill(Varni et al., 2003)

PedsQL 4.0 Generic Core Total Scale Scores by demographics for Child Self-Report and Parent Proxy-Report

Demographics

Child Self-Report Total Score (Mean (SD))

Parent Proxy-Report Total Score (Mean (SD))

Male

83.16 (13.06)

81.25 (15.90)

Female

82.54 (13.27)

81.45 (15.95)

Toddler (age 2-4)

---

87.42 (12.49)

Young child (age 5-7)

81.86 (12.64)

78.02 (16.44)

Child (age 8-12)

83.31 (13.45)

78.86 (16.61)

Adolescent (age 13-18)

83.65 (13.30)

79.45 (16.40)

Spanish Language

82.12 (13.25)

79.18 (17.14)

English Language

83.27 (13.06)

83.48 (14.20)

Chinese Language

86.71 (12.49)

83.20 (13.91)

Korean Language

88.09 (10.93)

82.86 (15.85)

Vietnamese Language

86.48 (13.89)

87.35 (13.56)

Hispanic/Latino

82.42 (13.11)

80.40 (16.47)

White

83.70 (12.91)

84.53 (13.39)

Asian/Pacific Islander

85.22 (13.02)

82.30 (15.71)

Black/African-American

81.75 (13.08)

82.88 (13.61)

American Indian/Native Alaskan

77.17 (19.76)

83.75 (15.80)

 

 

PedsQL 4.0 Generic Core Total Scale Scores for Healthy and Chronic Health Condition Samples by Report Type

Report Type

Healthy Sample (Mean (SD))

Chronic Health Condition Sample* (Mean (SD))

Child self-report

83.91 (12.47)

74.16 (15.38)

Parent proxy-report

82.29 (15.55)

73.14 (16.46)

*Identified by their parents as having 1 of the following conditions: asthma, diabetes, attention deficit hyperactivity disorder (ADHD), depression, or “other.”

Internal Consistency

Healthy, Psychiatric Disorders, Cancer, Diabetes: (Limbers, 2011; n = 179 (children); n = 181 (parents))

  • Excellent internal consistency for total score child self-report: Cronbach’s alpha = 0.85
  • Excellent internal consistency for total score parent proxy-report: Cronbach’s alpha = 0.92

 

Healthy, Acutely and Chronically Ill (Varni , 2001)

  • Excellent internal consistency for Total Scale Score (Cronbach's alpha = 0.88 child, 0.90 parent)
  • Excellent internal consistency for Physical Health Summary Score (Cronbach's alpha = 0.80 child, 0.88 parent)
  • Excellent internal consistency for Psychosocial Health Summary Score (Cronbach's alpha = 0.83 child, 0.86 parent)

 

Healthy UK and US Toddlers (Buck, 2012)

  • Excellent internal consistency for Total PedsQL Score and Psychosocial Summary subscale (Cronbach’s alpha = 0.86 and 0.82, respectively)
  • Adequate internal consistency for:
    • Physical Health subscale (Cronbach’s alpha = 0.76)
    • Emotional Functioning subscale (Cronbach’s alpha = 0.76)
    • Social Functioning subscale (Cronbach’s alpha = 0.77)
  • Poor internal consistency for Nursery Functioning subscale (Cronbach’s alpha = 0.58)

 

Healthy and  Chronically Ill (Varni et al., 2003)

  • Excellent internal consistency for Total Scale Score (cronbach's alpha = 0.89 child self-report, 0.92 parent proxy-report)
  • Adequate to Excellent internal consistency for Physical Health Summary Score (cronbach's alpha = 0.77 child self-report, 0.88 parent proxy-report)
  • Excellent internal consistency for Psychosocial Health Summary Score (cronbach's alpha = 0.87 child self-report, 0.88 parent proxy-report)

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Pediatric Inpatient Population (Desai et al., 2014; Children n = 359; Parents n = 4,637)

  • A 10-point decrement in the PedsQL Total Score below the established community-based mean scores for the Child Self-Report was associated with:
    • A 15% increase in risk for length of stay (LOS) of 3 days or longer, p < 0.001.
    • An 8% increase in risk for 30 day unplanned readmissions, p < 0.01.
    • A 13% increase in risk for 30-day emergency department return visits, p < 0.001.

Construct Validity

Convergent validity:

Healthy, Acutely and Chronically Ill Children (Varni et al., 2001; n = 963; mean age = 9.3 (4.37))

  • Poor convergent validity between child self-report total score and care needed, school missed, work routine impact, and work concentration impact (r ranged from  -.28 to -.22)
  • Adequate convergent validity between parent proxy-report total score and care needed, work missed, work routine impact, and work concentration impact (r ranged from  -.50 to -.29)
  • Poor convergent validity between parent proxy-report total score and school missed (r = -.29)

 

Healthy, Psychiatric Disorders, Cancer, Diabetes (Limbers et al., 2011)

  • Significant mean differences between total scores for ADHD/Comorbid Psychiatric Disorders patients and healthy patients for both child self-report and parent proxy-report (p< 0.001)

 

Healthy, Acutely and Chronically Ill Children (Varni et al., 2001; n = 963; mean age = 9.3 (4.37))

  • The PedsQL distinguished between healthy children and pediatric patients with acute or chronic health conditions, was related to indicators of morbidity and illness burden, and displayed a factor-derived solution largely consistent with the a priori conceptually-derived scales.

 

Healthy and Chronically Ill Children (Varni et al., 2003)

  • The PedsQL distinguished between healthy children and children with chronic health conditions (total score mean difference was 9.15 for the child self-report and 9.75 for the parent proxy report).

Floor/Ceiling Effects

Healthy, Acutely and Chronically Ill Children (Varni et al., 2001)

  • Excellent: No floor effects for both healthy and ill children for child self-report for Total score and Physical Health, Psychosocial Health, and Social Functioning subscales.
  • Excellent: No floor effects for healthy children for parent proxy-report for Total score and Physical Health, Psychosocial Health, and Social Functioning subscales.
  • Adequate floor effects for both healthy and ill children on Emotional Functioning and School Functioning subscales of child self-report (0.3 - 0.8%) and the Emotional Functioning and School Functioning subscales of the parent proxy-report (0.1 – 0.7%).
  • Adequate floor effects for ill children on the Total Score and Physical Health, Psychosocial Health, and Social Functioning subscales of the parent proxy-report (0.2 - 2.3%).  
  • Adequate ceiling effects for both healthy and ill children for the Total Score and Psychosocial Health subscale on both the child self-report and the parent proxy-report (1.9 - 13.8%).
  • Adequate ceiling effects for ill children for the Physical Health and School Functioning subscales on the child self-report (13.0 - 13.1%) and the Physical Health, Emotional Functioning, and School Functioning subscales on the parent proxy-report (15.5 – 19.5%).
  • Poor ceiling effects for both healthy and ill children on the Emotional Functioning and Social Functioning subscales of the child self-report (22.4 - 47.1%) and the Social Functioning subscale of the parent proxy-report (34.4 - 58.1%).
  • Poor ceiling effects for healthy children on the Physical Health (25.8%) and School Functioning (23.1%) subscales of the child self-report (2 - 47.1%) and the Physical Health (39.6%), Emotional Functioning (29.5%), and School Functioning (34.5%) subscales of the parent proxy-report).
  • The ceiling effects were in the expected direction, with healthy children and their parents reporting more ceiling effects than children with health conditions.

 

Healthy UK and US Toddlers (Buck, 2012)

  • Excellent: no floor effects
  • Adequate ceiling effects:
    • 11% for Emotional Functioning subscale
    • 8% for Psychosocial Summary subscale
  • Poor ceiling effects:
    • 37% for Physical Health subscale
    • 39% for Social Functioning subscale
    • 57% for Nursery Functioning subscale

Mental Health

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Normative Data

Children with Psychiatric Problems: (Bastiaansen et al., 2004; n = 310; mean age = 11.3 (3.18) years; age range = 6 - 18.6 years)

Mean and Std. Deviation for PedsQL Total Score (TS) on Child Self-Report and Parent Proxy Report

Scale (Total Score)

PedsQoL 4.0 TS (Mean)

PedsQoL 4.0 TS (SD)

Child self-report

72.2

12.7

Parent proxy-report

66.9

14.0

 

ADHD: (Varni et al., 2006; ADHD children n = 72; ADHD parent n = 69; Healthy children n = 3,256; Healthy parent n = 3,251)

Mean and Std. Deviation for PedsQL Total Score (TS) on Child Self-Report and Parent Proxy Report for ADHD and Healthy Samples

Scale (Total Score)

PedsQoL 4.0 TS (Mean)

PedsQoL 4.0 TS (SD)

ADHD (child self-report)

               70.17

            18.28

ADHD (parent proxy-report)

               69.50

            16.17

Healthy (child self-report)

               84.29

            12.56

Healthy (parent proxy-report)

               79.87

            16.24

Interrater/Intrarater Reliability

Psychiatric Disorders, Cancer, Diabetes: (Limbers et al., 2011; comparison between child self-report and parent proxy-report)

  • Poor interrater reliability for Total Score (ICC = 0.24)

 

ADHD: (Varni et al., 2006; comparison between child self-report and parent proxy-report)

  • Adequate interrater reliability (ICC = 0.71)

Internal Consistency

ADHD: (Varni et al. 2006; n = 72 (children); n = 69 (parent))

  • Excellent internal consistency for total score child self-report (Cronbach’s alpha = 0.92)
  • Excellent internal consistency for total score parent proxy-report (Cronbach’s alpha = 0.92)

Construct Validity

Convergent Validity:

Children with Psychiatric Problems: (Bastiaansen et al., 2004)

  • Excellent convergent validity between total PedsQL score for child self-report and Youth Self-Report (r = -0.73)
  • Adequate convergent validity with total PedsQL score for parent proxy-report and Youth Self-Report (r = -0.39)

 

ADHD: (Varni et al., 2006; ADHD children n = 72; ADHD parents n = 69; Known Groups Method)

  • Large effect size of d = 1.12 for differences in total score child self-report for ADHD, cancer, cerebral palsy, and healthy samples
  • Moderate effect size of d = 0.64 for differences in total score parent proxy-report for ADHD, cancer, cerebral palsy, and healthy samples

Floor/Ceiling Effects

ADHD/Comorbid Psychiatric Disorders (Limbers et al., 2011; children n = 179; parents n = 181)

  • Excellent: No floor or ceiling effect for total score on child self-report
  • Excellent: No floor effect for total score on parent proxy report.
  • Adequate: Ceiling effect = 0.5% for total score on parent proxy-report

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