To Explore the Validity of Change Scores of the Children's Hand-use Experience Questionnaire (CHEQ) in Children with Unilateral Cerebral Palsy

ABSTRACT

Aims: To explore the validity of change scores of the Children's Hand-use Experience Questionnaire (CHEQ). Methods: Analysis of the CHEQ included 44 children (15 girls) between 6–16 years (median 9.0; IQR 8–11) with unilateral cerebral palsy, with baseline and post- (two-week intensive) intervention assessments using the Goal Attainment Scale (GAS) as external anchor for change. Hypotheses on the magnitude of expected change were formulated and correlation coefficients and effect sizes calculated. Receiver operating curve analysis was performed and the area under the curve (AUC) calculated to investigate the ability of CHEQ to discriminate between improvement and non-improvement according to GAS. Results: All hypotheses about the magnitude of change were confirmed supporting longitudinal validity of CHEQ scales to measure change in the perception of bimanual performance. AUCs for the Grasp efficacy and the Time utilization were slightly below, and for the Feeling bothered slightly above the threshold. The latter one accurately discriminating between children that improved and did not improve according to the GAS. Conclusions: Evidence was found that CHEQ scales capture change in bimanual performance but with limited accuracy for two out of three scales. The validity of CHEQ change scores needs to be further explored in a wider population.

KEYWORDS:

• Anchor
• bimanual performance
• construct approach
• longitudinal validity
• psychometric properties
• responsiveness

Acknowledgments

We would like to thank all children and their parents that contributed to this research project as well as students from Oxford Brookes University for collecting the data.

Disclosure statement

We hereby declare that Ann-Christin Eliasson is co-developer of the Children's Hand-use Experience Questionnaire. All other authors involved in this project declare no conflict of interest.

About the Author

Ulrike C. Ryll, MSc, is a clinical epidemiologist and physiotherapist currently a PhD student at the Department of Women's and Children's Health, Karolinska Institutet, Stockholm. Her particular interests are in neuropediatric rehabilitation and health outcome measures.

Carolien H. G. Bastiaenen, PhD, is a clinical epidemiologist, physiotherapist, and Assistant Professor at the Department of Epidemiology, Maastricht University. Her expertise is in the field of health measures within the ICF framework as well as in evaluation research in the field of rehabilitation from an epidemiological perspective.

Ann-Christin Eliasson, PhD, is an occupational therapist and professor at the Department of Women's and Children's Health, Karolinska Institutet, Stockholm. Her research focus is on children with developmental disorders with her main interest in hand function in children with cerebral palsy.

Dido Green, PhD, is an occupational therapist and researcher at the Centre for Rehabilitation at Oxford Brookes University and Associate Professor at the Department of Occupational Therapy, Jönköping University. Her focus is on translational medicine and evidence based practice, emphasizing an ecological approach to understanding challenges to performance and participation in children with movement disorders.

Additional information

Funding

This research was supported by funding from Stiftelsen Frimurare Barnhuset Stockholm, Guy's and St Thomas' Charity and Beit Issie Shapiro and supported by Breathe Arts Health Research.