Do parents and children agree on rating a child’s HRQOL? A systematic review and Meta-analysis of comparisons between children with attention deficit hyperactivity disorder and children with typical development using the PedsQL^TM

Abstract

Purpose: This meta-analysis was conducted to assess differences in a child’s health-related quality of life (HRQOL) as reported by the child and their parents using the Pediatric Quality of Life Inventory^TM, and the effects in both children with attention deficit hyperactivity disorder (ADHD) and those with typical development.

Methods: Eight studies encompassing 16 independent groups met the inclusion criteria and were combined and compared in this meta-analysis. Fixed effect analysis was applied in the subgroup analysis to compare differences between children with ADHD and those with typical development.

Results: Small to moderate magnitudes of parent-child discrepancies were found in the ratings of the children’s HRQOL both in those with ADHD (g = −0.23 [−0.33, −0.13], p < 0.001, physical HRQOL; g = −0.60 [−0.71, −0.48], p < 0.001, psychosocial HRQOL) and in those with typical development (g = −0.27 [−0.31, −0.23], p < 0.001, physical HRQOL; g = −0.29 [−0.33, −0.25], p < 0.001, psychosocial HRQOL) except for emotional HRQOL in children with typical development (g = 0.003 [−0.04, 0.04], p = 0.90). The parent-child discrepancy in rating the child’s psychosocial HRQOL was significantly larger in the children with ADHD than in those with typical development.

Conclusions and implications: This meta-analysis suggests that a child’s HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports. Parent-child discrepancies, especially in psychosocial HRQOL, and sources of discrepancy need to be addressed when assessing the child’s HRQOL and planning interventions in children with ADHD.

Implications for Rehabilitation

• Parents reported a significantly worse health-related quality of life of their children than both the children with attention deficit hyperactivity disorder and those with typical development.

• A child’s health-related quality of life needs to be assessed both by parent proxy and self-reports of the children.

• Children with attention deficit hyperactivity disorder and those with typical development differed significantly in parent-child discrepancy in child’s psychosocial health-related quality of life, but not in physical health-related quality of life.

• Parent-child discrepancies, especially in psychosocial health-related quality of life, and sources of discrepancy (e.g., child, parent or family characteristics) need to be addressed when assessing the child’s health-related quality of life and planning interventions in children with attention deficit hyperactivity disorder.

Keywords:

• ADHD
• parent
• child
• HRQOL
• informant agreement
• proxy report

Disclosure statement

All the authors have no commercial conflict of interest.

Additional information

Funding

This research was supported in part by a grant from the National Science Council in Taiwan (NSC 102 – 2410 - H- 040 – 008 MY2) to Y-C. L.