Child engagement in daily life: a measure of participation for young children with cerebral palsy

PURPOSE: The objectives of this study were to determine the: (1) internal consistency and test-retest reliability of the Child Engagement in Daily Life measure; (2) construct validity of the measure (known groups methods), that is, the ability of the measure to discriminate participation in family and recreational activities and self-care among young children of varying age and motor ability and between children with and without cerebral palsy, and (3) stability and hierarchical ordering of the items for young children with CP to devise an interval-level scoring system. METHODS: 429 children with CP and their parents and 110 parents of children without CP participated in this methodological study. Parents completed the Child Engagement in Daily Life measure and therapists assessed the children's gross motor function. Rasch analysis was used to create an interval-level measure. RESULTS: Children's frequency in and enjoyment of participation in family and recreational activities and self-care varied by age and gross motor ability. Internal consistency of the domains of the measure was high, Cronbach alpha values ranging from 0.86 to 0.91; test-retest for participation in family and recreational activities was acceptable, ICC = 0.70, and in self-care was high, ICC = 0.96. The items in the measure had a good fit and a logical hierarchical ordering. CONCLUSION: Study results support the validity and reliability of the Child Engagement in Daily Life measure as an assessment of participation in family and recreational activities and self-care for young children with CP. IMPLICATIONS FOR REHABILITATION: Participation in family and recreational activities and self-care for young children with cerebral palsy can be reliably and validly assessed using the Child Engagement in Daily Life measure. Service providers are encouraged to support young children's participation in family and recreational activities and self-care.