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RehabMeasures Instrument

Lifestyle Assessment Questionnaire

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Purpose

(Jessen, Colver, Mackie & Jarvis, 2003)

The assessment is a measure of the impact of disability based on how frequently children engage and participate in a range of activities and what those activities are. It also provides additional contextual information on the impact of the disability on the participation of the family unit.

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Instrument Details

Acronym LAQ/ LAQ-CP (Cerebral Palsy)/ LAQ-G (generic)

Area of Assessment

Activities of Daily Living
Social Support
Social Relationships
Behavior
Sleep
Functional Mobility

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$0.00

Cost Description

Free

Key Descriptions

  • 46 items in the instrument
  • Two types of scores are derived from the questionnaire. The first is a descriptive profile of the disadvantages experienced by the child and the second is an overall assessment of the total impact of the disability.
  • Disadvantages experienced by the child scores:
    1. Scores range from 0-4
    2. Scores are summed
    3. Raw scores are scaled on a quasi-continuous scale from 0-100
  • Total Impact of Disability Scores
    1. Linear Additive Model
    2. J=β〖〖_1〗n〖_1〗+〗_ β〖_2〗n〖_2〗....β〖_j〗n〖_j〗+C
    J=LAS
    β=weighting applied to each dimensional score
    n=dimensional score
    C=the constant term of the model
  • Administration: Caregivers are asked to complete the questionnaire

Number of Items

LAQ-CP: 46 items
LAQ-G: 53 items

Equipment Required

  • Questionnaire
  • Pen

Time to Administer

20 minutes

LAQ-CP: Approximately 20 minutes to complete
LAQ- G: 15-20 minutes to complete

Required Training

Reading an Article/Manual

Age Ranges

Preschool Children

2 - 5

years

Child

6 - 12

years

Instrument Reviewers

Lindsey Smits, OTS

Jessica Prucha, OTS

Danielle Roe, OTS

Shana Mangaldas, OTS

ICF Domain

Participation

Measurement Domain

Activities of Daily Living
Emotion
Motor
General Health
Cognition

Considerations

  • The LAQ manual has not been updated for several years
  • LAQ-CP is solely validated as a descriptive tool (Mackie et al., 2003)
  • Questionnaire is completed by proxy, not by the children themselves, so there may be discrepancies between parent and child perception of the consequences of disability
  • LAQ-G takes about 20 minutes to complete, which may be too lengthy for parents with significant care responsibilities
  • There is not a ‘gold standard’ tool to capture the impact of childhood disability to compare the results (Jessen et al., 2003)
  • The LAQ-CP was developed in England (Mackie et al., 1998)

Cerebral Palsy

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Cut-Off Scores

Cerebral Palsy: (Mackie, Jessen & Jarvis, 1998)

The LAQ-CP is scored out of 100 and can be represented as a percentage with a score of 100% describing a maximally disadvantaged child. A score of 70% would describe a child completing very few self care activities, posing substantial economic burden on their family, and would be in a specialized education setting. A score of 50% would describe a child who would need assistance in many self-care activities, would limit the economic status of their family, and would be receiving educational support. A score of 30% would describe a child who could complete most self care activities without assistance, does not pose an economic burden on their family, and attends mainstream school with little extra assistance.

Test/Retest Reliability

Cerebral Palsy: (Mackie et al., 1998; n=33, parents of children from the birth cohort of 1964-75 from the North-East England Cerebral Palsy Register) (LAQ-CP)

  • Excellent retest correlation after 4 years (r= 0.97, p <0.0001)
  • Friedman’s two-way, non-parametric analysis of variance between differences in two individuals’ scores showed no significant variation between the two data sets and large and stable variations between individuals’ first and second scores (X2 =0.29, NS)

Criterion Validity (Predictive/Concurrent)

Concurrent validity

Cerebral Palsy: (Mackie et. al, 1998)

Due to absence of a ‘gold standard’ with regard to children with CP, alternative theoretical construction was used and determined correlation between LAQ-CP score and functional limitation score (r = 0.76, p < 0.0001)

Construct Validity

Cerebral Palsy: (Mackie et al., 1998; n=44, from the birth cohort of 1980-85 from the North-East England Cerebral Palsy Register) (LAQ-CP)

  • Excellent correlation with the Central Motor Deficit Form (CMDF), a standardized measure for clinical findings in children with cerebral palsy (r = 0.76, p < 0.0001)

Pediatric Disorders

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Minimally Clinically Important Difference (MCID)

Children with Disabilities: (Jessen et al., 2003)

  • MCID > 0.5, p = 0.05; with a clinical difference determined to be no less than 0.5 between cases and controls on an item, it was calculated using an alpha level of 0.05, power of 0.9 and a standard deviation of 0.6, that the minimum sample size needed to detect a difference between groups is 33 cases and 33 controls.

Test/Retest Reliability

Children with Disabilities: (Jessen et al., 2003, n=24 parents)

  • Adequate test-retest reliability: Parents completed two questionnaires four to six weeks apart. P values for each item confirmed that none of the differences between controls and case children were statistically significant (p values for all 51 items are >0.24).

Interrater/Intrarater Reliability

Children with Disabilities: (Jessen et al., 2003, n=18 sets of caregiver)

  • Adequate Interrater reliability: Two parents each completed a questionnaire. P values confirmed that none of the differences were statistically significant (p values for all 51 items for cases and controls were >0.42)

(McConachie, Colver, Forsyth, Jarvis & Parkinson, 2006)

  • Acceptable reports acceptable levels of interrater reliability.

Internal Consistency

LAQ-G has a Cronbach a value of 0.66 or higher (McConachie et al., 2006).

Criterion Validity (Predictive/Concurrent)

Children with Disabilities (Jessen et al., 2003)

Predictive Validity:

  • Adequate specific patterns with Life Assessment Questionnaire domain scores by diagnostic category can be predicted. For example communication domain will have a higher impact score for children with autism or speech impairments

Concurrent Validity: (n=164 children with disabilities)

  • Good case/control comparisons showed that cases scored higher than controls for all except one questionnaire item, and this difference was significant (p < 0.05) for 49 out of the 53 of the questionnaire items. This suggests that the LAQ-G can appropriately discriminate between children with and without disability

Construct Validity

Children with Disabilities (Jessen et al., 2003, n=164 children with disabilities)

Discriminant validity:

  • Excellent discriminant validity of children with disabilities and control children. For all but one item cases scored higher than controls with p <0.05 for 49 out of 53 items.  

Content Validity

Children with Disabilities (Jessen et al., 2003)

  • Good Content Validity of the LAQ-G was determined by a panel of 17 specialists in the fields of pediatrics, child mental health, special education, health services research and social services. These experts reviewed 70 items and provided feedback. Then the authors and two additional professionals reached a consensus on 66 items that were then pilot tested on 16 families. Items that were highly correlated (Kendall’s correlation of 0.8 or higher) were removed.

Face Validity

Children with Disabilities (Jessen, Colver, & Jarvis, 2005)

  • Face validity of the LAQ-G was determined by asking parents who have filled out the questionnaires for comments. The LAQ-G manual reports that overall the questions made sense to parents and the face validity appears “reasonable”.

Bibliography

Jessen, E.C., Colver, A.F., Mackie, P.C., & Jarvis, S.N. (2003). Development and validation of a tool to measure the impact of childhood disabilities on the lives of children and their families. Child: Care, Health & Development: 29(1), 21-34.

Jessen, C., Colver, A., & Jarvis, S. (2005). The generic lifestyle assessment questionnaire (LAQ-G): An instrument to measure restrictions in the participation of children with disabilities and their families. Retrieved from https://research.ncl.ac.uk/cargo-ne/contents.html

Mackie, P.C., Jessen, E.C., & Jarvis, S.N. (1998). The lifestyle assessment questionnaire: An instrument to measure the impact of disability on the lives of children with cerebral palsy and their families. Child: Care, Health & Development: 24(6), 473-486.

Mackie, P. C., Jessen, E. C., & Jarvis, S. N. (2003). The lifestyle assessment questionnaire (LAQ-CP) manual. Newcastle upon Tyne: North of England Collaborative Cerebral Palsy Survey.

McConachie, H., Colver, A. F., Forsyth, R. J., Jarvis, S. N., & Parkinson, K. N. (2006). Participation of disabled children: how should it be characterised and measured?. Disability and Rehabilitation28(18), 1157-1164.