Assessing the PedsQL’s Effectiveness as a Multidisciplinary Outcome Measure in Pediatric Rehabilitation

Children with complex conditions often receive occupational (OT), physical (PT) and speech (ST) therapy to improve participation in meaningful activities. These therapies utilize standardized assessments, which may not fully reflect improvements in a child’s performance. The Pediatric Quality of Life Inventory (PedsQL) is a widely used tool to measure health-related quality of life (HRQOL) across physical, emotional, social, and cognitive domains. Evidence is limited in its ability to capture clinically significant changes in therapy. This research examined the inclusion of the PedsQL Generic Core form within rehabilitation to bridge the gap between standardized assessments and meaningful performance changes. This retrospective study reviewed OT, PT, and ST electronic records over one year across three pediatric outpatient clinics. Records included a PedsQL at initial evaluation and a formal progress review. Records were categorized and cross-tabulated in Excel based on therapy type, standardized assessments, PedsQL scores, clinical impressions, areas of concern, and therapy goals. PedsQL scores below 65% were flagged to examine alignment with assessments and goals. Clinical impressions and therapy concerns were also reviewed to gauge the PedsQL’s effectiveness in capturing these issues. Of 91 children, 28 met the inclusion criteria. Only 46% of the goals aligned with low PedsQL scores. Additionally, 28% of OT, 70% of PT, and 79% of ST clinical impressions did not align with the PedsQL scores. Common therapy targets such as balance and coordination, fine and visual motor skills, communication, and play skills were not explicitly captured by the generic PedsQL. While the PedsQL is effective for assessing HRQOL, it does not adequately capture clinically significant improvements.

IMPACT STATEMENT: Clinically significant gains are crucial for effective therapy. Including a more precise tool could better reflect the true impact of therapy on quality of life.

References

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