Applicability of goal attainment scaling in the evaluation of gross motor changes in children with cerebral palsy

The purpose of the study was to investigate the applicability of goal attainment scaling (GAS) in children with cerebral palsy (CP) by examining the psychometric properties of GAS. Three areas of psychometric properties were studied, namely: responsiveness, reliability and content validity. Three gross motor functional goals in the format of GAS and behavioural objectives were developed for 25 children with CP, but one child was excluded because of poor attendance. The content validity of the goals in the GAS format was first reviewed by a panel of experts. All children then received 4 months of conductive education as the intervention in a special child care centre. After the intervention, GAS scores as well as T-scores were compared with the achievement of behavioural objectives for responsiveness, and the inter-rater and intra-rater reliability of GAS were tested. GAS had good content validity (based on the descriptive analysis) and reliability (based on intraclass correlation coefficient) and was more responsive than the corresponding behavioural objectives. Thus, GAS was more useful than behavioural objectives in monitoring the longitudinal progress of a child and in providing precise information on the effectiveness of interventions to therapists and administrators. In conclusion, GAS is applicable in children with CP but limitations to its applicability are discussed.