Comparative content review of children's participation measures using the international classification of functioning, disability and health-children and youth

Objective: To evaluate to what extent instruments that intend to measure children's participation actually do so, and to what extent their items can be classified according to the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). Data Sources: A systematic search was conducted in MEDLINE, CINAHL, PsycINFO, ERIC, and EMBASE and was limited to the period between January 2000 and May 2011. The search terms of participation, outcome measure, and children were used to identify potential children's participation measures. Data Selection: Instruments were included if they (1) evaluated children's participation based on assessment purpose; (2) were suitable for use with children aged 2 to 12 years; (3) were generic assessments that could be used with a range of disabilities; and (4) involved self-report, proxy report, or interview administrations. Data Extraction: Instruments were obtained from identified full-text articles and were evaluated for inclusion through group discussion. Two researchers further independently reviewed each included instrument to determine which of the items measured participation based on a contemporary definition. These items were also classified using the ICF-CY linking rules to reflect each instrument's content coverage. Data Synthesis: Sixteen instruments were identified with 11 found to have more than half of their items measuring participation, but only the School Function Assessment-Participation section comprised 100% participation items. The participation items in each instrument captured between 3 and 9 ICF-CY Activities and Participation domains. Only the Child and Adolescent Scale of Participation and the Participation and Environment Measure for Children and Youth covered all domains. Among the ICF-CY Activities and Participation domains, the interpersonal interactions and relationships domain was addressed the least. Conclusions: This review revealed differences in the inclusion of participation items in existing children's participation measures and their classification according to the ICF-CY. These differences need to be considered when selecting an instrument.