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Arch Phys Med Rehabil. 1995 Oct;76(10):913-8.

The role of children in reporting their physical disability.

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Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.



To explore the contributions of children during the development of a disability scale, and their competence using the new scale.


A new self-report measure of pediatric physical performance, the Activities Scale for Kids (ASK), was developed based on interviews and pilot testing with children. The ASK was then filled out by children on two occasions 2 weeks apart to assess the reliability of child self-report. Validity was assessed by comparison of interview data and ASK scores from children with similar data collected from their parents, and to clinician and family global ratings of disability.


The study was conducted at a pediatric tertiary care hospital and its affiliated rehabilitation center.


All subjects, 5 to 15 years of age, experienced activity limitations because of musculoskeletal disorders and were free of cognitive impairment. Thirty children (mean age, 11.5 years) participated in the development of the ASK, and 28 children (mean age, 11.4 years) participated in testing of reliability and validity.


Children generated items similar to those generated by parents (85% agreement) and identified 10 items not obtained from parents or the literature. Children demonstrated excellent test-retest reliability (intraclass correlation coefficient [ICC] = .97) using the ASK, and their scores were highly concordant with parent-reported ASK scores (ICC = .96). Validity was ascertained by comparison of ASK scores across different levels of disability based on global ratings of families and clinicians (p = .0023).


Children are able to play an important role in pediatric physical disability evaluation.

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