Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. e93-e102 (doi:10.1542/10.1542/peds.2005-3211)
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ARTICLE

At What Age Can Children Report Dependably on Their Asthma Health Status?

Lynn M. Olson, PhDa, Linda Radecki, MSa, Mary Pat Frintner, MSPHa, Kevin B. Weiss, MDb, Jon Korfmacher, PhDc and Robert M. Siegel, MDd

a Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois
b Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
c Erikson Institute, Chicago, Illinois
d Cincinnati Pediatric Research Group, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

OBJECTIVE. This study examined psychometric properties and feasibility issues surrounding child-reported asthma health status data.

METHODS. In separate interviews, parents and children completed 3 visits. Child questionnaires were interviewer administered. The primary instrument was the Children's Health Survey for Asthma–Child Version, used to compute 3 scales (physical health, activities, and emotional health). The following were assessed: reliability (internal consistency and test-retest reliability), validity (general health status, symptom burden, and lung function), and feasibility (completion time, missing data, and inconsistent responses).

RESULTS. A total of 414 parent-child pairs completed the study (mean child age: 11.5 years). Reliability estimates for the activities and emotional health scales were >.70 in all but 1 age category; 5 of 9 age groups had acceptable internal consistency ratings (≥.70) for the physical health scale. Cronbach's {alpha} tended to increase with child age. In general, test-retest correlations between forms and intraclass correlation coefficients were strong for all ages but tended to increase with child age. Correlations between forms ranged from .57 (7-year-old subjects, physical health) to .96 (14-year-old subjects, activities). Intraclass correlation coefficients ranged from .76 (13-year-old subjects, emotional health) to .94 (15–16-year-old subjects, physical health). Children with less symptom burden reported higher mean Children's Health Survey for Asthma–Child Version scores (indicating better health status) for each scale, at significant levels for nearly all age groups. Children's Health Survey for Asthma–Child Version completion times decreased from 12.9 minutes at age 7 to 6.9 minutes at age 13.

CONCLUSIONS. This research indicates that children with asthma as young as 7 may be dependable and valuable reporters of their health. Data quality tends to improve with age.

Key Words: child • pediatric • asthma • health status • Children's Health Survey for Asthma

Abbreviations: CHSA—Children's Health Survey for Asthma • CHSA-C—Children's Health Survey for Asthma–Child Version • ASD-14—Asthma Symptom Day-14 • FEV1—forced expiratory volume in 1 second • LSD—least-significant difference • PPVT-III—Peabody Picture Vocabulary Test • Third Edition

Accepted Aug 1, 2006.


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