Objectives: The assessment of activities of daily living is important for planning and evaluation of therapeutic methods in handicapped children. The previous instruments are dependent on training and time-consuming. The objective was to develop a screening-questionnaire being easily applicable for the pediatrician in his daily work.
Material and Methods: In two studies, 80 3 to 7year old normal and 72 cerebral paretic children (GMFCS I to V) were examined by a parental questionnaire(M-ADL) assessing their activities of daily living on the dimensions eating/drinking, self care at home, mobility, toiletting, dexterity, communication, interactive skills. The internal and the external validity (comparison with the Pediatric Disability Inventory (PEDI)) were elicited. Further, the interrater reliability (comparison of the parent ratings with therapist ratings), the sensibility and specificity (comparison with the normal group) and the sensitivity for change (longitudinal comparison of a ADL-oriented therapy) were examined.
Results: The internal validity (comparison of a global rating with a rating based on scales) was high for the areas toiletting and mobility (r=0,96 resp. 0,82) and moderately high for dexterity and eating/drinking (r=0,69 resp. r=0,59). The external validity with the PEDI was high on the scales mobility and self care (r=0,9, r=0,72) and moderately high for social functions (r=0,60).
The interrater-reliability was 0,85 (eating and drinking), 0,94 (toiletting), 0,74 (dexterity) und 0,93 (mobility). The sensibility for eating and drinking was 0,82 (specificity 0,85), for toiletting 0,99 (1,0), for dexterity 0,91 (0,9)and for mobility 0,96 (0,91). Changes under a therapeutic approach focussing of everyday activities (A-B-A-Design) could be detected by the questionnaire.
Conclusions: The M-ADL is a good, easy to apply and fast screening instrument for the assessment of everyday activities which fulfills all essential test criterias.
