Measuring child functioning: Assessing correlation and agreement between caregiver and child responses at the Iganga-Mayuge health and demographic surveillance site in Uganda.
Nukhba Zia, Abdulgafoor M Bachani, Dan Kajungu and 6 others
PMID 33218854WHAT IT FOUND
Children aged 11 to 17 in Uganda reported their own disability levels with agreement similar to their caregivers.
Clinicians can trust child self-reports for physical and cognitive domains, but should still interview caregivers to capture context and mental health nuances.
Key findings
01Overall agreement between caregiver and child disability scores was substantial, with a kappa statistic of 0.623.
02Agreement was lower for anxiety and depression domains compared to physical domains, suggesting caregivers and children perceive mental health limitations differently.
03Children reported higher percentages of mild and moderate disability, while caregivers reported more severe disability, indicating potential differences in perception of severity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was conducted at a single site in Uganda, so results may not generalize to other regions or low- and middle-income countries. There was no clinical verification of the reported disabilities, so agreement reflects perception rather than objective diagnostic accuracy. The cross-sectional design cannot account for changes in disability perception over time or as children develop coping mechanisms. Data on factors influencing school enrollment, such as teacher attitudes or school accommodations, were not collected.
Declared interests
None declared.
The easy way to misread this
Do not assume that high overall agreement means child self-reports are sufficient for all domains. Agreement was notably lower for anxiety and depression, and caregivers reported significantly more severe disability than children, so clinical judgment should still weigh caregiver perspectives heavily for mental health and severity assessments.