Worldwide, Cerebral Palsy (CP) is the most common disability in childhood. In Thailand, the CP population was reported to be more densely distributed in central and north-eastern region. Due to lack of information related to current local practices, a chart audit was used to extract information about management of children with CP in Thailand, using charts from hospitals and schools in central region including Bangkok Metropolitan Region. This region, where better practice was expected than other regions, was selected to initially reflect the current situation in Thai health care practice. The International Classification of Functioning, Disability and Health-Children and Youth version (ICF-CY) framework was applied to explore assessment and intervention reported on the charts in hospital and school settings for children with CP aged 0-14 years. It appeared that assessment and intervention was provided and recorded in all components of the ICF-CY; Body Functions and Structures, Activity, Participation, and Contextual factors (Personal and Environmental factors) but that reports were mainly found in Body Functions and Structures, a few in Activity with few in Participation. Furthermore, use of standardized tools for assessment was rarely reported in the charts.
The paucity of reports in Activity and Participation components of the ICF-CY might be due to a lack of appropriate Thai measures for these children. Consequently, translation of a measure of Health-Related Quality of Life (HRQOL) into the Thai language was performed. The Pediatric Quality of Life Inventory 3.0 Cerebral Palsy Module (PedsQL 3.0 CP) was translated into Thai and its psychometric properties established in a cohort of 54 children/adolescents with CP (aged 5-18 years) and 97 parents of those aged 2-18 years. Good to excellent test-retest reliability and acceptable internal consistency (except for Movement and Balance Scale) were found for the Thai PedsQL 3.0 CP. A generic HRQOL instrument, the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL 4.0) has already been translated into Thai, but no psychometric properties were reported. Therefore, a further study explored the reliability and internal consistency of the Thai PedsQL 4.0 in the same group of children with CP (N=54, parents N=97). Additionally, the relationship between these instruments, correlation and differences between parent proxy-report and self-report, were also investigated. Good reliability and acceptable internal consistency of most scales in PedsQL 4.0 was supported. The PedsQL 3.0 CP tends to provide better psychometric properties for this CP cohort. Some correlation was found between the two instruments, and it might be important to use both instruments to assess HRQOL more completely for children/adolescents with CP. Correlation between parents and children/adolescents ranged from ii fair to excellent and some significant differences between their rating scores were reported. It is important to note that parent-proxy report might not be always a true reflection of how the child’s self perception. Therefore, self-report should be used where possible.