Measuring child functioning: Assessing correlation and agreement between caregiver and child responses at the Iganga-Mayuge health and demographic surveillance site in Uganda

• Published in: Disability and health journal Vol. 14; no. 2; p. 101022
• Main Authors: Zia, Nukhba, Bachani, Abdulgafoor M., Kajungu, Dan, Galiwango, Edward, Loeb, Mitchell, Diener-West, Marie, Wegener, Stephen, Pariyo, George, Hyder, Adnan A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2021
• Subjects: Adolescent; Africa; Caregivers; Child; Child disability; Child functioning module (CFM); Demography; Disabled Persons; Family; Humans; Iganga-Mayuge health and demographic surveillance site; Male; Uganda; Uganda; Iganga-Mayuge health and demographic surveillance site; Uganda; Child functioning module (CFM); Child disability; Africa
• ISSN: 1936-6574; 1876-7583
• DOI: 10.1016/j.dhjo.2020.101022

Empirical data is scare on assessment of concordance between caregiver-child responses on child functioning. To assess correlation and agreement between children (11–17 years old) and their caregivers’ responses to the UNICEF/Washington Group Child Functioning Module (CFM) at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Uganda. CFM with 24-questions corresponding to 13 domains of functioning was administered to children between 11 and 17 years of age and their caregivers. Descriptive analyses of the child/caregiver responses were conducted. Correlation and agreement between caregiver and child responses were assessed. Of the 217 caregiver/child pairs eligible for this study, 181 pairs agreed to participate (83.4%). The mean age of children was 13.9 ± 1.9 years, and 56.4% were males. Cronbach’s alpha was 0.892 and 0.886 for the caregiver and child versions of CFM respectively, showing good internal consistency in both. There was a significant overall agreement between mean score of caregiver (5.36 ± 5.63 out of 39) and child (5.45 ± 5.34) pairs. Spearman’s rank correlation between the pairs was 0.806 (strong positive correlation). Bland-Altman plots for CFM scores showed greater agreement between caregiver and child at lower scores. Percentage agreement between the pairs for overall disability was greater for mild (83.53%) and moderate (79.37%) categories as compared to the severe (66.67%) category. There was substantial agreement (kappa 0.623) for overall disability between the pairs. This study indicates that there is significant correlation and agreement between self-reported caregiver-child pair responses, opening the way for considering children as CFM respondents, when possible.