CHILDREN WITH SPECIAL HEALTH CARE NEEDS (CSHCN): ISSUES AND OPTIONS IN SELECTING HEALTH INDICATORS REVIEW OF LITERATURE AND QUALITY ASSURANCE TOOLS Family Health Outcomes Project University of California, San Francisco

The advantages and limitations of using functional methods are discussed in the context of identifying undernutrition and hunger in children in the United States. At this time, many of these methods have been used only in developing countries where undernutrition is more serious. However. there is great need to investigate whether, when and how undernutrition in the United States affects children's development. Functional measures can detect undernutrition and hunger in some situations where biochemical or clinical measures cannot. Andersson Gare B; Fasth A; Wiklund I. Measurement of Functional Status in Juvenile Chronic Arthritis: Evaluation of a Swedish Version of the Childhood Health Assessment Questionnaire. Clin Exp Rheumatol, 1993 Sep-Oct, 11(5):56976. Abstract: Few well-validated selfand/or parent-administered instruments are available for measuring functional status in children with rheumatic diseases. Parts of the Stanford Health Assessment Questionnaire (HAQ) have been adapted for use in children in the so-called Child HAQ. The aim of this study was to investigate the validity of this instrument in a Swedish setting. The Child HAQ was administered to 186 patients and 211 patients participating in a population-based follow-up study of juvenile chronic arthritis (JRA) in southwestern Sweden. The EULAR criteria were used for inclusion. Children who were 9 years of age or older self-reported. Reliability, evaluated by test-retest, inter-observer correlations and internal reliability, was excellent. Convergent validity was demonstrated by strong correlations of the disability index, pain. and morning stiffness with disease activity and the Steiribrocker functional classes. Discriminant validity was evidenced by the capacity of the instrument to evaluate patients as being active or in remission. Thus, the Child HAQ showed Few well-validated selfand/or parent-administered instruments are available for measuring functional status in children with rheumatic diseases. Parts of the Stanford Health Assessment Questionnaire (HAQ) have been adapted for use in children in the so-called Child HAQ. The aim of this study was to investigate the validity of this instrument in a Swedish setting. The Child HAQ was administered to 186 patients and 211 patients participating in a population-based follow-up study of juvenile chronic arthritis (JRA) in southwestern Sweden. The EULAR criteria were used for inclusion. Children who were 9 years of age or older self-reported. Reliability, evaluated by test-retest, inter-observer correlations and internal reliability, was excellent. Convergent validity was demonstrated by strong correlations of the disability index, pain. and morning stiffness with disease activity and the Steiribrocker functional classes. Discriminant validity was evidenced by the capacity of the instrument to evaluate patients as being active or in remission. Thus, the Child HAQ showed