Cross-cultural adaptation, validation and reliability of turkish version of child engagement in daily life measure for children with cerebral palsy

Introduction and Purpose: The assessment of participation in daily life activities among children with cerebral palsy (CP) is essential for the implementation of effective rehabilitation interventions. It is imperative to use standardized functional assessment scales to objectively measure participation in activities, particularly in CP. The purpose of this study is to translate the Child Engagement in Daily Life Measure (CEDL) into Turkish and assess the psychometric properties, including cultural adaptation, reliability, and validity of Turkish CEDL in children with CP. Materials and Method: 273 children diagnosed with cerebral palsy (CP) and 110 healthy children without CP, aged 1.5-12 years, and their parents participated in this study. Parents completed the CEDL measure, which consists of two domains: (1) participation in family and recreational activities (11 items) and (2) self-care (18 items). The Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) were recorded for children with CP. The reliability of CEDL was assessed through internal consistency and test-retest reliability, internal structural validity was evaluated through Rasch analysis, and external validity was assessed using the known-groups method by comparing results with age-specific GMFCS and MACS levels from the literature. Results: The internal consistency of CEDL was high, with Cronbach's alpha values ranging from 0.89 to 0.98. Test-retest reliability was high for participation frequency in family and recreational activities (ICC = 0.827, 95% CI = 0.723-0.895), moderately high for enjoyment status (ICC = 0.778, 95% CI = 0.647-0.864) and quite high for self-care performance (ICC = 0.97, 95% CI = 0.948-0.982). The items in the measure demonstrated a good fit and a logical hierarchical ordering. Children with CP exhibited lower participation frequency, enjoyment status in family and recreational activities, and self-care performance compared to their healthy peers, varying based on GMFCS and MACS levels. Conclusions: The Turkish CEDL proves to be a valid and reliable measure with adequate psychometric properties for assessing participation in children with cerebral palsy aged 1.5-12 years. Keywords: Cerebral palsy, participation, self-care, reliability, validity