Child Health Questionnaire (CHQ)
Child Health Questionnaire · Also known as: CHQ-50, CHQ-28, CHQ-PF28, CHQ-CF87
The Child Health Questionnaire is a generic, parent-reported instrument developed by Landgraf et al. in 1996 to measure health-related quality of life in children aged 5–18 years. Unlike disease-specific measures, the CHQ captures broad domains of physical, emotional, social, and school functioning, making it suitable for diverse pediatric populations with or without chronic conditions. The CHQ-50 is the most widely used parent-report form; shorter (CHQ-28) and comprehensive (CHQ-CF87 child + family) versions are also available.
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When to use it
The CHQ is a generic measure appropriate for children aged 5–18 years with any condition, chronic or acute, or for health surveillance in school or community settings. It is particularly valuable in pediatric trials with heterogeneous populations (e.g., general quality-of-life improvement studies), in chronic disease management programs (asthma, diabetes, arthritis, cancer), in surgical outcome evaluation, and in population health research. The CHQ-50 is the standard in research; CHQ-28 is used when brevity is needed (e.g., clinic follow-up); CHQ-CF87 is used when child self-report and extended family data are important. The CHQ is not appropriate for children <5 years (use infant/toddler measures instead) or for adult populations.
Strengths & limitations
- Generic instrument suitable for any pediatric population, enabling cross-condition comparisons and use in mixed or heterogeneous samples.
- Includes family-impact measures (parental emotional and time burden), recognizing that child health affects parental well-being.
- Multiple versions (CHQ-50, CHQ-28, CHQ-CF87) accommodate different research contexts and respondent populations.
- Norm-referenced (US population mean = 50, SD = 10), enabling comparison to population reference values.
- Extensively validated and translated into multiple languages with strong psychometric properties (Cronbach's α >0.70 for most scales).
- Captures 12 distinct health concepts, providing detailed profile of strengths and limitations across domains.
- Parent-report bias: Parents may not fully perceive or report their child's emotional or social experiences; child self-report often differs significantly from parent proxy.
- Limited child self-report versions: The primary CHQ-50 and CHQ-28 are parent-report; the CHQ child self-report (CHQ-CY) is less widely available, limiting adolescent voice.
- US-normed population reference: The norm-referenced scores are based on a US population; international use requires separate normative data.
- Not disease-specific: Generic approach may lack sensitivity to disease-unique impacts (e.g., diabetes burden, asthma symptoms) compared to disease-specific measures.
- Requires license for use: Unlike some public-domain instruments, the CHQ requires permission and licensing from the copyright holder (HealthAct).
Frequently asked
Is the CHQ-50 or CHQ-28 better for my study?
CHQ-50 is the standard research version with all 12 scales; use it unless brevity is a critical concern (e.g., busy clinic settings with time constraints). CHQ-28 is shorter but has fewer items per scale, reducing precision. If time permits, CHQ-50 is preferred for research.
How do I interpret a CHQ summary score of 45?
A score of 45 is below the population mean (50) by 0.5 SD and indicates below-average health. However, this summary score should be examined alongside the 12 individual scale scores to identify which specific domains are affected. A score of 45 might reflect one severely impaired scale or several mildly impaired scales; the clinical interpretation differs.
Can I use the CHQ with non-English-speaking families?
Yes, the CHQ has been translated into many languages (Spanish, French, German, etc.). Ensure that the specific translation you use has been validated and normed in the target population, as cultural differences may affect item interpretation. Using a translated version with US norms can produce misleading results.
Should I use CHQ-50 parent report or CHQ child self-report for adolescents?
Ideally, use both. Parent and child perspectives often differ for adolescents. Parent report captures family-level impacts and observable behaviors, while child self-report captures emotional and social experiences that parents may not perceive. In research with limited resources, adolescent self-report is typically prioritized.
Sources
- Landgraf, J. M., Abetz, L., & Ware, J. E. (1996). The CHQ User's Manual. HealthAct. ISBN: 978-0965475303
- Landgraf, J. M., Rich, M., & Rapoff, M. A. (2002). Measuring quality of life in children with arthritis: The Childhood Health Assessment Questionnaire. Journal of Rheumatology, 29(8), 1609-1617. link ↗
How to cite this page
ScholarGate. (2026, June 3). Child Health Questionnaire. ScholarGate. https://scholargate.app/en/pediatric-medicine/child-health-questionnaire
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