PURPOSE: The Pediatric Quality of Life Inventory™ (PedsQL™ 4.0) is widely used to assess quality of life (QoL) in children, yet evidence on the reliability and validity of young children's self-reports is inconsistent. We evaluated whether self-reported QoL in young children varies by parental presence during administration and whether parent-child agreement differed between mothers and fathers. METHODS: Secondary analyses were conducted using data from primary schools (n = 303, children aged 5-7 years) including at least one participating parent. Children completed the PedsQL self-report either at school with a trained research assistant (parent-absent) or at home with a parent who read items aloud and recorded answers (parent-present). Mothers and fathers completed parallel proxy-reports. Multilevel modeling was used to estimate mean differences and correlations between reporters and conditions, with age and sex as covariates. RESULTS: Internal consistency of child self-reports was limited across the four subdomains, with somewhat lower values in the parent-absent condition. Parent ratings showed no systematic differences between conditions, whereas children scored higher when a parent was present, yielding smaller parent-child gaps and higher correlations. These patterns were similar for mothers and fathers. CONCLUSIONS: In this school-based community sample, improved agreement with a parent present was driven by higher child scores, consistent with brief, non-leading parental assistance (clarification/recall). Self-reports of young children obtained without a parent present warrant caution. Clear, age-appropriate guidance on administration and structured parental support is needed.
Hartman et al. (Sat,) studied this question.