Construct-concurrent validity and reliability of the European Child Environment Questionnaire (ECEQ) in a sample of Turkish children with cerebral palsy

Disabil Rehabil. 2020 Sep 29;1-9. doi: 10.1080/09638288.2020.1822930. Online ahead of print.


Purpose: To investigate the construct-concurrent validity and reliability of the Turkish version of the European Child Environment Questionnaire (ECEQ-T) in children with cerebral palsy (CP).

Methods: Mean age 9.53 ± 4.45 years 306 children with CP and their parents participated in the study. While construct validity was assessed using confirmatory factor analysis, concurrent validity was investigated using the correlation between ECEQ-T and Pediatric Evaluation of Disability Inventory (PEDI) with Spearman's correlation analysis. For test-retest reliability, ECEQ-T was administered twice to 65 parents with an interval of two weeks. Cronbach's alpha (α) and Intraclass Correlation Coefficient (ICC) were used for reliability.

Results: Construct validity (RMSEA > 0.080; GFI ≥ 0.90) and concurrent validity (r: -0.533 to -0.293; p < 0.05) were confirmed as acceptable. Eight items were dropped out as they did not fit the model and finally ECEQ-T contains 54 items in three domains. High Cronbach's α and ICC values were found (Cronbach αPE: 0.960/ICCPE: 0.959, Cronbach αSS: 0.955/ICCSS: 0.954), Cronbach αA: 0.822/ICCA: 0.802, Cronbach αT: 0.957/ICCT: 0.955).

Conclusion: ECEQ-T has demonstrated good psychometric properties and can be used as a reliable and valid measure to assess environmental factors. We believe that ECEQ-T is a useful and detailed questionnaire to determine barriers-facilitators for increasing activity and participation in Turkish children with CP.IMPLICATIONS FOR REHABILITATIONThe Turkish version of ECEQ has acceptable construct validity and moderate concurrent validity for evaluating environmental factors in children with cerebral palsy.The Turkish version of ECEQ provides valuable information, which could be helpful to guide public health services and government policies in order to optimize the participation of children with CP.Environmental factors may play an important role in activity and participation in children with cerebral palsy. Turkish version of the ECEQ can be used for evaluating the environmental factors to determine barriers of activity and participation.

Keywords: European Child Environment Questionnaire; ICF-CY; cerebral palsy; reliability; validity.