Childhood Health Assessment Questionnaire (CHAQ)

Childhood Health Assessment Questionnaire (CHAQ)

1. Dressing & Grooming

1a. Dress, including tying shoelaces and doing buttons?

1b. Shampoo his/her hair?

1c. Remove socks?

1d. Cut fingernails?

2. Arising

2a. Stand up from a low chair or floor?

2b. Get in and out of bed or stand up in a crib?

3. Eating

3a. Cut his/her own meat?

3b. Lift a cup or glass to mouth?

3c. Open a new cereal box?

4. Walking

4a. Walk outdoors on flat ground?

4b. Climb up five steps?

5. Hygiene

5a. Wash and dry entire body?

5b. Take a tub bath (get in and out of tub)?

5c. Get on and off the toilet or potty chair?

5d. Brush teeth?

5e. Comb/brush hair?

6. Reach

6a. Reach and get down a heavy object from above head?

6b. Bend down to pick up clothing or paper from floor?

6c. Pull on a sweater over his/her head?

6d. Turn neck to look back over shoulder?

7. Grip

7a. Write or scribble with pen or pencil?

7b. Open car doors?

7c. Open jars that have been previously opened?

7d. Turn faucets on and off?

7e. Push open a door when turning a doorknob?

8. Activities

8a. Run errands and shop?

8b. Get in and out of a car, toy car, or school bus?

8c. Ride bike or tricycle?

8d. Do household chores (dishes, trash, vacuum, yardwork, etc.)?

8e. Run and play?

Pain Assessment
0 (No Pain) 100 (Very Severe)
Current Pain: 0
Global Evaluation
0 (Very Well) 100 (Very Poor)
Current Global: 0

CHAQ Disability Index (0 - 3): 0

Pain Score (scaled 0 - 3): 0

Global Score (0 - 100): 0

Assistive Devices Used: None

Help Needed: None

CHAQ Tool Guide

Childhood Health Assessment Questionnaire (CHAQ) Tool Guide

This web application was created by Dr. Ahmed Omar for RheumGuide.ca (Version 1 – April 2025).

This web application streamlines the administration and scoring of the Childhood Health Assessment Questionnaire (CHAQ). The CHAQ is designed to assess a child's functional ability over the past week by focusing on disabilities directly related to illness. It is intended for use by clinicians and parents to document functional status, pain, and overall health.

How to Use the CHAQ Application

  1. Patient Information:
    • Enter the Encounter Date.
    • Enter the Patient Name (optional) and Date of Birth (DOB) (optional). The application will automatically calculate the patient’s age.
  2. Functional Ability Assessment:
    • The CHAQ consists of 30 questions grouped into 8 domains: Dressing & Grooming, Arising, Eating, Walking, Hygiene, Reach, Grip, and Activities.
    • For each question, select one of the following responses (based solely on difficulties caused by illness):
      • No Difficulty (0)
      • Some Difficulty (1)
      • Much Difficulty (2)
      • Unable to Do (3)
      • Not Applicable (if the activity is not expected for the child's age)
    • The score for each domain is the highest rating among the answered questions. If any assistive device or help is marked, the domain score is adjusted to a minimum of 2 (unless a 3 is already recorded).
    • If all questions in a domain are marked as "Not Applicable" or left unanswered, that domain is excluded from the overall scoring.
  3. Pain and Global Evaluation:
    • Use the Pain slider (0–100) to indicate the severity of pain experienced over the past week. This is automatically scaled to a 0–3 score.
    • Use the Global Health slider (0–100) to rate overall health status.
  4. Review and Calculate:
    • Before clicking the Calculate button, ensure that all questions in each section have been reviewed and answered as applicable.
    • Then click the Calculate CHAQ Scores button to generate the results.
  5. Results:
    • The application displays the CHAQ Disability Index (ranging from 0 to 3), the scaled Pain Score (0–3), and the raw Global Health Score (0–100).
    • It also lists any assistive devices used and help required, as indicated in the assessment.
    • You can copy the results summary to your clipboard for documentation or further review.

Scoring Overview

The CHAQ Disability Index is computed by taking the highest score from each domain (excluding those marked as "Not Applicable"), applying adjustments for any marked assistive devices or help, summing the scores, and then averaging them over the number of domains answered. The Pain Score is scaled from the 0–100 slider to a 0–3 range, while the Global Health Score is provided as a raw value between 0 and 100.

Important: Review All Questions

Before clicking on the Calculate button, please review and ensure that all questions in each section are answered. Incomplete assessments may lead to inaccurate scoring.

References

For detailed documentation and official scoring instructions, please consult the following resources:


DISCLAIMER:
This tool is for informational and documentation purposes only and does not replace clinical judgment or formal diagnostic criteria. Always review scores in context and consult relevant guidelines when making treatment decisions. If patient information is entered, be sure to comply with applicable privacy regulations (e.g., HIPAA, PHIPA). An anonymization feature is available to reduce identifiable data in reports.