Open Access Research article

Brazilian Portuguese translation and cross-cultural adaptation of the “Caregiver Priorities and Child Health Index of Life with Disabilities” (CPCHILD©) questionnaire

Luiz Antonio Pellegrino1*, Erika Veruska Paiva Ortolan2, Claudia Saad Magalhães3, Ariane Aparecida Viana1 and Unni G Narayanan4

Author Affiliations

1 Bauru State Hospital Bauru, Bauru, SP ZIP 17033-360, Brazil

2 Department of Surgery and Orthopedics, Post Graduate Surgery Program, Botucatu Medical School, Botucatu, SP ZIP 18618-970, Brazil

3 Department of Pediatrics and Pediatric Rheumatology, Post Graduate Public Health Program, Botucatu Medical School, Botucatu, SP ZIP 18618-970, Brazil

4 Divisions of Orthopaedic Surgery & Child Health Evaluative Sciences, The Hospital for Sick Children, Bloorview Research Institute, University of Toronto, Toronto, Ontario M5G 1X8, Canada

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BMC Pediatrics 2014, 14:30  doi:10.1186/1471-2431-14-30

Published: 1 February 2014



Consideration of the quality of life in relation to individual health status is crucial for planning and maintaining a system of patient-centered care. Until recently, there have been no suitable instruments to assess health-related quality of life (HRQoL,) of children and adolescents with severe, non-ambulant cerebral palsy (GMFCS functional levels IV and V). The “Caregiver Priorities and Child Health Index of Life with Disabilities Questionnaire” (CPCHILD©) was developed in English specifically for this population, and has been validated in Canada. The aim of this study was to translate and adapt the CPCHILD© Questionnaire into Brazilian Portuguese, thus permitting researchers in Brazil to access this important tool for measuring HRQoL in this population, as well as the possibility of making comparisons with other studies that use the same questionnaire in other languages.


The cross-cultural adaptation included two forward translations by independent translators, their synthesis, two back-translations by independent translators, an assessment of the versions by an expert committee and the development of a pre-final version, which was tested on 30 caregivers of children (5 -18) with severe cerebral palsy (GMFCS IV & V).


Despite the relative equivalence between the two translations, some items required adaptations for the synthesized version. Certain modifications were necessary in the pre-final version to achieve idiomatic equivalence. The modifications were required to account for the socioeconomic and cultural levels of the target population.


The translation and cross-cultural adaptation of the CPCHILD© questionnaire provides a Brazilian Portuguese equivalent to measure the HRQoL of children with severe developmental disabilities, with the potential to measure the benefits of various procedures that are indicated for these patients. This adaptation exhibited a satisfactory level of semantic equivalence between the Portuguese target and the original English source versions. The validity of the Brazilian version of the instrument must be established in the future by assessing its psychometric properties on Brazilian epidemiological samples.

Translation; Adaptation; Questionnaire; Assessment; Health-related quality of life; Developmental disabilities