Assessing children’s quality of life in health and social services: Meeting challenges and adding value.

The measurement of children’s quality of life has an important role to play in improving their experience of health and social services, and in promoting a child-centred approach to service provision. This article provides a rationale for both the development of robust quality of life measures specifically for children and also the use of these measures in assessing the effectiveness of treatments and policy changes. It highlights recent advances in the development of quality of life measures, and provides examples of two instruments that have incorporated these steps to produce reliable and valid measures that are not only comprehensible to children of different age groups but also and meaningful to parents and health professionals. The challenge of matching statistically significant change in quality of life to changes of perceived importance for the individual is also discussed in the light of the advantages to be gained from the increased uptake within health and social care of quality of life measures for children. Summary of policy and practice implications: • Quality of life measurement provides a broad perspective on the impact of health and social services for children, and is pivotal to a child-centred approach to service provision. • Children’s quality of life measures can contribute meaningfully to the assessment of individual treatment, the outcome of clinical trials (or evaluation of services) and the impact of policies more broadly in health and social care for children. • With built-in precautions and use of new methods, children as young as five are able to reliably report on their own quality of life, providing information about different areas of subjective well-being that are not immediately visible to proxy reporters, such as parents or practitioners. • Although not widely appreciated, robust measures of children’s quality of life are readily available for use in practice and research.