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How to assess participation and environment together in children and youth?

Translation and cross-cultural adapation of the Participation and Environment Measure for Children and Youth (PEM-CY)

At a glance



The Participation and Environment Measure for Children and Youth (PEM-CY) (Coster et al., 2011) is a standardized parent-reported assessment to determine the extent and participation pattern of children and youth between 5 and 17 years, their levels of participation involvement, related environmental barriers and supports and parent's wishes for change. Officially in English, it is recently been translated and culturally adapted in various counties like Korea, the Netherlands, Island and Belgium. 2014 translated Füssel  PEM-CY into German, but standards for valide, cross-cultural translation and adaptation (Beaton, Bombardier, Guillemin, & Bosi Ferraz, 2000) were not met. German is spoken in 3 different countries (Austria, Germany, Switzerland) as main language. Although having the same origin, and the same written expression, spoken language vary greatly. Occupational therapist in these three countries work closely together and conditions of education, social support and leisure activities are on a general level similar. Thus, a valid cross-cultural adaptation of the PEM-CY for the whole German speaking area is reasonable and should be possible. It should contain a consent translation understandable in all three countries and an adaptation to the different educational and vocational system compared to US and Canada. Beside schooling, youth with 15 years can start in all three countries apprenticeship, which is not covered by the Original PEM-CY.

Aims and Research Question
To cross-culturally translate and adapt the PEM-CY to a common German culture based on a strict and rigourious guideline (Beaton et al., 2000).

The following research questions are addressed:

1. How can the PEM-CY-G be translated and adapted to reach semantic, idiomatic, experiential and conceptual equivalence with the original PEM-CY version?
2. Are there any items that need to be added to suite the German cultural context?
3. To what extend is the newly elaborated version of the PEM-CY-G understandable and reportable to parents of children with disabilities in Austria, Germany and Switzerland?

To address these questions, the specific guidelines for cross-cultural adaptations by Beaton (2000) will be followed. The process includes “adaptation of individual items, the instructions for the questionnaire and the respond options” (p 3186). In an iterative process, an expert group consenses on translations and adaptations and conduct think-aloud interviews with parents of children with disabilies in all three countries. All stages will be documented. Finally, after conducting back translations, CanChild needs to aprouve the final version of PEM-CY-G (German).


Beaton, D. E., Bombardier, C., Guillemin, F., & Bosi Ferraz, M. (2000). Guidelines for the process of Cross Cultural adaptation of Self Report mesures. Spine, 25(24), 3186–3191.

Coster, W., Bedell, G., Law, M., Khetani, M. A., Teplicky, R., Liljenquist, K., … Kao, Y.-C. (2011). Psychometric evaluation of the Participation and Environment Measure for Children and Youth. Developmental Medicine and Child Neurology, 53(11), 1030–7

Füssel, C. (2014). Partizipation bei Kindern udn Jugendlichen mit und ohne Beeinträchtigung - Ein Vergleich im Rahmen der Übersetzung und Validierung der “Participation and Environment Measure - Children and Youth (PEM-CY).” University Vienne, Vienna.

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