Pediatric Volitional Questionnaire

Last Updated

May 01, 2024

Purpose

The Pediatric Volitional Questionnaire (PVQ) uses observation of the child’s daily behaviors and occupations to assess volition. It provides information about the child’s motivational strengths and weaknesses, environmental supports and hindrances, and activities that maximize the child’s interests and motivation. The PVQ can be used in conjunction with other assessments to facilitate intervention planning, develop individualized education plans, or monitor efficacy of various therapy strategies.

Link to Instrument

instrument details

Acronym PVQ

Area of Assessment

Assertiveness
Attention & Working Memory
Behavior
Cognition
Communication
Infant & Child Development
Life Participation
Motivation
Occupational Performance
Reasoning/Problem Solving
Self-efficacy
Social Support

Assessment Type

Observer

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$40.00

Diagnosis/Conditions

Cerebral Palsy
Pediatric + Adolescent Rehabilitation

Pediatric Disorders

Mixed Populations

Cerebral Palsy

The PVQ is a pediatric, play-based assessment centered on the Model of Human Occupation (MOHO). Volition is assessed through observation, making it an effective tool to use with most children regardless of their ability.
It is designed to evaluate young children or those with significant cognitive, verbal, and/or physical limitations. Level of volition is evaluated by degree of spontaneity in observed behaviors, and the level of support required from the therapist.
The therapist observes for 14 different behavioral items, which are scored on a 4-point rating scale: (S) Spontaneous, (I) Involved, (H) Hesitant, and (P) Passive. Children are scored on a continuum of volitional development: exploration (requires less volition), competency, and achievement (requires the most volition).
The information from the PVQ provides information about how much and what types of support elicits the child’s volition. (Kiraly-Alvarez, 2015)
The PVQ will help therapists to understand what supports or hinders a child’s volition in a specific environment through the completion of the Environmental Characteristics Form (Kiraly-Alvarez, 2015)

Number of Items

30 minutes

Observation typically lasts between 10 and 30 minutes.
Two separate observations are recommended.

Required Training

Reading an Article/Manual

Preschool Child

2 - 5

years

Child

6 - 12

years

Instrument Reviewers

Initially reviewed by Sophia Anagnos, BS, Annie Elder, BA, Eva Hoffrichter, BSN, RN

ICF Domain

Activity
Participation

Measurement Domain

Cognition
Emotion
Motor
Sensory

Considerations

It is recommended that therapists score behaviors as close to the observation time as possible.
The assessment can be administered in a variety of settings.
Appropriateness of assessment should be based off of developmental age rather than chronological age.

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Cut-Off Scores

Final volitional level is determined by predominant ratings within the continuum of volitional development.

Interrater/Intrarater Reliability

Autism Spectrum Disorder

(Taylor, 2009; n=3 children with autism spectrum disorder, Autism Spectrum Disorder)

Pretest: Excellent (r= 0.85)
Mid-course: Excellent (r= 0.76)
Final: Excellent (r= 0.76)

Internal Consistency

Pediatric Population (Andersen, Kielhofner, & Lai, 2005) "Poor" (No statistical metric provided)

Construct Validity

Pediatrics: (Geist, 2005, Pediatrics)

Excellent construct validity
All 15 items returned mean squared values below 1.4, suggesting measurement of a single construct.

Cut-Off Scores

Final volitional level is determined by predominant ratings within the continuum of volitional development.

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Cerebral Palsy(Reid, 2005; n=16 with cerebral palsy, Cerebral Palsy)

Adequate concurrent validity of the PVQ and Test of Playfulness (ToP15)
Over 50% of PVQ items were correlated with average motivation score of ToP15 (r=0.62, p=0.001)

Test/Retest Reliability

Mixed Populations: (Liu et al., 2013; n = 40 preschoolers formally diagnosed with developmental delays and 40 preschoolers with confirmed normal development age matched to developmental delay group; age = 3 to 6 years; rating scale of 2 “hesitant” and 3 “involved” combined into rating 2 and original rating of 4 then becoming rating 3; Chinese version of PVQ (PVQ-C))

Poor (< 0.7) to Acceptable (>=0.7) test-retest agreement:

Test-retest reliability on the Pediatric Volitional Questionnaire (PVQ) (n = 20)

Item No.	PVQ item	Weighted kappa
1.	Shows curiosity	1.000
2.	Initiates actions	0.704
3.	Task directed	0.659
4.	Shows preferences (n = 12)	0.520
5.	Tries new things	0.747
6.	Stays engaged	0.714
7.	Expresses mastery pleasure	0.557
8.	Tries to solve problems (n = 18)	0.737
9.	Tries to produce effects (n = 7)	0.143
10.	Practices skills	0.708
11.	Seeks challenges	0.825
12.	Organizes/modifies environment (n = 7)	0.000
13.	Pursues activity to completion	0.569
14.	Uses imagination/symbolism (n = 8)	1.000

Interrater/Intrarater Reliability

Mixed Populations: (Askins et al., 2013; n = 6 children, age range = 9-12; 4 w/autism, 1 w/cerebral palsy, 1 w/orthopedic impairment; four parents also participated; each child observed two times for 30-60 minutes using the PVQ)

Inter-rater reliability 90% for all observations between two independent observers

Mixed Populations: (Liu et al., 2013; Chinese version of PVQ (PVQ-C))

Adequate (0.40 – 0.74) to Excellent (>=0.75) intra-rater agreement:

Intra-rater reliability on the Pediatric Volitional Questionnaire (PVQ) (n = 20)

Item No.	PVQ item	Weighted kappa
1.	Shows curiosity	1.000
2.	Initiates actions	1.000
3.	Task directed	0.847
4.	Shows preferences (n = 7)	0.462
5.	Tries new things	0.590
6.	Stays engaged	0.500
7.	Expresses mastery pleasure	0.583
8.	Tries to solve problems	0.900
9.	Tries to produce effects (n = 7)	0.588
10.	Practices skills	0.727
11.	Seeks challenges	0.755
12.	Organizes/modifies environment	1.000^a
13.	Pursues activity to completion	0.886
14.	Uses imagination/symbolism (n = 10)	0.412

^aData based on only one subject.

Internal Consistency

Mixed Populations: (Liu et al., 2013; Chinese version of PVQ (PVQ-C))

Rasch item reliability on the 3-point scale = 0.96*

*Scores higher than 0.9 may indicate redundancy in the scale items

Construct Validity

Convergent validity:

Mixed Populations: (Liu et al., 2013; Chinese version of PVQ (PVQ-C))

Adequate to Excellent convergent validity of the PVQ-C with the language/communication, social/personal, gross motor skill, fine motor skill, and perception/cognition subtests (r = 0.562 – 0.656, p < 0.01)

Content Validity

Mixed Populations: (Askins et al., 2013)

The researcher completed the PVQ for a specific context and a parent took a photo of that same context. The parent then described what was happening in that context/photo.
There was consistency between content of the PVQ and what parents viewed as important

Bibliography

Andersen, S., Kielhofner, G., & Lai, J. (2005). An Examination of the measurement properties of the pediatric volitional questionnaire. Physical & Occupational Therapy in Pediatrics, 25(1/2): 39-57.

Askins, L., Diasio, B., Szewerniak, D., & Cahill, S. M. (2013). Children with developmental disabilities and their motivation to play. The Open Journal of Occupational Therapy, 1(4). https://doi.org/10.15453/2168-6408.1062

Basu, S., Kafkes, A., Schatz, R., Kiraly, A., & Kielhofner, G. (2008). A user’s manual for the Pediatric Volitional Questionnaire (2.1 ed.). Chicago, IL: Model of Human Occupation Clearinghouse, Department of Occupational Therapy, University of Illinois of Chicago.

Geist, R. (1998). The validity study of the pediatric volitional questionnaire. Unpublished master’s thesis, University of Illinois at Chicago, Chicago, IL.

Kiraly-Alvarez, A. (2015). Assessing volition in pediatrics: Using the Volitional Questionnaire and the Pediatric Volitional Questionnaire. The Open Journal of Occupational Therapy, 3(3). https://doi.org/10.15453/2168-6408.1176

Liu, L., Pan, A., Chung, L., Gau, S., Kramer, J., & Lai, J. (2013). Reliability and validity of the Pediatric Volitional Questionnaire Chinese version. Journal of Rehabilitation Medicine, 45(1), 99-104. https://doi.org/10.2340/16501977-1052

Miller, L., Ziviani, J., & Boyd, R. N. (2014). A systematic review of clinimetric properties of measurements of motivation for children aged 5-16 years with a physical disability or motor delay. Physical & occupational therapy in pediatrics,34(1), 90-111.

Reid, D. T., (2005). Correlation of the Pediatric Volitional Questionnaire with the Test of Playfulness in a virtual environment: the power of engagement. Early child development and care, 175(2), 153-164.

Taylor, R. R., Kielhofner, G., Smith, C., Butler, S., Cahill, S. M., Ciukaj, M. D., & Gehman, M. (2009). Volitional change in children with autism: A single-case design study of the impact of hippotherapy on motivation. Occupational Therapy in Mental Health, 25(2), 192-200.

Last Updated

Purpose

Link to Instrument

Area of Assessment

Assessment Type

Administration Mode

Cost

Actual Cost

Diagnosis/Conditions

Number of Items

Required Training

Instrument Reviewers

ICF Domain

Measurement Domain

Considerations

Cut-Off Scores

Interrater/Intrarater Reliability

Internal Consistency

Construct Validity

Cut-Off Scores

Criterion Validity (Predictive/Concurrent)

Test/Retest Reliability

Interrater/Intrarater Reliability

Internal Consistency

Construct Validity

Content Validity

Bibliography

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