Psychometric evaluation of the revised child and family quality of life questionnaire (CFQL-2)

•The CFQL-2 reliably measures quality of life (QoL) in families with children diagnosed with ASD or related conditions.•The measure was related to other behavioral measures but is clearly distinct from these measures.•The CFQL-2 can be used to identify reduced QoL in clinical evaluations and to track changes in QoL.•Behavior problems, especially externalizing behaviors negatively impact several aspects of child and family QoL. The revised Child and Family Quality of Life (CFQL-2) questionnaire was adapted from the original version to be shorter and more sensitive to changes in psychosocial quality of life (QoL) in families of children with Autism Spectrum Disorder (ASD) or related neurodevelopmental conditions. The present study examined the psychometric properties of the CFQL-2. Caregivers of 566 patients presenting to an ASD-specific diagnostic clinic completed the CFQL-2 and other behavioral measurements as part of a diagnostic evaluation. Psychometric properties, including factor structure, internal consistency reliability, reliability across the latent trait, relationships with other clinical measures, and ASD vs. non-ASD group differences were examined for the total score and each subscale. Test-retest reliability and sensitivity to change were evaluated in a separate sleep intervention trial. Results indicated that the CFQL-2 reliably measured eight independent QoL domains (Child, Family, Caregiver, Financial, Social Network, Partner Relationship, Coping, and QoL Change), with good-to-excellent reliability across score ranges, good test-retest reliability, and expected relationships with other measures. The change subscale was slightly, but not significantly, more sensitive to change than the total score. Externalizing behavior problems in the child had a strong negative association with several aspects of QoL. The CFQL-2 is a brief, reliable scale that effectively measures psychosocial aspects of QoL and is sensitive to changes in QoL in families of children with ASD or related neurodevelopmental disorders. Child externalizing behavior is strongly associated with reductions in multiple aspects of child and family psychosocial QoL.