The methodological application of goal attainment scaling in pediatric rehabilitation research: a systematic review.

The objectives of this review article were to (1) describe the populations and interventions to which Goal Attainment Scaling (GAS) has been applied in pediatric rehabilitation, (2) summarize the scientific rigor of published studies utilizing GAS as an outcome measure in pediatric rehabilitation, and (3) illustrate the responsiveness of GAS following intervention. Four electronic databases were searched for English language, human subject studies. Two reviewers independently extracted data, graded evidence, and rated study quality. Fifty-two studies utilizing GAS as an outcome measure within pediatric rehabilitation were included. A majority of studies were characterized as low-level evidence in the Sackett hierarchy (Sackett levels IV-V; 33 of 52). Quality appraisal scores for all reviewed studies ranged from 1-13 points (17 possible points) and averaged 4.71 points. GAS appeared to detect meaningful change in more than 60% of studies. GAS is a clinically useful tool for measuring progress toward goals, but has not been utilized with a high level of methodological rigor in research. Emphasis on reduced variation in administration and interpretation will strengthen the utility of GAS for efficacy and program evaluation in future research.Implications for rehabilitationGoal Attainment Scaling (GAS) can be used across a diversity of interventions and diagnoses as an outcome measure in pediatric rehabilitation.Careful consideration should be used in the study design to standardize administration and scoring of GAS to strengthen the study.Goal Attainment Scaling is responsive to change, and the tool appears to detect meaningful change the majority of the time in pediatric rehabilitation.