A clinical study of competency to consent to treatment in pediatrics.

A 19-item competency questionnaire for pediatric patients (CQ-Peds) was used to evaluate competency to consent to treatment in pediatric outpatients and inpatients at two university hospitals. Sixty-nine consecutive English-speaking pediatric outpatients were studied at Hospital A, and 23 consecutive English-speaking pediatric inpatients were studied at Hospital B. Demographic data were statistically analyzed using the chi-square test, and there were no significant differences between the competent and incompetent groups (using CQ-Peds scores and cutoffs). CQ-Peds scores correlated highly with age (r = .947, p < .003; Outpatient Hospital A). Using the Child Behavior Checklist (CBCL) and the Pediatric Symptom Checklist (PSC) as a screen for psychopathology, the presence of psychiatric disturbance, per se, did not correlate with low CQ-Peds scores, nor was there a statistical difference between children from Spanish-speaking households and those from English-speaking households (Inpatient Hospital B). Overall, the children scored well on the CQ-Peds and demonstrated a good appreciation for their illnesses and treatment. The CQ-Peds score correlated highly with the that on the Wechsler Intelligence Scale for Children Revised Edition (WISC-R) vocabulary, comprehension, and similarities subtests and also with the Wide-Range Achievement Test-III (WRAT-III) reading assessment score (Inpatient Hospital B).