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PeLTQL Questionnaire
PeLTQL Questionnaire

The PeLTQL Questionnaire

The PeLTQL© is a 26-item self-administered questionnaire with both a patient and a parent
version. The measure has been assessed to be at a Flesch-Kincaid grade five reading level.

The PeLTQL© questionnaire assesses the following domains:

  • Future Health (nine questions: #5, 8, 9, 11, 13, 14, 17, 19, 20)
  • Coping & Adjustment (eight questions: #1, 3, 4, 6, 10, 15, 24, 25)
  • Social-Emotional (nine questions: #2, 7, 12, 16, 18, 21, 22, 23, 26)


PeLTQL sample

The PeLTQL© is intended to be self-administered and takes approximately five minutes to complete. Patients eight to 17 years of age complete the PeLTQL© Patient Version and parents complete the PeLTQL© Parent Version. Patients and parents are encouraged to complete the questionnaire at a clinical visit in case they have any questions or concerns, however they can complete it at home and return it by mail. Patients and parents should complete the questionnaire separately so as not to influence each other’s responses.

Patients who are unable to read the questionnaire by themselves can have the questions read to them but should mark their own answers. Ideally someone other than the parent would do this for the patient.  Questions should not be interpreted for the patients.

Detailed instructions on administering the PeLTQL can be found in the Manual of Operations. Clinical and research professionals who are interested in using the PeLTQL should contact PeLTQL.info@sickkids.ca and they will be sent a PeLTQL information package which includes the manual of operations.