Caregiver's concerns-quality of life scale (CC-QoLS): development and evaluation of psychometric properties.
A fresh 16-question caregiver scale gives you a quick, reliable snapshot of how aggression in adults with ID affects family quality of life.
01Research in Context
What this study did
Unwin et al. (2014) built a short survey for caregivers of adults with intellectual disability. The team wanted one number that shows how aggression hurts family life.
They wrote 16 plain questions, tested them with caregivers, and checked if the score really tracks with how bad the aggression is.
What they found
The 16-item CC-QoLS gave steady answers when caregivers filled it out again. Higher scores lined up with more severe aggression and heavier caregiver burden.
The scale met the mark for both reliability and validity, so BCBAs can trust the number they get.
How this fits with other research
Libero et al. (2016) did the same kind of work earlier with kids. Their KidsLife scale is long (96 items) and targets general quality of life, while CC-QoLS is short and zeros-in on aggression in adults.
Cheves et al. (2026) came later with OWLS-ID, a 27-item self-report distress scale for the same adult group. CC-QoLS stays caregiver-only, so the two tools pair up: one hears from the client, the other from the family.
Austin et al. (2015) offered INICO-FEAPS, a scale that lets either the adult or the caregiver respond. CC-QoLS keeps the reporter fixed (caregiver only), making it faster for busy clinics.
Why it matters
You now have a 2-minute scale that tracks caregiver strain while you work on aggression. Use it at intake, after 8 weeks of treatment, and at discharge to show families real change. If the score drops, you have data that the plan is lightening their load, not just cutting behavior.
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02At a glance
03Original abstract
We have developed a Caregiver's Concerns-Quality of Life Scale (CC-QoLS) for adults with intellectual disabilities (ID) who exhibit aggressive behaviour. The CC-QoLS is a brief (8 items in each subscale, CC and QoL respectively) proxy measure completed by caregivers. This is a specific health related quality of life instrument (HRQoL) combined with measures of caregiver's concerns for use as an outcome measure to assess clinical and cost effectiveness of interventions for aggression in adults with ID. The CC-QoLS was found to have good face validity and very good test-retest reliability with an ICC of 0.81 for CC (range 0.46-0.83 across items) and 0.80 for QoL (range 0.65-0.81 across items). Similarly, the scale had good inter-rater reliability with an ICC of 0.67 for CC (range 0.31-0.63 across items) and 0.63 for QoL (range 0.31-0.65 across items). Internal consistency for each subscale was also good (Cronbach's alpha was 0.85 for CC and 0.80 for QoL; Split-half Spearman-Brown was 0.81 for CC and 0.70 for QoL). Furthermore, the scale showed good concurrent validity with measures of severity of aggressive behaviour, namely Modified Overt Aggression Scale (MOAS) (CC: r=0.4; p≤0.01 and QoL: r=-0.2; p≤0.05) and Aberrant Behavior Checklist-Irritability subscale (ABC-I) (CC: r=0.5; p≤0.01 and QoL: r=-0.02; p≤0.05) as well as Caregiver's Uplift and Burden Scale score (<0.05). We believe that the CC-QoLS is a user friendly, easy to complete, first-ever HRQoL measure for adults with ID and aggressive behaviour with very good psychometric properties.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.05.018