Pediatric Evaluation of Disability Inventory (PEDI)

Full Name of Assessment:		Pediatric Evaluation of Disability Inventory (PEDI)
Author, Publisher, Date:		Haley, S.M., et al. , PEDI research group/ Trustees of Boston University, Date: 1992
Source: Pearson via www.pearsonassessments.com			Pricing: $125.95 for the manual and $45.60 for scoring supplies (25 count)
Brief description (purpose, domains, subscales, time to administer, space/equipment needs): Purpose: Comprehensive clinical assessment of key functional capabilities and performance in children between the ages of six months and seven years. The PEDI can be used to evaluate older children with functional abilities that are less than those expected of a 7-year-old child without disabilities. The PEDI is a descriptive measure of a child’s current functional performance and can track changes over time. The PEDI measures both capability and performance of functional activities in three content domains. For age ranges of 6 months – 7.5 years. You can go older if their abilities are not there. Time: Experienced teachers and therapists can complete the PEDI on a child with whom they are familiar in 20-30 minutes. Administration of the PEDI by structured parent interview can be completed in 45-60 minutes. Subscales: The three subscales are: self-care, mobility, and social function. Domains: The 3 domains are functional skills (197 items), caregiver assistance (20 complex activities), and modifications (20 complex activities).  Under each of these areas contains self-care, mobility, and social function. The self-care has different items under alphabetical categories (A-O) with categories including food texture, use of utensils, tooth brushing, nose care, hand washing, dressing, toilet tasks, and management of bowel and bladder. The same procedure occurs mobility and social function. Space/Equipment needs:  The practitioner will need the PEDI scoring form, the PEDI manual, a writing utensil, and additional scoring sheets.
Scoring: Under each domain area, the subscales are scored as follows: Functional skills: 0= unable, or limited in capability, to perform item in most situations. 1= capable of performing item in most situations, or item has been previously mastered by and functional skills have progressed beyond this level. There are three subsections are self-care, mobility, and social function. Under the self-care domain there are 73 total items that are scored either 0 or 1. 0 meaning unable to complete and 1 meaning they are capable to complete. There are different areas including food texture, tooth brushing, hair brushing, washing face, dressing, etc. These are ordered from A-O. The administer sums the scores for the “1” category. The same process is repeated for the mobility and social function subscales. The three summed scores from each scale are the raw scores. Caregiver Assistance: 5= independent, 4= supervise/prompt/monitor, 3= min. assist, 2= mod. Assist, 1= max. assist, and 0= total assist. The same three subscales are used here. The self-care scale has 8 items scored from 1-5. The mobility scale has 7 items scored from 1-5. The social function scale has 5 items scored from 1-5. Each scale is summed to give a total for each scale which is the raw score for the child. Modifications: N= no modifications, C= child oriented modifications, R= rehabilitation equipment, and E= extensive modifications. The same subscales are used here. The self-care scale has 8 items and each item is scored for a modification. The same applies to the other two categories. The N,C, R, E modification scale values are totaled. For example the self-care scale will be totaled to 8, therefore 5 –Ns and 3-Cs etc. The mobility score must be equal to 7 then, so 5-Ns and 2-Cs and so forth. The scaled score provide an estimate of the child’s functional performance along the continuum of items that make up a particular scale. These scores do not take into account the age of the child, but provide an estimate of the level of capability in each content domain. The manual has appendices 6 and 7 to convert the raw summary scores into the scaled scores. The FIT scores are computed via computer software programs.
Psychometric properties (describe briefly; e.g. reliability, validity, sensitivity, specificity, etc): Chapter 5 in the PEDI manual has a complete overview of the psychometric properties for this assessment. Reliability: The PEDI uses a few different types of reliability including internal consistency, inter-interviewer reliability, and agreement between the responses of parents and rehab. team members. Table 5-1 in the PEDI manual gives the full internal consistency results. The coefficients range between .95 and .99 for the Cronbach’s alpha. This means the six items have excellent internal consistency. Tables 5-2 and 5-3 respectively, report the full results for the inter-interviewer reliability category. The 5-2 table reports inter-interviewer reliability in the normative sample. The researchers used a ICC to measure for agreement. The agreement was very high as the ICCs = .96 to .99. The 5-3 table reports inter-interviewer reliability for the clinical sample. The ICC was used to measure for agreement. The ICC reported high for both sets of Caregiver Assistance and Modifications as the ICCs ranged from .84 to 1.00.  The reliability between the two respondents (parents and rehab team members) were deemed high based off the ICC. The ICCs ranged from .74-.96 for the summary scores for all scales. Validity: The PEDI looked as several types of validity including: Content Validity: degree to which both the individual items and the overall assessment represent the domain and construct the instrument is intended to measure. The content validity of the PEDI is provided in the PEDI manual in chapter 2, under table 2-3. The results indicate strong content validity of the instrument. Construct Validity: concerned with demonstrating that the characteristics of an instrument are consistent with what is known about the theoretical concepts it purports to reflect or measure. The construct validity of the PEDI is provided in chapter 5 of the PEDI manual under table 5-5. The results indicate that the progression of mean scores as age increases and the magnitude of the correlations of scores with age provide support for the assumption that functional status as measured by the PEDI is age-dependent. These patterns are consistent with expectations and support the construct validity of these scales to represent functional development across the age span of 6 months to 7.5 years. Concurrent Validity: This looks at the results of the PEDI compared to other established tests. The results are reported in Chapter 5 of the PEDI manual in table 5-6. The PEDI was compared to the BDIST (Battelle Developmental Inventory Screening Test). The results indicated that the overall correlations between the two instruments in the group with disabilities were moderate (r= .70-.73). Discriminant Validity: These results were reported in table 5-9, 5-10, and 5-11 of the PEDI manual. The results indicated that the PEDI modifications and functional skills scale were better predictors of group status than the Battelle. This validity measure also indicates that the PEDI places children in the correct age classifications on the basis of their scores on each measure. The specificity and sensitivity of this assessment was not addressed in the manual. This assessment doesn’t rule a condition or diagnosis in or out for a child, therefore these psychometric properties were not reported.
Citations/References (source at least 2 articles that use the tool or reports on psychometrics): Bourke‐Taylor, H. (2003). Melbourne assessment of unilateral upper limb function: construct validity and correlation with the pediatric evaluation of disability inventory. Developmental Medicine & Child Neurology, 45(2), 92-96. Feldman, A. B., Haley, S. M., & Coryell, J. (1990). Concurrent and construct validity of the Pediatric Evaluation of Disability Inventory. Physical Therapy, 70(10), 602-610. Nichols, D. S., & Case-Smith, J. (1996). Reliability and validity of the Pediatric Evaluation of Disability Inventory. Pediatric Physical Therapy, 8(1), 15.
Comments/critique (include application to practice – settings, needs, populations):  This is a very elaborate assessment that looks at a lot of different aspects of a child’s life. The PEDI is designed for the use with young children with a variety of disabling conditions. The age is 6 months to 7.5 years for typically developing children. The age range for children with disabilities can range all the way up to 20 years. This assessment evaluates children with disabilities for their functional skills in several different areas including mobility, self-care, and social functioning. The results of this assessment will help the occupational therapist establish functional goals for ADLs, functional mobility, and other areas of occupation that are in need of improvement for the child. The PEDI is an instrument that is used to detect functional delays or deficits. This instrument will help occupational therapists monitor individual or group progress in pediatric rehabilitation programs. This assessment can be used as an outcome measure for program evaluation for pediatric rehabilitation programs or for therapeutic programs in an educational setting. The PEDI can be used in schools and pediatric medical settings.
Training or certification requirements:	No additional training is required to administer the PEDI. It is wise to familiar with the manual and scoring systems. The PEDI results need to be interpreted by a skilled practitioner that uses professional judgment to provide the child what they need.