Pediatric Functional Independence Measure (WeeFIM)

Full Name of Assessment:		WeeFIM (Pediatric Functional Independence Measure)
Author, Publisher, Date:		Carl V. Granger & Margaret A. McCabe; Uniform Data System for Medical Rehabilitation; 1990
Source:		www.udsmr.org	Pricing:$4100 in/outpatient; $2200 inpatient only
Brief description (purpose, domains, subscales, time to administer, space/equipment needs): The WeeFIM II® System allows credentialed clinicians across the United States and around the world to measure and document functional performance in infants (0-3 years old), children, and adolescents with either acquired or congenital disease in a consistent manner. The WeeFIM® instrument is a reliable outcomes measurement instrument that can be applied uniformly across inpatient, outpatient, and community-based settings to track clinical, managerial, and performance improvement efforts and initiatives. The WeeFIM II® System is a benchmarked outcomes management system that provides a method of evaluating outcomes for patients, groups of patients (population-based), and overall medical rehabilitation/habilitation programs. The WeeFIM® instrument was developed to measure the need for assistance and the severity of disability in children between the ages of 6 months and 7 years. The WeeFIM® instrument may be used with children above the age of 7 years as long as their functional abilities, as measured by the WeeFIM® instrument, are below those expected of children aged 7 who do not have disabilities. The WeeFIM® instrument consists of a minimal data set of 18 items that measure functional performance in three domains: self-care, mobility, and cognition. The WeeFIM® Instrument: 0-3 Module is a questionnaire that measures precursors to function in children 0-3 years old who have a variety of disabilities. The 0-3 module can be administered to parents by interview or self-report and is useful across many settings, including early intervention and preschool. Domain: self care eating grooming bathing dressing – upper body dressing – lower body toileting bladder management bowel management mobility transfer: chair, wheelchair transfer: toilet transfer: tub, shower walk, wheelchair, crawl stairs cognition comprehension expression social interaction problem solving memory
Scoring: Performance of the child on each of the items is assigned to one of seven levels of an ordinal scale that represents the range of function from complete and modified independence (levels 7 and 6) without a helping person to modified and complete dependence (levels 5 to 1) with a helping person.. FIM™ LEVELS No helper 7 Complete Independence (Timely, Safely) 6 Modified Independence (Device) Helper – Modified Dependence 5 Supervision (Subject = 100%) 4 Minimal assistance (Subject = 75% or more) 3 Moderate assistance (Subject = 50% or more) Helper – Complete Dependence 2 Maximal assistance (Subject = 25% or more) 1 Total assistance (Subject less than 25%)
Psychometric properties (describe briefly; e.g. reliability, validity, sensitivity, specificity, etc): Test-retest: for the six domains range from r = 0.83 to 0.99 Internal consistency (Cronbach’s alpha), ICC, and PSI values of the WeeFIM motor and cognitive scales were high (>0.90) and consistent for individual use. Interrater reliability was excellent with ICC values of 0.98 and 0.93 for the motor and cognitive scales respectively. External construct validity: The correlations of the WeeFIM scale with four areas of the Denver-II were as expected, the strongest (r=0.94) being between the WeeFIM cognitive scale and the Denver II language section, and the least strong (r=0.71) between the WeeFIM cognitive and the Denver II gross motor function section.
Citations/References (source at least 2 articles that use the tool or reports on psychometrics): Ottenbacher, K.J., Msall, M.E., Lyon, N., Duffy, L.C., Granger, C.V., & Braun, S. (1999).  Measuring developmental and functional status in children with disabilities.  Developmental Medicine & Child Neurology, 41, 186-194. Ottenbacher, K.J., Msall, M.E., Lyon, N., Duffy, L.C., Ziviani, J., Granger, C.G., Braun, S. & Feidler, R.C. (2000).  The WeeFIM instrument:  Its utility in detecting change in children with developmental disabilities.  Archive of Physical Medicine Rehabilitation, 81, 1317-1326.
Comments/critique (include application to practice – settings, needs, populations): Brief, easy to administer, discipline-free measure of disability in children with different conditions Multiple applications:  clinical, management, performance improvement, & research and development Can be utilized with children above age 7, as long as functional abilities (those measured by the instrument) are below those expected of 7-year-olds who do not have disabilities.
Training or certification requirements:	To use the FIM and WeeFIM assessors need to attend training and pass an online exam to become credentialed. Once an assessor has passed the exam, credentialing remains valid for two years, after which time the exam must be sat again.

Vineland - II

Full Name of Assessment:		Vineland -II
Author, Publisher, Date:		Author(s): Sara S. Sparrow, Domenic V. Cicchetti & David A. Balla; Pearson; 2005
Source:		http://psychcorp.pearsonassessments.com/HAIWEB/Cultures/en-us/Productdetail.htm?Pid=Vineland-II	Pricing:  Vineland-II Training CD: $ 115
Brief description (purpose, domains, subscales, time to administer, space/equipment needs): Purpose: The Vineland-II is a standardized norm-referenced assessment tool that can be used for: measuring an individual's daily functioning measuring deficits in adaptive behavior clinical diagnosis of autism spectrum disorders delays, emotional and behavioral disturbances as well as other mental, physical or injury related conditions developmental evaluations progress monitoring program planning research Domain: The Vineland-II consists of 5 domains each with subdomains. The manual lists the following description of the vineland-II communication domain ◦      receptive ◦      expressive ◦      written daily living skils domain ◦      personal ◦      domestic ◦      community socialization domain ◦      interpersonal relationships ◦      play and leisure time ◦      coping skills motor skills domain ◦      gross motor ◦      fine motor maladaptive behavior domain (optional) ◦      maladaptive behavior index ◦      maladaptive behavior critical items ◦      adaptive behavior composite Administration: Paper-and-pencil Completion Time: 20-60 minutes –Survey Interview and Parent/Caregiver Rating Forms; 25–90 minutes—Expanded Interview Form; 20 minutes—Teacher Rating Form
Scoring: the Vineland-II manual suggests that the test examiners and scorers have graduate training in test administration and interpretation. A rater (e.g., teacher, parent, and caregiver) should be an adult who is familiar with the everyday activities and behavior of the individual being assessed. The rater should also have significant contact with the individual over an extended period of time. A caregiver could be a parent, guardian, grand parent, nurse, social worker or other individual who is close to the person being assessed. Raw scores can be converted to vineland-II derived scores, standard scores, V-scale scores, percentile ranks, age equivalents, and stanines. In addition, confidence intervals can be constructed for scores. Results can be described by adaptive levels and maladaptive levels. Adaptive levels are descriptive categories which communicate test results. The maladaptive levels are descriptive categories in which maladaptive behaviors are rated as average, elevated, or clinically significant. Individuals with formal graduate-level or professional training in psychological assessment should interpret test results using the 6 step interpretation method described in the manual.
Psychometric properties (describe briefly; e.g. reliability, validity, sensitivity, specificity, etc): Reliability:  Internal consistency: across the age groups, the communication domain correlations ranged from .84 to .93. for the daily living skills domain correlations ranged from .86 to .91. the socialization domain ranged form .84 to .93. the motor skills domain ranged from .77 to .90. the maladaptive behavior index demonstrated internal consistency coefficients ranging from .85 to .91 across age groups. Test-retest reliability: average correlations were found to range between .76 and .92 across domains. Inter-interviewer reliability: average correlations ranged between .71 to .81 across domains/subdomains Validity: test content: the vineland-II was designed to measure 4 major aspects of adaptive functioning: communication, daily living skills, socialization and motor skills. Group differences: the test developers evaluated measurement bias at the item and scale levels using differential item functioning (DIF). Difference among sex, socioeconomic status, ethnic and group membership were found to small. Test structure: overall, howerver, the amount of subdomains clustering is modest, implying that there are functional relationships among adaptive behaviors in different subdomains
Citations/References (source at least 2 articles that use the tool or reports on psychometrics): Gleason, K., & Coster, W. (January 01, 2012). An ICF-CY-based content analysis of the Vineland Adaptive Behavior Scales-II. Journal of Intellectual & Developmental Disability, 37, 4, 285-93. Becker-Weidman, A. (January 01, 2009). Effects of early maltreatment on development: a descriptive study using the Vineland Adaptive Behavior Scales-II. Child Welfare, 88, 2, 137-61
Comments/critique (include application to practice – settings, needs, populations):  Addresses today’s special needs populations, such as individuals with intellectual and developmental disabilities, autism spectrum disorder, and ADHD Updated with new norms, expanded age range, and improved items Useful for diagnosis, qualification for special programs, progress reporting, program and treatment planning, and research Offers both respected semi-structured interview format which focuses discussion and gathers in-depth information, and also offers convenient rating forms Get the most reliable picture of functioning: In addition, more test items have been added at the lower and upper age ranges of Vineland-II. This provides a more reliable picture of an examinee’s level of functioning for all ages. Report to Parents: Help meet reporting requirements with this time-saving tool. The Survey Form Report to Parents makes it easy to communicate test results to parents and caregivers. Scores and percentile ranks are explained in understandable language. There’s also space to write in comments and recommendations.
Training or certification requirements:	The Vineland-II manual suggests that the test examiners and scorers have graduate training in test administration and interpretation.