Functional Independence Measure for Children (WEEFIM)


Mar 15 2015

Functional Independence Measure for Children (WEEFIM)

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Descriptive Information

  1. Title, Edition, Dates of Publication and Revision: WeeFIM, 1990
  2. Authors: Carl V. Granger & Margaret A. McCabe
  3. Source: Uniform Data System for Medical Rehabilitation, 270 Northpointe Parkway, Suite 300, Amherst, New York 14228
  4. Costs: $4100 in/outpatient; $2200 inpatient only
  5. Purpose: measure changes in function over time to weigh the burden of care in terms of physical, technologic, and financial resource
  6. Type of Test: evaluative
  7. Target Population and Ages – 6 months to 7 years. May be used with children above the age of 7 years as long as their functional abilities are below those expected of children aged 7 who do not have disabilities.
  8. Time Requirements:  <20 minutes

Test Administration

  1. Test Administration: Administered through observation, direct interview, or both. 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.
  2. 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.
  3. Type of information, resulting from testing: Rating (rating between 18-126)
  4. Environment for Testing – no requirements
  5. Equipment and Materials Needed – none
  6. Examiner Qualifications – Discipline free. Assessors need to attend training and pass an online exam to become credentialed.
  7. Psychometric Characteristics: 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. 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.
  8. Predictive: Has been shown to predict longitudinal functional recovery in children with disability.

Summary Comments

  1. Strengths – excellent interrater reliability, easy and efficient to administer, valuable predictor of function in children with disabilities.
  2. Weaknesses – WeeFIM training and subscription is expensive
  3. Clinical Applications – WeeFIM can be used for discharge planning, prediction of functional outcomes, functional evaluation, as well as documentation of functional performance.

Resources

Austin CA, Slomine BS, Dematt EJ, Salorio CF, Suskauer SJ. Time to follow commands remains the most useful injury severity variable for predicting WeeFIM® scores 1 year after paediatric TBI. Brain Inj. 2013;27(9):1056-62.

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.

http://www.udsmr.org/WebModules/WeeFIM/Wee_About.aspx. Accessed March 14, 2015.

Article Summary

Austin CA, Slomine BS, Dematt EJ, Salorio CF, Suskauer SJ. Time to follow commands remains the most useful injury severity variable for predicting WeeFIM® scores 1 year after paediatric TBI. Brain Inj. 2013;27(9):1056-62.

The article “Time to follow commands remains the most useful injury severity variable for predicting WeeFIM® scores 1 year after paediatric TBI” looks at the relationship between time to follow commands and long term functional outcomes in 40 children with moderate to severe TBI. Subjects were measured using injury severity levels including the Glascow Coma Scale, time to follow commands, duration of post traumatic amnesia, and the total duration of impaired consciousness. The subjects function was evaluated using WeeFIM® scores one year after discharge. Correlations found that injury severity variables are associated with WeeFIM® scores. The greatest amounts of variance in WeeFIM® scores were due to time to follow command and total duration of impaired consciousness. The study concluded that time to follow command is an important predictor of functional outcome one year post discharge in children after a TBI.

One Response to “Functional Independence Measure for Children (WEEFIM)”

  1. kleamon Says:

    Much of the research that I read regarding the outcome measure I was assigned, the Pediatric Evaluation of Disability Inventory (PEDI) compared the results to that of the WeeFIM. They both have a high interrater reliability and are both used to assess children in the age range of 6mo – 7 years. It appears that the after closer review they are very similar with one of the differences being that the WeeFIM incorporates a cognitive component, whereas the PEDI assess a social function instead. Other difference is that the WeeFIM is much more costly to administer and requires training but can be done in a shorter time frame, and the PEDI is more more cost effective, could be administered without specific training but is more time consuming. I like that a variety of test and measures can closely mimic each other yet contain unique characteristic measures that separate one from another thus making it more reliable and valid for a specific venue compared to another.

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