Functional Independence Measure (WeeFIM) for Chinese Children: Hong Kong Cohort

Abstract

ABSTRACT. Background. The Functional Independence Measure (WeeFIM) for children is a simple-toadminister scale for assessing independence across 3 domains in American children. WeeFIM was based on a conceptual framework by the World Health Organization (1980) of pathology, impairment, disability and handicap, and the "burden of care." WeeFIM is useful in assessing functional independence in children aged 6 months to 7 years. It can be used for children with developmental disabilities aged 6 months to 21 years. Normative WeeFIM data had been validated for American children. Because of cultural and environmental differences among countries, normative data for the Chinese population are needed. With a normative database, the progression of independence at home and in the community can be evaluated.WeeFIM is an 18-item, 7-level ordinal scale instrument that measures a child's consistent performance in essential daily functional skills. Three main domains (selfcare, mobility, and cognition) are assessed by interviewing or by observing a child's performance of a task to criterion standards. WeeFIM is categorized into 2 main functional streams: "Dependent" (ie, requires helper: scores 1-5) and "Independent" (ie, requires no helper: scores 6 -7). Scores 1 (total assistance) and 2 (maximal assistance) belonged to the "Complete Dependence" category. Scores 3 (moderate assistance), 4 (minimal contact assistance), and 5 (supervision or set-up) belonged to the "Modified Dependence" category. Scores 6 (modified independence) and 7 (complete independence) belonged to the "Independent" category. The WeeFIM is a 7-level criterion-specific ordinal scale. Level 7 requires no assistance for the child and the child completes the task independently without requiring a device. During the task, there is no concern about safety or taking an inordinate amount of time. Level 6 reflects modified independence and includes use of an assistive device or not completing the task in a timely or safe manner.Objective. To examine the utility of the WeeFIM in Chinese children and to create a normative WeeFIM profile suitable for Chinese children.Method. Direct interviews were conducted for 445 normal Chinese children, aged 6 months to 7 years, in the community.Results. 1. WeeFIM total score and 3 domains subscores versus age. The total WeeFIM scores increased progressively with age, reaching a plateau at 72 months.There was a progressive increase in subscores of selfcare, mobility, and cognition independence between 6 to 62 months, especially between 6 to 45 months. Similarly, the WeeFIM self-care subscores increased progressively with age, reaching a plateau at around 72 months. The WeeFIM mobility subscores increased progressively with age, reaching a plateau at around 54 months. The WeeFIM cognition subscores increased progressively with age, reaching a later plateau at around 80 months.2. WeeFIM subtotal scores versus age. The total WeeFIM score and 3 domain subscores correlated significantly with age. We further classified the 18 items into 3 ...

Inter-rater reliability in assigning ICF codes to children with disabilities

“…It is based on the conceptual framework of the ICIDH and adds 'burden of care' to impairment, disability and handicap. 31,32 It was prohibitively expensive to use for the narrow scope of this study. The Battelle overlaps with the PEDI in appropriate age range and requires direct testing of the child.…”

Spinal Muscular Atrophy: Survival Pattern and Functional Status

“…It has been used in children with various acute and chronic neurodevelopmental disorders, 11,12 and its Chinese version has been validated. 13,14 The parents or the chief caregivers were interviewed by a trained research assistant (S.H.) for WeeFIM scoring in September 2002.…”

Measuring functional outcomes after prematurity: Developmental impact of very low birth weight and extremely low birth weight status on childhood disability

“…The WeeFIM has demonstrated responsiveness to change in children with cerebral palsy in early intervention, children ages 1-7 years with motor, communicative, developmental, or genetic impairments in early childhood programs and in children ages 7-16 years receiving orthopedic interventions for cerebral palsy McAuliffe et al, 1998;Azuala et al, 2000;Ottenbacher et al, 2000;Msall et al, 2001]. The WeeFIM has been used as part of outcomes assessment in surfactant clinical trials, after cryosurgery for retinopathy of prematurity, in children with congenital heart disease, in children with genetic disabilities, in children with traumatic injury, and in Chinese and Japanese children [Msall et al, 1993b;Liu et al, 1998;Tsuji et al, 1999;Msall and Tremont, 2000;Limperopoulous et al, 2001;Aitkin et al, 2002;Wong et al, 2002]. The WeeFIM takes approximately 20 minutes to administer.…”