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Family Assessment Device (FAD)
Availability
The instrument is freely available here: Family Assessment Device
Classification
Supplemental: Cerebral Palsy (CP), Sport-Related Concussion (SRC) Persistent/Chronic (3 months and greater post concussion), and Traumatic Brain Injury (TBI)
 
Exploratory: Sport-Related Concussion (SRC) Subacute (after 72 hours to 3 months)
Short Description of Instrument
The Family Assessment Device (FAD) assesses structural and organizational properties of families and the patterns of transactions among family members. It has been found to distinguish between healthy and unhealthy families, and has been used in TBI samples. The FAD-GF has been used to assess global family functioning in numerous studies of children with TBI and their families.
 
Based on the McMaster Model of Family Functioning (MMFF), The Family Assessment Device (FAD) measures the structural, organizational, and transactional characteristics of families (Epstein et al., 1983a). The FAD consists of 6 dimensions of the MMFF: Problem Solving, Communication, Roles, Affective Responsiveness, Affective Involvement, Behavior Control, and a 7th scale measuring General Functioning (Epstein et al., 1978, 1983,& 1983a). This instrument is used in both research and clinical practice to screen and indentify families experiencing problems and the domains in which those problems occur and to assess change following treatment.
Comments/Special Instructions
Time to complete: less than 5 minutes.
 
Ages: 12 years and up
 
A multi-informant assessment designed to be completed by all family members over age 12.
Scoring
Scoring: Scores range from 1 (healthy functioning) to 4 (unhealthy functioning). The higher the overall score, the worse the level of family function.
 
Raw scores can be calculated for the six subscales (Problem Solving, Communication, Roles, Affective Responsiveness, Affective Involvement, and Behavior Control) and for the General Functioning scale.
 
The FAD is scored by adding responses of each scale (1 – 4) and dividing by the number of items in each scale (between 6 – 12). The higher the overall score, the worse the level of family function.
Rationale/Justification
The FAD has been used broadly in pediatric samples including families of children with asthma, cancer, cerebral palsy, diabetes, inflammatory bowel disease, sickle cell disease, spina bifida, spinal cord injuries, thalassemia, and traumatic brain injury (Alderfer et al., 2008).
 
There is no commercially available manual or representative norms.  Descriptive statistics are available for a variety of patient samples including healthy community dwelling controls.
 
Sport Concussion Specific: Assesses perceived family functioning.  It is not likely to be relevant in the acute stage post concussion.
 
Advantages: The FAD has been widely used in both research and clinical practice. It has been found to distinguish between healthy and unhealthy families, and has been used in TBI samples. Satisfactory psychmetric properties. It has face validity with underlying constructs derived from clinical experience. Translated into a relatively large number of languages.
 
It has been used in both research and clinical practice to screen and identify families experiencing problems and the domains in which those problems occur and to assess change following treatment.
 
Highly recommended for questions involving relationship of family interaction to recovery trajectory.
 
Measures several dimensions of structural and organizational characteristics of families. Multiinformant 60 item report, all family members, several languages. Developed in clinical and nonclinical individual.
 
Disadvantages: (1) No manual which could challenge standardization; (2) Unclear how to interpret multiple family member perspectives; (3) Unclear generalisability to diverse racial/ethnic and socio-economic groups; (4) Validity of some translations uncertain, (5) Sub-scales are correlated with one another, so families with problematic functioning in one area are likely to experience problems in other areas as well and (6) Limited standardization and instructions.
 
References
Bishop DS, Epstein NB, Baldwin LM. Structuring a family assessment interview. Can Fam Physician. 1980;26:1534–1537.
 
Epstein N, Baldwin LM, Bishop DS. (1983). Family Assessment Device. Retrieved 10/19/2016, from http://www.nctsnet.org/content/family-assessment-device.
 
Alderfer MA, Fiese BH, Gold JI, Cutuli JJ, Holmbeck GN, Goldbeck L, Chambers CT, Abad M, Spetter D, Patterson J. Evidence-based assessment in pediatric psychology: family measures. J Pediatr Psychol. 2008;33(9):1046–1061.
 
Barney M and Max J. The McMaster family assessment device and clinical rating scale: Questionnaire vs interview in childhood traumatic brain injury. Brain Inj. 2005;19:801–809.
 
Epstein NB, Bishop DS, Levin S. The McMaster Model of Family Functioning. J Marriage Fam Couns. 1978;4:19–31.
 
Epstein NB, Bishop DS, Baldwin LM. (1982). McMaster model of Family Functioning: A view of the normal family. In Walsh F. (Ed.), Normal Family Processes. New York, NY: Guilford Press.
 
Epstein NB, Baldwin LM, Bishop DS The McMaster Family Assessment Device. J Marital Fam Ther. 1983a;9(2):171–180.
 
Hamilton E, Carr A. Systematic Review of Self-Report Family Assessment Measures. Fam Process. 2016;55(1):16–30.
 
Mansfield AK, Keltner GI, Dealy J. The family assessment device: an update. Fam Proc.2015;54:82–93.
 
Ridenour TA, Daley JG, Reich W. Factor analysis of the family assessment device. Fam Proc. 1999;38:497–510.
 
Ryan CE, Epstein NB, Keitner GI, Miller IW, Bishop DS. (2005). Evaluating and Treating Families: The McMaster Approach. New York, NY: Routledge Taylor and Francis.
 
Staccini L, Tomba E, Grandi S Keitner GI. The Evaluation of Family Functioning by the Family Assessment Device: A Systematic Review of Studies in Adult Clinical Populations. Fam Proc. 2015;54: 94–115.
 
Taylor H, Yeates K, Wade S, Drotar D, Klein S, Stancin T. Influences on first-year recovery from traumatic brain injury in children. Neuropsychol. 1999;13:76–89.
 
Yeates K, Swift E, Taylor H, Wade S, Drotar D, Stancin T, Minich N. Shortand long-term social outcomes following pediatric traumatic brain injury. J Int Neuropsychol Soc. 2004;10:412–426.
 
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