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NINDS CDE Notice of Copyright
Functional Independence Measure for Children (WeeFIM)
Availability
The FIMTM is proprietary. For further information about obtaining the scale, syllabus, and training materials please contact:
Uniform Data System for Medical Rehabilitation
270 Northpointe Parkway, Suite 300
Amherst, New York 14228 (716) 817-7800 FAX (716) 568-0037
Email: info@udsmr.org
Classification
Supplemental: Cerebral Palsy (CP), Chairi I Malformation (CM), Spinal Cord Injury (SCI)-Pediatric (age 0 to 7 years), Traumatic Brain Injury (TBI)
Short Description of Instrument
Purpose: The FIM measures degree of independence in activities of self-care, sphincter control, transfers, locomotion, communication, and cognition.
Overview: The FIM emerged from a thorough developmental process overseen by a National Task Force of Rehabilitation Research. The National Task force reviewed 36 published and unpublished functional assessment scales before agreeing on an instrument. The FIM is an 18-item ordinal scale, used with all diagnoses within a rehabilitation population. It is viewed as most useful for assessment of progress during inpatient rehabilitation.
 
FIM was originally an acronym for "Functional Independence Measure". It is still often cited as this in the literature. The current owners of the FIM instrument have decided that the acronym FIM no longer stands for anything and should be referred to only as FIM.
 
The WeeFIM builds on the format of the Functional Independence Measure for Adults of the Uniform Data System for Medical Rehabilitation, tracking disability outcomes in children. Specifically, this assessment measures independence in self- care, sphincter control, transfers, locomotion, communication, and social cognition. The WeeFIM consists of 18 items within the six domains.
 
Time: Administered through an interview by a trained rater or a telephone interview of caregiver or subject by trained rater. The test takes between 20–30 minutes.
Scoring: A 7-level Likert scale is used to score level of dependence. Scores for the WeeFIM range from 18 (complete dependence in all skills) to 126 (complete independence in all skills).
Rationale: “The motor scale (8 self-care, 5 mobility items) was primarily selected … to assess motor function in the acute recovery phase.” – McCauley et al., 2012.
Other Important Notes: The measure is used with children aged 6 months to 7 years. It can be used by children above 7 years if their abilities are below that of 7-year-olds without disabilities.
 
SCI-Pediatric-specific: The WeeFIM instrument may be used with children above the age of 7 years provided their functional abilities, as measured by the WeeFIM instrument, are below those expected of children aged 7 who do not have disabilities.
 
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. Tthere is a cost to use for research.
 
 
References
Chen CC, Bode RK, Granger CV, Heinemann AW. Psychometric properties and developmental differences in children's ADL item hierarchy: a study of the WeeFIM instrument. Am J Phys Med Rehabil. 2005;84(9):671–679.
 
Granger CV. The emerging science of functional assessment: our tool for outcomes analysis. Arch Phys Med Rehabil. 1998;79(3):235–240.
 
Granger C, Hamilton BB, Kayton R. Guide for the Use of the Functional Independence Measure (WeeFIM) of the Uniform Data Set for Medical Rehabilitation. Buffalo NY: Research Foundation of the State University of New York, 1989.
 
Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1:6–18.
 
Massagli TL, Michaud LJ, Rivara FP. Association between injury indices and outcome after severe traumatic brain injury in children. Arch Phys Med Rehabil.1996;77(2):125–132.
 
McCauley SR, Wilde EA, Anderson VA, Bedell G, Beers SR, Campbell TF, Chapman SB, Ewing-Cobbs L, Gerring JP, Gioia GA, Levin HS, Michaud LJ, Prasad MR, Swaine BR, Turkstra LS, Wade SL, Yeates KO. Pediatric TBI Outcomes Workgroup. Recommendations for the use of common outcome measures in pediatric traumatic brain injury research. J Neurotrauma. 2012;29(4):678–705.
 
Msall ME, DiGaudio K, Duffy LC, LaForest S, Braun S, Granger CV. WeeFIM. Normative sample of an instrument for tracking functional independence in children. Clin Pediatr (Phila). 1994;33(7):431–438.
 
Msall ME, DiGaudio K, Rogers BT, LaForest S, Catanzaro NL, Campbell J, Wilczenski F, Duffy LC. The Functional Independence Measure for Children (WeeFIM). Conceptual basis and pilot use in children with developmental disabilities. Clin Pediatr (Phila). 1994;33(7):421–430.
 
Ottenbacher KJ, Msall ME, Lyon N, Duffy LC, Ziviani J, Granger CV, Braun S, Feidler RC. The WeeFIM instrument: its utility in detecting change in children with developmental disabilities. Arch Phys Med Rehabil. 2000;81(10):1317–1326.
 
Ottenbacher KJ, Msall ME, Lyon NR, Duffy LC, Granger CV, Braun S. Interrater agreement and stability of the Functional Independence Measure for Children (WeeFIM): use in children with developmental disabilities. Arch Phys Med Rehabil. 1997;78(12):1309–1315.
 
Ottenbacher KJ, Taylor ET, Msall ME, Braun S, Lane SJ, Granger CV, Lyons N, Duffy LC. The stability and equivalence reliability of the functional independence measure for children (WeeFIM). Dev Med Child Neurol. 1996;38(10):907–916.
 
Rice SA, Blackman JA, Braun S, Linn RT, Granger CV, Wagner DP. Rehabilitation of children with traumatic brain injury: descriptive analysis of a nationwide sample using the WeeFIM. Arch Phys Med Rehabil. 2005;86(4), 834–836.
 
Swaine BR, Pless IB, Friedman DS, Montes JL. Effectiveness of a head injury program for children: a preliminary investigation. Am J Phys Med Rehabil. 2000;79(5), 412–420.
 
Ziviani J, Ottenbacher KJ, Shephard K, Foreman S, Astbury W, Ireland P. Concurrent validity of the Functional Independence Measure for Children (WeeFIM) and the Pediatric Evaluation of Disabilities Inventory in children with developmental disabilities and acquired brain injuries. Phys Occup Ther Pediatr. 2001;21(2-3), 91–101.
 
SCI-Pediatric:
Garcia RA, Gaebler-Spira D, Sisung C, Heinemann AW. Functional improvement after pediatric spinal cord injury. Am J Phys Med Rehabil. 2002;81(6), 458–463.
 
Prosser LA. Locomotor training within an inpatient rehabilitation program after pediatric incomplete spinal cord injury. Phys Ther. 2007;87(9), 1224–1232.
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