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School Function Assessment (SFA)
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Supplemental: Cerebral Palsy (CP)
Short Description of Instrument

The School Function Assessment (SFA) evaluates a child's performance in functional tasks necessary for participation in academic and social activities in elementary school. The entire SFA (Coster et al., 1998) is not strictly a measure of participation. It is a generic tool developed for use with children with and without disabilities for elementary aged school children aged 5 to 12 years. It has three sections: participation, task supports, and activity performance – all related to school (Coster et al, 1998). The participation section measures the child's level of participation in six school settings: general or social education classroom; playground; transportation to and from school; bathroom; transitions to and from class; and mealtimes. Each item is rated based on the extent to which the child participates in the tasks and activity in comparison with peers in the same grade. All 6 of these items map to the participation domain of ICF-CY (Chien et al., 2014). The task support section measures assistance given and adaptations made which contribute to the child's school related functions. These functions include physical tasks and cognitive/behavioral tasks. Finally, the performance section measures performance in more detail in school related functional tasks such as using school material, following school rules and communicating needs.

Comments/Special Instructions
Numerous studies have examined the content and construct validity of the SFA. Evidence for content validity is supported through use of expert panels (Davies et al., 2004; Sakzewski et al., 2007) and for construct validity in cohorts of children with and without disability (Davies et al., 2004; Sakzewski et al., 2007). Internal consistency  has been reported as excellent (0.92–0.98) (Davies et al., 2004; Hwang et al., 2009), inter rater reliability as adequate (ICC 0.68–0.73) (Davies et al., 2004), and test retest reliability as excellent (ICC 0.82–0.98) (Davies et al., 2004; Chien et al., 2014).

Part 1 Participation 6-point scale in 6 major school settings (i.e., score is 6 to 36). Part 2 Task supports (adaptations and assistance for physical and cognitive/hehavioural tasks) 4 point scale. Part 3 Activity performance (physical and cognitive/Behavioural tasks) 4 point scale.

This assessment has been widely used for children with a range of disabilities, not specifically cerebral palsy.
Coster W, Deeney T, Haltiwanger J, Haley S. School Function Assessment (SFA) San Antonio, TX: Pearson; 1998 [cited 2016 05 Jan]. Available from:
Additional References:
Chien CW, Rodger S, Copley J, McLaren C. Measures of participation outcomes related to hand use for 2- to 12-year-old children with disabilities: a systematic review. Child Care Health Dev. 2014;40(4):458–471.
Davies PL, Soon PL, Young M, Clausen-Yamaki A. Validity and reliability of the school function assessment in elementary school students with disabilities. Phys Occup Ther Pediatr. 2004;24(3):23–43.
Sakzewski L, Boyd R, Ziviani J. Clinimetric properties of participation measures for 5- to 13-year-old children with cerebral palsy: a systematic review. Dev Med Child Neurol. 2007;49(3):232–240.
Hwang JL, Davies PL. Rasch analysis of the School Function Assessment provides additional evidence for the internal validity of the activity performance scales. Am J Occup Ther. 2009;63(3):369–373.
Chien CW, Rodger S, Copley J, Skorka K. Comparative content review of children's participation measures using the International Classification of Functioning, Disability and Health-Children and Youth. Arch Phys Med Rehabil. 2014;95(1):141–152.