Few tools are available to pediatricians for tracking and monitoring disability status in children. We describe the conceptual basis and pilot use of the Functional Independence Measure for Children (WeeFIM) . Our pilot use of this instrument in children with limb deficiency, Down's syndrome, spina bifida, cerebral palsy, and extreme prematurity demonstrates that the WeeFIM is a valid measure for tracking disability in preschool age and middle childhood. The WeeFIM measures the impact of developmental strengths and difficulties on independence at home, in school, and in the community. This allows the pediatrician to prioritize interventions for enhancing comprehensive functional outcomes and supporting families.
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References
1.
Capute AJ, Biehl RFFunctional Developmental Evaluation: Prerequisite to habilitation. Pediatr Clin North Am. 1973;20:3-26.
2.
Capute AJ, Shapiro BK, Palmer FB, et al. Normal gross motor development: Influence of race, sex, and socio-economic status. Dev Med Child NeuroL1985;27:635-643.
3.
Capute AJ, Palmer FB, Shapiro BK, et al. Clinical Linguistic and Auditory Milestone Scale: prediction of cognition in infancy. Dev Med Child Neurol.1986;28:762-771.
4.
Capute AJ, Palmer FB, Shapiro BK, et al. Primitive Reflex Profile: a quantification of primitive reflexes in infancy. Dev Med Child Neurol.1984;25:375-383.
5.
Hoon AH, Pulsifer MB, Gopalan R., et al. Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale in early cognitive assessment. J Pediatr.1993;123:S1-S8.
6.
Capute AJ, Shapiro BK, Wachtel RC, et al. TheClinical Linguistic and Auditory Milestone Scale (CLAMS): identification of cognitive defects in motor-delayed children. Am J Dis Child.1986;140:694-698.
7.
Gesell A., Halvern AM, Thompson H., et al. TheFirst Five Years of Life: A Guide To The Study of the Preschool Child. New York, NY: Harper and Brothers; 1940.
8.
Gesell A., Thompson H., Amatruda CSInfant Behavior: Its Genesis and Growth. New York: McGraw-Hill;1934.
9.
Doll EAA genetic scale of social maturity. Am J Orthopsychiatry. 1935;5:180-188.
10.
Doll EAThe social basis of mental diagnosis. J Appl Psychol.1940;24:160-169.
11.
Doll EAMeasurement of Social Competence: A Manual for the Vineland Social Maturity Scale. Circle Pines, MN: American Guidance Service; 1965.
12.
Grossman HJ, ed. Classification in Mental Retardation. Washington, DC: American Association on Mental Deficiency; 1983.
13.
Luckasson R., Coulter DL, Polloway S., et al. MentalRetardation: Definition, Classification and Systems of Supports. 9th ed. Washington, DC: American Association on Mental Retardation; 1992.
14.
Granger CV, Hamilton BB, Keith RA, Zielezny M., Sherwin FSAdvances in functional assessment for medical rehabilitation. Topics Geriatric Rehabilitation.1986;1:59-74.
15.
Granger CV, Hamilton BBThe Uniform Data System for medical rehabilitation report of first admissions for 1990. Am J Phys Med Rehab.1992;71:108-113.
16.
Granger CV, Cotter AC, Hamilton BB, Fiedler RCFunctional Assessment Scales: a study of persons after stroke. Arch Phys Med Rehab. 1993;74:133-138.
17.
Granger CV, Cotter AC, Hamilton BB, et al. Functional Assessment Scales: a study of persons with multiple sclerosis. Arch Phys Med Rehab. 1990;71:870-875.
18.
NationalAdvisory Board on Medical Rehabilitation. Research Plan for the National Center for Medical Rehabilitation Research. Bethesda, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Child Health and Human Development. NIH Publication No. 93-3509; March, 1993.
19.
Granger CV, Gresham GEFunctional Assessment in Rehabilitation Medicine. Baltimore, MD: Williams & Wilkins; 1984 :20.
20.
Knoblock H., Pasamanick B.Gesell and Armatruda's Developmental Diagnosis: The Evaluation and Management of Normal and Abnormal Neuropsychologic Development in Infancy and Early Childhood . 3rd ed. New York, NY Harper and Row; 1974.
21.
Capute AJ, Shapiro PK The motor quotient A method for the early detection of motor delay . Am J Dis Child.1985 ;139:940-942.
22.
Illingworth RDThe Development of the Infant and Young Child: Normal and Abnormal. 9th ed. New York, NY Churchill Livingston; 1987.
Nihera K., Foster R., Shellhaar M., Leland H.American Association on Mental Deficiency Adaptive Behavior Scale. Revised ed. Washington DC: American Association on Mental Deficiency; 1974.
30.
Brigance A.Brigance Diagnostic Inventory of Early Development. North Billerica, MA: Curriculum Associates; 1978.
31.
Sparrow SS, Balla DA, Cicchetti DVVineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service; 1984.
32.
Vulpe SG, Rollin EI, Wilson J.Vulpe Assessment Battery for the Atypical Child. 2nd ed. Toronto, Ontario Canada: National Institute on Mental Retardation; 1977.
33.
Johnson-Martin N., Kens KG, Attermeir M.The Carolina Curriculum for Handicapped Infants and Infants at Risk. Baltimore, MD: Paul Brookes; 1986.
34.
Msall ME, DiGaudio KM, Duffy LCUse of functional assessment in children with developmental disabilities. Phys Med Rehab Clin North Am.1993;4:517-527.
35.
Russell D., Rosenbaum P., Cadman D., et al. The gross motor function measure: a means to evaluate the effects of physical therapy. Dev Med Child NeuroL1989;31:341-352.
36.
Feldman AB, Haley SM, Coryell J.Concurrent and construct validity of the pediatric evaluation of disability inventory. Phys Ther.1990;70:602-610.
37.
Braun SL, Msall ME, McCabe M., Granger CVGuide for Use of the Functional Independence Measure for Children (WeeFIM) of the Uniform Data System for Medical Rehabilitation. Version 4.0. Buffalo, NY Center for Functional Assessment Research, State University of New York at Buffalo; April 1994.
38.
Msall ME, Braun S., Granger CVUse of the functional independence measure for children (WeeFIM): an interdisciplinary training tape. Dev Med Child Neurol.1990;32(Suppl 62):46. Abstract.
39.
Braun SL, Granger CVA practical approach to functional assessment in pediatrics. Occupat TherPract.1991;2:46-51.
40.
McCabe MAEvaluating the validity and reliability of the pediatric functional independence measure. Dissertation Abstracts International.1991;5: 2302.
41.
Msall ME, Rosenberg S., DiGaudio KM, et al. Pilot testing of the WeeFIM in children with motor impairments . Dev Med Child Neurol .1990;32(Sup 62):41. Abstract.
42.
Msall ME, Wargula JC, DiGaudio KM, et al. Functional independence in children with limb deficiencies. Pediatr Res.1993; 33:14A. Abstract.
43.
Msall ME, Roehmholdt SJ, DiGaudio KM, Duffy LCFunctional independence of school age children with Down syndrome. PediatrRes.1992;31: 13A. Abstract.
44.
Msall ME, Monti DA, Duffy LC, LaForest S.Measuring functional independence in children with spina bifida. Pediatr Res.1992;31:12A. Abstract.
45.
Msall M., Mallen S., Rogers B., et al. Pilot use of a functional status measure at age 4.5 years in extremely premature infants after surfactant. Dev Med Child Neurol.1991;33(Suppl 64):15-16. Abstract.
46.
Msall ME, Rogers BT, Buck GM, et al. Functional status of extremely premature infants at kindergarten entry. Dev Med Child Neurol.1993;35:312-320.
47.
Blackman JA , Healy A., Ruppert ESParticipation by pediatricians in early intervention: impetus from Public Law 99-457 (Individuals with Disabilities Education Act) . Pediatrics. 1992; 9:98-102.
48.
Palfrey JC, Mervis RC, Butler JANew directions in the evaluation and education of handicapped children: Public Law 94-142 (The Education for All Handicapped Children Act). N Engl J Med.1978;298:819-824.
49.
Sullivan vs Zebley, 88-1377 (US Supreme Court 20 Feb. 1990).
50.
Perrin JM, Stein Rek.Reinterpreting disability: changes in supplemental security income for children . Pediatrics. 1991;88:1047-1051.
51.
Ireys HT, Nelson RPNew federal policy for children with special health care needs: implications for pediatricians. Pediatrics.1992;90:321-327.
52.
Stein Rek, Bauman LJ, Westbrook LE, et al. Framework for identifying children who have chronic conditions: the case for a new definition. J Pediatr.1993;122:342-347.
