About the WeeFIM

  /  About the WeeFIM

The effectiveness of any therapeutic approach must be periodically assessed using standardized and validated measures. The Family Hope Center assesses the effectiveness of its approach using the WeeFIMĀ®, the pediatric version of the Functional Independence MeasureTM (FIMĀ®).

Both the FIMĀ® and WeeFIMĀ® were developed by Uniform Data System for Medical Rehabilitation (UDSMR) from the World Health Organizationā€™s bio-psycho-social model of disability. They are functional assessment tools for evaluating essential abilities in individuals with neurodevelopmental disabilities along three dimensions: self-care, motor function, and cognition.

UDSMR notes: ā€œSince its inception in 1987, the FIMĀ® instrument has been widely regarded and adopted by clinicians and researchers around the world for its brevity and reliability. A sizeable library of supporting research and study sustains the FIMĀ® instrumentā€™s reliability and validity. To date, more than 1,300 published articles support the FIMĀ® instrument, and ongoing research and study continues.ā€ (Read more clinical research about the WeeFIM here).

Our WeeFIMĀ® results show that childrenā€™s neurological and functional capabilities significantly improve through the Family Hope Centerā€™s parent-implemented home-based therapy.

The WeeFIM IIĀ® System

ā€œThe WeeFIM IIĀ® System is the most respected pediatric outcomes management tool in the market. Used by pediatric inpatient, outpatient, and community-based rehab programs, the WeeFIM IIĀ® System provides a simple, uniform construct that measures function in children. Based on the principal underpinnings of the FIMĀ® instrument, the system allows clinicians to quickly assess functional status and track progression. It also provides patient-level data, profile reports, and program summary reports that demonstrate individual patient progress and overall program effectiveness.ā€2

The WeeFIM Instrument

Both the WeeFIM and the FIM were developed from the World Health Organizationā€™s bio-psycho-social model of disability ā€“ the International Classification of Functioning, Disability, and Health ā€“ which identifies individuals as having a disability according to functional ability along various domains, their limitations in basic activities, and participation (or restrictions) in work, school, family life, and other social activities.

Both instruments have also been researched extensively and have high reliability and validity as diagnostic tools. This makes them especially helpful in measuring the outcome of rehabilitative treatment.

ā€œThe Functional Independence Measure (WeeFIM) for children is a simple-to-administer scale for assessing independence across 3 domains in American childrenā€ (Wong, 2002, p. 1).

The instrumentā€™s three domains are Selfcare, Mobility, and Cognition. In total, there are 18-items. Each item is assessed on a 7-level ordinal scale by the clinician, either through parent interview, or by observing a childā€™s performance of essential daily functional skills to criterion standards.

Scoring is categorized into 2 main functional streams: ā€œDependentā€ (i.e., requires helper: scores 1ā€“5) and ā€œIndependentā€ (i.e., requires no helper: scores 6ā€“7) (Wong, 2002).

This means the WeeFIM measures how well children independently perform basic activities of daily living and over time, demonstrates their ā€œdecrease in disabilityā€ in response to therapy.

The Target Population

ā€œWeeFIM was based on a conceptual framework by the World Health Organization (1980) of pathology, impairment, disability and handicap, and the ā€œburden of care.ā€ The instrument 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 yearsā€ (Wong, 2002).

How the WeeFIM is Used

As an international tool developed from the WHOā€™s model of disability, the WeeFIM is used by inpatient and outpatient facilities around the world. It provides them an easily understandable record of a childā€™s progress in therapy, which parents can then use in support of reimbursement claims to their respective local systems of care.

The WeeFIM is used to:

  • Track functional improvement and goal attainment for individuals or groups of children
  • Evaluate the effectiveness and efficiency of the care individual facilities provide by comparing facility outcomes to national benchmarks
  • Predict the burden of care at discharge
  • Network with other pediatric rehabilitation providers

How the Family Hope Center Uses the WeeFIM

The Family Hope Center conducts a full WeeFIMĀ® assessment of each child at each appointment. Clinical staff assess each childā€™s degree of need and independence in 18 abilities across the three domains (self-care, mobility, and cognition). For each function, a child is assigned a number from 1 to 7 ā€“ with 1 meaning the child cannot perform the function independently at all and 7 meaning the child can fully perform the function without assistance.

With the first assessment creating a baseline, subsequent assessments allow for the measurement of each childā€™s progress toward these abilities over the course of their treatment.

The data from these assessments are then logged into the UDSMR database. UDSMR organizes the data, aggregates it, and prepares quarterly and annual reports. These reports show how well each child is doing ā€“ both individually and compared to averages for all other facilities in the database.

Parents receive a record of their childā€™s levels of function (in the form of a polar graph like the sample shown below). These graphs illustrate the level of the childā€™s degree of ability in each of the 18 functions. The parents, in turn, can provide copies of these graphs and raw scores of WeeFIM assessments to local systems as proof of their childā€™s response to therapeutic intervention and for support when seeking reimbursement for their efforts.

The WeeFIM Accreditation Process

  • Every WeeFIM outpatient clinic must be accredited and pass the credentialing exam every two years.
  • Facilities that participate in the WeeFIM submit data to UDSMR after being trained and credentialed.
  • Facilities receive a customized report years comparing them to the national average on 18 functional abilities according to each category of disability.

The Family Hope Centerā€™s Accreditation History

The FHC is currently accredited and was originally accredited in 2002. As an accredited clinic, we are required to pass an extensive credentialing exam every two years.

The Family Hope Centerā€™s WeeFIM Results

  • The FHCā€™s WeeFIM results are consistently higher than the national average benchmarks
  • Each childā€™s WeeFIM results demonstrate that parents, with proper education, guidance, and support, can implement therapeutic interventions in their homes with fidelity and achieve results consistent with ā€“ and surpassing ā€“ standard therapy options.
  • Further, the results demonstrate that parents can improve their childā€™s functional independence through home-based therapy.

References

General

Psychometric Properties of:

Original Publications:

Compared with other Pediatric Developmental Assessment Tools:

About the WeeFIM (UDSMR Resources):

International Use of the WeeFIM:

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