1. What is the WeeFIM?
WeeFIM is an 18-item, 7-level ordinal scale instrument that measures a child’s consistent performance in essential daily functional skills. Three main domains (selfcare, mobility, and cognition) are assessed by interviewing or by observing a child’s performance of a task to criterion standards. WeeFIM is categorized into 2 main functional streams: “Dependent” (ie, requires helper: scores 1–5) and “Independent” (ie, requires no helper: scores 6–7)” (Wong, 2002, p.1)
- A pediatric outcomes management tool for assessing functional status in children with neurodevelopmental disabilities. It is brief, concise, and applicable to outpatient health and educational sites.
- Measures how well patients independently perform basic activities of daily living and levels of ‘decease in disability’.
- Guides quality improvement efforts by providing specific data on the relative effectiveness of treatment modalities.
- Provides an easily understandable record of each child’s progress in therapy which parents can use in support of insurance reimbursement claims.
- Has a national database and compares individual programs with national benchmarks.
2. What is the Target Population?
3. How is the WeeFIM used?
The WeeFIM is the largest pediatric outcomes database that exists in the world and is considered the ‘gold standard’ for measuring the outcome of rehabilitative treatment. More than 14 countries nearly 1500 facilities in the USA use the WeeFIM.
- Tracks functional improvement and goal attainment for individuals or groups of children
- Compares their outcomes against national benchmarks
- Evaluates the effectiveness and efficiency of the care they provide
- Predicts the burden of care at discharge
- Networks with other pediatric rehab providers
- Supports Joint Commission and CARF accreditation efforts
4. What is the FHC’s WeeFIM Process?
Family Hope Center staff members assess each child’s degree of need and independence in 18 functions across the three general “domains” of self-care, mobility and cognition. For each function, a child is assigned a number from 1 to 7, with 1 meaning the child cannot perform the function independently at all and 7 meaning the child can fully perform the function without assistance. This creates a baseline for measuring the child’s progress toward these functions over the course of his or her treatment program. Additional assessments are conducted at subsequent appointments. The data from these assessments are sent to UDSMR electronically.
UDSMR organizes the data, aggregates it, and prepares quarterly and annual reports. These reports show how well our participants are doing – by themselves and compared to the averages for other facilities. The Family Hope Center conducts a full WeeFIM® assessment of each child at each evaluation appointment. Parents receive a record of their child’s levels of function, in the form of a “polar graph” like the sample shown below. These graphs illustrate the level of the child’s degree of ability in each of the 18 functions. The parents, in turn, can provide copies of these graphs to insurance companies if and when seeking reimbursement.
5. What is 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 comparing them to the national average on 18 functional abilities according to each category of disability.
6. Is the Family Hope Center Accredited?
7. What are the Family Hope Center’s WeeFIM Results?
- The FHC’s WeeFIM results are significantly higher (2.5 x’s) than the national average
- Click here for a cumulative 2002-2017 report (results on pp. 5-9)
- Slomine B. (2011) Functional Independence Measure for Children. In: Kreutzer J.S., DeLuca J., Caplan B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, New York, NY
- Ottenbacher, K. J., Msall, M. E., Lyon, N., Duffy, L. C., Ziviani, J., Granger, C. V., … & Feidler, R. C. (2000). The WeeFIM instrument: its utility in detecting change in children with developmental disabilities. Archives of physical medicine and rehabilitation, 81(10), 1317-1326
- Ottenbacher, K. J., Msall, M. E., Lyon, N., Duffy, L. C., Ziviani, J., Granger, C. V., & Braun, S. (2000). Functional assessment and care of children with neurodevelopmental disabilities. American journal of physical medicine & rehabilitation, 79(2), 114-123
- Sperle, P. A., Ottenbacher, K. J., Braun, S. L., Lane, S. J., & Nochajski, S. (1997). Equivalence reliability of the Functional Independence Measure for Children (WeeFIM®) administration methods. American Journal of Occupational Therapy, 51(1), 35-41
Psychometric Properties Of
- McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires. Oxford University Press,USA
- Chen, C. C., Bode, R. K., Granger, C. V., & Heinemann, A. W. (2005). Psychometric properties and developmental differences in children’s ADL item hierarchy: A study of the WeeFIM® instrument. American journal of physical medicine & rehabilitation, 84(9), 671-679
- Granger, C. V., Hamilton, B. B., Keith, R. A., Zielezny, M., & Sherwin, F. S. (1986). Advances in functional assessment for medical rehabilitation. Topics in geriatric rehabilitation, 1(3), 59-74
- Msall, M. E., DiGaudio, K., Rogers, B. T., LaForest, S., Catanzaro, N. L., Campbell, J., … & Duffy, L. C. (1994). The Functional Independence Measure for Children (WeeFIM) conceptual basis and pilot use in children with developmental disabilities. Clinical Pediatrics, 33(7), 421-430
- Msall, M. E., DiGaudio, K., Duffy, L. C., LaForest, S., Braun, S., & Granger, C. V. (1994). WeeFIM: normative sample of an instrument for tracking functional independence in children. Clinical Pediatrics, 33(7), 431-438
Compared with other Pediatric Developmental Assessment Tools:
- Ottenbacher, K. J., Msall, M. E., Lyon, N., Duffy, L. C., Granger, C. V., & Braun, S. (1999). Measuring developmental and functional status in children with disabilities. Developmental medicine and child neurology, 41(3), 186-194
- Willis, C. D., Gabbe, B. J., Butt, W., & Cameron, P. A. (2006). Assessing outcomes in paediatric trauma populations. Injury, 37(12), 1185-1196
About the WeeFIM (UDSMR Resource):
- Uniform Data System for Medical Rehabilitation (UDSMR)
- Uniform Data System for Medical Rehabilitation (2004–2006). WeeFIM II ® System.
- The FIM Instrument: Its Background, Structure, and Usefulness
- Uniform Data System for Medical Rehabilitation (UDSMR) – Clinical Guide
International Use of the WeeFIM
- Wong, V., Wong, S., Chan, K., & Wong, W. (2002). Functional independence measure (WeeFIM) for Chinese children: Hong Kong cohort. Pediatrics, 109(2), e36-e36
- Serghiou, M. H., Rose, M. W., Pidcock, F. S., Esselman, P. C., Engrav, L. H., Kowalske, K. J., & Lezotte, D. C. (2008). The WeeFIM [R] instrument–a paediatric measure of functional independence to predict longitudinal recovery of paediatric burn patients. Developmental neurorehabilitation, 11(1), 39-50
- Tur, B. S., Küçükdeveci, A. A., KUTLAY, Ş., YAVUZER, G., Elhan, A. H., & Tennant, A. (2009). Psychometric properties of the WeeFIM in children with cerebral palsy in Turkey. Developmental Medicine & Child Neurology, 51(9), 732-738