Michelle Stahlhut, PT MSc

Brneterapien, Gentofte Kommune

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 Authors: Stephen M. Haley, Wendy J. Coster,
Larry H. Ludlow, Jane T. Haltiwanger, and
Peter J. Andrellos

Publication date: 1992

Purpose: To assess and evaluate functional

status in children aged 6mo 7 years

Users: PTs, OTs and other health care

professionals

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 Generic instrument
Used for children with various types of congenital
and acquired disorders

Applicable to all children aged 6mo 7

years with potential delays in functional skill
development
Can be used for older children if their functional
development is delayed

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 Discrimination detection of delay or deficit

Evaluation monitoring change over time

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 Administration time: 45-60 min.

Methods:
Structured interview
Professionel observation
Questionnaire
Combination of methods

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 Scales

Functional Caregiver Modifications

skills assistance
Self-care 73 8 8
Mobility 59 7 7
Social function 65 5 5
Rating Scale Two-point Six-point Four categories

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 Translation and content validity, 2005
Inter-respondent reliability, pilot study 2008
Low-to-moderate agreement (weighted kappa <0.6)

Applicability, 2010
PEDI reference values were partly applicable in a Danish
population (Danish children had significantly lower scores in
the subscales Caregiver assistance: self-care and mobility)

Intra-respondent reliability, 2010

Good to high levels, ICC=0.62-0.97

Discriminative validity, 2011

CP vs non-disabled, sensitivity=77.3%, specificity=97.8%
JIA vs non-disabled, sensitivity=99.8%, specificity=81.7%

New and improved Danish translation, 2012

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 Covers all components of the ICF (mostly
activity and participation)
Focuses on the capabilities and performance
of the child
Supports a family-centered practice
Each scale is self-contained and can be used
separately or in combination

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 Time-consuming
Floor- and ceiling effects
Can only be used for discriminative purposes
for children between 6mo-7 years
Problematic software program

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 Authors: Originators of the PEDI
Publication date: 2012?
Purpose: To assess and evaluate functional
status in children and youth aged 0 20
years
Completed by parent report or professional
judgment
Administration time: Approx 15 min!

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 CAT uses a computer algorithm that selects
questions from a large item bank
1) All respondents answer the same first question in the
middle of the scoring range (start point)
2) Response of first question dictates the next question
(easier or harder)
3) With each new response a score and CI are re-
estimated until the desired level of precision has been
satisfied (stop point)

Items are tailored to each child, irrelevant items

are avoided assessment time reduced
Approx 10-15 items are necesserary in each
domain/scale

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 Functional skills scales Responsibility scale
Daily activities 68
Mobility (incl devices) 97 51
Social/cognitive 60
Response scale Four-point difficulty* Five-point**

* unable, hard, a little hard, easy + I dont know

** adult full responsibility, adult most responsibility, shared

responsibility, child most responsibility, child full responsibility
+ I dont know

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 Daily activities Mobility

Social/cognitive Responsibility

Writes short notes or sends text
messages or email
Putting items and objects away after
use (includes: knowing where objects
are stored, organizing belongings and
objects so they can be found when
needed)
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 6 year-old boy with bilateral spastic CP

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 6 year-old boy with bilateral spastic CP

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 6 year-old boy with bilateral spastic CP

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 Thanks to the Association of Danish
Physiotherapists, Copenhagen University
Hospital Hvidovre, and The Danish
Rheumatism Association for financial support

Thanks to Richard Moed (CreCare) and Wendy

Coster (Boston University) for sharing a trial
version of the PEDI-CAT

A special thanks to Jette Christensen, Mette

Aadahl and all my colleagues in Brneterapien

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 Haley, SM., Coster, WJ., Ludlow, LH., Haltiwanger, JT. & Andrellos, PJ. (1992).
Pediatric Evaluation of Disability Inventory (PEDI). Development, Standardization and
Administration Manual (version 1.0). Boston University.
Christensen, J. (2005) Anvendeligheden af PEDI som dansk sprgeskema. Danish.
[The use of a Danish questionnaire version of PEDI].
http://fysio.dk/fafo/Afhandlinger/Master-og-magister/2005/Anvendeligheden-af-PEDI-
som-dansk-sporgeskema/
Hansen, M.W., Laursen, B., Zangger, G., Andersen, B. & Stahlhut, M. (2008) Inter-
respondent reliabilitet af Pediatric Evaluation of Disability Inventory PEDI. Danish.
[Inter-respondent reliability of the Pediatric Evaluation of Disability Inventory (PEDI)].
http://fysio.dk/Upload/graphics/PDF-
filer/Studerendes%20Pris/Interrespondent_reliabilitet_PEDI_HansenMW_LaursenB_
ZanggerB_AndersenB_StahlhutM_StuderendesPris_2008.pdf
Stahlhut, M., Christensen, J. & Aadahl, M. (2010) Applicability and intra-respondent
reliability of the Pediatric Evaluation of Disability Inventory (PEDI) in a random Danish
sample. Pediatr Phys Ther.22:161-169.
Stahlhut, M., Gard, G., Aadahl, M. & Christensen, J. (2011) Discriminative validity of
the Danish version of the Pediatric Evaluation of Disability Inventory (PEDI). Phys
Occup Ther Pediatr 31(1):78-89

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 Dumas, H., Fragala-Pinkham, M., Haley, S., Coster, W., Kramer, J., Kao, Y. & Moed,
R. (2010) Item Bank Development for a Revised Pediatric Evaluation of Disability
Inventory (PEDI). Phys Occup Ther Pediatr 30(3): 168-184.
Ketelaar, M. & Wassenberg-Severijnen, J. (2010) Developments in Measuring
Functinal Activities: Where Do We Go with the PEDI-CAT? Phys Occup Ther Pediatr
30(3): 185-189.
Dumas, HM., Fragala-Pinkham, MA., Haley, SM., Ni, P., Coster, W., Kramer, JM.,
Kao, Y., Moed, R. & Ludlow, LH. (2012) Computer adaptive test performance in
children with and without disabilities: prospective field study of the PEDI-CAT. Disabil
Rehabil 34(5): 393-401.

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