Developments in Measuring Functional Activities: Where Do We Go with the PEDI-CAT?
Physical & Occupational Therapy in Pediatrics Volume 30, Number 3, ISSN 0194-2638
During the past 30 years many pediatric assessment and outcome measures have been developed. Based on Rasch analysis, the Pediatric Evaluation of Disability Inventory (PEDI) was designed to measure functional status by asking parents about both the skills of their children and the performance of daily tasks in three functionally important domains (self-care, mobility, and social functioning). Although the PEDI is clearly established in clinical practice, some disadvantages of the original PEDI have been noted as well. Most importantly, the length of the interview has been perceived as a barrier; time that can be spent on individual patients or clients is limited and sometimes service providers prefer to use that time for therapy instead of using it for assessment. Another disadvantage is that the PEDI can be used for discriminative purposes for children between 6 months and 7.5 years of age only. And finally, children with behavioral problems are difficult to score. Most of the time, they are physically able to perform the skills but rarely show them due to behavioral problems, or only when the parent is present and verbally cues the activity. The development of the PEDI-CAT described by Dumas and her colleagues in this issue might overcome these disadvantages. The PEDI-CAT differs from the PEDI in both the scope of the constructs that are measured and the method of administration. The addition of new items extend the functional content assessed by the domains of self-care, mobility, and social functioning, providing the opportunity to assess children and youth over a broader age range. Moreover, the new Responsibility Scale is a useful addition both for older youth and children with behavioral problems. It provides information on the way a young person manages to fulfill life tasks that enable independent living, such as cooking and planning and following a weekly schedule. The authors conclude that the PEDI-CAT is a promising instrument to assess self-care, mobility, and social function activities in children and young persons, and to assess the extent to which a young person is managing life tasks that enable independent living. In future, more experience will be gained with the instrument, both in terms of validity and reliability and clinical utility.
Ketelaar, M. & Wassenberg-Severijnen, J. (2010). Developments in Measuring Functional Activities: Where Do We Go with the PEDI-CAT?. Physical & Occupational Therapy in Pediatrics, 30(3), 185-189.