WeeFIM

Functional Independence
Measure- for children

A standardized, BADL assessment tool for

children with special needs
 Introduction

 WeeFIM measures the impact of developmental strengths and difficulties

on independence at home, in school, and in the community

 It is a pediatric version of FIM for adults>>> It is very similar to the adult FIM

but differs in its scoring processes in order to take into account the child’s

developmental stages.

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 It used to:

 Detect functional limitations and disabilities

 Help staff to develop individualized treatment programs for the

child

 Monitor child progress

 Evaluate the relative effectiveness of treatment modalities

 Evaluate programs within the same institution

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 Age-groups, and exclusion criteria

 Children aged 3-8 years /// or older children with special needs that have functional
limitations and perform in the same levels as typical children aged 3-8 years.

 Children with SCI – spinal cord injuries, Amputations and children with Blindness are
excluded due to specific functional limitations.

 weeFIM performed with children having the following conditions:

Autism Stroke

Cerebral palsy Developmental disabilities: cognitive and developmental

Brain dysfunction delay // disorders of attention, socialization and behaviour //

speech and language // disorders of motor control

Congenital disorders
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 Components and items

Administration time is approximately 15 – 30 minutes

 4 separate categories: with graded

a. Self-care: including 8 items Likert scale
b. Mobility: including 5 items All- of

c. Communication: including 2 together, responses/an

18 items swers from
items
1-7
d. Social cognition: including 3
items

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General Level Descriptions for the
WeeFIM® Instrument
Each of the eighteen items that compose the
WeeFIM® instrument is rated on a seven-level ordinal
scale.
The maximum rating of 7 on this scale represents
complete independence, and the minimum rating of 1
represents total assistance.
The level descriptions below provide a general
overview of the ratings. See the item descriptions for
specific guidelines. See the general guidelines
regarding “percentage of effort.”
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:No Helper
No Helper: The child performs all tasks without assistance from another
person.
7 Complete Independence: The child safely performs all the tasks
described as making up the activity without assistance from a helper, within
a reasonable amount of time, and without modification, assistive devices, or
aids.
6 Modified Independence: The child performs all tasks without assistance
from a helper, and one or more of the following are true
The child requires an assistive device or aid to perform the tasks.
The child requires a prosthesis or an orthosis that is necessary for
performing the tasks.
• The child takes more than a reasonable amount of time to perform the
tasks.
• There is a concern for the child’s safety when he performs the tasks.

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:Helper
Helper: The child requires another person (whether for supervision
or physical assistance) to perform the tasks, or the child does not
perform the tasks. Modified Dependence: The child performs 50% or
more of the tasks.
5 Supervision/Setup: The child performs all the tasks but requires
either supervision (standby supervision, cues, or coaxing) without
physical contact or setup assistance (e.g., setting up necessary items
or helping to apply an assistive/adaptive device, a prosthesis, or an
orthosis).
4 Minimal Assistance: The child performs 75% or more of the tasks,
requiring no more help than touching.
3 Moderate Assistance: The child performs 50% to 74% of the
tasks, requiring physical assistance beyond touching.

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:Complete Dependence
Complete Dependence: The child performs less than 50% of
the tasks, requiring maximal or total assistance from a
helper, or does not perform the activity.
2 Maximal Assistance: The child performs 25% to 49% of
the tasks.
1 Total Assistance: One or more of the following are true:
The child performs less than 25% of the tasks (includes
nonperformance of tasks).
The child requires assistance from two helpers to perform
the tasks.
The activity does not occur
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 Likert scale of responses/scoring

No helper level weeFIM

Helper- Modified levels

independence
7 = complete independence
(Timely, safely)
5= supervision only Helper-complete

6 = modified independence dependence

4= Minimal assistance
(Device/s only)
(subject 75% at least) 2= Maximal assistance
(subject 25%-49%)
3= Moderate assistance
(subject 50% or more) 1= Total assistance
(subject 0%-24%)
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Decision
Tree

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 weeFIM assessment

 Each item of the total 18 items should be scored from 1-7 >>> with 1 meaning the child can
not perform the function independently at all (total assistance needed from a helper or
device) + 7 meaning the child can fully perform the function without assistance (complete
child independence)

 Each Category must be calculated for separate Category total score.

 Each item should be checked √ (Yes/No) if the limitation is due to injury or due to not
(maybe due to environmental factor) 12
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 Calculations and interpretation of
scoring

 All 4 total category score should be added in order to calculate the Total
WeeFIM score, from maximum of 126 marks, and minimum of 18 marks.

Then, the evaluator (assessor) should use the TABLE OF NORMS in order
to interpret the:

 Separate item’s score

 Total Category score
 Total WeeFIM score.

 Reassessment is conducted at subsequent appointments or after standard

intervals
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 Interpretation of the scores

 Each score should be compared to the score of the typical child in the
same-age group in the same item.

 If the assessed child’s score is LESS than the typical child’s score  then
the OT should set the goals and aims to improve the functional level.

 If improving the functional level requires: SUPERVISION or DEVICE/S

or ASSISTANCE  then it should be noted in the client’s WeeFIM sheet
and the personal file

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