There are no known studies of reference values of Indian children aged 3–7 years. With reference values, the progression of independence at home and in the community can be evaluated. Due to such cultural and environmental differences among countries and the dearth of WeeFIM application in India, there is a need for reference values for Indian children. concluded that children from different cultures develop at different rates therefore, applying a set of norms from one culture to another culture could misrepresent a child's true developmental status. Contextual issues deal with the influence of environmental and social issues on a child's functions. ,, In the assessment of functional performance, some investigators emphasize the importance of context. Prior studies have identified ethnic, cultural and environmental differences in different countries and these influence the pattern of independence. Normative WeeFIM data have been validated previously for American, Chinese, Japanese and Turkish children. ,, ,, ,, ,, WeeFIM has various advantages that include a clear scoring system, consistency in application, being comprehensive, and administration by multidisciplinary health professionals. However, the scale can be used up to 21 years for children with developmental disabilities. WeeFIM is usually applied in typically developing children of 6 months to 7 years of age. Each domain has some test items which were assessed by observations or by interview. There are three main domains: self-care, mobility and cognition. Each item is evaluated on a 7-point ordinal scale and assesses a child's performance in day-to-day functional tasks. ,, ,, , However, though the former three instruments have discriminative measures, they are time-consuming to administer and their scoring does not have the ability to track the performance of an individual over a period of time. There are four well-accepted and widely used functional outcome measures available: the Pediatric Evaluation of Disability Inventory, Vineland Adaptive Behavior Scale, Battelle Developmental Inventory Screening Test and Functional Independence Measure for children (WeeFIM Unified Data System for Medical Rehabilitation, Buffalo, NY, USA). It can evaluate the environmental needs and circumstances to complete the activity in an educational or community set up. Functional assessment has many advantages. McCabe and Granger described the functional assessment of children as an attempt to systematically describe and quantify a child's capabilities and restrictions while performing activities of daily living. We could not find any effect of socioeconomic status on WeeFIM raw rating or functional independence level.ĭuring comprehensive evaluation of a child, it is essential to assess function, as it will determine what a child can achieve in a particular environment. Children in private schools showed better performance versus children in government schools in the early age ranges. There were no differences between boys and girls regarding WeeFIM performance. We have provided reference values for WeeFIM in children of India aged 3–7 years (35–84 months). At the beginning of 3 years, children were at WeeFIM level 3 that is moderate assistance stage in their functional independence, but by the age of 7 years, they became completely independent on all the three domains of WeeFIM functional scale. Total score of the WeeFIM instrument showed a similar performance between boys and girls. There was a progressive increase of functional independence with increasing chronological age across all WeeFIM domains. After obtaining written informed consent, direct interviews for WeeFIM II Clinical Guide (version 6.0) were conducted for parent/guardian/teacher of 182 typically developing children. Participants were recruited randomly from schools. We obtained permission from the Unified Data System for Medical Rehabilitation, a non-profit organization to use the WeeFIM instrument. We sought to establish reference values of the functional independence measure (WeeFIM Unified Data System for Medical Rehabilitation, Buffalo, NY, USA) for children aged 3–7 years in India using this cross-sectional study.
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