psychology press is an imprint of the taylor & francis ... · everyday memory questionnaire...

First published 2010by Psychology Press27 Church Road, Hove, East Sussex BN3 2FA

Simultaneously published in the USA and Canadaby Psychology Press270 Madison Avenue, New York NY 10016

Psychology Press is an imprint of the Taylor & Francis Group, an Informa business

© 2010 Psychology Press

Typeset in Times by RefineCatch Ltd, Bungay, SuffolkPrinted and bound in Great Britain by TJ International Ltd, Padstow, CornwallCover design by Andy Ward

All rights reserved. No part of this book may be reprinted or reproduced or utilised in anyform or by any electronic, mechanical, or other means, now known or hereafter invented,including photocopying and recording, or in any information storage or retrieval system,without permission in writing from the publishers.

This publication has been produced with paper manufactured to strict environmentalstandards and with pulp derived from sustainable forests.

British Library Cataloguing in Publication DataA catalogue record for this book is available from the British Library

Library of Congress Cataloging-in-Publication DataTate, Robyn L.

A compendium of tests, scales, and questionnaires : the practitioner’s guide to measuringoutcomes after acquired brain impairment / Robyn L. Tate.p. ; cm.

Includes bibliographical references and indexes.ISBN 978–1–84169–561–7 (hardcover)1. Neuropsychological tests. I. Title.[DNLM: 1. Brain Diseases—diagnosis. 2. Neuropsychological Tests. WL 141 T217c 2010]RC386.6.N48T38 2010616.8’0475—dc22 2009011393

ISBN 978-1-84169-561-7

http://www.compendium-of-scales.com/


Contents

List of figures xiiiList of tables xvForeword xviiPreface xix

1 Introduction 1

Background and methodology 1The International Classification of Functioning, Disability and Health (ICF) 7Placing measuring instruments for ABI within the ICF taxonomy 11References 15

Part ABody Functions 19

2 Scales of consciousness and orientation 21

Introduction 23

Section 1 Scales measuring coma, vegetative and minimally conscious states 25Coma/Near Coma (C/NC) Scale 25Comprehensive Level of Consciousness Scale (CLOCS) 29Glasgow Coma Scale (GCS) 32JFK Coma Recovery Scale – Revised (CRS-R) 38Rancho Los Amigos Levels of Cognitive Functioning Scale (LCFS) 42Wessex Head Injury Matrix (WHIM) 45Western Neuro Sensory Stimulation Profile (WNSSP) 48

Section 2 Scales measuring delirium 51Cognitive Test for Delirium (CTD) 51Confusion Assessment Method (CAM) 54Confusion Assessment Protocol (CAP) 58Delirium Rating Scale – Revised – 98 (DRS-R-98) 60Memorial Delirium Assessment Scale (MDAS) 66

Section 3 Scales measuring orientation and post-traumatic amnesia 70Galveston Orientation and Amnesia Test (GOAT) 70Orientation Group Monitoring System (OGMS) 77Orientation Log (O-Log) 80Post-traumatic Amnesia Questionnaire (PTAQ) 83Westmead Post-traumatic Amnesia Scale (WPTAS) 86

3 Scales of general cognitive functions 91

Introduction 93Addenbrooke’s Cognitive Examination – Revised (ACE-R) 97



Blessed Information-Memory-Concentration Test (BIMCT) 106Capacity to Consent to Treatment Instrument (CCTI) 111Clifton Assessment Procedures for the Elderly (CAPE) 114Cognitive Abilities Screening Instrument (CASI) 118Cognitive Failures Questionnaire (CFQ) 124Cognitive Log (Cog-Log) 129General Practitioner Assessment of Cognition (GPCOG) 134Hopkins Competency Assessment Test (HCAT) 140Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) 145Mini-Cog 149Mini-Mental State Examination (MMSE) 154Montreal Cognitive Assessment (MoCA) 161Rowland Universal Dementia Assessment Scale (RUDAS) 165Severe Mini-Mental State Examination (SMMSE) 170Telephone Interview for Cognitive Status (TICS) 174Test for Severe Impairment (TSI) 177

4 Scales of specific cognitive functions 183

Introduction 185

Section 1 Scales measuring attention functions 188Moss Attention Rating Scale (MARS) 188Rating Scale of Attentional Behaviour (RSAB) 194

Section 2 Scales assessing executive functions 197Dysexecutive Questionnaire (DEX) 197Executive Interview (EXIT25) 200Frontal Assessment Battery (FAB) 205Problem Solving Inventory (PSI) 210

Section 3 Scales assessing language functions 213Communicative Effectiveness Index (CETI) 213Frenchay Aphasia Screening Test (FAST) 217La Trobe Communication Questionnaire (LCQ) 220Mississippi Aphasia Screening Test (MAST) 224

Section 4 Scales assessing memory functions 229Comprehensive Assessment of Prospective Memory (CAPM) 229Everyday Memory Questionnaire (EMQ) 235Memory Compensation Questionnaire (MCQ) 241Memory Functioning Questionnaire (MFQ) 244Memory Impairment Screen (MIS) 250Prospective and Retrospective Memory Questionnaire (PRMQ) 253

Section 5 Scales assessing self-awareness 258Awareness Questionnaire (AQ) 258Patient Competency Rating Scale (PCRS) 262Self-Awareness of Deficits Interview (SADI) 266

5 Scales assessing the regulation of behaviour, thought and emotion 271

Introduction 273Agitated Behavior Scale (ABS) 275Apathy Evaluation Scale (AES) 279Behavioral Dyscontrol Scale (BDS) 284Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD) 289Behavior Rating Inventory of Executive Function (BRIEF) 295Cohen-Mansfield Agitation Inventory (CMAI) 299

viii Contents



Fatigue Impact Scale (FIS) 302Fatigue Severity Scale (FSS) 307Frontal Behavioral Inventory (FBI) 311Frontal Systems Behavior Scale (FrSBe) 316Harmful Behaviours Scale (HBS) 319Katz Adjustment Scale – Form R1 (KAS-R1) 322Neuropsychiatric Inventory (NPI) 328Neuropsychology Behavior and Affect Profile (NBAP) 331Overt Aggression Scale – Modified for Neurorehabilitation (OAS-MNR) 334Overt Behaviour Scale (OBS) 341

6 Scales of sensory, ingestion and motor functions 345 .

Introduction 347

Section 1 Scales assessing sensory functions 349Seeing functions 349Snellen Chart 349Hearing functions 352Whispered Voice Test (WVT) 352Smell functions 354San Diego Odor Identification Test (SOIT) 354Touch functions 356Semmes Weinstein Monofilament (SWM) 356Pain functions 358Visual Analogue Scale (VAS) For Pain, Numeric Rating Scales (NRS), and other

pain scales 358McGill Pain Questionnaire (MPQ) 362

Section 2 Scales assessing ingestion functions 365Bedside Swallowing Assessment (BSA) 365

Section 3 Scales assessing motor functions 368Muscle power functions 368Medical Research Council Motor Scale (MRC-MS) 368Muscle tone functions 370Ashworth Scale (AS) 370Tardieu Scale (TS) 373Movement functions 376Berg Balance Scale (BBS) 376Fugl-Meyer Assessment (FMA) 381High-level Mobility Assessment Tool (HiMAT) 384Motor Assessment Scale (MAS) 388Motricity Index (MI) 394Rivermead Mobility Index (RMI) 398Timed Gait Pattern Function Tests 401

Part BActivities and Participation 405

7 Scales assessing activities of daily living 407

Introduction 409Activities of Daily Living Questionnaire (ADLQ) 411Assessment of Living Skills and Resources (ALSAR) 416Barthel Index (BI) 421

Contents ix



Bristol Activities of Daily Living Scale (BADLS) 426Frenchay Activities Index (FAI) 430Functional Independence Measure (FIM) 434Functional Independence Measure and Functional Assessment Measure

(FIM+FAM) 439Functional Independence Measure for Children (WeeFIM) 443Katz Index of Activities of Daily Living (KIADL) 446Instrumental Activities of Daily Living Scale (IADLS) and Physical

Self-Maintenance Scale (PSMS) 452Northwick Park Dependency Score (NPDS) 457Nottingham Activities of Daily Living Scale (NADLS) 465Nottingham Extended Activities of Daily Living (NEADL) 468Rivermead Activities of Daily Living (RADL) 471Systeme de Mesure de l’Autonomie Fonctionnelle (SMAF; English version:

Functional Autonomy Measurement System) 475

8 Scales assessing participation and social role 479

Introduction 481Child and Adolescent Scale of Participation (CASP) 483Community Integration Measure (CIM) 486Community Integration Questionnaire (CIQ) 489Community Outcome Scale (COS) 494Craig Handicap Assessment and Reporting Technique (CHART) 498Impact on Participation and Autonomy (IPA) Questionnaire 506Leeds Assessment Scale of Handicap (LASH) 511London Handicap Scale (LHS) 516Nottingham Leisure Questionnaire (NLQ) 521Participation Objective, Participation Subjective (POPS) 524Reintegration to Normal Living (RNL) Index 528Sydney Psychosocial Reintegration Scale (SPRS) 532World Health Organization Disability Assessment Schedule II (WHODAS II) 539

Part CContextual Factors 547

9 Scales of environmental factors 549

Introduction 551Care and Needs Scale (CANS) 553Craig Hospital Inventory of Environmental Factors (CHIEF) 557Home and Community Environment (HACE) Instrument 563Interpersonal Support Evaluation List (ISEL) 568Lubben Social Network Scale (LSNS) 573Measure of Quality of the Environment (MQE) 577Northwick Park Care Needs Assessment (NPCNA) 580Social Support Survey (SSS) 584Supervision Rating Scale (SRS) 588Survey of Unmet Needs and Service Use (SUNSU) 592

Part DMulti-domain Scales 595

10 Global, multidimensional and quality of life scales 597

Introduction 597

x Contents



Section 1 Global scales 599Clinical Dementia Rating (CDR) Scale 599Expanded Disability Status Scale (EDSS) 603Glasgow Outcome Scale (GOS) 606Global Deterioration Scale (GDS) and Functional Assessment Staging (FAST) 614Modified Rankin Scale (mRS) 617

Section 2 Multidimensional and quality of life scales 622Disability Rating Scale (DRS) 622European Brain Injury Questionnaire (EBIQ) 626Functional Status Examination (FSE) 631Health of the Nation Outcome Scales (HoNOS) 635Mayo-Portland Adaptability Inventory – 4 (MPAI-4) 643Neurobehavioral Functioning Inventory (NFI) 647Neurobehavioral Rating Scale – Revised (NRS-R) 650Rivermead Post-Concussion Symptoms Questionnaire (RPQ) 654Satisfaction with Life Scale (SWLS) 658Short-Form 36 Health Survey (SF-36) 661World Health Organization Quality of Life (WHOQOL) 671

Appendices 679

A Clinical populations for which scales were originally designed and with whichthey have been used 681

B List of abbreviations 689

C Listing of ICF categories and codes pertinent to instruments included in thecompendium 695

D Items from scales of Activity/Participation mapped to ICF domains 701

E Item content of scales of Activity/Participation 702

Alphabetical list of scales 705

Indexes 709

Scale index 711

Author index 717

Subject index 737

Contents xi



1 Introduction

Assessment after acquired brain impairment (ABI) orany other health condition is conducted for at least threemain reasons: diagnosis, prognosis and evaluation(Dekker, Dallmeijer, & Lankhorst, 2005; Kirshner &Guyatt, 1985). This compendium provides a resourceof assessment instruments for these purposes and themeasures are described in the following nine chapters.The present introductory chapter contains threesections. First, a background to the book is provided,including the methodology used in the selection anddescription of the instruments. The second sectiondescribes the International Classification of Functioning,Disability and Health (ICF; WHO, 2001), which is theconceptual framework underlying the structure andorganization of the compendium. Challenges that wereencountered in placing instruments developed for ABIinto the ICF framework are addressed in the finalsection of the chapter. The following nine chapters aregrouped into four parts, which correspond in anapproximate way to components of the ICF: Part A –Body Functions; Part B – Activities and Participation;Part C – Contextual Factors, specifically EnvironmentalFactors; and Part D presents multidimensional scales –that is, instruments containing a disparate set of itemscrossing multiple ICF components and domains.

Background and methodology

Purpose

This compendium is intended primarily for health pro-fessionals who work with people experiencing (or atrisk of) ABI. Users will include clinical practitioners indiagnostic, rehabilitation and community settings, aswell as clinical researchers, educators and advancedstudent trainees. The main objective is to present a rangeof tests, scales and questionnaires suitable for adminis-tration by generic health professionals, as well as byspecialists including clinical and neuropsychologists,medical practitioners, nurses, occupational therapists,physiotherapists, speech pathologists, and socialworkers. There is a vast array of such measures, andthe observations made in 1969 by Lawton and Brody,

whose instrumental activities of daily living scale con-tinues to be widely used today, still apply: “The presentstate of the trade seems to be one in which each investi-gator or practitioner feels an inner compulsion to makehis own scale and to cry that other existent scales cannotpossibly fit his own setting” (p. 179). Indeed, recent yearshave seen an explosion of published tests, scales andquestionnaires. More than one quarter of the instru-ments included in this compendium were published inthe last 10 years.

Good assessment is fundamental to evidence-basedclinical practice. The advantage of using standardizedassessment instruments is that they provide a systematicand often objective means of evaluating level of func-tioning. This may be an end in itself, as in differentialdiagnosis, or it may provide a baseline against whichfuture change (either improvement or deterioration) canbe measured. Sometimes the need will be for predictionof the natural history and course of the condition; othertimes the baseline will be used to measure the effect of atherapeutic intervention. Prigatano and Pliskin (2003)and others observed that there is an increasing pressureto justify services – the best measures will yield themost valid results. Additionally, results from assess-ments can be used in clinical practice to describe levelsof functioning from various perspectives, identify areasof need, ascertain the differential contribution of arange of factors, inform treatment planning anddecisions, help people to make practical decisions,and educate families and people with ABI as well asother professionals.

As shown in the ICF model in the next section,a person’s level of functioning can be assessed from avariety of perspectives (e.g., body system, functionalactivities, social role and participation, environmentalmilieu), and in turn, level of functioning is a con-sequence of interaction among such factors. Theassessment instruments presented in this volumeexamine functioning from each of these various perspec-tives, and best practice suggests that comprehensiveevaluation of an individual requires evaluation of eachdomain. Hall (1992) and Wade (2003) proffer a series ofquestions that clinicians and researchers can pose to



refine the process of selecting measures. Even so, theystill can be placed in the situation of not knowing whatmeasures are available. Moreover, Jette and Haley (2005)point to the tension between the need for comprehensiveand clinically sensitive outcome instruments and thedemands from the field for measures that are feasible inbusy clinical settings. A resource manual such as thepresent one can provide guidance in these respects.

A number of other compendia of assessment instru-ments for clinical populations is available. Some covera range of health conditions, not only neurologicaldisorders (e.g., Bowling, 1997; Cole, Finch, Gowland, &Mayo, 1995; Cushman & Scherer, 1995; McDowell,2006; Sederer & Dickey, 1996). These generally includegeneric as well as condition-specific instruments. It isrecognized that both types of assessment measures haveadvantages and disadvantages. Yet, the large andincreasing number of instruments developed specificallyto measure neurological and neuropsychological func-tion are testimony to the limitations and short-comingsthat clinicians and researchers have found in the applica-tion of generic instruments to people with neurologicalconditions (Kersten, Mullee, Smith, McLellan, &George, 1999).

Indeed, the sheer volume of assessment measuresdeveloped specifically for the investigation of ABIdemands a dedicated compendium. Such resources areavailable for specialized neuropsychological tests(e.g., Lezak, Howieson, & Loring, 2004; Mitrushina,Boone, & D’Elia, 1999; Strauss, Sherman, & Spreen,2006). Compendia of assessment instruments that aresuitable for administration by generic health pro-fessionals are also available, some of which focus onspecific areas such as cognitive screening (e.g., Shulman& Feinstein, 2006; Strub & Black, 2000) and othersaddress a range of functional areas (e.g., Herndon, 1997;Wade, 1992). In the years since these latter books werepublished, however, a multitude of new measures hasappeared in the literature.

An important development, also since the publica-tions of Herndon (1997) and Wade (1992), has been theintroduction of the ICF. This is “a globally agreedframework and classification to define the spectrum ofproblems in functioning” (Geyh et al., 2004a, p. 137),which is likely to exert an increasing influence on clinicaland research practice. Üstün, Chatterji, and Kostanjsek(2004) liken the ICF to the Rosetta Stone, enabling link-age of data across health conditions and interventions.Systematic reviews, such as that of Geyh et al. (2004b)examining assessment instruments used in clinical trialsof interventions for stroke, showed how concepts can besuccessfully linked to the ICF. Eighty-three differentICF categories were measured in at least 10% of trials,and more than 100 additional ICF categories for lessfrequently measured concepts. The present volume

draws on the ICF framework to classify instruments forABI.

Methodology

A range of methods was used to identify and selectinstruments for inclusion in this compendium. Theliterature was examined using various procedures.Searches of the electronic databases, Medline andPsycINFO, were used to identify scales in cognate areasof ICF domains and categories pertinent to ABI (e.g.,delirium, memory questionnaires, community participa-tion). Additionally, searches were conducted of websites,along with hand-searching of reference lists, reviewpapers, books, journals, as well as recommendationsfrom colleagues and the author’s personal referencecollection.

Candidate instruments were examined to identifythose meeting the following five selection criteria forinclusion in the book:

1 An empirical study of the instrument, using an ABIpopulation (or one at risk of ABI, e.g., older adultsinvestigated for dementia), was published in ascientific, peer-reviewed journal.

2 Information was available on the psychometricproperties of the instrument.

3 The instrument was suitable for administration bya generic health professional and was not restrictedto a particular discipline (e.g., specialist neuro-psychological tests).

4 Administration and/or scoring procedures did notrequire specialized equipment, although somecommonly available and portable stimulus materialswere deemed acceptable (e.g., pen and paper, stop-watch, torch, picture cards, common objects).

5 The instrument was in current clinical and/orresearch use and available in the English language.

For reasons of space, it was not possible to include allpertinent measures identified. The guiding principlefor the final selection was to provide a representativearray of instruments across broad ranges of functioning,at the expense of exhaustive coverage of a narrow area.For some areas (e.g., general cognitive screening, self-care functions) there are large numbers of scales, butthe item content and structure of many instrumentsare very similar, thereby raising the question of thevalue of a detailed inclusion of all scales in these areas.Consequently, instruments selected for inclusion inthis volume are those with adequate psychometricproperties, as well as those representing industry stand-ards, in frequent use, or having special features.

The principle of a broad coverage of functional areasextended to including special-purpose instruments that

2 Tests, scales and questionnaires



are not necessarily in wide circulation (e.g., scales toassess minimally conscious states, establish mental com-petence), as well as those with special features (such asevaluation of neglected groups, e.g., people in advancedstages of dementia, patient/client-centred approaches).An effort was made to cover the spectrum of ABI,including progressive conditions (such as Alzheimer’sdisease and other dementias), as well as non-progressiveconditions (such as stroke, traumatic brain injury).Appendix A lists the clinical conditions for which theincluded instruments were originally developed and withwhich they are currently used.

Inevitably, there are omissions. Sometimes these willbe author-related, and in particular the scope of thebook did not allow inclusion of scales examiningpsychological well-being. Many such scales, however, areinstruments developed for other populations that havebeen applied to ABI groups, and the decision was takento focus largely on those scales specifically developed forthe ABI population rather than instruments that areavailable in other compendia. Another area not coveredis that of so-called carer-burden. The reason for itsomission relates to the conceptual framework of the ICFused as the structure for this book, which explicitlyexcludes the providers of support (i.e., caregivers) –see the introduction to Chapter 9 for discussion ofthis point. Furthermore, some neurological conditions(e.g., dementia, traumatic brain injury) contain a muchlarger number of published instruments than otherconditions (e.g., neurotoxicity, cerebral neoplasms) andthe scales featured in this book reflect this imbalance.In other situations, the apparent omissions reflect thestate of the field – for instance, there is a dearth ofinstruments suitable for the assessment of children withABI.

Structure of the entries on instruments

In order to facilitate use of this compendium, each entrydescribing an instrument is written as a stand-alonereport and follows the same format. The structure ofthe entries has been informed by the characteristicsdelineated by Andresen (2000). A particularly appealingaspect of her set of 11 characteristics is the blendof clinical considerations (viz. administrative andrespondent burdens, availability of alternative forms,cultural/language adaptations, normative/comparativedata), along with the conceptual underpinnings ofthe instrument and the strength of its measurementproperties (viz. conceptual characteristics, measurementmodel, instrument bias, reliability, validity, responsive-ness). These characteristics and criteria, which appearin various configurations in many psychometric texts,provide the “gold standard” against which instrumentscan be evaluated and compared.

By the same token, it is also recognized that variouspsychometric or clinimetric criteria may differ in rele-vance according to the purpose of the instrument(Kirshner & Guyatt, 1985). Responsiveness, forexample, is more important for instruments whosepurpose is evaluative rather than diagnostic (Guyatt,Walter, & Norman, 1987); internal consistency maybe compromised in those diagnostic or prognosticinstruments that, perhaps in the interests of minimizingrespondent burden, intentionally select a small set ofitems that make separate and distinctive contributionsto the scale; knowledge of practice effects is particularlyrelevant for cognitive tests and they need to be takeninto account in subsequent administrations of theinstrument, and so forth.

The intention of the standardized presentation ofeach entry is to provide the reader with practical infor-mation, including item description, administration andscoring procedures. Wherever possible and feasible,items from instruments that are in the public domainare reproduced, using a standardized format to lendconsistency of presentation of the scales across thebook. In so doing, however, this compendium is notintended to be a replacement for the test manual, andusers are advised to consult the original source. Informa-tion is also provided to assist the reader to determine thecalibre of the scale in terms of the manner of its initialdevelopment and psychometric properties. The entriesdo not provide an exhaustive coverage of all the pub-lished psychometric studies on an instrument. Rather,the aim has been to strike a balance between detail andbreadth of coverage, such that the reader gains an over-all flavour of the characteristics of the instrument. Everyeffort was made to identify pertinent psychometricinformation, but some relevant references may have beenmissed. Each entry concludes with a brief commentary,regarding the strengths and limitations of the instru-ment. A selection of key references, with a psychometricfocus, is also included.

Terminology and definitions

The screening tests, rating scales and questionnairesincluded in this compendium are largely based onbehavioural observation, but they differ according to theway in which (a) information is collected and (b)responses are coded. Classification of the types ofinstruments is operationally defined as follows:

• Objective tests or performance-based scales: Thoseinstruments that objectively measure observableperformance. In most cases, the veracity of theresponse can be readily ascertained by an objectivecriterion (e.g., “repeat these numbers after me: 5,8, 3”; “open your eyes”). Responses may be scored

Introduction 3



using a variety of procedures. Sometimes a continu-ous score range is used, such as the number ofwords correctly recalled or the time taken to com-plete a task. For other tests, the clinician elicits abehavioural response that is then classified intoa hierarchy according to predetermined criteria; forexample, whether the eyes open spontaneously,after verbal request, in response to noxious stimuli,not at all. Other instruments in this categorymeasure the presence or other objectively verifiablecharacteristic of natural observations.

• Rating scales: Those instruments where theresponse involves a judgement, generally using arating scale describing intensity, frequency or othercharacteristic (e.g., “how much pain do you experi-ence?”, “how often do you forget things?”, “howwell do you get along with other people?”).Responses for many rating scales use a Likert-typerating scale, for example, a 5-point scale from “notat all” to “a lot”. Ratings can be made by a clinician,using behavioural observation, clinical judgementor direct questioning. Ratings can also be made byan informant (such as a relative, friend, caregiver) orcan be self-ratings by the person with/at risk of ABI.

• Questionnaires/interviews: Those instruments usingopen-ended questions in which the respondent isfree to give an individualized response (e.g., “whendid you have your injury?”, “what duties didyour work entail?”, “what problems do youexperience?”).

A uniform set of terms is generally used throughout thebook, and on occasion these may depart from terms thatauthors of an instrument have used. For instance, thereis considerable variability in the way in which authorsdescribe sources of information provided by proxies(e.g., relative, family member, significant other, caregiver,informant). In the present volume, the term “informant”is frequently used to refer to all proxy respondents whoare not clinicians. Similarly, a report provided by theperson with ABI (who may be a patient, client, resident,participant, or respondent, depending on the setting) isgenerally referred to as “self” report. Following on fromWade and Halligan (2003) the person with/at risk ofABI is also often referred to as a patient, this being “themost appropriate word for someone who is in contactwith and using health care systems . . . The word clientsuggests a different relationship, not the type usuallyfound in health professional relationships” (p. 350). Anexception to this principle is terminology used byauthors to refer to various cognitive constructs and pro-cesses. For example, in the area of memory authorsuse different labels to refer to very similar processes(e.g., short-term, recent, anterograde, episodic) and inthese instances the terminology used by the authors

to describe/classify items from their instruments isretained. Variation also occurs in definitions ofmeasurement properties of instruments. For example,the internal consistency of an instrument is conceptual-ized by some authors as a component of reliability andby others as an aspect of validity. A standard set ofdefinitions for common psychometric properties, con-sistent with those used by Hinderer and Hinderer (2005),has been adopted for this book (see Table 1.1), and thesemay vary from terms used by the authors. Additionally,Appendix B presents a list of abbreviations used in thiscompendium.

Diagnostic tests, a number of which are described inChapters 2 to 6 in Part A, need to provide informationon diagnostic accuracy. This can be done by using acriterion-referenced measure or normative data. Theformer compares the new test against acceptedstandards, procedures or criteria (such as a diagnosis).Commonly used statistics to judge diagnostic accuracyinclude likelihood ratios, defined as “the odds that agiven level of a diagnostic test would be predicted ina patient with (as opposed to one without) the targetdisorder” (Sackett, Haynes, Guyatt, & Tugwell, 1991,p. 120) and sensitivity/specificity. Cut-off scores toindicate the presence/absence of the condition areestablished, often using receiver operating characteristic(ROC) curves, and investigators usually report on thelevels of sensitivity, specificity and/or likelihood ratiosobtained using the cut-off scores.

Generally, there is a trade-off between sensitivityand specificity, and different situations will dictatethe desirability of one over another: screening testsoften require high sensitivity to maximize detection ofreal cases, whereas other situations may demand highspecificity to screen out non-cases (e.g., clinical situ-ations depending on the base rate of the condition,clinical trials and other types of research studies).Different cut-off scores on a single test may be estab-lished to differentiate diagnostic conditions (e.g.,dementia vs no dementia; Alzheimer’s disease vs fronto-temporal dementia). In the tables appearing for relevantentries, where practical the convention is used of refer-ring to cut-off scores as follows: “x/y” where x and yrefer to scores either side of the cut-off (e.g., present/absent, or vice versa according to the direction of thescores). This bypasses the misunderstanding that canarise when “score x” is stipulated as the cut-off (i.e., isscore x, the cut-off itself, to be classified as present orabsent?). Related concepts to sensitivity and specificity,which are reported less commonly but arguably are moreclinically useful, are the positive and negative predictivevalues. These characteristics of diagnostic tests,described by Sackett, Straus, Richardson, Rosenberg,and Haynes (2000), among others, are easily calculatedusing Table 1.2.




Table 1.1 Psychometric properties frequently examined byscales included in this book

Term Definition

Validity The extent to which the testmeasures what it was designed tomeasure (i.e., what the testmeasures)

Types of validity:Content The test provides a representative

sampling of the domain ofbehaviours. Methods use evidenceprovided for developmentprocedures of the test and use ofexpert judges

Criterion Extent to which the test measures(is correlated with) a specificcriterion

(a) Concurrent The criterion is obtained at thesame time as the test isadministered

(b) Predictive The criterion is obtained at sometime after the test is administered

Construct Extent to which the test measuresa theoretical construct or trait.Methods use factor analysis,multitrait–multimethod matrix

Internal consistency Homogeneity of items within atest, a statistical test of contentsampling

Convergent andDivergent

The test is correlated with similarconstructs, and the test is notcorrelated with dissimilarconstructs

Discriminant The test discriminates betweengroups with differentcharacteristics pertinent to the test

Reliability Reproducibility or consistency ofscores obtained on the test (i.e.,how well the test measures what itmeasures)

Types of reliability:Alternate form An alternate (or parallel) form of

the test with comparable itemcontent, response format andscoring procedures. Important forinstruments subject to practiceeffects (e.g., cognitive tests)

Inter-rater Extent of agreement betweenscores of two (or more)independent examiners of a singletest administration or behaviouralobservation

Test–retest Also referred to as intra-raterreliability or temporal stability.Refers to the stability of testscores over time. The intervalshould be sufficiently long tocounteract effects of memory ofthe previous administration, butshort enough to ensure clinicalchange does not occur. Deyo,

Studies published in the older literature often usedPearson (r) or Spearman (rs) correlation coefficients toexamine aspects of an instrument’s reliability, or usedpercentage agreement in the case of dichotomousdata. Current practice recommends the use of the moreconservative intra-class correlation coefficient (ICC)for continuous data because it takes into account notonly the rank order of the association between datapoints but also score differences. Similarly, the kappastatistic, which takes account of chance level of agree-ment, is recommended for dichotomous classifications;weighted kappa, used for ordinal data, adjusts for themagnitude of the disagreements. The criteria ofCicchetti (1994, 2001), presented in Table 1.3 are used todescribe the clinical or practical significance of (i) theICC and kappa statistic, (ii) Cronbach coefficient alpha,which is commonly used to determine the internalconsistency of a test, and (iii) diagnostic accuracy forsensitivity, specificity, positive and negative predictivevalues. As noted earlier, however, the importance ofcoefficients for Cronbach alpha and the levels of sensi-tivity/specificity may vary according to the purpose ofthe instrument and its particular applications. If Pear-son coefficients are used for reliability analyses, thenhigh values are required and the range r = .80 to r = .90 isrecommended (Anastasi & Urbina, 1997).

Term Definition

Diehr, and Patrick (1991) suggest a1–2 week interval

Responsiveness Sensitivity to detect true changesoccurring in the individual, asopposed to random fluctuations(error) against which the testshould be impervious (see test–retest reliability)

Table 1.2 Determining sensitivity, specificity, positive pre-dictive value and negative predictive value of a test

Target disorder

Positive Negative

Test result Positive a b a+bNegative c d c+d

a+c b+d

• Sensitivity: Proportion of people with the target disorder whohave a positive test result (a/(a+c))

• Specificity: Proportion of people without the target disorder whohave a negative test result (d/(b+d))

• Positive predictive value: Proportion of people with a positivetest result who have the target disorder (a/(a+b))

• Negative predictive value: Proportion of people with a negativetest result who are free of the target disorder (d/(c+d))

Introduction 5



In the assessment of inter-rater reliability, Andresen’s(2000) criteria include patient-proxy reliability (i.e.,the degree to which proxy or informant responses aresimilar to those of the respective patients). A number ofinstruments presented in this book have informationavailable on patient-proxy reliability, but the coefficientsare often relatively low, in the order of r = .4 to r = .5.Emphasis has not been placed on this type of reliabilitybecause when the patient is a person with ABI, theresulting coefficient may not so much measure thereliability of the instrument, but rather be confoundedby compromised cognitive functioning, particularly ifthe patient experiences significant impairments inmemory, insight and judgement. In this context it ismore meaningful to report inter-rater reliability betweendifferent clinicians or different informants and, whenavailable, such information has been provided.

When reporting coefficients for the individualinstruments described in Chapters 2 to 10, results aregenerally recorded for the total score (where applicableand information is available), as well as the range forsubscales/items (where applicable/available). Often therange of coefficients for the subscales/items is wide. Thereader is assisted to make an overall determinationof the number of subscales/items with good (e.g.,ICC/k ≥ .6) or poor (e.g., ICC/k < .4) coefficients by useof the following summary notation. A scale with 10items, for example, may have the following profileentered into the “psychometric box” for test–retestreliability: “Total score k = .7, item range k = .2–.9(k ≥ .6 for 5/10 items; k < .4 for 2/10 items)”, whichmeans that kappa coefficients for 5 out of 10 items were.6 or higher, coefficients for 2 out of 10 items were lessthan .4, and thus, by implication, for the remaining 3 outof 10 items kappa coefficients were between .4 and .59.

Effect sizes are a common means of measuring theresponsiveness of an instrument. The rule of thumbfor interpreting the strength of the effect size variesaccording to the type of analysis, but for comparisons of

Table 1.3 Descriptive terms corresponding to coefficients forintra-class correlation (ICC), kappa, Cronbach coefficientalpha, sensitivity, specificity, positive and negative predictivevalues (after Cicchetti, 1994, 2001)

Level ofclinicalsignificance

ICC andkappa

Cronbachcoefficientalpha

Sensitivity,specificity, positiveand negativepredictive values

Coefficient Coefficient Diagnostic accuracy(%)

Excellent ≥ .75 ≥ .90 90–100Good .6–.74 .8–.89 80–89Fair .4–.59 .7–.79 70–79Poor <.4 <.7 <70

mean scores Cohen (1988) suggested that d = .8 is large,d = .5 is medium, and d = .2 is small. These thresholdsto classify effect sizes have not gone unchallenged,however, with some authors suggesting that lowervalues are significant for health status measures (Kazis,Anderson, & Meenan, 1989) and other authors arguingthat higher values are required for treatment studies(Beeson & Robey, 2006). At the individual level, it ishelpful to know whether or not the change that occurs(either improvement or deterioration) is beyond thatwhich can be attributed to measurement error of thetest (i.e., a statistically reliable change); and further,whether such a change is also clinically significant (i.e.,that the patient’s classification changes from dys-functional to functional or vice versa). Few studies,however, report on these features. A number of pro-cedures are available to calculate the reliable changeindex, and Perdices (2005) has provided a review offormulae.

All instruments presented in this book are quantita-tive and use numbers to summarize responses. A featureof scores yielded by many of these instruments is thatthe unit of measurement is at the ordinal level (see Cic-chetti et al., 2006, for an interesting critical re-evaluationof levels of measurement). That is, there is a rank orderor hierarchy of measurement units within an item (e.g.,each item rated on a 5-point scale reflecting an increas-ing degree of disability). With ordinal data (unlikeinterval and ratio levels of measurement), it cannot beassumed that the intervals between the units are equiva-lent (e.g., that the degree of disability between responsecategories 2 and 3 is the same degree of disability asbetween response categories 3 and 4). Yet it is verycommon for developers of test instruments to transgressthis assumption and sum scores from the items to formsubscale scores, aggregate subscale scores to form a totalscore, and conduct statistical analysis on the data asif the units of measurement represent interval data. Inother words, ordinal data are often treated in a mannerthat is appropriate only for interval and ratio levels ofmeasurement. In a strict sense, “because the intervals onan ordinal scale are either not known or are unequal,mathematical manipulations such as addition, sub-traction, multiplication, or division of ordinal numbersare not meaningful” (Domholdt, 2005, p. 246). Someauthors of instruments acknowledge the licence theytake in aggregating scores, and the consequent cautionneeded to interpret results. Increasingly, however, scalingprocedures, such as Rasch analysis, are being applied toinstruments to develop an equal-interval measure fromraw scores (see Bond & Fox, 2007; Tesio, 2003). Theroutine application of such procedures in test develop-ment is a welcome advance in improving measuringinstruments in the field of ABI.




Figure 1.1 International classification of functioning, disability and health (reproduced from World Health Organization (2001).International Classification of Functioning, Disability and Health (Chapter 1, Section 5, Model of functioning anddisability, p. 18, Fig. 1). Geneva: World Health Organization. Reprinted by permission of WHO Press).

The International Classification of Functioning,Disability and Health (ICF)

Organization of this compendium draws on the ICFtaxonomy. The ICF is depicted graphically in Figure 1.1.A more specific tabular overview of the ICF is presentedin Figure 1.2, which also shows correspondence betweenICF domains and the chapters covered in this book.Appendix C (Tate & Perdices, 2008) provides a graphicalrepresentation of an “ICF tree” containing the cate-gories and codes for selected Body Functions, Activities/Participation and Environmental Factors componentsnested within the above domains.

The aim of the ICF is “to provide a unified andstandard language and framework for the description ofhealth and health-related states” (WHO, 2001, p. 3). It istherefore in the interests of clinicians and researchersin the area of ABI, as well as in other fields, that theinstruments they use to measure health and health-related states conform to such a standard. Stineman,Lollar, and Üstün (2005) report that the ICF has beenaccepted by 191 counties, and “is fast becoming theworld standard for describing health and disabilities”(p. 1099). Challenges that were encountered in placinginstruments developed for assessment of ABI within theICF framework are discussed in the following section.

Origins and uses of the ICF

The ICF is a revision of the International Classificationof Impairments, Disabilities and Handicaps (ICIDH;WHO, 1980). Development of the original ICIDH isdescribed in detail in the 1980 publication and Bicken-

bach, Chatterji, Badley, and Üstün (1999) provide aninformative review of issues necessitating the revision.The ICF retains a number of elements of the ICIDH,building on, updating and refining the terminology forimpairments and disablement. It also differs from theICIDH in significant ways; in particular, the inclusion ofcontextual factors and the use of neutral language (e.g.,“participation” replaces “handicap”) allow positiveexperiences to be described. In so doing, the ICF hasmore fully integrated medical and social models toadopt a “biopsychosocial” approach; in a rehabilitationcontext it “will engender expansion of the restorativerehabilitative paradigm to include empowerment”(Stineman et al., 2005, p. 1104).

The primary reference for the ICF (WHO, 2001)essentially comprises a listing of approximately 1500alphanumeric codes describing various aspects of func-tioning. The ICF Australian User Guide (AustralianInstitute of Health and Welfare [AIHW], 2003) isintended to complement the ICF, and it provides infor-mation regarding the revision process, instructions in itsuse and its practical applications. Similar, but brieferoverviews can be found in de Kleijn-de Vrankrijker(2003), Stucki, Cieza, and Melvin (2007), Stucki andMelvin (2007) and Üstün, Chatterji, Bickenbach,Kostanjsek, and Schneider (2003). Other descriptions ofthe ICF (e.g., Peterson, 2005) and critical reviews of itsstrengths and weaknesses (Wade and Halligan, 2003)have appeared, along with progress towards the develop-ment of a procedural manual to facilitate use of the ICFin health care settings in the USA (Reed et al., 2005).Discussions of the application of the ICF to clinicalpractice, education and research are also available

Introduction 7



(Bruyère, van Looy, & Peterson, 2005; Stucki, 2007;Stucki & Grimby, 2007; Stucki, Reinhardt, & Grimby,2007; Wade, 2005).

The WHO (2001) enumerates a range of potentialapplications of the ICF: for statistical purposes; as aresearch tool; for clinical practice in vocational andneeds assessment, matching treatments with specificconditions, rehabilitation and outcome evaluation; inthe planning and design of social policy; as a vehicle foreducation in curriculum design, raising awareness andtaking social action. Ideally, it provides a scientific basisto learn about and research health and health-relatedstates and provides a uniform coding system, therebyenabling comparison of data. It is recommended that forspecialist services, such as rehabilitation, geriatrics andmental health, coding is conducted at the more detailedfourth-level category, whereas for surveys and healthoutcome evaluation coding at the second-level categoryis appropriate.

Components of the ICF

The ICF classifies health and health-related states; thehealth conditions (i.e., diseases, disorders, injuries, etc.)to which they relate are classified in the complementaryWHO taxonomy, the International Statistical Classi-fication of Diseases and Related Health Problems, 10threvision (ICD-10; WHO, 1992). The specific sectionswithin components of the ICF are defined as follows(WHO, 2001, p. 10):

• Body functions: Physiological functions of bodysystems (including psychological functions).

• Body structures: Anatomical parts of the body, suchas organs, limbs and their components.

• Activity: The execution of a task or action by anindividual.

• Participation: Involvement in a life situation.• Environmental factors: Physical, social and attitu-

dinal environments in which people live and con-duct their lives.

These sections (along with another, not yet classified,Personal Factors) work in an interactive and recursivefashion (see Figure 1.1), for example, EnvironmentalFactors (e.g., distracting stimuli or ground texture) caninteract with Body Functions (attention or balancerespectively).

Structure of the ICF

A nested, hierarchical structure, described as stem–branch–leaf, is used in the ICF. It comprises parts,components, domains (also referred to as the first levelof classification), blocks (which are “provided as a con-

venience to the user and, strictly speaking, are not partof the structure of the classification and normallywill not be used for coding purposes”; WHO, 2001,p. 220) and categories (second, third and fourth levels ofclassification). This detailed organizational structureresults in a very large number of categories. Therefore, aschematic summary of the ICF is depicted in Figure 1.2adapted from Tate and Perdices (2008) to enable thereader to quickly grasp the overall structure of the ICF.

As shown in the figure, the ICF comprises two parts:(i) Functioning and Disability, and (ii) ContextualFactors. Within Functioning and Disability, there aretwo components: (a) Body (Functions and Structures)and (b) Activities and Participation. The component“Body” has eight domains for each of Functions andStructures, organized according to the body system (e.g.,nervous system, cardiovascular system); each domain ofBody Function corresponds to one of Body Structure.The component “Activities and Participation” containsa single set of nine domains, addressing both individualand social aspects of functioning (e.g., mobility, inter-personal interactions and relationships). Unlike theICIDH, there is no recommended partitioning to dis-tinguish domains within the Activities and Participationcomponent. In fact, the ICF suggests any of four separ-ate options for their differentiation, which “if users sowish [they can apply] in their own operational ways”(WHO, 2001, p. 16; see pp. 224–237 for options). Thisrecommendation to use any one of a variety of methodsof partitioning the Activities/Participation component isless than satisfactory in that it serves to create confusionamong users and is not in keeping with the principle ofpromoting a unified framework.

Within the second part of the ICF, Contextual Fac-tors, there are also two components: (a) EnvironmentalFactors and (b) Personal Factors. The “EnvironmentalFactors” component contains five domains, referringto physical, social and attitudinal environments. Thesecond component, “Personal Factors”, is not yetclassified within the ICF “because of the large social andcultural variance associated with them” (WHO, 2001,p. 8). According to the ICF, Personal Factors comprisethe following: “gender, race, age, other health con-ditions, fitness, lifestyle, habits, upbringing, copingstyles, social background, education, profession, pastand current experience (past life events and concurrentevents), overall behaviour pattern and character style,individual psychological assets and other character-istics” (p. 17).

Some degree of variability occurs at the domain andcategory levels of the ICF. Domains may or may nothave blocks (e.g., there are none in the Body Structuresand Environmental Factors components), but alldomains contain categories. Categories are subdivided.The domain of Mental functions, for instance, contains




Figure 1.2 Overview of the International Classification of Functioning, Disability and Health, and chapters in which instrumentsmapping to ICF domains are located.

two blocks, one of which has 8 categories and the secondblock contains 14 categories. Each of these 22 categoriesis further subdivided. Figure 1.3 depicts the full ICFlisting for the block, Global mental functions, which is

subdivided to at least the third level (orientation toperson is subdivided to the fourth level).

The ICF recognizes both positive and negativeaspects of the components. For Body Functions, Body

Introduction 9



Figure 1.3 Full listing of the ICF block of Global mental functions.

Structures, Activities and Participation, the positiveaspect is labelled functioning, as defined above. Thenegative aspects are labelled impairments for Body Func-

tions and Body Structures, and limitations and restric-tions for Activities and Participation respectively. Theterm disability is used as an umbrella term to refer to




impairment, activity limitation and participation restric-tion. For Environmental Factors, positive aspects arelabelled facilitators and negative aspects barriers orhindrances.

Codes and qualifiers used in the ICF

As noted, each of the ICF categories is assigned a code,using alphanumeric notation: commencing with “b”for body functions, “s” for body structures, “d” fordomain (referring to domains of the Activities and Par-ticipation component, which alternatively can bereferred to as “a” and “p” respectively if the user sodesires) and “e” for environment. For example, as shownin Figure 1.3, the code b1142 is classified to the fourthlevel and refers to “orientation to person”, which lieswithin b114 second-level “orientation function”, withinthe block of Global mental functions, within the domainof Mental functions (b110–b139), within the componentof Body Functions. In total, there are 1424 codes at thethird and fourth category level (WHO, 2001, p. 220). Thecategory codes are fully enumerated in the 2001 WHOpublication (see also Appendix C for codes attachedto the Body Functions and Activities/Participationcomponents that are addressed in this volume).

The ICF also advises the use of at least one qualifier,without which “the codes have no inherent meaning”(WHO, 2001, p. 222). The qualifiers are numeric descrip-tors that appear following a point after the code. Thefirst qualifier is generic, referring to extent or severity;Body Structures additionally use second and thirdqualifiers to designate the nature of the impairment(e.g., partial absence) and location of impairment (e.g.,left side) respectively. Two codes are used for ActivityLimitation and Participation Restriction, which refer tothe environments in which the measurements occur. Thefirst code refers to performance (i.e., what a person actu-ally does in the current or usual environment, includinguse of aids and personal assistance) and the secondrefers to capacity (i.e., the person’s ability or highestlevel of functioning occurring in a standardizedenvironment, such as a testing area, typically reflectingtheir “true ability which is not enhanced by an assistivedevice or personal assistance”; p. 230). Identifying thegap between performance and capacity “provides a use-ful guide as to what can be done to the environment ofthe individual to improve performance” (WHO, 2001,p. 15). Environmental Factors uses the same set ofnumeric qualifiers as impairments to describe the extentof the barriers with a − sign preceding the qualifier;facilitators use the same set of codes with a + sign pre-ceding the qualifier.

The first qualifiers for impairments, the perform-ance and capacity qualifiers for Activity Limitation/Participation Restriction, and environmental factors, all

of which refer to the extent of the problem, are tabulatedin Table 1.4; coding for other qualifiers is listed in Annex2 of the ICF publication (WHO, 2001). Taking theabove example of disorientation to person, a severeimpairment would be coded b1142.3. Stineman et al.(2005) and Tate and Perdices (2008) provide workedexamples of the application of the ICF and their codesin clinical practice.

Further development of the ICF

It is recognized that the ICF is an evolving classification,and the 2001 reference publication points to furtherdevelopmental work that is required. There is also dis-cussion in the literature regarding the practical applica-tion of the ICF. For example, it has been tailored forspecific purposes, one of these being the developmentof “core sets” of ICF categories pertinent to varioushealth conditions (see special issues of the Journalof Rehabilitation Medicine (Supplement 44, 2004) andDisability and Rehabilitation (Issue 7/8, 2005)), theICF checklist for use in clinical practice, and the avail-ability of a procedural manual (AIHW, 2003). Furtherdevelopmental work is being conducted on the use andreliability of the codes (see Cieza et al., 2002; Cieza,Geyh, Chatterji, Kostanjsek, Üstün, & Stucki, 2005;Granlund, Eriksson, & Ylvén, 2004; Okochi, Utsu-nomiya, & Takahashi, 2005), along with empiricalstudies on the factor structure of the Activities/Partici-pation component (Jette, Haley, & Kooyoomjian, 2003).Development of the Personal Factors component isspecifically identified as an area of future work, and thisis particularly relevant for the area of ABI in terms of anapparent overlap with some of the categories from theMental functions domain (see below).

Placing measuring instruments for ABI within theICF taxonomy

Challenges

A number of challenges were encountered in attempting

Table 1.4 First qualifiers for ICF codes

Code Definition Percentage

.0 – no problems none, absent,negligible . . .

0–4

.1 – mild problem slight, low . . . 5–24

.2 – moderate problem medium, fair . . . 25–49

.3 – severe problem high extreme . . . 50–95

.4 – complete problem total . . . 96–100

.8 – not specified

.9 – not applicable

Adapted from World Health Organization (2001). Internationalclassification of functioning, disability and health. Geneva: WorldHealth Organization.

Introduction 11



to place instruments designed for assessing ABI into theICF taxonomy. One insurmountable difficulty is thatmany instruments currently used in clinical and researchpractice were developed prior to the introduction of theICF. Thus, the structure of such instruments reflects theclinical manifestation of impairments and/or disable-ment in people with ABI, rather than adhering in an apriori way to a taxonomic structure.

As a consequence, a large number of instrumentsincluded in this book, even those addressing a veryspecific area of functioning, such as motor function,contain an admixture of items crossing Body Functionsand Activities/Participation components (e.g., domainsof Neuromusculoskeletal and movement-relatedfunctions vs Mobility respectively). The crossing of ICFcomponents as well as domains also occurs in theGlobal psychosocial functions category (Mentalfunctions domain of the Body Functions component)versus the Interpersonal interactions and relationshipsdomain (Activities/Participation component). A thirdrelevant area where admixtures occur is the speech/language/communication area. Within the BodyFunctions component is the Voice and speech domainand the Language category (Mental functions domain).In turn, these can be contrasted with the Communi-cation domain within the Activities/Participationcomponent.

Reed et al. (2005) have also commented on overlap-ping ICF codes between ICF components. By way ofexample they contrast the Body Function, Expressionof written language, with the Activity, Writing. Theynote that “these items cannot be distinguished clinicallyand would be assessed using the same tests or pro-cedures. That is, expression of written language cannotbe assessed except by writing” (p. 126). At a conceptuallevel, however, it is recognized that a distinction can bedrawn between the linguistic and motor components ofwriting and, indeed, in clinical practice the impairmentof one and/or the other can be readily distinguished.But a writing sample is needed for this purpose, andhence, in this instance, application of the appropriatecode/s is difficult. Stineman et al. (2005) raise similarissues with respect to the Body Function “seeing”versus the Activity “watching”; and “hearing” versus“listening”.

The complexities of accurate code assignment, alongwith the admixture of item content of ABI scales acrossvarious ICF components and domains, has implicationsfor the way in which instruments are described andclassified in the present volume. In other cases, the ICFdoes not cover particular constructs that are pertinentto health conditions. In their systematic review of out-come measures used in clinical trials of interventionsfor depressive disorders, Brockow et al. (2004) foundthat the ICF did not include a number of “personal

concepts” contained in measures used by researchers(e.g., locus of control, life satisfaction, self-esteem).

Other challenges centred on the level of agreementbetween current conceptualizations of ABI versus theICF constructs and terminology. For example, althoughPersonal Factors are defined as the particular back-ground of an individual’s life and living, and “comprisefeatures of the individual that are not part of a healthcondition or health states” (WHO, 2001, p. 17; emphasisadded), in a number of neurological conditions somepersonal factors that represent cognitive/psychologicalconstructs can, in fact, be “impaired” as a direct con-sequence of the health condition (e.g., executive func-tions regulating problem-focused or emotion-focusedcoping strategies in frontal systems dysfunction; thestore of knowledge in semantic dementia). In the area ofABI, the Body Structure relevant to the health condition(viz. the brain) is itself responsible for these personalfactors. Thus it is difficult to conceptualize the PersonalFactors as merely contextual – rather, they are integralto Body Functions. A proposed method of distinguish-ing between the two is that if one of the constructsfrom the Personal Factors component is impaired (e.g.,coping skills as a result of executive impairment withfrontal systems dysfunction), then it should be classifiedand coded as an impairment (in this case, of Mentalfunctions); not as a Personal Factor. In this sense,because Personal Factors are not part of functioning,they cannot be impaired, limited or restricted; age andrace being clear examples of this principle (personalcommunication, A. Cieza, 18 May 2008).

Notwithstanding the laudable objective of the ICFto establish a lingua franca, important differences interminology used in the ICF and current nomenclaturein the area of ABI were encountered. This was par-ticularly notable in the domain of Mental functions.For example, the term “executive functioning”,appearing in the second edition of Lezak’s (1983) sem-inal reference work, has been standard usage in the fieldof neuropsychology for decades, replacing the olderterm “higher cognitive functioning” that is currentlyused in the ICF. Similarly, neuropsychologists refer to“self-awareness” (see Prigatano & Schacter, 1991) ratherthan the ICF terminology, “experience of self”. Wherediscrepancies occur, preference has been given to currentABI terminology.

Moreover, it can be appreciated from Figure 1.3 thata large number of specific areas of function areaddressed at the category level of the ICF, and AppendixC provides the specific detail for five domains of the BodyFunctions component, nine domains of the Activities/Participation component and four domains of Environ-mental Factors that are addressed in this volume. Somescales included in this compendium focus on the degreeof detail at the ICF category level. This was commonly




the case for scales of mental functions, where individualtests are available for virtually all of the second-levelcategories described (e.g., consciousness, orientation,attention, memory, etc.). By contrast, it is uncommonfor scales addressing the Activities/Participationcomponent to have this degree of specificity; ratherscales of Activities/Participation generally adopt abroader selection of items, at the level of domain (firstlevel); for example, self-care, domestic life (althoughthere are some instances of specific scales addressingcategories of the self-care domain, e.g., the NottinghamStroke Dressing Assessment of Walker and Lincoln,1990, 1991). Consequently, there is some variation indetail among scales in different chapters of this book.

Decisions

The foregoing considerations necessitated a slightreconfiguration of the ICF terminology and structurefor this compendium in order to increase its relevanceto ABI, particularly for the Mental functions domain.The decisions are summarized below and the rationaleis provided in the relevant chapters. At the outset, it isrecognized that overlap occurs between some BodyFunctions (as defined in the ICF) and Health Con-ditions (as defined in ICD-10). For example, delirium isclassified within the ICF Mental functions domain(Consciousness category, b110), as well as withinICD-10 Chapter V: Mental, Behavioural Disorders(F05: delirium, not induced by alcohol and otherpsychoactive substances). Similarly, temperament andpersonality functions are classified within the ICFBody (Mental functions) domain (Temperament andpersonality category, b126), as well as within ICD-10Chapter V: Mental, Behavioural Disorders (F07: per-sonality and behavioural disorders due to brain disease,damage and dysfunction). A number of scales presentedin this volume, particularly those examining Mentalfunctions, have as their aim a diagnosis (e.g., delirium,fronto-temporal dementia). In this sense, they are argu-ably more properly considered assessments of the healthcondition per se (see ICD), as opposed to a consequenceor component of that health condition. Nonetheless,because the categories that these instruments examineappear within the ICF nomenclature, they have beenincluded in this compendium.

The guiding principle in organizing this volume wasto place the ABI instruments in ICF domains that bestrepresented the item content and made clinical sense –a model of best-fit, if you will. Consequently, inthe interests of providing a simple and logical structureto this compendium, all instruments assessing a con-ceptually similar construct (e.g., speech/language/communication; movement-related/mobility function)are placed together. Additionally, some arbitrary

decisions were made in reference to the grouping of setsof scales within the ICF structure. Thus, all scales in thespeech/language/communication area appear within theSpecific mental functions block (Mental functionsdomain) even though it could be argued that they aremore properly placed within the Activities/Participationcomponent (Communication domain). The reason thatthey have been grouped within the Body Functionscomponent (Specific Mental Functions block) is becausethey assess a specific cognitive function (as do attention,memory, etc.). Figure 1.2 indicates the chapters thataddress those ICF domains represented by instrumentsincluded in this book.

More specifically, in Part A, Chapters 2 to 6 describeinstruments assessing Mental functions, Sensory func-tions and pain, Voice and speech, Neuromusculoskeletaland movement-related functions, as well as the Ingestioncategory from the Digestive, metabolic and endocrinedomain. Within the ICF taxonomy, these five domainsfall within the component of Body Functions (seeFigure 1.2). Although the Body Functions componentcomprises an additional three domains (Cardiovascular,haematological, immunological and respiratory;Genitourinary and reproductive; and Skin and relatedstructures), these have less direct relevance to ABI. Inkeeping with common clinical practice in ABI, theinstruments in Part A are grouped into two sections:(i) Mental functions (Chapters 2 to 5) and (ii) Sensory,ingestion and motor functions (Chapter 6). Theimbalance in the number of chapters reflects the quan-tity of standardized instruments in the respective areasof functioning; the tradition of psychology (i.e., mentalfunctions) being grounded in functional measurement.The specific chapters primarily addressing ICF domainsand categories are described below.

Mental functions

The seven specific second-level categories of the blockof Global mental functions are reconfigured forChapters 2 to 5 in order to facilitate an integration of theICF with current clinical conceptualizations of ABI. Forreasons explained in the introduction to Chapter 2, thefirst two ICF categories of the Global mental functionsblock (Consciousness and Orientation) are combined.Intellectual functions is relabelled with the morecommonly used term in ABI parlance, Cognitive, andentitled General cognitive functions (Chapter 3) to dis-tinguish it from Specific cognitive functions (Chapter 4).Scales in Chapter 3 often include items that are pertinentto other categories of Mental functions. As explained inthe introduction to Chapter 5, Global psychosocialfunctions, Temperament and personality functions andEnergy and drive functions (as well as three categoriesfrom Specific mental functions and the Interpersonal

Introduction 13



interactions and relationships domain from Activities/Participation) are combined. Scales of Sleep functions,the final category of Global mental functions, are notconsidered in this volume.

The second block, Specific mental functions, con-tains 11 specific second-level categories (see AppendixC) and a number of representative tests are described inChapter 4, Specific cognitive functions. Instrumentsincluded in Chapter 4 address the following ICF cate-gories: (i) Attention, (ii) Memory, (iii) Higher-levelcognitive (relabelled with the more commonly usedterm, Executive), (iv) Language (including the Voiceand speech domain from Body Functions, as well as theCommunication domain from Activities/Participation),and (v) Experience of self and time (relabelled with themore commonly used term, Self-awareness). At the itemlevel, scales in Chapter 4 (and Chapter 3) overlap withthe Learning and applying knowledge domain fromActivities/Participation. Instruments assessing (vi)Emotional functions and (vii) Thought functions, arecovered in Chapter 5 on scales assessing the Regulationof behaviour, thought and emotion. Specific instrumentsassessing (viii) Psychomotor, (ix) Perceptual, (x)Calculation, and (xi) Sequencing complex movementsare not covered. Items reflecting some these Specificmental functions categories are occasionally includedin multidimensional scales (see Chapter 10).

Sensory, ingestion and motor functions

Tests and scales described in Chapter 6 map to at leastthree ICF domains from the Body Functions com-ponent: mainly (i) Sensory and pain, (ii) Functions ofthe digestive, metabolic and endocrine systems, and (iii)Neuromusculoskeletal and movement-related functions,as well as the Mobility domain from the Activities/Participation component. A number of performance-based measures that are suitable for use by generichealth professionals are available. These have theadvantage of providing a standardized and objectiveevaluation. Additionally, rating scales and self-reportmeasures of sensory-motor functions also contribute toevaluation, and for some Body Functions are arguablythe best methods of assessment, the obvious examplebeing pain. As noted earlier in this chapter, there is oftenan admixture of motor function items between BodyFunctions and Activities/Participation components. Alltests and scales that exclusively assess motor function, asdistinct from multiple Activities/Participation domainsincluding Mobility, are included in Chapter 6.

In Part B, Chapters 7 and 8 present scales relating toActivities and Participation. Within the ICF taxonomy,the Activities and Participation component containsnine domains (see Figure 1.2). Scales from three of the

nine domains (General tasks and demands, Self-care,and Domestic life) are presented in Chapter 7 (Activitiesof daily living). As noted in the preceding paragraph,scales exclusively addressing the Mobility domain arepresented in Part A, Chapter 6 (Sensory, ingestion andmotor scales). It is not uncommon, however, for scalesof basic activities of daily living to focus on self-careand mobility, and in these cases, where self-care itemspredominate, the scale is more appropriately placedin Chapter 7 rather than Chapter 6. A further twoActivities/Participation domains (Major life areas andCommunity, social and civic life) are addressed inChapter 8 (Participation and social role). The arbitrarydemarcation of scales in Chapters 7 and 8 is acknow-ledged and the problem of admixtures of items acrossmultiple domains in the Activities/Participation com-ponent means that there is not always a neat separationbetween the item content of scales located in Chapters 7and 8. Multidimensional scales, which often includeitems at the Activities/Participation level, as well as theBody Function level, are presented in Chapter 10. Finally,instruments sampling the remaining three Activities/Participation domains (Learning and applying know-ledge, Communication, and Interpersonal interactionsand relationships) are dealt with in Chapters 3 to 5 inPart A, in the interests of locating conceptually similarscales together.

As noted, with few exceptions, scales for ABI classi-fied in the Activities/Participation component do notaddress specific ICF categories in isolation. Rather, theapproach is more global, and ABI scales of Activities/Participation tend to be spread across the nine domains.In order to enable the reader to quickly grasp thesampling of ICF domains within each instrument andcompare the content of instruments, Appendix D pro-vides a comparative checklist for the scales featuring inChapters 7, 8 and 10, identifying the number of itemsin each scale that address the ICF domains withinthe Activities/Participation component. Additionally,Appendix E provides a comparative checklist of the itemcontent of scales assessing functional activities of dailyliving from a clinical perspective.

Part C examines the single component of ContextualFactors currently classified in the ICF, EnvironmentalFactors (Chapter 9). The importance of incorporatingcontextual factors into the ICF cannot be overstated. Itspresence serves to remind clinicians and researchers thatpeople with ABI (or other health conditions) are notdefined by that health condition, but rather live in aphysical, social and attitudinal environment that canexert a dramatic (positive or negative) influence on theirfunctioning. The five domains comprising the com-ponent of Environmental Factors represent a diverserange. In some domains, notably Support and relation-ships, a number of instruments are available, but few




have been developed for or used with the ABI group.In other domains pertinent to the physical environ-ment, specific scales are just starting to appear in theliterature.

Part D (Chapter 10) is the final chapter of the com-pendium, containing scales that cannot be classifiedneatly within specific components of the ICF. They aredescribed as multidimensional scales because theyprovide a sampling of disparate items from both theBody Functions and Activities/Participation com-ponents and their domains. A small selection of genericscales assessing so-called health-related quality of lifeis also included in Chapter 10.

Cautionary statements

It is recognized that for each of the components anddomains of the ICF there are specialists who are trainedto provide detailed and comprehensive evaluations ofrespective functions and their disorders: for example,clinical and neuropsychologists in Mental functions;physicians in Sensory and other body systems;speech pathologists in Voice and speech, Language, andCommunication; physiotherapists in Neuromusculo-skeletal and movement-related functions; occupationaltherapists, social workers and other allied health pro-fessionals in various domains of Activities and Partici-pation and Environmental Factors. In particular, thetests of Mental functions described in this volume areessentially cognitive screening tests, and while theseserve a useful purpose in many situations, they are not asubstitute for a detailed neuropsychological or languageassessment by a specialist clinician. Johnston, Keith, andHinderer (1992, p. S13) recommend that:

screening tests should be used cautiously fordiagnostic, placement, or treatment planning . . .Screening tests are most effectively used to indicatethe need for more extensive testing and treatment ofspecific problem areas. Flexibility and professionaljudgment are essential to the use of measures inprofessional practice.

Thus, while the instruments contained in this volume arerecommended as suitable for administration by generichealth professionals, it is expected that the administratorwill adhere to standards of test administration andbest clinical practice, as recommended by professionalcolleges and organizations (see Johnston et al. for dis-cussion of measurement standards and responsibilitiesthat are applicable to both test developers and testusers).

An obvious caveat applies to the administration ofrating scales, questionnaires and interviews. Responseson these instruments involve the person’s perceptions.

In situations where an actual, objective evaluation isdesired, the veracity of responses on rating scales frompeople with ABI may be compromised when significantcognitive impairments, particularly in memory, judge-ment and/or awareness, are present. A score may wellbe produced, but the validity of that score needs to beevaluated. Even visual analogue rating scales (bothvertical and horizontal) have been shown to be anunreliable method of measurement of some functionsfor people with stroke (Price, Curless, & Rodgers, 1999).For these reasons, rating scales are often completed by aproxy-respondent, generally a family member who hasclose contact with the person and knew them wellprior to the onset of their ABI. Yet, this method,wherein the informant’s responses are used as a “goldstandard”, can introduce another set of problems,because informants may over-estimate or under-estimatelevel of functioning for a variety of reasons (Kertesz,Nadkarni, Davidson, & Thomas, 2000; McKinlay &Brooks, 1984; Prigatano, Altman, & O’Brien, 1990). Anumber of the scales presented in this volume have datacollected from three sources: patient, family member andclinician, and there are advantages and disadvantagesto each. Who should do the rating? Wilson, Alderman,Burgess, Emslie, and Evans (1996) intimate thatjudicious selection of the family member is probably thebest source, whereas Bennett, Ong, and Ponsford (2005)conclude that the treating clinician provides the mostaccurate evaluation.

On a final note, tests and scales are developed fordifferent purposes, and that which is suitable for oneapplication will be unsuited to another purpose. Hall,Bushnik, Lakisic-Kazazic, Wright, and Cantagallo(2001, p. 368) observed that “using a measure at thewrong phase of recovery may . . . jeopardize the validityof an otherwise valid scale”. Accordingly, the selectionof instruments featured in this volume is intended topresent the reader with a representation of a variety ofmethods, procedures and formats, while at the same timeenabling a reliable and valid evaluation of functioning.Responsibility for the selection and use of a particularinstrument as suitable for a given purpose, however, restswith the clinician or researcher.

References

Anastasi, A., & Urbina, S. (1997). Psychological testing(7th ed.). Englewood Cliffs, NJ: Prentice Hall International,Inc.

Andresen, E. M. (2000). Criteria for assessing the tools ofdisability outcomes research. Archives of Physical Medicineand Rehabilitation, 81(Suppl. 2), S15–S20.

Australian Institute of Health and Welfare. (2003). ICFAustralian user guide. Version 1.0. Canberra: AustralianInstitute of Health and Welfare.

Introduction 15



Beeson, P. M., & Robey, R. R. (2006). Evaluating single-subject treatment research: Lessons learned from aphasialiterature. Neuropsychology Review, 16(4), 161–169.

Bennett, P. C., Ong, B., & Ponsford, J. (2005). Assessment ofexecutive dysfunction following traumatic brain injury:Comparison of the BADS with other clinical neuro-psychological measures. Journal of the InternationalNeuropsychological Society, 11(5), 606–613.

Bickenbach, J. E., Chatterji, S., Badley, E. M., & Üstün, T. B.(1999). Models of disablement, universalism and the inter-national classification of impairments, disabilities andhandicaps. Social Science and Medicine, 48(9), 1173–1187.

Bond, T. G., & Fox, C. M. (2007). Applying the Rasch model.Fundamental measurement in the human sciences (2nd ed.).Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Bowling, A. (1997). Measuring health: A review of qualityof life measurement scales. (2nd ed.). Buckingham & Phila-delphia: Open University Press.

Brockow, T. T., Wohlfahrt, K., Hillert, A., Geyh, S., Weigl, M.,Franke, T., et al. (2004). Identifying the concepts containedin outcome measures of clinical trials on depressive dis-orders using the International Classification of Functioning,Disability and Health as a reference. Journal of Rehabilita-tion Medicine, Suppl. 44, 49–55.

Bruyère, S. M., van Looy, S. A., & Peterson, D. B. (2005). TheInternational Classification of Functioning, Disability andHealth: Contemporary literature overview. RehabilitationPsychology, 50(2), 113–121.

Cicchetti, D. V. (1994). Guidelines, criteria, and rules ofthumb for evaluating normed and standardized assessmentinstruments in psychology. Psychological Assessment, 6(4),284–290.

Cicchetti, D. V. (2001). The precision of reliability and validityestimates re-visited: Distinguishing between clinical andstatistical significance of sample size requirements. Journalof Clinical and Experimental Neuropsychology, 23(5),695–700.

Cicchetti, D., Bronen, R., Spencer, S., Haut, S., Berg, A.,Oliver, P., et al. (2006). Rating scales, scales of measurement,issues of reliability: Resolving some critical issues for clini-cians and researchers. The Journal of Nervous and MentalDisease, 194(8), 557–564.

Cieza, A., Brockow, T., Ewert, T., Amman, E., Kollerits, B.,Chatterji, S., et al. (2002). Linking health-status measure-ments to the International Classification of Functioning,Disability and Health. Journal of Rehabilitation Medicine,34(5), 205–210.

Cieza, A., Geyh, S., Chatterji, S., Kostanjsek, N., Üstün, B., &Stucki, G. (2005). ICF linking rules: An update based onlessons learned. Journal of Rehabilitation Medicine, 37(4),212–218.

Cohen, J. (1988). Statistical power analysis for the behavioralsciences. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.

Cole, B., Finch, E., Gowland, C., & Mayo, N. (1995). Physicalrehabilitation outcome measures. Baltimore: Williams &Wilkins.

Cushman, L. A., & Scherer, M. J. (Eds.). (1995). Psychologicalassessment in medical rehabilitation. Washington, DC:American Psychological Association.

de Kleijn-deVrankrijker, M. W. (2003). The long way from the

International Classification of Impairments, Disabilities andHandicaps (ICIDH) to the International Classification ofFunctioning, Disability and Health (ICF). Disability andRehabilitation, 25(11–12), 561–564.

Dekker, J., Dallmeijer, A. J., & Lankhorst, G. J. (2005).Clinimetrics in rehabilitation medicine: Current issues indeveloping and applying measurement instruments. Journalof Rehabilitation Medicine, 37(4), 193–201.

Deyo, R. A., Diehr, P., & Patrick, D. L. (1991). Reproducibilityand responsiveness of health status measures. Statistics andstrategies for evaluation. Controlled Clinical Trials, 12(S4),142S–158S.

Domholdt, E. (2005). Rehabilitation research. Principles andapplications (3rd ed.). St Louis, MO: Elsevier Saunders.

Geyh, S., Cieza, A., Schouten, J., Dickson, H., Frommelt, P.,Omar, Z., et al. (2004a). ICF core sets for stroke. Journal ofRehabilitation Medicine, Suppl. 44, 135–141.

Geyh, S., Kurt, T., Brockow, T., Cieza, A., Ewert, T., Omar, Z.,et al. (2004b). Identifying the concepts contained inoutcome measures of clinical trials on stroke using theInternational Classification of Functioning, Disability andHealth as a reference. Journal of Rehabilitation Medicine,S44, 56–62.

Granlund, M., Eriksson, L., & Ylvén, R. (2004). Utility ofInternational Classification of Functioning, Disability andHealth’s participation dimension in assigning ICF codesto items from extant rating instruments. Journal of Rehabili-tation Medicine, 36(3), 130–137.

Guyatt, G., Walter, S., & Norman, G. (1987). Measuringchange over time: Assessing the usefulness of evaluativeinstruments. Journal of Chronic Disease, 40, 171–178.

Hall, K. M. (1992). Overview of function assessment scalesin brain injury rehabilitation. NeuroRehabilitation, 2(4),98–113.

Hall, K. M., Bushnik, T., Lakisic-Kazazic, B., Wright, J., &Cantagallo, A. (2001). Assessing traumatic brain injuryoutcome measures for long-term follow-up of community-based individuals. Archives of Physical Medicine andRehabilitation, 82(3), 367–374.

Herndon, R. M. (Ed.). (1997). Handbook of neurologic ratingscales. New York: Demos Vermande.

Hinderer, S. R., & Hinderer, K. A. (2005). Principles andapplications of measurement methods. In J. A. DeLisa, B.M. Gans, N. E. Walsh, W. L. Bockenek, W. R. Frontera,S. R. Geiringer, et al. (Eds.), Physical medicine and rehabili-tation: Principles and practice (4th ed., pp. 1139–1162).Philadelphia: Lippincott, Williams & Wilkins.

Jette, A. M., & Hayley, S. M. (2005). Contemporary measure-ment techniques for rehabilitation outcomes assessment.Journal of Rehabilitation Medicine, 37(6), 339–345.

Jette, A. M., Haley, S. M., & Kooyoomjian, J. T. (2003). Arethe ICF Activity and Participation dimensions distinct?Journal of Rehabilitation Medicine, 35(3), 145–149.

Johnston, M. V., Keith, R. A., & Hinderer, S. R. (1992). Measure-ment standards for interdisciplinary medical rehabilitation.Archives of Physical Medicine and Rehabilitation, 73(S12),S3–S23.

Kazis, L. E., Anderson, J. J., & Meenan, R. F. (1989). Effectsizes for interpreting changes in health status. Medical Care,27(S3), S178–S189.




Kersten, P., Mullee, M. A., Smith, J. A. E., McLellan, L., &George, S. (1999). Generic health status measures areunsuitable for measuring health status in severely disabledpeople. Clinical Rehabilitation, 13(3), 219–228.

Kertesz, A., Nadkarni, N., Davidson, W., & Thomas, A.(2000). The Frontal Behavioral Inventory in the differ-ential diagnosis of frontotemporal dementia. Journalof the International Neuropsychological Society, 6(4), 460–468.

Kirshner, B., & Guyatt, G. (1985). A methodological frame-work for assessing health indices. Journal of ChronicDisease, 38(1), 27–36.

Lawton, M. P., & Brody, E. M. (1969). Assessment of olderpeople: Self-maintaining and instrumental activities of dailyliving. Gerontologist, 9(3), 179–186.

Lezak, M. D. (1983). Neuropsychological assessment (2nd ed.).New York: Oxford University Press.

Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004).Neuropsychological assessment (4th ed.). Oxford: OxfordUniversity Press.

McDowell, I. (2006). Measuring health: A guide to rating scalesand questionnaires. (3rd ed.). New York: Oxford UniversityPress.

McKinlay, W. W., & Brooks, D. N. (1984). Methodologicalproblems in assessing psychosocial recovery followingsevere head injury. Journal of Clinical Neuropsychology,6(1), 87–99.

Mitrushina, M. N., Boone, K. B., & D’Elia, L. F. (1999).Handbook of normative data for neuropsychologicalassessment. New York: Oxford University Press.

Okochi, J., Utsunomiya, S., & Takahashi, T. (2005). Healthmeasurement using the ICF: Test–retest reliability study ofICF codes and qualifiers in geriatric care. Health and Qualityof Life Outcomes, 3, 46.

Perdices, M. (2005). How do you know whether your patient isgetting better (or worse)? A user’s guide. Brain Impairment,6(3), 219–226.

Peterson, D. B. (2005). International Classification ofFunctioning, Disability and Health: An introduction forrehabilitation psychologists. Rehabilitation Psychology,50(2), 105–112.

Price, C. I. M., Curless, R. H., & Rodgers, H. (1999). Canstroke patients use visual analogue scales? Stroke, 30(7),1357–1361.

Prigatano, G., P., Altman, I., M., & O’Brien, K. P. (1990).Behavioural limitations that traumatic-brain-injuredpatients tend to underestimate. The Clinical Neuropsycholo-gist, 4(2), 163–176.

Prigatano, G. P., & Pliskin, N. H. (2003). Clinical neuro-psychology and cost outcome research: A beginning. NewYork: Psychology Press.

Prigatano, G. P., & Schacter, D. L. (Eds.). (1991). Awareness ofdeficit after brain injury: Clinical and theoretical issues. NewYork: Oxford University Press.

Reed, G. M., Lux, J. B., Bufka, L. F., Trask, C., Peterson, D.B., Stark, S., et al. (2005). Operationalizing the InternationalClassification of Functioning, Disability and Healthin clinical settings. Rehabilitation Psychology, 50(2), 122–131.

Sackett, D. L., Haynes, R. B., Guyatt, G. H., & Tugwell, P.

(1991). Clinical epidemiology: A basic science for clinicalmedicine (2nd ed.) Boston: Little, Brown & Company.

Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W.,& Haynes, R. B. (2000). Evidence based medicine: How topractise and teach EBM (2nd ed.). Edinburgh: ChurchillLivingstone.

Sederer, L. I., & Dickey, B. (Eds.). (1996). Outcomes assessmentin clinical practice. Baltimore: Williams & Wilkins.

Shulman, K., & Feinstein, A. (2006). Quick cognitive screeningfor clinicians: Mini-mental, clock drawing and other brieftests. Abingdon, UK: Martin Dunitz.

Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compen-dium of neuropsychological tests. Administration, norms andcommentary (3rd ed.). New York: Oxford University Press.

Stineman, M. G., Lollar, D. J., & Üstün, T. B. (2005). TheInternational Classification of Functioning, Disability, andHealth: ICF empowering rehabilitation through anoperational bio-psycho-social model. In J. A. DeLisa,B. M. Gans, N. E. Walsh, W. L. Bockenek, W. R. Frontera,S. R. Geiringer, et al. (Eds.), Physical medicine and rehabili-tation: Principles and practice (4th ed., pp. 1099–1108).Philadelphia: Lippincott, Williams & Wilkins.

Strub, R. L., & Black, F. W. (2000). The mental status examin-ation in neurology. (4th ed.). Philadelphia: F. A. DavisCompany.

Stucki, G. (2007). Developing human functioning and rehabili-tation research. Part I: Academic training programs. Journalof Rehabilitation Medicine, 39(4), 323–333.

Stucki, G., Cieza, A., & Melvin, J. (2007). The InternationalClassification of Functioning, Disability and Health: Aunifying model for the conceptual description of therehabilitation strategy. Journal of Rehabilitation Medicine,39(4), 279–285.

Stucki, G., & Grimby, G. (2007). Organizing human func-tioning and rehabilitation research into distinct scientificfields. Part I: Developing a comprehensive structure fromcell to society. Journal of Rehabilitation Medicine, 39(4),293–298.

Stucki, G., & Melvin, J. (2007). The International Classificationof Functioning, Disability and Health: A unifying model forthe conceptual description of physical and rehabilitationmedicine. Journal of Rehabilitation Medicine, 39(4),286–292.

Stucki, G., Reinhardt, J. D., & Grimby, G. (2007). Organizinghuman functioning and rehabilitation research into distinctscientific fields. Part II: Conceptual descriptions anddomains for research. Journal of Rehabilitation Medicine,39(4), 299–307.

Tate, R. L., & Perdices, M. (2008). Facilitating use of the Inter-national Classification of Functioning, Disability and Healthin acquired brain impairment. Brain Impairment, 9(3),282–292.

Tesio, L. (2003). Measuring behaviours and perceptions:Rasch analysis as a tool for rehabilitation research. Journalof Rehabilitation Medicine, 35(3), 105–115.

Üstün, T. B., Chatterji, S., Bickenbach, J., Kostanjsek, N., &Schneider, M. (2003). The International Classification ofFunctioning, Disability and Health: A new tool for under-standing disability and health. Disability and Rehabilitation,25(11–12), 565–571.

Introduction 17



Üstün, B., Chatterji, S., & Kostanjsek, N. (2004). Commentsfrom WHO for Journal of Rehabilitation Medicine supple-ment on ICF core sets. Journal of Rehabilitation Medicine,Suppl. 44, 7–8.

Wade, D. T. (1992). Measurement in neurological rehabilitation.New York: Oxford University Press.

Wade, D. T. (2003). Outcome measures for clinical rehabilita-tion trials: Impairment, function, quality of life or value?American Journal of Physical Medicine and Rehabilitation,82(10), S26–S31.

Wade, D. T. (2005). Applying the WHO ICF framework tothe rehabilitation of patients with cognitive deficits. InP.W. Halligan & D. T. Wade (Eds.), Effectiveness of rehabili-tation for cognitive deficits (pp. 31–42). Oxford: OxfordUniversity Press.

Wade, D. T., & Halligan, P. (2003). New wine in oldbottles: The WHO ICF as an explanatory model ofhuman behaviour. Clinical Rehabilitation, 17(4), 349–354.

Walker, M. F., & Lincoln, N. B. (1990). Reacquisition of

dressing skills after stroke. International Disability Studies,12, 41–43.

Walker, M. F., & Lincoln, N. B. (1991). Factors influencingdressing performance after stroke. Journal of Neurology,Neurosurgery, and Psychiatry, 54, 699–701.

Wilson, B. A., Alderman, N., Burgess, P. W., Emslie, H., &Evans, J. J. (1996). Behavioural assessment of the dysex-ecutive syndrome. Bury St Edmunds, UK: Thames Valley TestCompany.

World Health Organization. (1980). International classificationof impairments, disabilities, and handicaps. Geneva: WorldHealth Organization.

World Health Organization. (1992). The international stat-istical classification of diseases and related health problems,10th revision, Australian modification (ICD-10-AM).Sydney: National Centre for Health Classification inHealth.

World Health Organization. (2001). International classificationof functioning, disability and health. Geneva: World HealthOrganization.




psychology press is an imprint of the taylor & francis ... · everyday memory questionnaire...

Documents