Pediatric Evaluation of Disability Inventory

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Objective[edit | edit source]

The Pediatric Evaluation of Disability Inventory (PEDI) is an interview-based tool that assesses functional abilities, level of independence and extent of modification needed for a child to carry out functional activities. Originally published in 1992 by Haley et al., it has been translated into multiple languages and developed into a computer-adaptive test called Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT)[1][2]

Intended Population[edit | edit source]

  • PEDI measures functional performance in children ranging from 6 months to 7 and a half years of age.
  • PEDI-CAT can be used for newborns up to 21-year-olds with various developmental disorders.

Method of Use[edit | edit source]

The PEDI comprises three domains: self-care, mobility, and social function. Each domain evaluates specific tasks including feeding, dressing, walking, and communicating with others. It takes into consideration the child's age, developmental stage, and specific diagnosis.[1]

It is scored on a four-point scale:

  • 0 - unable to perform the task
  • 1 - can perform the task with assistance
  • 2 - can perform the task independently but with some difficulty
  • 3 - can perform the task independently and without difficulty


The PEDI-CAT, on the other hand, is a revised version of PEDI that utilizes item response theory. Instead of having three domains, it has four. The responsibility domain, which evaluates the degree to which the child or caregiver assumes the responsibility for multi-step activities of daily living, is added to the three functional domains of PEDI-CAT. It is administered via computer or tablet and the initial set of answers determines the subsequent questions to identify the child's functional abilities with as few questions as possible.[3]

Scoring[edit | edit source]

The method of scoring is essentially the same for both versions: raw scores are converted into standard scores based on age and gender. However, due to the adaptive testing algorithm of PEDI-CAT, it can provide real-time scoring and graphic profile of the child's functional abilities.

Evidence[edit | edit source]

Reliability[edit | edit source]

PEDI[edit | edit source]

In the study of Haley et al., the PEDI was administered to 457 children with different conditions and found that PEDI has:[1]

  • Excellent internal consistency, with Cronbach's alpha coefficients ranging from 0.92 to 0.98 for the three domains.
  • High test-retest reliability, with intraclass correlation coefficients ranging from 0.86 to 0.98.

PEDI-CAT[edit | edit source]

  • Excellent test-retest reliability for all four domains (Daily Activities 0.997, Mobility 0.986, Social/Cognitive 0.979, Responsibility 0.958)[3]
  • Excellent reliability found in all PEDI-CAT for autism spectrum disorders domain scores (ICC≥0.86)[4]

Validity[edit | edit source]

PEDI[edit | edit source]

  • Overall excellent correlation between the PEDI scales and Battelle Developmental Inventory Screening Test in total Caregiver Assistance and Personal Social Domain (r=0.79)[1]
  • Overall excellent correlation between the PEDI scales and Battelle Developmental Inventory Screening Test in total Functional Skills and total Caregiver Assistance (r=0.92, 0.89)[1]
  • Overall excellent correlation between the PEDI scales and Wee-Functional Independence Measure in total Functional Skills and total Caregiver Assistance (r=0.92, 0.93)[1]

PEDI-CAT[edit | edit source]

Construct Validity of PEDI-CAT in children with Cerebral Palsy:[5]

  • Mobility and Daily Activities domains had excellent discriminant validity distinguishing between ambulatory and nonambulatory participants (AUC = 0.98 and 0.97)
  • Daily Activities domain showed excellent discriminant validity distinguishing between independent and dependent hand function (AUC = 0.93)
  • All PEDI-CAT domains were able to discriminate between ambulatory (GMFCS levels I-III) or nonambulatory (GMFCS levels IV-V) as well as manually independent (MACS levels I-II) or manually dependent functional levels (MACS levels III-V) ( P < .001).

References[edit | edit source]

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  1. 1.0 1.1 1.2 1.3 1.4 1.5 Haley SM. Pediatric Evaluation of Disability Inventory (PEDI): Development, standardization and administration manual. Therapy Skill Builders; 1992.
  2. Haley SM, Coster WJ, Kao YC, Dumas HM, Fragala-Pinkham MA, Kramer JM, Ludlow LH, Moed R. Lessons from use of the pediatric evaluation of disability inventory (pedi): Where do we go from here?. Pediatric physical therapy: the official publication of the Section on Pediatrics of the American Physical Therapy Association. 2010;22(1):69.
  3. 3.0 3.1 Haley SM, Coster WJ, Dumas HM, Fragala-Pinkham MA, Moed R. PEDI-CAT: development, standardization and administration manual. Boston: Boston University. 2012:648-57.
  4. Kramer JM, Liljenquist K, Coster WJ. Validity, reliability, and usability of the Pediatric Evaluation of Disability Inventory‐Computer Adaptive Test for autism spectrum disorders. Developmental Medicine & Child Neurology. 2016 Mar;58(3):255-61.
  5. Shore BJ, Allar BG, Miller PE, Matheney TH, Snyder BD, Fragala-Pinkham MA. Evaluating the discriminant validity of the pediatric evaluation of disability inventory: computer adaptive test in children with cerebral palsy. Physical therapy. 2017 Jun 1;97(6):669-76.