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Updated: Jul 10, 2026
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
The WeeFIM [R] instrument--a paediatric measure of functional independence to predict longitudinal recovery of
M H Serghiou1, M W Rose, F S Pidcock
1Rehabilitation and Outpatient Services, Shriners Burns Hospitals for Children, Galveston, TX 77550, USA. mserghiou@shrinenet.org
Insights
Severe burns in children can impact function, but the WeeFIM tool shows most achieve full independence within 24 months. Burn size affects recovery rate, with larger burns taking longer to heal functionally.
Area of Science:
- Pediatric burn care
- Rehabilitation medicine
- Functional outcomes assessment
Background:
- Burns significantly impact children's development, function, and aesthetics.
- The WeeFIM (Wee Functional Independence Measure) assesses functional performance in children.
- It uses an 18-domain, 7-point scale from total assistance to complete independence.
Purpose of the Study:
- To evaluate the influence of burn size on functional independence in children.
- To determine the time to recovery of functional independence after burn injury.
Main Methods:
- A 2-year longitudinal study of 249 children (6-16 years) with 10-100% TBSA burns.
- WeeFIM scores were analyzed at discharge, 6 months, 1 year, and 2 years post-burn.
- Focus on normalized WeeFIM scores for subjects aged 6-16 due to unstable scores in younger children.
Main Results:
- Mean WeeFIM scores varied by burn size at discharge but showed no significant differences at 24 months.
- All children achieved full functional independence by 24 months, requiring no hands-on assistance for ADLs.
- Recovery rates varied by burn size, with larger burns (51-100% TBSA) taking up to 24 months for maximum improvement.
Conclusions:
- The WeeFIM effectively quantifies diminished functional capacity in severely burnt children upon acute care discharge.
- This tool aids burn centers in tracking the return to baseline functional independence in pediatric patients post-burn.
Introduction:
Burns create a myriad of complications that affect the child's developmental, functional and aesthetic status. The WeeFIM is a standardized measure of functional performance developed for use in children 6-months to 8-years of age but with application through adolescence. It includes 18 domains of performance which are scored on a 7-point scale from 'total assistance' to 'complete independence'. In this study, the WeeFIM was used to evaluate the influence of burn size on functional independence and on time to recovery.
Methods:
Children, 6 months to 16 years of age, with total body surface area (TBSA) bums of 10-100% burn injury were recruited for a 2-year longitudinal study. Due to unstable WeeFIM measurements on children 6 months to 6 years, analyses on normalized WeeFIM scores among subjects 6-16 years are presented. Children were evaluated at discharge from acute care, 6 months, 1 year and 2 years after burn injury.
Findings:
In this analysis, 454 WeeFIM evaluations from 249 patients, 6-16 years of age, were reviewed. While mean WeeFIM scores varied significantly at discharge based on the size of burn, there were no significant differences in any of the WeeFIM scales at 24 months post-burn. At 24 months, the mean WeeFIM score for all children, independent of size of their bum, indicated full independence. Hands-on assistance was not required for performing activities of daily living (ADLs). The rates of improvement differed statistically by size of bum. Maximum improvement was attained by 6 months for 10-15% TBSA burns, 12 months for 16-30% burns, 12 months for 31-50% burns and 24 months for 51-100% TBSA.
Conclusion:
The WeeFIM can be utilized by burn centres to describe diminished functional capacity at discharge from acute care for severely burnt children. The tool can be used to track return to baseline independence after a major burn injury in a paediatric population.
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