Limitation of developmental test to measure functional independence of children: Relationship between the Japanese version of WeeFIM II® and KSPD
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Updated: Aug 16, 2025
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Mizuki Sugiyama1,2, Sayaka Aoki3, Nobuyuki Kawate1
1Department of Rehabilitation Medicine, Showa University School of Medicine, Yokohama, Japan.
Insights
Developmental tests offer limited insight into a child's functional independence. An independent assessment tool, like the WeeFIM II, is necessary for evaluating daily living skills in children with developmental delays.
Area of Science:
- Pediatric developmental assessment
- Child functional independence evaluation
Background:
- Assessing functional independence in children is crucial for intervention planning.
- Developmental tests are commonly used but their ability to predict functional independence requires further investigation.
Purpose of the Study:
- To determine if developmental tests adequately estimate a child's functional independence.
- To investigate the relationship between developmental level and functional independence across various skills.
Main Methods:
- 397 children (age 0-7 years) with suspected developmental delay were assessed.
- Kyoto Scale of Psychological Development (KSPD) measured developmental level.
- Japanese version of WeeFIM II® assessed functional independence.
- Partial correlation analyses controlled for chronological age to examine relationships.
Main Results:
- Correlation coefficients between KSPD domains and WeeFIM II items varied (r=0.169-0.692).
- Developmental tests partially explained functional independence for most daily living skills after controlling for chronological age.
- The strength of the relationship varied across age groups and skill domains.
Conclusions:
- Developmental tests have limitations in measuring children's functional independence.
- Independent tools like WeeFIM II are essential for evaluating support needs in daily living skills.
- A comprehensive approach combining developmental and functional assessments is recommended.
Purpose:
The purpose of the study was to explore whether a developmental test provides enough information to estimate a child's functional independence. The strength of the relationship between developmental level and functional independence of different skills was investigated.
Methods:
The participants were 397 children (age 0-7 years) who were referred to NCCHD for suspected developmental delay. The participants' developmental level was measured with the Kyoto Scale of Psychological Development (KSPD) and their functional independence was assessed through a Japanese version of the WeeFIM II®. To calculate the strengths of the relationship between developmental age (DA) in different domains of the KSPD and WeeFIM II item scores, partial correlation analyses were conducted, controlling for chronological age.
Results:
Partial correlation coefficients between the score of each of the 18 WeeFIM II items and each of the three KSPD domain DAs (controlling chronological age) fell in the ranges of r = 0.169-0.581 (Posture-Motor; P-M), r = 0.377-0.627 (Cognitive-Adaptive; C-A), and r = 0.332-0.655 (Language-Social; L-S). When the participants were divided into three age groups, the correlations ranged from -0.095 to 0.552 for the youngest group (mean age = 14.21 months), from 0.283 to 0.653 for the middle group (mean age = 32.98 months), and from 0.345-0.692 for the oldest group (mean age = 57.48 months), depending on the combinations of the WeeFIM II items/developmental domains of the KSPD. The results indicated that for most of the daily living skills, its functional independence was only partially explained by the scores of a developmental test, once chronological age was controlled.
Conclusion:
This study showed the limitation of a developmental test as a tool to measure the functional independence of children and the necessity of using an independent tool, such as WeeFIM II, to evaluate the level of required support for each daily living skill.
