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PEDI and the PEDI-CAT

The PEDI (Pediatric Evaluation of Disability Inventory), is an interview-based assessment that can be used to monitor the self-care, mobility and social abilities of a person with cerebral palsy. In this assessment, the parent or care giver answers questions about the person’s performance in these aspects of life. There are two versions of this assessment widely used in clinical practice today:

  • The original PEDI, suitable for children aged six months to 7.5 years
  • The PEDI-CAT (Computer-Adaptive Test), a version suitable for newborns to 21-year-olds. This later version incorporates the larger age range, new items and different computer-based measurement methodologies1.

The purpose of the PEDI and PEDI-CAT is to determine a person’s ability to perform day-to-day tasks like dressing, brushing teeth, doing up buttons, walking and socialising. It can identify if someone has functional delays and then monitor their improvements during treatment.

The PEDI and PEDI-CAT can be used for newborns to 21-year-olds with a wide-range of developmental disabilities.

The PEDI and PEDI-CAT are questionnaires used to obtain information about a person from their parent or care giver in the following domains:

  • Daily Activities – can the person perform everyday activities like putting on socks, drinking through a straw or using an electric razor to shave their face?
  • Mobility – can the person move around adequately? Can they walk without aids, transfer from sitting to standing position, walk up steps and kick a ball?
  • Social/Cognitive – can a person interact and communicate with others at their level of cognition and manage their own behaviour?
  • Responsibility (for people aged between three and 21 years) – can the person perform independent living tasks like getting ready on time in the morning and taking care of minor health needs?

The responses on the questionnaire are scored on a four-point scale ranging from ‘unable’ to ‘easy’. These scores are then compared to other test subjects in the same age group to rate performance against the general population. The test is then performed again later on so the person’s progress can be measured over time.

  • The PEDI takes 45 to 60 minutes to complete.
  • With the PEDI-CAT, there are two different options; the Speedy CAT which has fewer items and takes approximately 10 to 15 minutes, or the Content-balanced CAT which has more items and takes roughly 20 to 30 minutes.

Training

The PEDI should be administered by a trained health professional, like an occupational therapist, who has experience using the assessment.

The PEDI-CAT can be administered by a trained health professional or a parent or caregiver, however the manual should always be reviewed beforehand to familiarise oneself with the assessment.

Cost

The manuals that are essential to administer the assessments can be purchased online:

Method

The method will depend on whether the PEDI or PEDI-CAT is being used.

  • The PEDI is a paper-based system, while the PEDI-CAT requires a computer for scoring.
  • The PEDI-CAT can also be completed directly by the parent or caregiver, whereas the PEDI must be administered by an experienced health professional.

Psychometric properties reviewed

Construct validity - Several studies have assessed the concurrent validity of both the PEDI and the PEDI-CAT. The PEDI shows excellent concurrent validity with the Gross Motor Function Measure (GMFM)2,3 while the PEDI-CAT shows fair concurrent validity against the Alberta Infant Motor Scale (AIMS)4, and good results when assessed against the PEDI functional scale5. Both versions of the PEDI show adequate discriminant validity (t = 4.7-7.6, p = <0.0001). This means that the assessment can distinguish equally between those with and without disability6.

Reliability - Item-specific reliability (i.e. how reliable individual assessment items are) of the PEDI-CAT shows fair to excellent results (ICC = 3.4-1.0; percentage agreement 60-100%)5.

Reliability - Responsiveness has been reviewed on both versions of the assessment. The PEDI shows good results (effect size = > 0.5, SRM = >0.5) indicating that it is responsive to change7. The PEDI-CAT also shows good responsiveness to change (75% percentage change)4.

NOTE: Assessments should have strong psychometric properties. These properties refer mainly to i) validity – whether the tool measures what it is meant to measure, ii) reliability – whether the results of the tool are stable under different conditions and, for tools which measure outcome iii) responsiveness – whether the test is responsive to change.

Date of literature searches: January 2017

  1. Mancini, M. C., Coster, W. J., Amaral, M. F., Avelar, B. S., Freitas, R., & Sampaio, R. F. (2016). New version of the Pediatric Evaluation of Disability Inventory (PEDI-CAT): translation, cultural adaptation to Brazil and analyses of psychometric properties. Brazilian Journal of Physical Therapy, 20(6), 561–570.
  2. McCarthy, M. L., Silberstein, C. E., Atkins, E. A., Harryman, S. E., Sponseller, P. D., & Hadley-Miller, N. A. (2002). Comparing reliability and validity of pediatric instruments for measuring health and well-being of children with spastic cerebral palsy. Developmental Medicine & Child Neurology, 44(7), 468-76.
  3. Han, T., Gray, N., Vasquez, M. M., Zou, L. P., Shen, K., & Duncan, B. (2011). Comparison of the GMFM-66 and the PEDI Functional Skills Mobility domain in a group of Chinese children with cerebral palsy. Child: care, health and development, 37(3), 398-403. See abstract
  4. Dumas, H. M., Fragala-Pinkham, M. A., Rosen, E. L., Lombard, K. A., & Farrell, C. (2015). Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) and Alberta Infant Motor Scale (AIMS): Validity and Responsiveness. Physical Therapy, 95(11), 1559-1568.
  5. Dumas, H. M., & Fragala-Pinkham, M. A. (2012). Concurrent validity and reliability of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test mobility domain. Pediatric Physical Therapy, 24(2), 171-176. See abstract
  6. Dumas, H. M., Fragala-Pinkham, M. A., Haley, S. M., Ni, P., Coster, W., Kramer, J. M., Kao, Y., Moed, R., Ludlow, L. H. (2012). Computer adaptive test performance in children with and without disabilities: prospective field study of the PEDI-CAT. Disability & Rehabilitation, 34(5), 393-401.
  7. Vos-Vromans, D. C. W., Ketelaar, M., & Gorter, J. W. (2005). Responsiveness of evaluative measures for children with cerebral palsy: the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory. Disability & Rehabilitation, 27(20), 1245-1252. See abstract
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The information on this page was developed using the best research evidence combined with the expertise of clinicians and people with cerebral palsy and their families. It is provided to help people with cerebral palsy, their families and caregivers, clinicians and service providers make decisions about suitable interventions. This information is intended to support, but not replace, information exchanged, and decisions made, between people with cerebral palsy, their families and health professionals.