World Health Organization Disability Assessment Schedule 2.0

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The SAGE Encyclopedia of Abnormal
and Clinical Psychology
World Health Organization Disability
Assessment Schedule 2.0
Contributors: Juan V. Luciano & Stefano Federici
Edited by: Amy Wenzel
Book Title: The SAGE Encyclopedia of Abnormal and Clinical Psychology
Chapter Title: "World Health Organization Disability Assessment Schedule 2.0"
Pub. Date: 2017
Access Date: April 12, 2017
Publishing Company: SAGE Publications, Inc.
City: Thousand Oaks,
Print ISBN: 9781483365831
Online ISBN: 9781483365817
DOI: http://dx.doi.org/10.4135/9781483365817.n1493
Print pages: 3739-3740
©2017 SAGE Publications, Inc.. All Rights Reserved.
This PDF has been generated from SAGE Knowledge. Please note that the pagination of
the online version will vary from the pagination of the print book.

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The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a
generic assessment instrument designed by the World Health Organization (WHO) to provide
a cross-cultural standardized method for measuring activity limitations and participation
restrictions experienced by individuals irrespective of medical diagnosis. Respondents are
asked to rate the level of difficulty experienced, taking into consideration how they usually do
the activity, including the use of any assistive devices and/or the help of a person. The
WHODAS 2.0 was developed from a large pool of International Classification of Functioning,
Disability and Health (ICF) items that was subjected to field trials in 19 countries. ICF experts
were asked to review the results to decide, taking all psychometric and qualitative data into
account, which were the best 36 items to illustrate the six domains of the ICF’s activities and
participation domains:
Understanding and communicating (6 items)
Getting around (5 items)
Self-care (4 items)
Getting along with people (5 items)
Life activities (8 items)
Participation in society (8 items)
The two best items from each domain were chosen for a 12-item version (Understanding and
communicating, Items 3 and 6; Getting around, Items 1 and 7; Self-care, Items 8 and 9;
Getting along with people, Items 10 and 11; Life activities, Items 2 and 12; Participation in
society, Items 4 and 5). The 12-item version accounts for 85% of the variance of the full, 36-
item version. It is usually employed in epidemiological studies and for routine outcome
measurement.
Instrument Manual
The manual of the instrument includes the seven paper-based versions of WHODAS 2.0,
which are different in length and mode of administration:
Three 36-item versions: interview administered, self-administered, and proxy administered
(knowledgeable informants)
Three 12-item versions: interview administered, self-administered, and proxy administered
One 12 + 24–item version: interview administered
The training manual is available online and is addressed to health professionals, health
policymakers, social scientists, and other professionals involved in studies on disability and
health.
Scoring Instructions
For each item, the individual rates how much difficulty he or she has had in specific areas of
functioning during the past 30 days using the following scale: 1 = none, 2 = mild, 3 =
moderate, 4 = severe, and 5 = extreme. There are two options for obtaining the summary
scores for the 36-item version: (1) simple scoring and (2) complex scoring.
Simple Scoring
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With simple scoring, the scores from each of the items are summed without recoding or
collapsing the response categories. This scoring method is useful to use as a hand-scoring
approach and may be the best option in busy clinical settings with scant time for evaluations
or in paper-and-pencil surveys. It is important to note that simple scoring of WHODAS 2.0 is
specific to the sample being evaluated and should not be considered to be comparable
across populations. Because of the sound psychometric properties of WHODAS 2.0, the
simple sum of the scores of the items across all domains constitutes a statistic that is
sufficient to reflect the degree of functional impairment.
Complex Scoring
This type of scoring, also called item response theory–based scoring, takes the coding for
each item response separately and then uses a syntax to determine the summary score by
differentially weighting the items and the levels of severity. This scoring is performed in three
steps:
Sum the recoded item scores within each domain
Sum all six domain scores
Convert the summary score into a metric ranging from 0 (no disability) to 100 (full
disability)
There are domain-specific scores for the six different functioning domains. The population
norms are available at the WHODAS 2.0 website.
Benefits and Limitations
In a nonpublished literature review, Stefano Federici has found that since 1999, roughly 800
studies have been published in scientific international journals (95%), in edited and
monograph books (3%), and in conference proceedings (1%), at a constant annual rate. Most
of these studies are cross-sectional (≈60%), carried out mainly in the fields of psychiatry
(≈43%), geriatrics (≈13%), and neurology (≈10%). The majority have adopted the 36-item or
12-item interviewer-administered version.
Thirty studies have investigated the psychometric properties of WHODAS 2.0, showing a
broad consensus on its reliability and validity when used with patients with mental health
disorders, breast cancer, hearing impairment, arthritis, lymphatic filariasis, musculoskeletal
and cardiovascular conditions, infarct, stroke, and sclerosis, in addition to use with the elderly
population. Limitations were found for patients with schizophrenia because some items were
not applicable to this disorder. In addition, with its focus on activities and participation,
WHODAS fails to measure the impact of environmental factors.
In Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-
5), titled Emerging Measures and Models, the WHODAS 2.0 is the recommended instrument
for assessment of global functioning and impairment. In 2013, a modified version was
designed specifically for use with children (WHODAS-Child) by the DSM-5
Impairment/Disability Work Group.
See alsoAssessment; Clinical Assessment and Diagnosis: Overview; Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition (DSM-5); Functional Assessment;
International Classification of Diseases; World Health Organization
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Juan V. LucianoStefano Federici
http://dx.doi.org/10.4135/9781483365817.n1493
10.4135/9781483365817.n1493
Further Readings
Gold, L. H. (2014). DSM-5 and the assessment of functioning: The World Health Organization
Disability Assessment Schedule 2.0 (WHODAS 2.0). Journal of the American Academy of
Psychiatry and the Law, 42(2), 173–181.
Ustün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., …
WHO/NIH Joint Project. (2010). Developing the World Health Organization Disability
Assessment Schedule 2.0. Bulletin of the World Health Organization, 88(11), 815–823.
doi:http://dx.doi.org/10.2471/BLT.09.067231
World Health Organization, WHO Disability Assessment Schedule 2.0 (WHODAS 2.0):
http://www.who.int/classifications/icf/whodasii/en/
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