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Pediatric Evaluation of Disability Inventory (PEDI) | APTA
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Pediatric Evaluation of Disability Inventory (PEDI)
Pediatric Evaluation of Disability Inventory (PEDI)
Test & Measure
Summary
What it measures:
The Pediatric Evaluation of Disability Inventory (PEDI) assesses self-care, mobility, and social functioning
in children aged 6 months to 7 years.
Conditions:
This summary contains information on the use of this test targeting children with Down syndrome, in
addition to children with other developmental and physical disabilities, such as cerebral palsy,
developmental disabilities, attention deficit disorder (ADD), chromosomal anomalies, fragile X syndrome,
sensory integration dysfunction, VATER syndrome, JIA, and spina bifida (Nichols and Case-Smith, 1996).
Taskforce Recommendations
American Physical Therapy Association Section on Pediatrics School-Based Special-Interest Group Task
Force on School-Based Physical Therapy Performance Appraisals
Get the Test:
The PEDI is a standardized test designed to identify and describe functional impairment in children. The
child’s current functional performance is measured in 3 domains: Self-care, Mobility, and Social Function.
The PEDI includes 3 measurement scales: Functional Skills (measuring capability to perform tasks),
Caregiver Assistance (viewing how much assistance the child typically requires), and modifications
(identifying the equipment used by the child to carry out the tasks). The PEDI is administered through
interview using the structured questionnaire provided. The interviewee may be the child’s parent/caregiver
or a therapist/teacher who knows the child well (Haley et al, 1992). The participant’s PEDI scores are
calculated using normative standard and scaled scores. Normative scores take into account the child’s age
and demonstrated age-expected performance; the scaled scores are distributed along a 0 to100 scale. The
scaled scores demonstrate the child’s performance on relatively easy to more difficult tasks (Armstrong et
al, 2010).
Get Test
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Administration / Interpretation / Reliability / Validity
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Administration:
(Taken from: Pediatric Evaluation of Disability Index. Pearson Education, Inc. website.
http://www.pearsonclinical.com/therapy/qualifications.html. Updated January 2014. Accessed October 18,
2014)
Time to Administer/Complete:
The PEDI requires approximately 45 to 90 minutes to administer and score. It consists of a structured
interview, professional observation, and questionnaire.
Equipment:
PEDI scoring form and manual.
Costs:
The PEDI manual can be purchased for $125.95 and the scoring forms for $45.60.
Training:
This test may be purchased and administered by individuals with a degree or license to practice in the
healthcare or allied healthcare field, a master’s degree (psychology, education, occupational therapy, social
work) or in a field closely related to the intended use of the assessment. This also includes individuals with
certification or active membership in a professional organization, in addition to formal, supervised mental
health, speech/language, and/or educational training specific to assessing children/infant development.
All individuals are required to have formal training in the ethical administration, scoring, and interpretation
of clinical assessments ("Pediatric Evaluation," 2014).
Interpretation:
Minimal Detectable Change (MDC)
3.91–9.92= MDC90 index range (in children without motor delay; n=17)
5.19–9.38= MDC90 index range (in children with motor delay; n=17, 1 child with Down syndrome)
Values were obtained for PEDI Functional Skills domain scaled scores for children receiving early
intervention services. Children were evaluated in 3 trials conducted at a mean age of 18, 31, and 53 months
of age (n=34, 1 child with Down syndrome) (Eigsti et al, 2010).
Minimal Clinically Important Difference (MCID)
MCID: 6–15 points or 11% on 0–100 scale
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In a retrospective study of charts of children and youth between 1–19 years of age (n=53) discharged from
an inpatient rehabilitation hospital, the MCID ranged from 6–15 points for all PEDI scales, and with a
change in PEDI score of “about” 11% on a 0–100 scale identified to be meaningful to clinicians (Iyer et al,
2003).
Standard Error of Measurement (SEM):
SEM: 0.72 points in children with cerebral palsy aged 3–10 years old (n=115) (Besios, et al, 2013).
Cutoff Scores/Diagnostic Accuracy/Predictive Accuracy
Sensitivity:
77.3% children with cerebral palsy
99.8% children with JIA
In a study using the Danish adaptation of the PEDI, in the case of discrimination between children with
cerebral palsy (n=22) and nondisabled children (n=224), the PEDI identified 77.3% of children with cerebral
palsy correctly. The area under the curve (AUC) was 0.950, implying that a child with cerebral palsy will
have a lower PEDI score than a nondisabled child in 95% of the cases. In the discrimination between
children with JIA (n=14) and children without disabilities, 99.8% of children with JIA were identified
correctly. The AUC was 0.946. (Stahlhut et al, 2011)
Specificity:
97.8% children without disabilities identified when compared to children with cerebral palsy
81.7% children without disabilities identified when compared to children with JIA
Using the Danish adaptation of the PEDI, n=22 children with cerebral palsy, n=224 children without
disabilities, n=14 children with JIA (Stahlhut et al, 2011).
Likelihood Ratios:
None available
Floor and Ceiling Effects:
All floor and ceiling percentages* were found to be 0% across the Self-care, Mobility, and Social Function
domains of the PEDI, with the exception of the Mobility domain, which had a ceiling percentage of 7%, in
children with cerebral palsy aged 3 to10 years old (n=115).
* In this study, floor and ceiling effects were defined as the proportion of participants that obtained the
highest or lowest possible score of each scale (McCarthy et al, 2002).
Normative Values:
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Mean (SD) Normative and Scaled Scores of the PEDI Functional Skills Scale by Gender for Children with
Down Syndrome (n=43 total, 20 girls, 23 boys between 5 to 6 years old) (Dolva et al, 2004)
Normative Scores
Girls
Boys
Overall
Self-Care Domain
27.4 (5.8)
23.5 (5.4)
25.4 (5.9)
Mobility Domain
--
--
--
Social Function Domain
27.4 (5.2)
27.3 (6.5)
27.3 (6.5)
Girls
Boys
Overall
Self-Care Domain
61.7 (7.1)
58.4 (4.8)
59.9 (6.1)
Mobility Domain
74.9 (6.1)
77.1 (7.9)
76.1 (7.1)
Social Function Domain
57.5 (4.9)
57.0 (5.8)
57.2 (5.3)
Scaled Scores
Mean (SD) Normative and Scaled Scores on the PEDI Functional Skills Scales by Age When Entered
Elementary School for Children with Down Syndrome (n=43) (Dolva et al, 2007)
Normative Scores
Started School at Age 6 (n=26)
Started School at Age 7 (n=17)
Overall
Self-Care Domain
--
--
--
Mobility Domain
--
--
--
Social Function Domain
31.2 (8.0)
26.1 (8.4)
29.2 (8.5)
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Scaled Scores
Started School at Age 6 (n=26)
Started School at Age 7 (n=17)
Overall
Self-Care Domain
71.5 (7.4)
66.3 (5.9)
69.5 (7.2)
Mobility Domain
86.5 (6.9)
85.2 (9.8)
85.9 (8.1)
Social Function Domain
67.9 (8.8)
61.4 (8.8)
65.4 (9.2)
Mean (SD) Normative and Scaled Scores on the PEDI Caregiver Assistance Scales by Age When Entered
Elementary School for Children with Down Syndrome (n=43). (Dolva, et al, 2004)
Normative Scores
Started School at Age 6 (n=26)
Started School at Age 7 (n=17)
Overall
Self-Care Domain
34.9 (7.2)
30.1 (7.0)
32.9 (7.5)
Mobility Domain
49.5 (11.7)
44.0 (12.7)
47.4 (12.2)
Social Function Domain
45.3 (12.7)
39.1 (10.0)
39.1 (10.0)
Started School at Age 6 (n=26)
Started School at Age 7 (n=17)
Overall
Self-Care Domain
67.6 (7.6)
62.5 (8.3)
65.6 (8.1)
Mobility Domain
93.3 (9.6)
88.7 (10.4)
91.5 (10.1)
Social Function Domain
71.6 (12.6)
63.6 (11.9)
68.4 (12.8)
Scaled Scores
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Pediatric Evaluation of Disability Inventory (PEDI) | APTA
Mean (SD) Normative and Scaled Standard PEDI Scores in Children with Typical Development, Sensory
Processing Disorders and Physical Disability (n=60, 20 children per group; mean age 56 months)
(Armstrong et al, 2010)
Normative Scores
Typical
Sensory
Physical Disability
Self-Care Domain
56.7 (22.3)
31 (8.5)
24.3 (21.8)
Mobility Domain
59.2 (18.8)
42.0 (10.6)
24.4 (23.9);
Social Function Domain
62.8 (16.7)
38.3 (13.3)
34.6 (23.1)
Typical
Sensory
Physical Disability
Self-Care Domain
79.4 (11.6)
60.3 (9.2)
49.4 (17.2)
Mobility Domain
94.4 (6.9)
83.4 (10.9)
55.4 (28.2)
Social Function Domain
71.4 (11.1)
55.8 (6.2)
46.5 (16.5)
Scaled Scores
Mean (SD) Scaled Score Values for the Dutch Adaptation of the PEDI (in children with Down syndrome;
mean age 82 months; n=25) (Volman, et al, 2007)
Scaled Scores
Functional Skill Scale
Caregiver Assistance Scale
Self-Care Domain
49.0 (11.0)
21.4 (10.9)
Mobility Domain
59.1 (4.1)
32.4 (3.1)
Social Function Domain
49.3 (6.8)
12.8 (5.8)
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Reliability:
Test-retest Reliability:
Intraclass correlation coefficient (ICC): .999 for overall PEDI scores.
Children with cerebral palsy (n=20, mean age 4.85 years), PEDI was performed twice on 2 separate days
under the same conditions. (Besios et al, 2013)
ICC > .90 for both the PEDI Functional Skills and Caregiver Assistance Scales
Cronbach alpha = .89 for Self-care domain, .74 for Mobility domain, .87 for Social Function domain.
Netherlands adaptation of the PEDI, which incorporates 4 additional items not on the original PEDI.
Children with cerebral palsy, juvenile idiopathic arthritis, and children without disabilities (n=260). (Stahlhut
et al, 2011)
ICC: .98 for the domains on the Functional Skills Scale (summary scores for content areas 1–15).
ICC: > .85 for the domains on the Caregiver Assistance Scale (summary scores content areas 1–8).
ICC: > .88 for normative standard scores for Functional Skills Scale domains.
ICC: > .70 for normative standard scores for Caregiver Assistance Scale domains.
ICC: > .93 for scaled scores for Functional Skills Scale domains.
ICC: > .74 for scaled scores for Functional Skills Scale domains.
Parents were interviewed (n= 23) 2 times using the Norwegian adaptation of the PEDI for children with and
without various disabilities, with 1 week between interviews. (Nichols and Case-Smith, 1996)
Interrater Reliability:
ICC: .99 for SC*, MD, SF domains of Functional Skill Scale of the PEDI
ICC: >.95 for SC*, MD, SF domains of Caregiver Assistance Scale of the PEDI
Norwegian version of the PEDI. Interviews conducted by occupational therapists and physical therapists on
children without disability in Norway (n=19). (Berg et al, 2004)
*SC=Self-care domain, MD=Mobility domain, SF=Social Function domain
Intrarater Reliability:
ICC: .99 for SC*, MD, SF domains of Functional Skill Scale of the PEDI
ICC: >.99 for SC, MD, SF domains of Caregiver Assistance Scale of the PEDI
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Norwegian Version of the PEDI. Children without disability; same interviewer conducted all interviews; each
parent interviewed twice; n=15. (Berg et al, 2004)
*SC=Self-care domain, MD=Mobility domain, SF=Social Function domain
Internal Consistency:
Cronbach alpha > .90 when performed with children aged 3–10 years old with cerebral palsy (n=115).
(McCarthy et al, 2002)
Validity:
Face Validity
Not Available
Criterion Validity
Concurrent Validity:
PEDI summary scale scores:
PEDI functional skill level vs. Battelle Developmental Inventory Screening Test (BDIST) total score r=.71
PEDI Caregiver assistance vs. BDIST total score r=.73
Pearson correlations between the PEDI and BDIST were moderately high and positive for all domains, with
the exception of the Social Function domain in the PEDI and the Personal/Social domain within the BDIST
(Feldman et al, 1990).
Predictive Validity:
Gestational age and 5-minute Apgar scores were predictors of disability severity within the PEDI Self-care
domain in children with sensory processing disorders (P<.008).
Gestational age was a predictor of disability severity within the PEDI Mobility and Social Function domains
in children with sensory processing disorders (P<.03).
(Armstrong et al, 2010; n=60, mean age 56 months)
Construct Validity:
Comparison of Mean PEDI Summary Scale and Domain Scores Between Disabled and Nondisabled
Children
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Pediatric Evaluation of Disability Inventory (PEDI) | APTA
(paired t tests, α=.05) (Subjects were 20 children between the ages of 2 and 8 years with arthritic
conditions and spina bifida and 20 children without disabilities matched for age and sex.) (Feldman et al,
1990)
(Insert Table)
Disabled Group
Nondisabled Group
Value
Functional Skill Level:
160.8
183.3
.002
Caregiver Assistance:
80.3
97.9
.009
Modifications:
7.7
1.4
.002
Functional Skill Level:
76.1
90.9
.007
Caregiver Assistance:
28.9
37.1
.02
Functional Skill Level:
43.1
49.2
.0003
Caregiver Assistance:
31.3
40.5
.0004
Functional Skill Level:
41.4
43.3
NS
Caregiver Assistance:
20.3
20.3
NS
PEDI Summary Scale Scores
PEDI Self-Care Domain Scores
PEDI Mobility Domain Scores
PEDI Social Function Domain Scores
Convergent Validity:
R= –0.54 to –0.72
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Pediatric Evaluation of Disability Inventory (PEDI) | APTA
Correlation of subscores of Movement-ABC* (manual dexterity, ball skills, balance) compared to Self-care
domain of the PEDI
R= –0.74 to –0.79
Correlation between PEDI scales (Functional Skills, Caregiver Assistance) and Movement-ABC
R= –0.19 to –0.65
Correlation between Gross-Form Board** and PEDI Functional Skill scale domains (Self-care, Mobility,
Social Function)
*Movement-ABC, also referred to as Movement Assessment Battery for Children, measures general motor
ability for children 4–12 years old. It measures manual dexterity, ball skills, and balance.
**Gross-Form Board, is a test for children 3–7 years of age that measures performance mental ability.
(Children with Down syndrome; mean age 82 months; n=25 Volman et al, 2007)
Comparison of Summary Scores of the PEDI and the Peabody Developmental Motor Scales (PDMS)a
Pearson correlation coefficients between subscale scores for the PDMS and the summary scores from
each domain of the PEDI were moderate to high (r=.74-.95, all P values <.01). The PDMS was more
sensitive in identifying children as delayed when using criterion of 1.5 SD below the mean than the PEDI.
(n=25 children with CP, developmental delay, down syndrome, attention deficit disorder, chromosomal
anomalies, fragile X syndrome, VATER syndrome, and sensory integration) (Nichols, 1996)
PEDI Scales
Functional Skill Scales
PDMS Scales
SC
MD
SF
Fine Motor
0.95
0.77
0.90
Gross Motor
0.94
0.88
0.94
SC
MD
SF
Caregiver Assistance Scales
PDMS Scales
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Pediatric Evaluation of Disability Inventory (PEDI) | APTA
Fine Motor
0.93
0.74
0.93
Gross Motor
0.92
0.84
0.90
aSC=Self-care
domain, MD=Mobility domain, SF=Social Function domain
Discriminant Validity:
AUC: 0.950, implying that a child with cerebral palsy will have a lower PEDI score than a child without
disabilities in 95% of the cases.
AUC: 0.946, which implies that a child with JIA will receive lower PEDI scores than a child without
disabilities in 94.6% of the cases.
AUC values above 0.9 indicate the Danish version of the PEDI has good discriminative validity. (Stahlhut et
al, 2011)
Author and Reviewer Disclosures 
Reference 
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Resource Details
Date: December 31, 1999
Contact: practice@apta.org
Content Type: Test & Measure
Symptoms & Conditions
Cerebral Palsy
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