Pediatric Evaluation of Disability Inventory (PEDI): Purpose and Application
The PEDI is a comprehensive functional assessment tool designed to evaluate capability and performance in children aged 6 months to 7.5 years across three core domains: self-care, mobility, and social function, measuring both what children can do and the level of caregiver assistance they require. 1, 2
Core Measurement Domains
The PEDI assesses functional performance through three distinct scales:
- Functional Skills Scale: Measures the child's current capability in performing specific discrete tasks within each domain 2, 3
- Caregiver Assistance Scale: Quantifies the level of help provided by caregivers to facilitate the child's performance in daily activities 2, 4
- Modifications Scale: Documents environmental or technical modifications needed to support the child's functional abilities 2
Primary Clinical Applications
The PEDI serves as a standardized instrument for documenting functional development and tracking progress in response to rehabilitation interventions in children with disabilities. 5
Key applications include:
- Baseline functional assessment in children with developmental disabilities and acquired brain injuries, providing objective documentation of capability across self-care, mobility, and social function domains 3
- Progress monitoring during rehabilitation, with the instrument demonstrating sensitivity to functional changes over time in clinical populations 5
- Treatment planning and goal setting, as the detailed task-level information helps identify specific areas requiring intervention 1
Administration and Scoring
The PEDI is administered through structured interview format with parents or caregivers:
- Interview-based assessment conducted by trained therapists (occupational therapists or physical therapists) ensures standardized data collection 4
- Scoring produces normative standard scores that allow comparison to typically developing children, facilitating identification of functional delays 2
- High inter-rater reliability (ICC 0.95-0.99) when administered by trained professionals following standardized procedures 4
Critical Implementation Considerations
Consistency in respondent selection is essential—scores show substantial variation when comparing parent reports versus teacher reports (ICC 0.64-0.74), so the same respondent should be interviewed for serial assessments. 4
Important caveats:
- Interviewer training is mandatory to ensure reliable scoring; both inter-rater and intra-rater reliability are excellent when proper training procedures are followed 4
- Cultural applicability has been validated in multiple countries including Sweden, where strong correlation (r = 0.90-0.99) with American normative data supports cross-cultural use 2
- The PEDI measures similar constructs to the WeeFIM (Spearman correlations >0.88), but provides greater depth of task-specific information useful for intervention planning 3
Relationship to Broader Outcome Measurement
The PEDI aligns with recommended pediatric outcome assessment approaches by measuring physical functioning, social functioning, and daily activity performance—core domains emphasized in contemporary pediatric care guidelines 6. The instrument's focus on functional capability rather than purely developmental milestones represents an important shift toward measuring meaningful real-world performance 5.
For children beyond 7.5 years, newer iterations including the PEDI-PRO (Patient Reported Outcome) extend functional assessment to youth and young adults with developmental disabilities, incorporating patient-reported perspectives on functional performance embedded in everyday life situations. 7