Podcast
Questions and Answers
What are the six domains assessed by the WHODAS 2.0?
What are the six domains assessed by the WHODAS 2.0?
What is the maximum total raw score possible when using the simple scoring method for WHODAS 2.0?
What is the maximum total raw score possible when using the simple scoring method for WHODAS 2.0?
In what situation can a proxy-administered version of WHODAS 2.0 be used?
In what situation can a proxy-administered version of WHODAS 2.0 be used?
What does each item on the WHODAS 2.0 ask the individual to do?
What does each item on the WHODAS 2.0 ask the individual to do?
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What is the main advantage of the simple scoring method for WHODAS 2.0?
What is the main advantage of the simple scoring method for WHODAS 2.0?
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How many items are included in the WHODAS 2.0?
How many items are included in the WHODAS 2.0?
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Which of the following accurately describes the scoring of individual items in the WHODAS 2.0?
Which of the following accurately describes the scoring of individual items in the WHODAS 2.0?
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When is the use of WHODAS 2.0 particularly beneficial?
When is the use of WHODAS 2.0 particularly beneficial?
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What is the final score range after converting the summary score in IRT-based scoring?
What is the final score range after converting the summary score in IRT-based scoring?
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Which step involves converting item responses to a rate of 0-4?
Which step involves converting item responses to a rate of 0-4?
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How many domains does WHODAS 2.0 assess?
How many domains does WHODAS 2.0 assess?
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Which domain is NOT assessed by WHODAS 2.0?
Which domain is NOT assessed by WHODAS 2.0?
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What is the primary role of the computer program in IRT-based scoring?
What is the primary role of the computer program in IRT-based scoring?
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Which of the following domains is related to daily living activities?
Which of the following domains is related to daily living activities?
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What should a clinician do if they believe a self-reported score does not accurately reflect the individual's condition?
What should a clinician do if they believe a self-reported score does not accurately reflect the individual's condition?
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How is the average domain score calculated?
How is the average domain score calculated?
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What is indicated by an average disability score of 3 on the WHODAS 5-point scale?
What is indicated by an average disability score of 3 on the WHODAS 5-point scale?
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What action should be taken if an individual does not respond to 10 or more items on the WHODAS 2.0?
What action should be taken if an individual does not respond to 10 or more items on the WHODAS 2.0?
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What is considered when calculating the average general disability score?
What is considered when calculating the average general disability score?
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Why are average scores deemed reliable and clinically useful according to DSM-5 Field Trials?
Why are average scores deemed reliable and clinically useful according to DSM-5 Field Trials?
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What does the WHODAS 5-point scale allow the clinician to assess?
What does the WHODAS 5-point scale allow the clinician to assess?
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In the context of WHODAS 2.0, what is encouraged for the individual?
In the context of WHODAS 2.0, what is encouraged for the individual?
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What may consistently high scores in a particular domain indicate?
What may consistently high scores in a particular domain indicate?
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At what intervals should the measure be completed for tracking disability changes?
At what intervals should the measure be completed for tracking disability changes?
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What should be considered regarding the individual's symptoms when completing the measure?
What should be considered regarding the individual's symptoms when completing the measure?
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Why might the simple or average domain scores not be helpful?
Why might the simple or average domain scores not be helpful?
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What should clinicians do if they notice consistently high scores for an individual?
What should clinicians do if they notice consistently high scores for an individual?
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Study Notes
World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)
- The adult self-administered version of WHODAS 2.0 is a 36-item measure that assesses disability in adults aged 18 years and older.
- It has been validated across numerous cultures worldwide and demonstrated sensitivity to change.
- WHODAS 2.0 assesses disability across six domains:
- Understanding and communicating
- Getting around
- Self-care
- Getting along with people
- Life activities (household, work, and/or school activities)
- Participation in society
- If the adult individual is of impaired capacity, a knowledgeable informant may complete the proxy-administered version of the measure.
WHODAS 2.0 Scoring Instructions
- Each item on the self-administered version asks the individual to rate how much difficulty they have had in specific areas of functioning during the past 30 days.
- There are two basic options for computing the summary scores for the WHODAS 2.0 36-item full version.
- The simple scoring method sums the scores from each item without recoding or collapsing of response categories.
- The scores assigned to each item are: "none" (1), "mild" (2), "moderate" (3), "severe" (4), and "extreme" (5).
- The maximum total raw score is 180.
- The simple scoring method is practical for hand-scoring and may be preferred in busy clinical settings or paper-and-pencil interview situations.
Complex Scoring Method
- Item-response-theory (IRT)-based scoring is a complex method of scoring that considers multiple levels of difficulty for each WHODAS 2.0 item.
- IRT-based scoring takes into account the coding for each item response as "none," "mild," "moderate," "severe," and "extreme" separately.
- A computer program is required to determine the summary score by differentially weighting the items and the levels of severity.
Scoring Steps
- Step 1: Recoded item scores are summed within each domain, converting response options 1-5 to a rate of 0-4, resulting in a total raw score of 144.
- Step 2: All six domain scores are summed.
- Step 3: The summary score is converted into a metric ranging from 0 to 100, where 0 = no disability and 100 = full disability.
WHODAS 2.0 Domain Scores
- WHODAS 2.0 produces domain-specific scores for six functioning domains:
- Cognition
- Mobility
- Self-care
- Getting along
- Life activities (household and work/school)
- Participation
WHODAS 2.0 Population Norms
- Population norms for IRT-based scoring of the WHODAS 2.0 and population distribution of IRT-based scores for WHODAS 2.0 can be found at www.who.int/classifications/icf/Pop_norms_distrib_IRT_scores.pdf.
DSM-5-TR Scoring and Interpretation Guidance
- Clinicians review individual's responses during the clinical interview and record self-reported scores in the "Clinician Use Only" section.
- Clinicians can override self-reported scores with corrected scores based on clinical interview and other available information.
- Average domain and general disability scores are recommended for calculation and use.
- Average scores are comparable to the WHODAS 5-point scale, ranging from none (1) to extreme (5).
- Average scores were found to be reliable, easy to use, and clinically useful in the DSM-5 Field Trials.
Calculating Average Scores
- Average domain score is calculated by dividing the raw domain score by the number of items in the domain.
- Example: If all items in the "understanding and communicating" domain are rated as moderate, the average domain score would be 18/6=3, indicating moderate disability.
- Average general disability score is calculated by dividing the raw overall score by the number of items in the measure (36).
Administering the WHODAS 2.0
- Individuals should be encouraged to complete all items on the WHODAS 2.0.
- If 10 or more items are left blank, the measure is considered invalid.
Frequency of Use
- The measure should be completed at regular intervals to track changes in an individual's level of disability over time.
- The frequency of completion depends on the stability of the individual's symptoms and treatment status, as clinically indicated.
- Consistently high scores on a particular domain may signal:
- Significant and problematic areas for the individual
- Need for further assessment and intervention
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Description
Assesses disability in adults across 6 domains, including understanding, movement, self-care, and more. Validated across cultures and sensitive to change.