Dr. Linda Isaac, PhD Director, Rehabilitation Research Center Santa Clara Valley Medical Center
Assistant Professor (Affiliated) Stanford University, School of Medicine Department of Orthopedic Surgery
Citation Wright, J. (2000). The
Functional Assessment Measure. The Center for Outcome
Measurement in Brain Injury. http://www.tbims.org/
combi/FAM ( accessed
This citation is for the COMBI web material. Mr. Wright is
not the scale author for the FAM.
to the Functional Assessment Measure
Independence Measure (FIM)
The FIM is an 18-item, seven level ordinal scale. It is the product
of an effort to resolve the long standing problem of lack of uniform
measurement and data on disability and rehabilitation outcomes.
The FIM emerged from a thorough developmental process overseen by
a National Task Force of rehabilitation research. The National Task
force reviewed 36 published and unpublished functional assessment
scales before agreeing on an instrument. Subsequent evaluation of
the metric properties of the FIM have been reported extensively.
The Uniform Data System for Medical Rehabilitation (UDS) provides
training materials, a shared database for participating facilities,
and requires overall 80% accuracy of raters at each facility for
qualifying members. There is a membership fee.
The FIM was intended to be sensitive to change in an individual
over the course of a comprehensive inpatient medical rehabilitation
program. The FIM can be completed in approximately 20-30 minutes
in conference, by observation, or by telephone interview. Rasch
analysis defines two FIM dimensions, labeled motor and cognitive.
It was designed to assess areas of dysfunction in activities which
commonly occur in individuals with any progressive, reversible or
fixed neurologic, musculoskeletal and other disorders. One limitation
relative to using the FIM in evaluating survivors of TBI is that
it is not diagnosis specific. Although found to be reliable and
valid, the scale has few cognitive, behavioral, and communication
related functional items relevant to assessing persons with TBI.
Functional Assessment Measure (FAM)
The FAM items were developed by clinicians representing each of
the disciplines in an inpatient rehabilitation program. The FAM
was developed as an adjunct to the FIM to specifically address the
major functional areas that are relatively less emphasized in the
FIM, including cognitive, behavioral, communication and community
functioning measures. The FAM consists of 12 items. These items
do not stand alone, but are intended to be added to the 18 items
of the FIM. The total 30 item scale combination is referred to as
the FIM+FAM. The time required to administer the FIM+FAM is approximately
In 1995 a United Kingdom FIM+FAM users group set out to develop
a UK version of the FAM, keeping the 7-level structure, but attempting
to improve the objectivity of scoring, especially for ten of the
more subjective items of the twelve. This work has been undertaken
in collaboration with SCVMC. Click here
for more information on the UK FAM.
regarding the UK FAM was contributed by Dr. Lynne Turner Stokes.
Please contact Dr. Lynne Turner Stokes at firstname.lastname@example.org
for more information.