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.
original FAM was developed by clinicians at the Santa Clara Valley
Medical Center (SCVMC) in San Jose, California, in the late 1980's.
A number of brain injury units in the UK were interested in using
the FIM+FAM as a common language measure, but some of the FAM items
were felt to be too vague and subjective to be useful in the original
1995 a UK FIM+FAM users group therefore set out to develop the 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. The Chair of the 28 center users group
is Lynne Turner-Stokes, M.D., Regional Rehabilitation Unit, Northwick
Park Hospital, in Harrow, England.
UK version of the FIM+FAM is also designed for measuring disability
in the brain injured population. The FIM data can be extracted and
used on its own, for example, when making comparisons with populations
in which only the FIM is rated. For this reason it is important
to score the FIM items as for the stand-alone scale, and the FAM
items as an add-on. Certain items contain overlapping information.
For example, "Eating" is a FIM item and includes swallowing, while
"Swallowing" alone is a FAM item. Eating should still be rated on
the basis that it includes swallowing, so that the integrity of
the FIM score is maintained.
Turner-Stokes and colleagues in the UK found that overall scoring
accuracy of vignettes for 37 individuals and 11 teams was improved
for the UK version over the original FAM on the ten "troublesome"
items (excluding Swallowing and Orientation):
of individual raters
of team scores
training vignettes and a syllabus with definitions and decision
trees are available that reflect the changes in the UK FAM item
definitions. For example, the most obvious change is in the original
FAM item "Employability," now defined as "Use of Leisure Time."
obtain more information on the UK FAM, contact:
Lynne Turner Stokes
Regional Rehabilitation Unit
Northwick Park Hospital
Harrow, Middlesex, UK