Contact Mr. Jerry Wright Director, Research Administration Santa Clara Valley Medical Center
Citation Wright, J. (2000). The Functional Assessment Measure. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/ combi/FAM ( accessed
*Note: This citation is for the COMBI web material. Mr. Wright is not the scale author for the FAM.
FAM Frequently Asked Questions
Is there a system similar to UDS that manages the FAM data?
What are the benefits to using both the FIM and the FAM?
Can the FAM be done over the phone?
Who rates the FAM?
How do you know whether to get the information from the Person with injury or Significant Other or Caregiver?
What do I score if the person cannot do the activity?, ie car transfers?
If the person doesn't write by hand, but uses a keyboard, how is that rated?
Can we change or modify the FAM for our sites?
If we use the FIM plus FAM, do we need to be a member of UDS?
What about employability? How do you rate someone who is retired?
At our facility, the descriptions "max", "mod" or "min assist" are frequently used to describe the functional level of the patient. Some of the FAM definitions have the same terms. Are they equivalent?
When in doubt, should I rate higher or lower?
1. Is there a system similar to UDS that manages the FAM data? a. No. Approximately 600 individuals and agencies were surveyed about the need for a database similar to UDS for the FAM. There wasn't sufficient interest in establishing a system to manage the data.
2. What are the benefits to using both the FIM and the FAM? a. The FIM has a limited number of items that address cognitive, behavioral, communication and community functioning; issues that are important in the brain injury population. The FAM was specifically developed for those with brain injury, and meant to enhance the FIM. Ceiling effects are less of a problem during rehabilitation when FAM items are included as well.
3. Can the FAM be done over the phone? a. Yes. Although the FAM was developed for inpatient rehabilitation use, the Decision Tree was designed to assist in follow-up assessments. It is important to note that the assessment is self report when done over the phone.
4. Who rates the FAM? a. For inpatient use the FAM can be completed in conference by the team, by individual team members, e.g., OTs, Nursing, PTs, Speech Pathologists, Psychologists, etc., or by a case manager or data collector who gathers the data from the treating team. When used for follow-up it is recommended that the interviewer have a clinical rehabilitation background. All raters should successfully complete the training for inter-rater reliability.
5. How do you know whether to get the information from the Person with injury or Significant Other or Caregiver? a. It is sometimes difficult to know if the individual with TBI can assess him/herself honestly, however, it is preferred that the evaluator contacts the person with TBI first. A roommate or caregiver can be asked in the event the person with the injury is not available.
6. What do I score if the person cannot do the activity?, ie car transfers? a. If the person cannot do the activity because of physical or cognitive problems, rate the person "1", even if the person can instruct others. If the activity is not going to be addressed during the rehab stay, rate the admission and discharge the same to prevent inaccurate reporting. On very rare occasions, an item may be left blank if the item is not addressed.
7. If the person doesn't write by hand, but uses a keyboard, how is that rated? a. A person can be rated for writing skills via typewriter and/or computer. The item "writing' is defined as the spelling, grammar, and completeness of written communication.
8. Can we change or modify the FAM for our sites? a. Changing the FAM is not recommended, however, some sites have augmented the present rating material. For example, one site developed a set of reading materials for several grade levels and included specific questions to answer. They use the responses to help rate the person's reading, writing and comprehension skills.
9. If we use the FIM plus FAM, do we need to be a member of UDS? a. UDS expects that all facilities who use their materials (FIM) are members. For more information please contact:
Uniform Data System (UDS) 232 Parker Hall, SUNY South Campus 3435 Main Street Buffalo, NY 14214-3007 (716) 829-2076
FAM item materials are in the public domain.
10. What about employability? How do you rate someone who is retired? a. "Employability" is not employment. Rather it is the ability to work, assume all household responsibilities, maintain a full load as a student. So, all can be rated, even retired persons.
11. At our facility, the descriptions "max", "mod" or "min assist" are frequently used to describe the functional level of the patient. Some of the FAM definitions have the same terms. Are they equivalent? a. Not necessarily. These sub-headings can be misleading. The FAM is rated on an ordinal* scale from 1-7, but the interpretation of the item can differ greatly from your common meaning of the terms. Read definitions carefully before rating.
*The functional abilities of the patient are rated onan ordinal scale which reflects a "better than" or "worse than" relationship between adjacent categories. Althought the numbers have been assigned to each level of the scale to facilitate computerization of the data, the reader is cautioned taht these numbers do not necessarily represent equal distances between any comparible point on the scale. Therefore, the mathematical operations performed on theses ordinal data points will not necessarily result in valid computations. conclusions drawn from invalid computations will be of questionabler validity.
12. When in doubt, should I rate higher or lower? a. Your scores should reflect the actual observed performance, not capability. In general, if the person is between scores, mark the lower score.