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Spinal Cord Independence Measure (SCIM)
Availability
For more information on this instrument, please see the article here.
Classification
Exploratory: SCI-Pediatric (8 years and over)
Short Description of Instrument
The Spinal Cord Independence Measure (SCIM)- III for Youth assesses traumatic and non-traumatic acute and chronic spinal cord injury. There are 3 domains:
 
Self-care
Respiration and sphincter management
Mobility
 
Construct measured: Function, Activities of Daily Living
Generic vs. disease specific: Disease specific
Intended respondent: Participant
# of items: 19
Comments/Special Instructions
The SCIM-III for Youth can be administered either by self-report or as a performance measure by a clinician (interview/observation).
 
The SCIM-III Self-Report for Youth was developed based on the SCIM-III and was modified based on formal cognitive testing with children and content expert input via the Modified Delphi Survey. The response scale has also been modified to accommodate cognitive levels of children (Mulcahey et al., 2016).
Rationale/Justification
Psychometric Properties: This test has undergone extensive psychometric testing in SCI.
 
Reliability: Test-retest reliability for the SCIM III Performance for Youth was good across all age, neurological levels, severity (complete/incomplete) and type of injury (paraplegia/tetraplegia) with ICC values?=?>?0.84, and most of them were?>?0.90 (Mulcahey et al., 2018).
 
Validity: Correlation of the SCIM III Performance for Youth with the FIM was strong. The total SCIM and FIM scores were r?=?0.92, p?<?0.0001 (Mulcahey et al., 2018). Subscale scores ranged from r?=?0.77, p?<?0.0001 for SCIM indoor/outdoor mobility and FIM® walk/stairs subscales to r?=?0.92, p?<?0.0001 for SCIM and FIM® self-care subscales (Mulcahey et al., 2018).
 
Responsiveness: When comparing the ability to detect a 1-point change from admission to discharge, the SCIM-III Performance for Youth detected more numerous changes than FIMTM in 3 of the 4 areas; self-care, respiration and sphincter management, and mobility indoors and outdoors, but NOT mobility in the room and toilet. The differences between the 2 scales' responsiveness to changes are not statistically significant (Mulcahey et al., 2018).
 
Floor/ceiling effects: There were no floor effects for the total SCIM-III or any subscale for any sample analysis. Ceiling effects were observed for the self-care subscale and the in-room mobility subscales for some age ranges and neurological levels of injury (Mulcahey et al., 2018).
 
Weaknesses: Limitations include youth not understanding medical terminology and jargon and this instrument was not tested for reliability or validity in a population of children 8 years and under (Mulcahey et al., 2016).
References
Key reference:
 
Mulcahey MJ, Calhoun CL, Sinko R, Kelly EH, Vogel LC. The spinal cord independence measure (SCIM)-III self-report for youth. Spinal Cord. 2016;54(3):204-212.
 
Additional references:
 
Dumas HM, Haley SM, Boyce ME, Peters CY, Mulcahey MJ. Self-report measures of physical function for children with spinal cord injury: a review of current tools and an option for the future. Dev Neurorehabil. 2009;12(2):113-118.
 
Fekete C, Eriks-Hoogland I, Baumberger M, Catz A, Itzkovich M, Lüthi H, Post MW, von Elm E, Wyss A, Brinkhof MW. Development and validation of a self-report version of the Spinal Cord Independence Measure (SCIM III). Spinal Cord. 2013;51(1):40-47.
 
Mulcahey MJ, Thielen CC, Sadowsky C, Silvestri JL, Martin R, White L, Cagney JA, Vogel LC, Schottler J, Davidson L, Parry I, Taylor HB, Higgins K, Feltz ML, Sinko R, Bultman J, Mazurkiewicz J, Gaughan J. Despite limitations in content range, the SCIM-III is reproducible and a valid indicator of physical function in youths with spinal cord injury and dysfunction. Spinal Cord. 2018;56(4):332-340.
 
Mulcahey MJ, Thielen C, Vogel LC, Davidson L, Sadowsky C, Dent K, Taylor H, Bultman J. (2018). Psychometric Properties of the Spinal Cord Independence Measure-III Self Report-Youth Presented at the 57th ISCoS Meeting, Sydney, Australia, September 13-15, 2018.