WHO Disability Assessment Schedule WHODAS 2.0
WHO Disability Assessment Schedule WHODAS 2.0 overview
Creator and Context
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a generic measure of health and disability, grounded in the International Classification of Functioning, Disability and Health.
It was developed by WHO through a 19 country cross cultural study, edited by Ustun, Kostanjsek, Chatterji and Rehm, with the manual published in 2012. It is also embedded in DSM-5. A licence from WHO is required to include it in an electronic record or data capture system.
Presenting Conditions
WHODAS 2.0 measures functioning across six domains:
Cognition, meaning understanding and communicating
Mobility, meaning moving and getting around
Self care, including hygiene, dressing, eating and staying alone
Getting along, meaning interacting with other people
Life activities, including domestic responsibilities, leisure, work and school
Participation in community activities
It deliberately places mental health and addiction on an equal footing with physical health.
Administration
Available in a 36 item version and a 12 item version, each of which can be interviewer administered, self administered or completed by a proxy such as a family member or carer. Items are rated for the last 30 days as None (0), Mild (1), Moderate (2), Severe (3) or Extreme or cannot do (4).
The 36 item version takes about 20 minutes and produces an overall score plus six domain scores. The 12 item version takes about 5 minutes, explains 81 percent of the variance of the full version, and produces an overall score only.
Desired Audience
Adults across all health conditions, in both general population surveys and clinical settings.
WHODAS answers a question symptom measures cannot: what can this person actually do. For funders and commissioners who buy function rather than symptom reduction, and for services working with complex or long term presentations, that is the outcome that matters.
Considerations
WHO publishes no clinical severity bands or cut offs. It provides population norms and score distributions for comparison instead. Any mild, moderate and severe banding presented elsewhere is not WHO sanctioned.
WHO has changed the numbers assigned to the response options. The current scoring uses 0 to 4, not the older 1 to 5. Getting this wrong silently shifts every score.
The 12 item version cannot produce domain profiles.
Translations supplied by third parties are not quality assured by WHO.
A WHO licence is required for inclusion in an electronic system.
How to score the WHO Disability Assessment Schedule WHODAS 2.0
Conducting the assessment
The person, or a proxy, rates each item for the last 30 days on the 0 to 4 difficulty scale.
Interpretation
WHO documents two scoring methods.
Simple scoring sums the item scores with no weighting or recoding, which is practical for hand scoring in busy clinical settings.
Complex scoring, which WHO recommends, is item response theory based. Recoded item scores are summed within each domain, the six domain scores are summed, and the result is converted to a metric from 0 to 100, where 0 is no disability and 100 is full disability. WHO provides the algorithm.
WHO does not publish severity cut offs. Interpretation is against published population norms.
Clinical Considerations
Use the 36 item version when you need the domain profile, and the 12 item version when you need a quick overall figure.
Interpret scores against the WHO population distribution rather than inventing severity bands.
Consider the proxy version where cognitive impairment or acute illness makes self report unreliable.
WHO Disability Assessment Schedule WHODAS 2.0 use cases
Measuring functioning and disability across physical and mental health
Outcome reporting for funders who care about function rather than symptoms
Assessing change in complex and long term presentations
Population health and epidemiological research
Category
General Well-being
Research Summary
Ustun, T. B., Kostanjsek, N., Chatterji, S., & Rehm, J. (Eds.). (2010). Measuring Health and Disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). Geneva: World Health Organization.
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