The National Disability Insurance Scheme

The World Health Organisation Disability Assessment Schedule (WHODAS) 2.0

April 2017

Overview of the WHODAS

a generic assessment instrument developed by the World Health Organisation
standardised method of measuring health, level of functioning, and disability in adult populations
covers six domains of functioning: cognition, mobility, self-care, getting along, life activities, and participation
there are several versions of the WHODAS 2.0 based on the number of items and administration method (for example 36-item self-administered)
the 12-item (interview-administered) version will be covered today and used for data collection.

Frames of reference

Frames of references for answering questions*

Respondents should answer questions with the following frames of reference:

frame 1 – degree of difficulty
frame 2 – due to health conditions
frame 3 – in the past 30 days
frame 4 – averaging good and bad days
frame 5 – as the respondent usually does the activity
frame 6 – items not experienced in the past 30 days are not rated.

*see pages 38 to 40 in the manual

Frames of reference (cont.)

Frames of reference 1 – degree of difficult

Respondents are asked questions about the degree of difficulty that they experience in doing different activities. For WHODAS 2.0, having difficulty means:

increased effort
discomfort or pain
slowness
changes in the way the person does the activity.

Frames of reference (cont.)

Frames of reference 2 – due to health conditions

respondents are asked to answer about difficulties due to their primary disability, rather than other causes.

Frames of reference 3 – in the past 30 days

the timeframe for WHODAS 2.0 is 30 days, as recall abilities are most accurate for the period of one month.

Frames of reference 4 – averaging good and bad days

some respondents will experience variability in the degree of difficulty that they experience over a 30 day period.
in these cases, respondents should be asked to give a rating that averages good and bad days.

Frames of reference (cont.)

Frames of reference 5 – as the respondent usually does the activity

respondents should rate the difficulty experienced by taking into consideration how they usually do the activity. For example, if assistive devices are usually available, respondents should keep this in mind.
support from a person should not be taken into account when responding.

Frames of reference 6 – items rated as not applicable

the instrument seeks to determine the amount of difficulty encountered in activities that a person actually does, rather than activities that person would like to do or can do, but does not actually do.
for example, considering item D2.5 “how much difficulty did you have in walking a long distance, such as one kilometre?”
If a participant cannot walk one kilometre because of his/her impairment, the item would be rated a “5” (for example “extreme or cannot do”).
However, if a participant has not tried to walk one kilometre simply because he/she drives everywhere, then the item would be coded “N/A (not applicable).”

Page 14 of 21

Preamble for the WHODAS

Script for introducing the 12-item WHODAS

Hello. I’m going to ask you a set of questions that relate to everyday activities that you may perform. I would like to understand the level of difficulty you have in doing these activities, as a result of your primary or core disability.

When I ask about difficulties in doing an activity, think about: increased effort, discomfort or pain, slowness, or changes in the way you do an activity.

Also, when answering, I’d like you to think back over the past 30 days about how much difficulty you have had on average.

Finally, please consider how you usually do an activity and use this scale when responding: none, mild, moderate, severe, extreme or cannot do.

Question-by-question specifications*

Domain	Question	Specification
D2: Mobility	1. Standing for long periods (such as 30 minutes)	-
D5: Life activities	1. Taking care of your household responsibilities	This global question is intended to elicit respondents’ appraisal of any difficulty they encounter in maintaining the household and in caring for family members or other people they are close to.
Ask respondents to consider all types of household or family needs, including: physical needs; emotional needs; financial needs; and psychological needs.
In some cultures, males may indicate that they do not have household responsibilities. In this situation, clarify that household responsibilities include; managing finances; car and home repairs; caring for the outside area of the home; picking up children from school; helping with homework; and disciplining children.
Here, “household” is defined broadly. In the case of participants who do not have a stable dwelling place, there are still activities surrounding the upkeep and maintenance of their belongings.
This question refers to those activities.

Source: WHODAS 2.0 manual. See pages 48 to 54 for more detailed information.

Page 16 of 21

Question-by-question specifications (cont.)

Domain	Question	Specification
D1: Cognition	Learning a new task (for example, learning how to get to a new place)	If respondents ask for clarification or appear to be thinking only about learning how to get to a new place, encourage them to think of other situations in the past month where learning something new was required, such as a task at: work (for example a new procedure or assignment); school (for example a new lesson); home (for example learning a new home-repair task); or leisure (for example learning a new game or craft). Ask the respondents when rating themselves to consider how easily they acquired new information, how much assistance or repetition they needed in order to learn and how well they retained what they learned.
D6: Participation	Joining community activities (for example festivities, religious or other activities) in the same way as anyone else can	If necessary, clarify this question using other examples of community activities, such as attending town meetings, fairs, leisure or sporting activities in the town, neighbourhood or community. The relevant issue being asked in this question is whether respondents can participate in these activities or whether there are inhibitors to them doing so.
If respondents appear confused by the phrase “in the same way anyone else can” ask them to use their judgement to: assess the extent to which average people in their community can join community activities; and consider their personal level of difficulty in joining community activities in relation to the assessment.

Source: WHODAS 2.0 manual. See pages 48 to 54 for more detailed information.

Page 17 of 21

Question-by-question specifications (cont.)

Domain	Question	Specification
D6: Participation	5. Emotionally affected by your health problems	This question refers to the degree to which respondents have felt an emotional impact due to their health condition. Emotions may include anger, sorrow, regret, thankfulness, appreciation, or any other positive or negative emotions.

If clarification is requested, encourage the respondent to think about their concentration in usual circumstances, rather than when they are preoccupied by a problem or are in an unusually distracting environment. If necessary, prompt the respondent to think about their concentration while they were doing something such as work tasks, reading, writing, drawing, playing a musical instrument, assembling a piece of equipment, and so on.

Convert distances into imperial measure where necessary (for example older people may be more familiar with miles than with kilometres). | | D6: Participation | 6. Concentrating on doing something for 10 minutes | This question refers to the degree to which respondents have felt an emotional impact due to their health condition. Emotions may include anger, sorrow, regret, thankfulness, appreciation, or any other positive or negative emotions.

If clarification is requested, encourage the respondent to think about their concentration in usual circumstances, rather than when they are preoccupied by a problem or are in an unusually distracting environment. If necessary, prompt the respondent to think about their concentration while they were doing something such as work tasks, reading, writing, drawing, playing a musical instrument, assembling a piece of equipment, and so on.

Convert distances into imperial measure where necessary (for example older people may be more familiar with miles than with kilometres). | | D2: Mobility | 7. Walking a long distance (such as a kilometre or equivalent) | This question refers to the degree to which respondents have felt an emotional impact due to their health condition. Emotions may include anger, sorrow, regret, thankfulness, appreciation, or any other positive or negative emotions.

If clarification is requested, encourage the respondent to think about their concentration in usual circumstances, rather than when they are preoccupied by a problem or are in an unusually distracting environment. If necessary, prompt the respondent to think about their concentration while they were doing something such as work tasks, reading, writing, drawing, playing a musical instrument, assembling a piece of equipment, and so on.

Convert distances into imperial measure where necessary (for example older people may be more familiar with miles than with kilometres). |

Question-by-question specifications (cont.)

Domain	Question	Specification
D3: Self-care	8. Washing your whole body	This question refers to respondents washing their entire body in whatever manner is usual for their culture. If respondents report that they have not washed their bodies in the past 30 days, ask whether this is due to a health condition (as defined under frame of reference 2)
D3: Self-care	9. Getting dressed	This question includes all aspects of dressing the upper and lower body. Ask respondents to consider activities such as gathering clothing from storage areas (for example closet, dresser) and securing buttons, tying knots, when making the rating.
D4: Getting along	10. Dealing with people you do not know	This item refers to interactions with strangers in any situation, such as: shop-keepers, service personnel, and people from whom one is asking directions. When making the rating, ask respondents to consider both approaching such individuals and interacting successfully with them to obtain a desired outcome.

Source: WHODAS 2.0 manual. See pages 48 to 54 for more detailed information. Page 19 of 21

Question-by-question specifications (cont.)

Domain	Question	Specification
D4: Getting along	11. Maintaining a friendship	This item includes: staying in touch; interacting with friends in customary ways; initiating activities with friends; and participating in activities when invited. Respondents will sometimes report that they have not engaged in friendship-maintenance activities in the past 30 days. In this case, ask whether this situation is due to a health condition.

| D5: Live activities | 12. Your day-to-day work and/or school | This global question is intended to elicit respondents’ appraisal of difficulties encountered in day-to-day work or school activities. This includes issues such as attending on time, responding to supervision, supervising others, planning and organising, meeting expectations in the workplace and any other relevant activities.

Source: WHODAS 2.0 manual. See pages 48 to 54 for more detailed information.

Page 20 of 21

Version control

Version No	Amended by	Brief description of change	Status	Date
2.0	NAN927	Class 1 Approval Annual Review consulted with PBQ096 from Insurance Support Branch.	APPROVED	2020-03-16
3.0	NAN927	Class 1 Approval Accessibility updates	APPROVED	2020-03-18