Pediatric Evaluation of Disability Inventory (PEDI)

The Pediatric Evaluation of Disability Inventory (PEDI) is a structured, interview- and questionnaire-based assessment tool designed to evaluate functional skills, independence, and the need for modifications or caregiver assistance in children. Originally published in the early 1990s, PEDI has since been translated into multiple languages and expanded into a computerized version known as the Pediatric Evaluation of Disability Inventory – Computer Adaptive Test (PEDI-CAT). Today, it is widely used both in clinical practice and research to measure children’s functional performance and support treatment planning.

Purpose and clinical use

The main goals of PEDI are to:

• Assess a child’s functional abilities across daily activities.

• Evaluate the level of independence vs. caregiver support required.

• Identify areas where environmental modifications or interventions are needed.

• Track progress over time and evaluate the effect of rehabilitation or therapy.

PEDI is widely used in pediatric rehabilitation, early intervention programs, and longitudinal studies of child development.

Target population

PEDI is suitable for children with and without disabilities, typically from 6 months to 7.5 years of age. It is also often applied to older children with developmental delays, provided their functional abilities fall within the test’s developmental range.

Common diagnostic groups include:

• Cerebral palsy

• Developmental delay

• Traumatic brain injury

• Autism spectrum disorders

• Musculoskeletal and neuromuscular conditions

Structure of the test

PEDI is divided into three core domains:

1. Functional Skills

   • Child’s ability to perform everyday tasks across self-care, mobility, and social function.

2. Caregiver Assistance

   • Degree of help the caregiver provides during activities.

3. Modifications

   • Assessment of environmental adaptations (e.g., special equipment, ramps, assistive technology).

The PEDI-CAT version expands these domains into:

• Daily Activities

• Mobility

• Social/Cognitive

• Responsibility (management of complex, age-appropriate life tasks)

Administration

• Format: Interview with caregivers and/or questionnaire completed by parents, teachers, or clinicians.

• Time: PEDI takes approximately 45–60 minutes to administer; PEDI-CAT requires only 15–20 minutes thanks to adaptive scoring.

• Scoring: Raw scores are converted into standard scores and normative data, allowing comparison against typically developing peers.

• Interpretation: Scores reflect both the child’s actual ability and the level of support/modifications needed.

Reliability and validity

Research has demonstrated strong psychometric properties for both PEDI and PEDI-CAT:

• Reliability:

  • Test–retest reliability is high (ICC values often >0.90).

  • Inter-rater reliability is consistently strong across domains.

• Validity:

  • Strong correlations with other measures of functional performance and independence.

  • Validated across multiple diagnostic groups and cultural contexts.

• Responsiveness:

  • Sensitive to changes over time, making it highly valuable for intervention evaluation.

Clinical relevance

PEDI provides clinicians and researchers with a detailed overview of:

• What the child can do independently

• Where support is needed

• How assistive devices or environmental adaptations contribute to functioning

This allows for goal-directed therapy, progress monitoring, and clear communication with families, schools, and healthcare providers. PEDI-CAT further increases efficiency and accessibility, making it suitable for both routine clinical practice and large-scale research.

Sources:

1. Haley SM. Pediatric Evaluation of Disability Inventory (PEDI): Development, standardization and administration manual. Therapy Skill Builders; 1992.

2. Haley SM, Coster WJ, Kao YC, Dumas HM, Fragala-Pinkham MA, Kramer JM, Ludlow LH, Moed R. Lessons from use of the pediatric evaluation of disability inventory (pedi): Where do we go from here?. Pediatric physical therapy: the official publication of the Section on Pediatrics of the American Physical Therapy Association. 2010;22(1):69.

3. Haley SM, Coster WJ, Dumas HM, Fragala-Pinkham MA, Moed R. PEDI-CAT: development, standardization and administration manual. Boston: Boston University. 2012:648-57.

4. Kramer JM, Liljenquist K, Coster WJ. Validity, reliability, and usability of the Pediatric Evaluation of Disability Inventory‐Computer Adaptive Test for autism spectrum disorders. Developmental Medicine & Child Neurology. 2016 Mar;58(3):255-61.

5. Shore BJ, Allar BG, Miller PE, Matheney TH, Snyder BD, Fragala-Pinkham MA. Evaluating the discriminant validity of the pediatric evaluation of disability inventory: computer adaptive test in children with cerebral palsy. Physical therapy. 2017 Jun 1;97(6):669-76.