Development of a Brief Instrument To Measure Independence of People with Head Injuries


More people with serious head injuries are surviving today because of emergency care advances. Instruments to determine the independence functioning levels of person with head injuries have mostly been tested with people with mental retardation and had narrow focus.

Purpose and Anticipated Benefits

The development of a brief, easy-to-use instrument to measure independence of people with head injuries to assist in their return to the community might be used as a way to determine eligibility for a waiver for people with head injuries in Kansas.


Vincent Adkins, Research and Training Center on Independent Living at the University of Kansas, worked with Community Works, Inc., in Kansas City, a clinical psychologist, and Topeka, Kansas, conference participants to identify 50 people diagnosed with head injuries and 50 people who were spouses, case workers, or clinical psychologists who would speak about the supervisory needs of the person with head injury. John Youngbauer, North Los Angeles County Regional Center, and Mark Mathews, University of Kansas, also were part of the research team.




Administering three instruments—the Supervision Rating Scale, the Personal Independence Profile, and the Home and Community Based Service/Head Injury—Adkins developed a six-part instrument that used several independence items. He also interviewed participants. To measure reliability, Cronbach’s alpha was calculated.


Correlated items were pooled to form the Brief Functional Independence Inventory, which proved to have high consistent internal reliability. Questions on the measure were:

  1. Is the person with head injury able to defend him or herself against unwanted sexual advances or physical abuse?
  2. Is the person with head injury able to perceive or judge other people’s motives, especially the motives of those persons who might take sexual or financial advantage of the person?
  3. If the person with head injury had to take his or her own medicine, could he or she take the medicine? A. With help (in the right doses at the right time) B. With some help (able to take medicine if someone prepares it for him or her or reminds him or her to take it).
  4. If the person with head injury had a kitchen, could he or she prepare own meals? A. Without help (plan his or her own meals) B. With some help (can prepare some things but unable to cook full meals by self) C. Completely unable to prepare any meals
  5. If the person had necessary transportation, could he or she go shopping for groceries or clothes? A. Without help (taking care of all shopping needs for self). B. With some help (needs someone to go with him or her to help on all shopping trips). C. Completely unable to do any shopping.
  6. How much help does the person with head injury need in getting dressed? A. No help at all. B. Only needs help in tying shoes C. Needs help getting dressed


The Brief Functional Independence Inventory’s brevity can quickly rule out potential hazards to the people with head injury and better capture distinction in supervisory needs.


Brief Functional Independence Inventory, plus:

Adkins, V. K., Youngbauer, J., & Mathews, R. M. (2000). Validation of a brief instrument to measure independence of persons with head injury. Journal of Rehabilitation, 66(3), 51-55.