Purpose
A generic instrument that measures health and disability in six life domains across cultures using a standardized method.
Link to Instrument
Area of Assessment
CognitionBodily Functions
Activities & Participation
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A generic instrument that measures health and disability in six life domains across cultures using a standardized method.
36
20 minutes
5 to 20 minutes
Adolescent
13 - 17
yearsAdult
18 - 64
yearsInitially reviewed in 2018 by University of Illinois at Chicago Master of Science in Occupational Therapy students Michelle Dominguez, OTS; Claudia Sanchez-Ayala, OTS; Vivian Villegas, OTS.
Interviewer, proxy, and self-administered versions available.
WHODAS 2.0 does not assess environmental factors enabling/inhibiting activity and participation.
Rheumatoid Arthritis: (Meesters et al., 2009; n = 85; mean age = 61.0 years; mean duration of RA = 6.0 years; female = 77%; scores after inpatient and day-patient therapy by trained multidisciplinary team; Netherlands sample)
Median score at baseline: 40.5
Rheumatoid Arthritis: (Meesters et al., 2009)
Excellent internal consistency (Cronbach¡¯s alpha = 0.91)
Convergent validity:
Rheumatoid Arthritis: (Meesters et al., 2009)
Adequate: HAQ, stair test, grip strength, D-AIMS2, DAS-28, VAS-Pain, and RAQoL (Pearson rank correlation coefficients = 0.50, 0.39, 0.29, 0.53, 0.28, 0.42, 0.52)
Poor: 50-feet walk test, timed-stands test, and Escola Paulista de Medicina Range of Motion scale (Pearson rank correlation coefficients = 0.22, 0.20, 0.19)
Rheumatoid Arthritis: (Meesters et al., 2009)
Adequate floor effect of 17% for subscale ¡°understanding and communicating¡±
Adequate floor effect of 18% for subscale ¡°getting along with people¡±
Adequate floor effect of 14% for subscale ¡°self-care¡±
Rheumatoid Arthritis: (Meesters et al., 2009)
High: ¡°getting around¡± and ¡°participation in society¡± (RR = 0.84, 0.80)
Moderate: WHODAS 2.0 total score, ¡°understanding and communicating¡±, ¡°self-care¡±, ¡°life activities¡± (RR = 0.58, 0.56, 0.58, 0.48)
Low: ¡°getting along with people¡± (RR = 0.04)
Schizophrenia: (Guilera et al., 2012; n = 352; mean age = 36.7; mean average duration of illness = 140.65 months; diagnoses include schizophrenia, schizoaffective disorder and schizophreniform disorder; Spanish sample)
Excellent test-retest reliability: (ICC = 0.92). Subscale range = 0.63-0.88
Trauma: (Abedzadeh-kalahroudi, 2015; n = 220; mean age = 34.7; mean time post trauma = at least 24 hours; mean GCS score = 12.7; Persian)
Excellent interrater reliability: (ICC = 0.99)
Trauma: (Abedzadeh-kalahroudi, 2015)
Acceptable to Excellent: Cronbach¡¯s alpha = 0.51-0.87 (only 3/12 items had an alpha value < 0.68)
Schizophrenia (Guilera et al., 2012)
Excellent: Cronbach¡¯s alpha = 0.94)
Normative Sample: (Haley et al., 1992; n = 412)
Excellent: Cronbach's alpha range from 0.95-0.99
Schizophrenia (Guilera et al., 2012)
Low/Moderate to High correlation with the Positive and Negative Syndrome Scale (PANSS-G) and the Hamilton Depression Rating Scale (HAM-D)
Trauma: (Abedzadeh-kalahroudi et al., 2015)
Items representing the activity domain have a very strong mean Spearman¡¯s rank coefficient (rho = .81). The range for these items is 0.67 - 0.93)
Items representing the participation domain have a strong mean Spearman¡¯s rank coefficient (rho = .76). The range for these items is 0.50 - 0.92)
Schizophrenia (Guilera et al., 2012)
All indicators are relevant for defining the corresponding domains (cognition, mobility, self-care, getting along, life activities and participation).
Schizophrenia (Guilera et al., 2012).
Strong floor effects
Strong ceiling effects, with more than 60% of participants obtaining the best score on sub scales of ¡°getting around¡± and ¡°self-care¡±
Spinal Cord Injury: (De Wolf et al., 2012; n = 63; mean age = 34.7 years; studied at 2 years post discharge from inpatient unit; male = 81%; ASIA Impairment Scale: A = 59%, B = 6%, C = 6%, D = 29%; Australian sample)
Excellent internal consistency for WHODAS 2.0 Total Score (Cronbach¡¯s alpha = 0.95)
Excellent internal consistency for following domains: ¡°understanding and communicating¡±, ¡°self-care¡±, ¡°life activities¡±, and ¡°participation¡± (Cronbach¡¯s alpha = 0.93, 0.94, 0.96, 0.97)
Adequate internal consistency for ¡°getting along with others¡± domain (Cronbach¡¯s alpha = 0.73)
Poor internal consistency for ¡°getting around¡± domain (Cronbach¡¯s alpha = 0.61)
Discriminant validity:
Spinal Cord Injury: (De Wolf et al., 2012)
Excellent discriminant validity for WHODAS 2.0 Total Score (Mann-Whitney U = 2.02)
Excellent discriminant validity for following domains: ¡°getting around¡±, ¡°self-care¡±, and ¡°life activities¡± (Mann-Whitney U = 2.79, 4.90, 1.89)
Spinal Cord Injury: (De Wolf et al., 2012)
Adequate ceiling effect of following domains: ¡°getting along with others¡± and ¡°life activities¡± (Ceiling Effects % = 19, 16)
Poor ceiling effect of following domains: ¡°understanding and communicating¡± and ¡°self-care¡± (Ceiling Effects % = 54, 29)
Stroke: (Schlote et al., 2008, n = 84; mean age = 56; diagnoses include: ischemic and hemorrhagic strokes)
Satisfactory to Excellent Interrater Reliability (ICC= 0.64*-0.94)
*Understanding and Communication and Total Score
Stroke: (K¨¹?¨¹kdeveci et al., 2013; n = 188; mean age = 61; time since stroke: min = 3 months, median = 27 months, and max = 240 months)
Stroke: (Schlote et al., 2008)
Stroke: (Schlote et al., 2008)
Items representing the different domains of the assessment have varying Spearman¡¯s Rank coefficients ranging from low to strong: (0.31-0.83)
Low to moderate correlation with ratings for understanding and communicating (rho = 0.44-0.56).
Moderate to strong correlation with rating for getting around (rho = 0.60-0.75).
Moderate to strong correlations with rating for self-care (rho = 0.62-0.83)
Moderate correlation with ratings for getting along with people (rho = 0.43-0.58).
Moderate to strong correlation with ratings for life activities (rho = 0.64-0.78).
Low to moderate correlation with ratings for participation in society (rho = 0.31-0.59).
Moderate correlation with ratings for single items (rho = 0.49-0.58)
Abedzadeh¨Ckalahroudi, M., Razi, E., Sehat, M., & Asadi-Lari, M. (2016). Psychometric properties of the World Health Organization Disability Assessment Schedule II-12 Item (WHODAS II) in trauma patients. Injury, 47(5), 1104-1108.
De Wolf, A. C., Tate, R. L., Lannin, N. A., Middleton, J., Lane-Brown, A., & Cameron, I. D. (2012). The World Health Organization Disability Assessment Scale, WHODAS II: Reliability and validity in the measurement of activity and participation in a spinal cord injury population. Journal of Rehabilitation Medicine, 44(9), 747-755.
Guilera, G., G¨®mez-Benito, J., Pino, O., Rojo, J. E., Cuesta, M. J., Mart¨ªnez-Ar¨¢n, A., ... & Crespo-Facorro, B. (2012). Utility of the World Health Organization Disability Assessment Schedule II in schizophrenia. Schizophrenia Ðǿմ«Ã½ÊÓÆµ, 138(2), 240-247.
K¨¹?¨¹kdeveci, A. A., Kutlay, ?., Y?ld?zlar, D., ?ztuna, D., Elhan, A. H., & Tennant, A. (2013). The reliability and validity of the World Health Organization Disability Assessment Schedule (WHODAS-II) in stroke. Disability and Rehabilitation, 35(3), 214-220.
Meesters, J. J., Verhoef, J., Liem, I. S., Putter, H., & Vliet Vlieland, T. P. (2009). Validity and responsiveness of the World Health Organization Disability Assessment Schedule II to assess disability in rheumatoid arthritis patients. Rheumatology, 49(2), 326-333.
Schlote, A., Richter, M., Wunderlich, M. T., Poppendick, U., M?ller, C., Schwelm, K., & Wallesch, C. W. (2009). WHODAS II with people after stroke and their relatives. Disability and Rehabilitation, 31(11), 855-864.
World Health Organization. (2017, September 4). WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Retrieved from
World Health Organization. (2010). Measuring health and disability. Manual for WHO disability assessment scale. Whodas 2.0. [assessment manual]. Retrieved from
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.