World Health Organization Disability Assessment Schedule (WHODAS 2.0) - 12-item Version

What is the WHODAS 2.0 (12-item Version)?

The World Health Organization Disability Assessment Schedule, or WHODAS 2.0 for short, is an assessment that comes in the form of a self-report questionnaire designed by WHO specifically to gauge a person’s potential level of disability and/or functional impairment. It does so by asking questions about the different aspects of a person’s life, mainly their mobility, cognition, social life, and even self-care.

There are two versions of WHODAS 2.0: the long version and the short version. The long version has thirty-six items, while the short version has only twelve. The long version zooms in on the same aspects of a person’s life mentioned earlier, but it asks more questions per aspect. You will still assess the same things whether you use the long or the short version.

Both versions are widely used, especially in clinical settings (which is what this guide is for), to give general, standardized assessments of patients and the possible level of disability and/or functional impairment that they have based on the past thirty days prior to answering the self-report surveys. The results will help healthcare professionals determine next steps regarding the patient. Do they endorse patients for further examinations? Do they draft treatment plans? Those two questions can be answered after receiving fully accomplished WHODAS surveys.

For this particular guide, we will be focusing on the twelve-item version of the World Health Organization Disability Assessment Schedule.

Check out this video for a demonstration of how to administer the WHODAS 2.0

What is the WHODAS 2.0 (12-item Version)?

The World Health Organization Disability Assessment Schedule, or WHODAS 2.0 for short, is an assessment that comes in the form of a self-report questionnaire designed by WHO specifically to gauge a person’s potential level of disability and/or functional impairment. It does so by asking questions about the different aspects of a person’s life, mainly their mobility, cognition, social life, and even self-care.

There are two versions of WHODAS 2.0: the long version and the short version. The long version has thirty-six items, while the short version has only twelve. The long version zooms in on the same aspects of a person’s life mentioned earlier, but it asks more questions per aspect. You will still assess the same things whether you use the long or the short version.

Both versions are widely used, especially in clinical settings (which is what this guide is for), to give general, standardized assessments of patients and the possible level of disability and/or functional impairment that they have based on the past thirty days prior to answering the self-report surveys. The results will help healthcare professionals determine next steps regarding the patient. Do they endorse patients for further examinations? Do they draft treatment plans? Those two questions can be answered after receiving fully accomplished WHODAS surveys.

For this particular guide, we will be focusing on the twelve-item version of the World Health Organization Disability Assessment Schedule.

How to use the WHODAS 2.0 (12-item Version)

The WHODAS 2.0, in both its forms, is relatively easy to accomplish, especially the version that we are discussing, which has twelve items. The healthcare professional simply needs to issue this to the patient they are handling. All the patient needs to do is answer the following questions based on how much difficulty they have had for the past thirty days:

1. Standing for long periods such as 30 minutes?

2. Taking care of your household responsibilities?

3. Learning a new task, for example, learning how to get to a new place?

4. How much of a problem did you have joining in community activities (for example, festivities, religious or other activities) in the same way as anyone else can?

5. How much have you been emotionally affected by your health problems?

6. Concentrating on doing something for ten minutes?

7. Walking a long distance such as a kilometer [or equivalent]?

8. Washing your whole body?

9. Getting dressed?

10. Dealing with people you do not know?

11. Maintaining a friendship?

12. Your day-to-day work?

The answer choices for all questions are already set, so patients simply need to select between five choices, which are arranged by severity from left to right:

• None
• Mild
• Moderate
• Severe
• Extreme or cannot do

There are also three questions at the end that they must answer:

1. Overall, in the past 30 days, how many days were these difficulties present?

2. In the past 30 days, for how many days were you totally unable to carry out your usual activities or work because of any health condition?

3. In the past 30 days, not counting the days that you were totally unable, for how many days did you cut back or reduce your usual activities or work because of any health condition?

To answer these, they just indicate the number of days they think applies to them based on these questions.

How to score the WHODAS 2.0 (12-item Version)

Once you receive your patients' fully-accomplished copies of WHODAS 2.0, it’s time to start scoring them. You don’t need to do any guesswork as to what scores the patients are supposed to get since there are assigned scores for each answer choice:

• None = 1
• Mild = 2
• Moderate = 3
• Severe = 4
• Extreme or cannot do = 5

The first thing you need to do is to calculate the sum of all items. The lowest score that a patient can get is 12, while the highest is 60.

Once you have calculated the total score, follow this equation: SUM OF ALL SCORES / 12 = AVERAGE GENERAL DISABILITY SCORE.

Here is an example: 43 / 12 = 3.58.

To help you interpret the average general disability score, just refer to these designations:

• 1 = None
• 2 = Mild
• 3 = Moderate
• 4 = Severe
• 5 = Extreme

Since the example has a score of 3.58, they still fall under moderate, however, they are pretty close to having a severe case. Make sure to take the in-betweens into account.

The following steps should be based on the results of the questionnaires. You must refer to both the score and the items. These should help you decide how to conduct further assessments to dive into the specifics of the different aspects of patient's lives.

Now, if you’re wondering about the last three questions of the questionnaire, they are not part of the scoring. However, the number of days they indicate may be valuable information when creating the groundwork for your treatment plans. These can be used as discussion points as well during appointments.

When is it best to use the WHODAS 2.0 (12-item version)?

Since this mini-guide is for healthcare professionals, the best time for them to use the WHODAS 2.0 (12-item version) is during initial appointments with patients, which are the times when professionals are still gauging their patients' conditions.

Given that this self-report assessment is a general questionnaire, the answers can provide the professional with the information necessary to conduct further investigations. Let’s say you receive a fully-accomplished questionnaire from one of your patients, who got an average general disability score of 3.

While you can base your next steps on that score, it’s also best to look at each item. What if questions 8 and 9 both scored 5? That’s an indication of them having trouble performing self-care and Activities of Daily Living (ADLs). You might want to conduct further assessments around these and endorse them to specialists if needed.

Do note that both versions of the WHODAS 2.0 should not be used as diagnostic tools. They are merely for screening the patient and gauging their possible level of disability or functional impairment. It’s always best that the next step you take is conducting more comprehensive examinations involving numerous other assessments or endorsing them to certain specialists depending on their answers.

Who can use the WHODAS 2.0 (12-item Version) for their work?

Given that the World Health Organization Disability Assessment Schedule zooms in on different aspects of a person’s life, a wide range of healthcare professionals can use this, such as:

• (Primary Care) Physicians
• (Clinical) Psychologists
• Psychiatrists
• Counselors
• Physical Therapists
• Mental Health Therapists
• Occupational Therapists
• Nurses

So long as healthcare professionals are highly trained and experienced in the respective fields that the questionnaire covers, they can definitely issue the WHODAS 2.0 to their patients and interpret their results. It’s even better if a wider team composed of various professionals focusing on different fields is handling a specific patient.

Let’s say the patient scored really high, and the glaring parts of the questionnaire are related to self-care, physical capabilities, and emotions. Then physical therapists and psychologists of the team can use this to set the groundwork for further examination and develop appropriate care plans.

This will always depend on the purpose of why the WHODAS 2.0 is being used and what the patient’s specific problems are based on what they find to be difficult or impossible.

What are the benefits of using the WHODAS 2.0 (12-item Version)?

It takes into account what the patient thinks.

Rather than being an objective way to look at a patient, the WHODAS 2.0 provides patients with options based on what they think best applies to them. This helps healthcare professionals determine what other assessments should be issued to them and what goes into their treatment plan. Everything that follows post-WHODAS 2.0 will be tailor-fitted to the patient.

It’s an inexpensive tool to use.

The WHODAS 2.0 does not require any special equipment. You simply need to hand it out while the patient needs to answer it. Not only that, given the length of the 12-item version, it can be accomplished really quickly. It shouldn’t take more than ten minutes to complete.

Results can be calculated as soon as it’s submitted back to you, and you should be able to determine the next steps immediately based on their score and answers.

It can be used as a monitoring tool.

While we mentioned earlier that the WHODAS 2.0 is best used during the initial stages of handling a patient, which is the getting-to-know-the-patient stages, the use of this assessment doesn’t necessarily have to be a one-time, big-time thing. You can choose to reissue this assessment as a way to monitor a patient’s progress!

Let’s say that you and your team have conducted a comprehensive examination of a patient, diagnosed them, and developed and implemented a treatment plan that covers several bases. Naturally, you’ll want to know how the patient is doing after a certain amount of time has passed. You can use this tool again to see if they are improving! In turn, you will also be able to determine if your team’s treatment plan needs to be maintained or adjusted.