The Disability Measurement Matrix

Barbara M. AltmanJennifer MadansElizabeth Rasch

Angela MeMargaret Mbogoni

Elena Palma

Orientation and ProcessMatrix as it evolved from first meeting of Washington City GroupInstructions and expectationsMeetings at the U.N.Resultant draft

Overview of Matrix PresentationsPart 1 – Explanation of the conceptual model

Barbara Altman

Overview of Matrix PresentationsPart 2 – An examination of the empirical reality in place now

Margaret Mbogoni & Malin SynnebornElizabeth RaschElena dePalma

Overview of Matrix PresentationsPart 3 – Using the matrix, identifying the gaps and other uses

Jennifer Madans

Matrix ObjectivesPut some order into the discussion of disability measurementHelp clarify the purpose of data collection in order to identify appropriate measuresUnderstand choices being made when time, expenses and respondent burden limit number of questions

Mapping the SpaceDisability measurement is multidimensional like the phenomena itself.Not every measure is appropriate for every purpose, nor is a single measure always sufficient.Objective of the The Disability Measurement Matrix is to develop a tool to guide the choice of measures appropriate to the purpose of the data collection.

Matrix Components3 major elements of basic matrix

Conceptual model – Work in progress, to be shared here

Actual examples – Work in progress, to be shared here

Ideal examples – Future project, for European meeting and beyond

Matrix ComponentsThe conceptual model is made up of three parts, A, B & C.Part A represents the variety of purposes for measurement . In graphic format it is represented by the Y axis.

Matrix ComponentsPart B represents the substantive aspects of the questions that enhance the understanding of the concept of disability. In graphic format it is represented by the X axis.Part C represents the characteristics of the questions that specify details about either the concept of disability or the format of the questions that can influence the data that is gathered. In graphic format it is represented by the Z axis.

Visualizing the Matrix Components

Part A-Purpose

Part B – ICF Domains

Part C - Characteristics

Part A – Y AxisData collection for a variety of purposes can be conceptualized at two levels of collectivity:

Individual - Data needs to reflect the differences as well as similarities between and among persons with disabilities. Data collected with a focus on its use relative to the individual.Population – Data reflects the aggregate level of measurement, detail is lost in an effort to reflect the nature of the group as a whole.

Part A – Y AxisWithin the two basic components the Y axis represents a variety of categories of purposes for which data may be collected including:

Equalization of OpportunityFinancial SupportNeeds AssessmentPreventionResearch and monitoring

Purposes at the Individual Level : Examples

Equalization of opportunity at the individual level is associated with providing access to services that will level the playing field for persons with limitations. Data provides information that will reflect needs of an individual or group of individuals.

Personal assistant services.Advocacy training.Access to legal services.

Population Level PurposesNeeds assessment at the population level provides information to assist with policy development and decisions about issues on a broader scale, such as:

Accessible transportationLocation and types of rehabilitationHousing units

Part B – X AxisIn the first section of the Measurement Matrix the elements of the X axis represent the components of the ICF as translated into measurement language or regularly used elements of disability measurement.

Environment elements represented by. Immediate physical world and social world measures. Assistive technology which provides accommodation.

Participation elements represented by. Involvement in social role activities such as those associated with

work, family and recreation. Participation implies taking on social roles.

Part B – X Axis (continued)

Activity limitations represented by Tasks or the substructure elements of role participation

Body and structure elements represented by Functional limitation measures that reflect abilities to

coordinate the body and structure to accomplish tasks

Impairments or pathology represented by indicators of conditions or residual damage to body structure.

Part C – Z AxisThe second table, Part C, contains the Z axis. Part B reflected characteristics of the individual and their situation. In Part C, most of the units are associated with characteristics of the question or further characteristics of the elements of Part B.

Duration of a circumstance.Number of categories included in the response choices.Specificity of items

Taking a Closer LookEach different Y-axis general purpose category is explained briefly.

Equalization of Opportunity – In the population context refers to the development of programs to improve life circumstances.

For each example of a purpose category, the relevance of each type of ICF category is briefly explained across the row.

Purpose of measurement to protect civil rights (see page 3) – 5 types of indicators are relevant for measurement.

Examining a Cell from Parts A and B

Participation

Financial Support

Major role participation is the concern here, can the person be self-supporting

Adding Part C to Parts A and B

Participation as related to Financial Support

Duration

How long has the work role limitation lasted?

Examining a Row – Parts A,B&CIdentifying the research question tracking the success of implementation of civil rights legislation

Part A - Equalization of Opportunity, Purpose 1 Part B – All categories of substantive measures are seen as contributing to information needed for policy formation and population trend monitoring

However, impairment if the only type of measure referred to in the legislation itself

Part C – Severity level is a characteristic of the measure to consider. For financial support is becomes an essential element, but for a civil rights measure, is it?

Culturally Relevant SubheadingsPopulation Data How Internationally

Compatible are Concepts?

Needs Assessment Purposes

Generally an internationally compatible purpose

Transportation The examples provided here are based on the U.S.

Nursing Home Beds How relevant are they elsewhere?

Translating the Matrix into an International Tool

Are the generalized purpose categories (Y-axis) universal?

What can be added?Should we limit the matrix to the population aspects for international purposes?

What concepts or characteristics (X-axis) do we want to include? Are some aspects of the ICF unsuitable for survey use or for international use?Are there international differences that would impact on question formats or characteristics.

Looking Toward the FutureDo we want to identify 1-2 purposes that a general measure can satisfy?Do we want to identify the questions we have, from all sources, that address those 1-2 purposes and select those that appear most promising?What other steps can we take to narrow this search?