Craig Handicap Assessment and Reporting Technique -- “CHART”
In the late 1980s, Craig Hospital developed a survey to measure Societal Participation or Community Integration. What are these concepts? Basically, they are two terms that deal with the same thing: how well people with disabilities are able to function as members of their households, participants in their communities, and citizens of their world. People who have limitations in these areas, are said to be handicapped (old terminology), or they have restrictions in their societal participation (new terminology). These concepts go beyond mere physical independence; they go beyond activities of daily living and ambulation or pushing a wheelchair. Two people with very similar disabilities who even complete the same rehabilitation program can still be very different in how they function. They can differ not only in how independent they are, but also in how successful they are in such things as building relationships with others, making and keeping friends, finding and keeping a job, moving about their communities, being productive, and supporting themselves. In short, even if they have the same disabilities, one may participate more than the other.
Craig Handicap Assessment and Reporting Technique -- “CHART” -- is designed to measure these concepts. It is designed to measure how well people with disabilities are active, productive members of society, well integrated in family and community life. On an individual level, CHART is able to show how one’s disability does – or does not – affect his or her participation in society. On a wider level, it can compare the participation levels of groups of people, and it can be used to measure how effective rehabilitation and other social programs are at reaching the most important goal: involving people with disabilities in their communities.
The CHART survey measures six separate areas of societal participation:
- Cognitive Independence
- Physical Independence
- Social Integration
- Economic Self-Sufficiency.
Each is scored on a one-hundred point scale, and has been standardized against people without disabilities living in the community. The original long version of CHART contains 32 questions, while a short form has 19 questions. Both forms are now used at Craig Hospital, by the US government-funded Spinal Cord Model Systems programs, and by other researchers throughout the world. In fact, CHART has been translated into Spanish, Japanese, Chinese, Korean, Italian and several other languages.
CHART has been studied and evaluated extensively, and has been found to be valid and reliable. If you would like more information about CHART and its developmental process, if you would like to see a copy of the instrument and learn how it is scored, and/or if you are a researcher interested in CHART and its psychometric properties, please go to CHART Manual.
The Craig Hospital Inventory of Environmental Factors (CHIEF)
The Craig Hospital Inventory of Environmental Factors (CHIEF) and its Short Form (CHIEF-SF) were designed to measure those things that keep a person from doing what he or she needs to do. It is well known that the type and severity of a disability can affect what an individual is able to accomplish. So can things like health, weight, education, and motivation. But, there are also factors that are beyond the person that can have a very great impact too – factors like the physical surroundings and accessibility, attitudes and support of others, resources that are available, rules and regulations of organizations, and even government policies. CHIEF is one of the first forms designed to look at these environmental factors and how they can affect people with disabilities.
Both CHIEF forms ask questions designed to track the frequency (how often are they encountered?) and magnitude (how severe are they?) of each potential environmental barrier. For each question, the frequency score is multiplied by the severity score to give a total. These totals are then averaged over all of the CHIEF question to give a Total CHIEF score. These two measures were designed to be used in large surveys, and are equally useful for both individuals with and without disabilities. The information collected in these surveys can be used to understand how the type of disability may or may not affect the type of environmental barriers that are encountered, what kind of barriers are most common in a particular community, and which are most problematic. Ultimately, this information might help policy makers to make the changes needed to minimize the effect of barriers on all people. In fact, Craig researchers used the CHIEF and a CHIEF Follow-up Questionnaire to interview 330 Colorado residents, (55% with disabilities and 44% without disabilities). These 330 people identified 1085 specific examples of environmental barriers. For both people with disabilities and those without disabilities, the number one barrier was weather – both hot and cold temperatures and snow, sleet, and ice. The second most common barrier reported by both those with disabilities and those without disabilities was lack of support by family.
The CHIEF has been translated into other languages and is being used in countries around the world. For a copy of the CHIEF survey, or for more information about the CHIEF, how it was developed, and how to administer and score it, please go to CHIEF Manual.