Assessment of Life Habits — Comprehensive Participation in Daily and Social Roles

WHODAS 2.0 is a quick (10–15 min) self-report questionnaire measuring functional limitation (difficulty with tasks). LIFE-H is a 60–90 minute trained-assessor interview measuring actual participation in life habits. WHODAS is designed for broad epidemiological use and is universal; LIFE-H is more detailed and designed for in-depth rehabilitation assessment. WHODAS uses fixed items; LIFE-H is flexible/semi-structured. In clinical rehabilitation, both are valuable: WHODAS for rapid outcome tracking, LIFE-H for comprehensive goal-setting.

Telephone administration by trained assessor is feasible but requires experienced interviewer to probe adequately without visual cues. Self-report questionnaire versions exist but are not as extensively validated as the interview. For high-fidelity assessment, in-person interview is preferred. Shorter modular versions are under development to reduce time burden.

Approximately 1–2 points on the 0–9 participation scale per domain is clinically meaningful (representing move from 'major difficulty' to 'moderate difficulty,' for example). Across domains, a mean change of >1 point is substantial. Time frame matters: 3–6 months may show greater change; 1 month may show minimal. Use change +domain profile (which improved, which remained stable) to interpret.

LIFE-H is not ideal for acute phase (0–4 weeks) when daily patterns are disrupted and person is still hospitalized. It is most valid in chronic/community phase (6+ weeks) when routines have begun to stabilize. However, LIFE-H can be used pre-injury (caregiver recall of pre-injury habits) as a baseline for comparison with post-injury outcomes.

Score based on current participation, not pre-injury baseline. If someone did not work pre-injury (retired, student), their current Work score reflects their current situation. If their pre-injury participation was very different, document that in narrative notes and use relative change as outcome (e.g., 'Returned to 75% of pre-injury community participation level').

All 11 domains are part of the full LIFE-H. If time is limited, some assessors score only priority domains (e.g., Work + Recreation for employed young adult, Personal care + Nutrition + Housing for older adult with ADL focus), but this reduces comprehensiveness. Shorter modular versions are in development; consult the developers for validated brief versions.

Yes, LIFE-H is in the public domain and may be used without license fees. Assessor training (available through CRIR or certified trainers) is highly recommended but not legally required. Training typically 1–2 days of workshops. Always cite the original Fougeyrollas & Noreau (2002) source.

Proxy interviews can be conducted (caregiver or clinician observes and reports on the person's participation), but self-report is preferred when cognitively capable. Proxy-self agreement is moderate (r 0.60–0.75) depending on domain; caregivers may overestimate or underestimate based on their exposure. Always note whether score is self or proxy.