The Family and Disability Assessment System: Consistency and Accuracy of Judgments Across Coders and Measures

ABSTRACT Individuals with a neurological disability, such as epilepsy, traumatic brain injury (TBI), and multiple sclerosis (MS), and their families are likely to encounter a number of challenges in adjusting to the physical demands and psychosocial consequences of the medical condition. Recent studies on family adaptation to disability have suggested that there is a broad, reciprocal association between the interpersonal and emotional characteristics of persons with disabilities and family functioning. The current paper argues that research examining broad-based relationships among disability-related factors, family characteristics, and adjustment to disability is only a starting point in understanding how persons with disabilities, family members, and significant others in the community influence one another's behavior and perceptions. An alternative problem-specific framework, the Family and Disability Assessment System (FDAS), is presented that emphasizes the specific linkages between conditions operating in the family and community, and the concerns of individuals with neurological disabilities. Following a description of the model's theory and operations, the results of an initial reliability study involving 30 persons with epilepsy, TBI, and MS, and their families are presented. Moderately high levels of consistency and accuracy across trained coders were found for three of five FDAS measures; the remaining two measures fell below expected levels of intercoder agreement. Reasons for the mixed pattern of findings are proposed along with future directions for research.