Objectives: Examine the sensitivity of the FIM+FAM as a primary outcome measure for comprehensive day program services. Hypotheses: (1) FAM items will demonstrate low ceiling effects (below 33%) at day program admission; and (2) current day program admission FIM+FAM mean total score and ceiling effect will be lower than those reported by Hall et al1 at acute rehabilitation discharge. Participants:N = 111 clients with moderate to severe traumatic brain injury (TBI) (M age = 31.9; 72% male; 80% Caucasian; mean education = 12.8 years) who were admitted to comprehensive day program services within 9 months of injury. Methods: Retrospective clinical data were analyzed. FIM+FAM ceiling effects were defined as the proportion of clients with a 6 or 7 on each item and an average item rating of 6 or above on total scores (per Hall et al1). Results: Six FAM items were below the 33% threshold with community mobility (4%), employability (9%), and adjustment (12%) being the lowest. Only 3 FAM items had ceiling effects above 42%. Day program admission mean FIM+FAM score 146.3 (SD = 28.2) and 13% ceiling effect was lower than the acute rehabilitation discharge mean FIM+FAM score 165.1 (SD = 34.3) and 34% ceiling effect reported by Hall et al.1Conclusions: The FIM+FAM demonstrated score distributions that provide evidence of sensitivity in a day program setting. Lower scores and ceiling effects likely reflect shifting of service delivery from acute to day program settings. Future research should examine scale content using Item Response Theory.

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