The WG question sets have been carefully developed and tested and should be used without any changes to the wording of questions, order of questions, response categories, and cut-off points for classification of disability. Extensive testing and experience in a variety of contexts has demonstrated that making changes to the questions in an attempt to ‘improve’ them tends to have unforeseen consequences in terms of reducing accuracy. Using the questions as developed also allows for comparability of data across communities within countries or internationally among countries.
A possible exception to the ‘no change’ rule is if pre-testing highlights aspects of the questions that are not relevant or confusing in particular contexts. For example, in Bangladesh it was observed that hearing aids are for the most part non-existent. In this situation the removal of reference to the use of hearing aids in the hearing question was permitted. If in any doubt, it is best to contact the WG Secretariat and ask about the implications of any adaptations.
If additional information on functioning or health conditions is required, these questions should be added following the WG questions – not before. It is important to maintain the integrity of the WG questions.
The short intro to the question set was developed given the census context where questions cover many disparate areas. The introductory sentence ‘The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM’ was included as a way of transitioning from one section of the questionnaire to another. Programs may choose not to use this introductory sentence, but it is important to not replace this with a sentence that uses the term ‘disability’. The WG-SS has deliberately been developed to focus attention on functioning – using neutral language and does not use the term ‘disability’.
Reporting of results using the WG questions should clearly state how the questions were used, the age range of participants and the cut-off points used to determine disability status. To allow comparison of data cross-nationally, the WG recommends that those who respond to at least one of the six questions with a lot of difficulty or cannot do at all be considered as with disability.