Needs Assessment Checklist (NAC)

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Tool Description:

The Needs Assessment Checklist (NAC) is an interview-based assessment, measuring patient perception of independence in a range of tasks from 9 SCI-specific rehabilitation domains: activities of daily living (ADL, 29 items), skin management (14 items), bladder management (10), bowel management (7), mobility (17), wheelchair and equipment (33), community preparation (24), discharge coordination (32) and psychological issues (19).


Available for free here:

ICF Domain:

Activities; Subcategory: Self Care

Number of Items:

199 Items

Brief Instructions for Administration and Scoring:

Scores are derived by summing sub-scale items; a “percentage achieved” is also calculated for each of the 9 sub-scale’s ranging from 0-100% with higher scores indicating greater independence.


MCID: not established for SCI
SEM: not established for SCI
MDC: not established for SCI



Measurement Property Summary:

# of studies reporting psychometric properties: 2


  • Test-retest reliability of the COPM is Low to High overall (alpha=0.8238) and for the subscales (alpha=0.694-0.904).
  • Internal consistency of the COPM is Low to High overall (alpha=0.83) and for the subscales (alpha=0.6729-0.9467).

[Kennedy et al. 2003, Barry and Kennedy 2002]


  • There is High correlation between the NAC ADL with SCIM-II (r = 0.873), the NAC Bladder & Bowel with SCIM-II (r = 0.754), and the NAC Mobility with SCIM-II (r = 0.696)
  • There is High correlation between the NAC psychological issues (mood subsection) with HADS (r = -0.726)
  • There is Moderate to High correlation between the NAC psychological issues (full subscale) with HADS (r = -0.523)

[Barry and Kennedy 2002]


Not established in SCI.

Floor/ceiling effect:

Not established in SCI.


Dr. Janice Eng, John Zhu, Bryce Jay

Date Last Updated:

August 3, 2020

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Equipment Needed

Berry C, Kennedy P. A psychometric analysis of the Needs Assessment Checklist (NAC). Spinal Cord. 2003;41(9):490-501.

Kennedy P, Evans MJ, Berry C, Mullin J. Comparative analysis of goal achievement during rehabilitation for older and younger adults with spinal cord injury. Spinal Cord. 2003;41(1):44-52.