Implications of the International Classification of Functioning, Disability and Health (ICF) for Test Development and Use

ERIC Educational Resources Information Center

Carlson, Janet F.; Benson, Nicholas; Oakland, Thomas

2010-01-01

Implications of the International Classification of Functioning, Disability and Health (ICF) on the development and use of tests in school settings are enumerated. We predict increased demand for behavioural assessments that consider a person's activities, participation and person-environment interactions, including measures that: (a) address…

Utility of the International Classification of Functioning, Disability and Health (ICF) for Educational Psychologists' Work

ERIC Educational Resources Information Center

Aljunied, Mariam; Frederickson, Norah

2014-01-01

Despite embracing a bio-psycho-social perspective, the World Health Organization's International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists' work with…

The Use of the International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY), in Portuguese Special Education Assessment and Eligibility Procedures: The Professionals' Perceptions

ERIC Educational Resources Information Center

Sanches-Ferreira, Manuela; Silveira-Maia, Mónica; Alves, Sílvia

2014-01-01

Portugal was the first country decreeing the mandatory use of the International Classification of Functioning, Disability and Health: Child and Youth (ICF-CY) framework for guiding special education assessment process and to base eligibility decision-making on students' functioning profiles--in contrast with traditional approaches centred on…

ICF-CY: A Universal Tool for Documentation of Disability

ERIC Educational Resources Information Center

Simeonsson, Rune J.

2009-01-01

The "International Classification of Functioning, Disability and Health--ICF" (ICF-CY) conceptual framework offers a new paradigm and taxonomy of human functioning disability, which can be used to guide holistic and interdisciplinary approaches to assessment and intervention. In settings serving children, youth, or adults with disabilities, the…

Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children with Language Impairments

ERIC Educational Resources Information Center

Westby, Carol; Washington, Karla N.

2017-01-01

Purpose: The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment. Method: This tutorial reviews the framework of the ICF, describes the implications of the ICF…

Internet Use in Aphasia: A Case Study Viewed through the International Classification of Functioning, Disability, and Health

ERIC Educational Resources Information Center

Menger, Fion; Morris, Julie; Salis, Christos

2017-01-01

Purpose: This article uses an illustrative case example to discuss a means of producing a holistic profile of Internet use for individuals with aphasia. Methods: The authors used the International Classification of Functioning, Disability, and Health as a framework to select novel and existing assessments to explore the Internet use and skills of…

Perceived functioning and disability in adults with myotonic dystrophy type 1: a survey according to the International Classification Of Functioning, Disability and Health.

PubMed

Kierkegaard, Marie; Harms-Ringdahl, Karin; Widén Holmqvist, Lotta; Tollbäck, Anna

2009-06-01

The purpose of this study was to describe and analyse self-rated perceived functioning, disability and environmental facilitators/barriers with regard to disease severity, using the International Classification of Functioning, Disability and Health (ICF) checklist, in adults with myotonic dystrophy type 1. Cross-sectional design. Forty-one women and 29 men with myotonic dystrophy type 1. A modified ICF checklist was used for self-rating of perceived problems in 29 body-function categories, difficulties in 52 activity and participation categories, and facilitators/barriers in 23 environmental-factor categories according to the verbal anchors of the ICF qualifiers. Disease severity classification was based on the muscular impairment rating scale. Of the persons with myotonic dystrophy type 1, 80% perceived problems of excessive daytime sleepiness, 76% of muscle power, and 66% of energy and drive functions, while over 59% perceived difficulties in physically demanding mobility activities. Disabilities in mobility, self-care and domestic life were more frequently reported by persons with severe disease. Support from the immediate family, medicines and social security services were perceived as facilitators for 50-60% of the participants. Disabilities and important environmental facilitators in adults with myotonic dystrophy type 1 were identified, and this clinically-relevant information can be used for developing health services for people with this condition.

How the Use of the International Classification of Functioning, Disability and Health for Children and Youth Changed the Individualized Education Programs in Portugal

ERIC Educational Resources Information Center

Silveira-Maia, Mónica; Lopes-dos-Santos, Pedro; Sanches-Ferreira, Manuela

2017-01-01

Current Portuguese Public Law No. 3/2008 requires the use of the International Classification of Functioning, Health and Disability for Children and Youth (ICF-CY) as a reference framework to guide assessment and intervention procedures for students with additional support needs. This study explores whether the ICF-CY use fostered multidimensional…

Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.

PubMed

Thyberg, Mikael; Arvidsson, Patrik; Thyberg, Ingrid; Nordenfelt, Lennart

2015-01-01

To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs. The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation. Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices. Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF. The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

Examining the Disability Model From the International Classification of Functioning, Disability, and Health Using a Large Data Set of Community-Dwelling Malaysian Older Adults

PubMed Central

Loke, Seng Cheong; Lim, Wee Shiong; Someya, Yoshiko; Hamid, Tengku A.; Nudin, Siti S. H.

2015-01-01

Objective: This study examines the International Classification of Functioning, Disability, and Health model (ICF) using a data set of 2,563 community-dwelling elderly with disease-independent measures of mobility, physical activity, and social networking, to represent ICF constructs. Method: The relationship between chronic disease and disability (independent and dependent variables) was examined using logistic regression. To demonstrate variability in activity performance with functional impairment, graphing was used. The relationship between functional impairment, activity performance, and social participation was examined graphically and using ANOVA. The impact of cognitive deficits was quantified through stratifying by dementia. Results: Disability is strongly related to chronic disease (Wald 25.5, p < .001), functional impairment with activity performance (F = 34.2, p < .001), and social participation (F= 43.6, p < .001). With good function, there is considerable variability in activity performance (inter-quartile range [IQR] = 2.00), but diminishes with high impairment (IQR = 0.00) especially with cognitive deficits. Discussion: Environment modification benefits those with moderate functional impairment, but not with higher grades of functional loss. PMID:26472747

Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

ERIC Educational Resources Information Center

Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

2017-01-01

Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

Measurement of Environmental Constructs in Disability Assessment Instruments

ERIC Educational Resources Information Center

Guscia, Roma; Ekberg, Stuart; Harries, Julia; Kirby, Neil

2006-01-01

The International Classification of Functioning, Disability and Health (ICF) assumes a biopsychosocial basis for disability and provides a framework for understanding how environmental factors contribute to the experience of disability. To determine the utility of prevalent disability assessment instruments, the authors examined the extent to…

The Importance of Motor Functional Levels from the Activity Limitation Perspective of ICF in Children with Cerebral Palsy

ERIC Educational Resources Information Center

Mutlu, Akmer

2010-01-01

Our purpose in this study was to evaluate performance and capacity as defined by Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) from the "activity limitation" perspective of International Classification of Functioning, Disability, and Health (ICF) and to investigate the relationship between the…

A content analysis of peripheral arterial disease patient-reported outcome measures using the International Classification of Functioning, Disability and Health.

PubMed

Osborne, Candice Lee; Kauvar, David Seth

2017-10-17

The purpose of this study was to link, classify and describe the content of peripheral arterial disease (PAD)-specific patient-reported outcome measures using the International Classification of Functioning. The results were then analyzed to determine if these assessments provide clinicians and researchers with a comprehensive understanding of the lived experience of patients with PAD. Each meaningful concept in identified PAD assessments was linked to the International Classification of Functioning, Disability and Health to determine included and excluded content areas. An overall perspective was assigned to each assessment item. Inter-rater reliability was established using a kappa statistic. The body functions component is most frequently addressed overall followed by the activities and participation component. International Classification of Functioning chapter and category distribution vary greatly between assessments and no assessment comprehensively examines community participation and relationships. The majority of the assessment items are of the health status-disability and quality of life perspectives. The results of this study suggest the need for the development of a comprehensive PAD assessment that includes a more even distribution of International Classification of Functioning topics and subtopics. A more comprehensive assessment would better capture the lived experience of this patient population. Implications for Rehabilitation A better understanding of the data collected using the current peripheral arterial disease-specific patient-reported outcome measures may contribute to the development of more comprehensive assessment tools that will ultimately lead to improved patient care. This study contributes to the preliminary foundation for the development of a peripheral arterial disease International Classification of Functioning, Disability and Health Core Set. Clinicians and researchers interested in using peripheral arterial disease-specific patient-reported outcome measures for clinical and research purposes can better understand what topics are included and excluded in the collection and what perspectives are addressed.

The International Classification of Functioning, Disability and Health (ICF) and nursing.

PubMed

Kearney, Penelope M; Pryor, Julie

2004-04-01

Nursing conceptualizes disability from largely medical and individual perspectives that do not consider its social dimensions. Disabled people are critical of this paradigm and its impact on their health care. The aims of this paper are to review the International Classification of Functioning, Disability and Health (ICF), including its history and the theoretical models upon which it is based and to discuss its relevance as a conceptual framework for nursing. The paper presents a critical overview of concepts of disability and their implications for nursing and argues that a broader view is necessary. It examines ICF and its relationship to changing paradigms of disability and presents some applications for nursing. The ICF, with its acknowledgement of the interaction between people and their environments in health and disability, is a useful conceptual framework for nursing education, practice and research. It has the potential to expand nurses' thinking and practice by increasing awareness of the social, political and cultural dimensions of disability.

[Functioning and disability: the International Classification of Functioning, Disability and Health (ICF)].

PubMed

Fernández-López, Juan Antonio; Fernández-Fidalgo, María; Geoffrey, Reed; Stucki, Gerold; Cieza, Alarcos

2009-01-01

The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has provided a new foundation for our understanding of health, functioning, and disability. It covers most of the health and health-related domains that make up the human experience, and the most environmental factors that influence that experience of functioning and disability. With the exhaustive ICF, patients' functioning -including its components body functions and structures and activities and participation-, becomes a central perspective in medicine. To implement the ICF in medicine and other fields, practical tools (= ICF Core Sets) have been developed. They are selected sets of categories out of the whole classification which serve as minimal standards for the assessment and reporting of functioning and health for clinical studies and clinical encounters (Brief ICF Core Set) or as standards for multiprofessional comprehensive assessment (Comprehensive ICF Core Set). Different from generic and condition-specific health-status measures, the ICF Core Sets include important body functions and structures and contextual factors. The use of the ICF Core Sets provides an important step towards improved communications between healthcare providers and professionals, and will enable patients and their families to understand and communicate with health professionals about their functioning and treatment goals. Specific applications include multi- and interdisciplinary assessment in clinical settings and in legal expert evaluations and use in disease or functioning-management programs. The ICF has also a potential as a conceptual framework to clarify an interrelated universe of health-related concepts which can be elucidated based on the ICF and therefore will be an ideal tool for teaching students in all medical fields and may open doors to multi-professional learning.

Toward International Comparability of Survey Statistics on Visual Impairment: The DISTAB Project

ERIC Educational Resources Information Center

Hendershot, Gerry E.; Crews, John E.

2006-01-01

Using data from recent national disability surveys in Australia, Canada, France, the Netherlands, South Africa, and the United States, an international team of researchers coded indicators of several types of disability using the International Classification of Functioning, Disability, and Health. This article discusses the Disability Tabulations…

Disability and Functional Profiles of Patients with Migraine Measured with ICF Classification

ERIC Educational Resources Information Center

Raggi, Alberto

2010-01-01

To describe the functional profiles of patients with migraine, and the relationships between symptoms, activities and environmental factors, using WHO's International Classification of Functioning (ICF). Patients were consecutively enrolled at the Besta Institute of Milan. The ICF checklist was administered and two count-based indexes developed:…

The ICF: International Classification of Functioning, Disability and Health (ICF)--a Swiss army knife? Accessibility and disability in a Scandinavian disability magazine (SDM)--a quantitative content analysis.

PubMed

Lundälv, Jörgen; Larsson, Per-Olof; Törnbom, Marie; Sunnerhagen, Katharina Stibrant

2012-11-01

The study describes the extent to which the concept of accessibility and accessibility issues has been reported in a national Scandinavian disability magazine. In this study particular attention is paid to how the compatibility between the various domains of the international classification - International Classification of Functioning, Disability and Health (ICF) - has been covered in the magazine over a decade. Furthermore, other types of descriptions that the magazine has made of accessibility for people with physical disabilities are considered. The study is based on a quantitative content analysis of a total of 326 articles from the Swedish disability magazine (SDM); 450 text pages published during the years 2000-2009. The magazine's coverage has been comprehensive. More than half of the studied texts were news items about various accessibility issues. Every third article can be characterised as a news article or feature article. The most frequently reported of the ICF domains consist of two perspectives: environmental accessibility and civil rights. Public opinion articles in the form of letters to editors and editorials focused on accessibility have a low frequency. Likewise, research reports are few. The study has included a review of illustrations and photographs. The illustrations are generally of high quality, reinforcing the disability message of the article. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Disability, Capability, and Special Education: Towards a Capability-Based Theory

ERIC Educational Resources Information Center

Reindal, Solveig Magnus

2009-01-01

The main objective of the article was to investigate the claim that the capability approach fares better with an understanding of disability as presented by the World Health Organization's "International Classification of Functioning, Disability and Health" (ICF) than by the social model, which has been promoted within disability studies. Scholars…

Using the International Classification of Functioning, Disability and Health Framework to Achieve Interprofessional Functional Outcomes for Young Children: A Speech-Language Pathology Perspective.

PubMed

McNeilly, Lemmietta G

2018-02-01

The International Classification of Functioning, Disability and Health (ICF) framework is an excellent tool to facilitate the writing of functional goals for children who exhibit communication disorders and other developmental problems that require services from professionals in multiple therapeutic areas. The holistic view of children provides each professional with an approach that integrates how one's specific health conditions and contextual factors influence a child's functioning and participation in daily activities. This allows the interprofessional team to view the child as a person, recognizing how one need influences another within his or her environment. Copyright © 2017 Elsevier Inc. All rights reserved.

Development of the first disability index for inflammatory bowel disease based on the international classification of functioning, disability and health

PubMed Central

Peyrin-Biroulet, Laurent; Cieza, Alarcos; Sandborn, William J; Coenen, Michaela; Chowers, Yehuda; Hibi, Toshifumi; Kostanjsek, Nenad; Stucki, Gerold

2011-01-01

Objective The impact of inflammatory bowel disease (IBD) on disability remains poorly understood. The World Health Organization's integrative model of human functioning and disability in the International Classification of Functioning, Disability and Health (ICF) makes disability assessment possible. The ICF is a hierarchical coding system with four levels of details that includes over 1400 categories. The aim of this study was to develop the first disability index for IBD by selecting most relevant ICF categories that are affected by IBD. Methods Relevant ICF categories were identified through four preparatory studies (systematic literature review, qualitative study, expert survey and cross-sectional study), which were presented at a consensus conference. Based on the identified ICF categories, a questionnaire to be filled in by clinicians, called the ‘IBD disability index’, was developed. Results The four preparatory studies identified 138 second-level categories: 75 for systematic literature review (153 studies), 38 for qualitative studies (six focus groups; 27 patients), 108 for expert survey (125 experts; 37 countries; seven occupations) and 98 for cross-sectional study (192 patients; three centres). The consensus conference (20 experts; 17 countries) led to the selection of 19 ICF core set categories that were used to develop the IBD disability index: seven on body functions, two on body structures, five on activities and participation and five on environmental factors. Conclusions The IBD disability index is now available. It will be used in studies to evaluate the long-term effect of IBD on patient functional status and will serve as a new endpoint in disease-modification trials. PMID:21646246

The International Disability Rights Movement and the ICF.

PubMed

Hurst, Rachel

To outline the thinking of disabled people about their situation and status before the formulation of the ICIDH (International Classification of Impairment, Disability and Handicap) in 1980, the growth of the international disability rights movement since 1980, its subsequent involvement in the revision process and then its hopes as to the effectiveness of the ICF (the International Classification of Functioning, Disability and Health-the revised ICIDH) in the future. This is a personal analysis based on the author's experience as a disability rights activist and as a member of the World Council of Disabled Peoples' International (DPI), elected in 1987 to represent DPI in the revision process and who later became Chair of the Environmental Task Force. These are shown to be a major shift from the medical model of disability to the adoption of the interactive model and the impacts of environmental factors in all aspects of health and functioning. That proper use of the environmental factors within the ICF will ensure appropriate policies, systems and services for health care and support, provide measurable indicators for health status and sustainable development and underpin the recognition that disability is a human rights issue.

Combined application of the International Classification of Functioning, Disability and Health and the NANDA-International Taxonomy II.

PubMed

Boldt, Christine; Grill, Eva; Bartholomeyczik, Sabine; Brach, Mirjam; Rauch, Alexandra; Eriks-Hoogland, Inge; Stucki, Gerold

2010-08-01

This paper presents a discussion of the conceptual and practical relationships between the International Classification of Functioning, Disability and Health and the NANDA-International Taxonomy II for nursing diagnoses, and their use in nursing practice. The ICF provides a common classification framework for all healthcare professionals, including nurses. Nursing care plans can be broadly based on NANDA-I taxonomies. No published attempt has been made to systematically compare the NANDA-I Taxonomy II to the ICF. The most recently published descriptions of both classifications and a case example presenting the combined use of both classifications. The work was carried out in 2009. There are conceptual commonalities and differences between the ICF and the NANDA-I Taxonomy II. In the case example, the overlap between the ICF categories and NANDA-I nursing diagnoses reflects the fact that the ICF, focusing on functioning and disability, and the NANDA-I Taxonomy II, with its functioning health patterns, are similar in their approaches. The NANDA-I Taxonomy II permits the fulfilment of requirements that are exclusively nursing issues. The application of the ICF is useful for nurses to communicate nursing issues with other healthcare professionals in a common language. For nurses, knowledge shared with other healthcare professionals may contribute to broader understanding of a patient's situation. The ICF and the NANDA-I Taxonomy II should be used in concert by nurses and can complement each other to enhance the quality of clinical team work and nursing practice.

Portugal's special education law: implementing the International Classification of Functioning, Disability and Health in policy and practice.

PubMed

Sanches-Ferreira, Manuela; Simeonsson, Rune J; Silveira-Maia, Mónica; Alves, Sílvia; Tavares, Ana; Pinheiro, Sara

2013-05-01

The International Classification of Functioning, Disability and Health (ICF) was introduced in Portuguese education law as the compulsory system to guide eligibility policy and practice in special education. This paper describes the implementation of the ICF and its utility in the assessment process and eligibility determination of students for special education. A study to evaluate the utility of the ICF was commissioned by the Portuguese Ministry of Education and carried out by an external evaluation team. A document analysis was made of the assessment and eligibility processes of 237 students, selected from a nationally representative sample. The results provided support for the use of the ICF in student assessment and in the multidimensional approach of generating student functioning profiles as the basis for determining eligibility. The use of the ICF contributed to the differentiation of eligible and non eligible students based on their functioning profiles. The findings demonstrate the applicability of the ICF framework and classification system for determining eligibility for special education services on the basis of student functioning rather than medical or psychological diagnose. The use of the International Classification of Functioning, Disability and Health (ICF) framework in special education policy is as follows: • The functional perspective of the ICF offers a more comprehensive, holistic assessment of student needs than medical diagnoses. • ICF-based assessment of the nature and severity of functioning can serve as the basis for determining eligibility for special education and habilitation. • Profiles of functioning can support decision making in designing appropriate educational interventions for students.

Using the International Classification of Functioning, Disability, and Health to identify outcome domains for a core outcome set for aphasia: a comparison of stakeholder perspectives.

PubMed

Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine

2017-11-12

This study synthesised the findings of three separate consensus processes exploring the perspectives of key stakeholder groups about important aphasia treatment outcomes. This process was conducted to generate recommendations for outcome domains to be included in a core outcome set for aphasia treatment trials. International Classification of Functioning, Disability, and Health codes were examined to identify where the groups of: (1) people with aphasia, (2) family members, (3) aphasia researchers, and (4) aphasia clinicians/managers, demonstrated congruence in their perspectives regarding important treatment outcomes. Codes were contextualized using qualitative data. Congruence across three or more stakeholder groups was evident for ICF chapters: Mental functions; Communication; and Services, systems, and policies. Quality of life was explicitly identified by clinicians/managers and researchers, while people with aphasia and their families identified outcomes known to be determinants of quality of life. Core aphasia outcomes include: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. International Classification of Functioning, Disability, and Health coding can be used to compare stakeholder perspectives and identify domains for core outcome sets. Pairing coding with qualitative data may ensure important nuances of meaning are retained. Implications for rehabilitation The outcomes measured in treatment research should be relevant to stakeholders and support health care decision making. Core outcome sets (agreed, minimum set of outcomes, and outcome measures) are increasingly being used to ensure the relevancy and consistency of the outcomes measured in treatment studies. Important aphasia treatment outcomes span all components of the International Classification of Functioning, Disability, and Health. Stakeholders demonstrated congruence in the identification of important outcomes which related Mental functions; Communication; Services, systems, and policies; and Quality of life. A core outcome set for aphasia treatment research should include measures relating to: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. Coding using the International Classification of Functioning, Disability, and Health, presents a novel methodology for the comparison of stakeholder perspectives to inform recommendations for outcome constructs to be included in a core outcome set. Coding can be paired with qualitative data to ensure nuances of meaning are retained.

Implementation of the International Classification of Functioning, Disability and Health in national legislation and policy in Japan.

PubMed

Okawa, Yayoi; Ueda, Satoshi

2008-03-01

The purpose of this paper is to present the results of a survey on the implementation of the International Classification of Functioning, Disability and Health (ICF) in legislation and policy in the fields of health, welfare and disability in Japan. In pursuance of this aim, we scrutinized the relevant laws, regulations and policy statements issued in Japan in recent years. As a result, it was found that the ICF had been introduced into the following regional and national policy statements and legislations: (i) the 'Biwako Millenium Framework for Action Towards an Inclusive, Barrier-free and Rights-based Society for Persons with Disabilities in Asia and the Pacific'; (ii) the 'Basic Programme for Persons with Disabilities'; (iii) national medical and personal care insurance systems; (iv) the report of the commission on 'the Care of the Elderly People'; (v) the report of the commission on 'the Rehabilitation of the Elderly People'; (vi) disability prevention in the elderly population; (vii) support for an independent life for people with mental disability living in the community; (viii) disability prevention after natural disasters; and (ix) the survey and care of patients with asthma due to air pollution.

Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey.

PubMed

Güeita-Rodríguez, Javier; García-Muro, Francisco; Cano-Díez, Beatriz; Rodríguez-Fernández, Ángel L; Lambeck, Johan; Palacios-Ceña, Domingo

To identify intervention categories encountered by physical therapists working in aquatic therapy with disabled children, using the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). Aquatic physical therapists were asked to describe concepts related to the functioning of disabled children and their contextual factors. Data were collected in three rounds using the Delphi technique. All answers were translated ('linked') to the ICF-CY and analyzed to determine the degree of consensus. Answers were linked and organized into four diagnostic groups. Overall, in the four groups, 41 Body Functions, 8 Body Structures, 36 Activities and Participation, and 6 Environmental Factors categories were identified as intervention targets. In addition, 8 Environmental Factors that influence aquatic physical therapy were identified. This study highlights the variety of intervention categories available to aquatic physical therapists when treating children in the water. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Comprehensive Stuttering Treatment for Adolescents: A Case Study.

PubMed

Coleman, Craig E

2018-01-09

This article will focus on a hypothetical case study to highlight comprehensive assessment and treatment for adolescent children who stutter. Assessment and treatment are laid out with a literature review utilizing the components of the International Classification of Functioning, Disability and Health model. Specific assessment and treatment strategies and approaches are discussed. Using the International Classification of Functioning, Disability and Health model can help guide clinicians through the assessment and treatment process to ensure that all areas of stuttering are considered. Comprehensive assessment and treatment helps clinicians address all relevant elements of a stuttering disorder, rather than focusing exclusively on reducing speech disruptions.

Fair opportunities, social productivity and wellbeing in disability: Towards a theoretical foundation.

PubMed

Siegrist, Johannes; Fekete, Christine

2016-06-13

Theory-based approaches provide explanations of the impact of components of the International Classification of Functioning, Disability and Health (ICF) classification on outcomes such as health and wellbeing. Here, one such approach is proposed, focusing on social participation and its association with wellbeing. In addition to elaborating a theoretical approach, a narrative review of research on labour market participation of persons with severe disability, spinal cord injury, is conducted to illustrate the utility of the proposed approach. Availability and good quality of productive activities, in particular paid work, are expected to improve wellbeing by strengthening favourable experiences of personal control and social recognition. As these opportunities are restricted among persons with disabilities, conditions that enable full social participation need to be strengthened. Research identified several such conditions at the individual (e.g. coping, social support, educational skills) and the contextual socio-political level (e.g. quality of care, medical and vocational rehabilitation), although their potential of improving wellbeing has not yet been sufficiently explored. In conclusion, supplementing the established ICF classification by theory-based approaches may advance explanations of adverse effects of reduced functioning and wellbeing in disability. This new knowledge can guide the development of interventions to improve participation in general and social productivity in particular.

Detecting Changes Following the Provision of Assistive Devices: Utility of the WHO-DAS II

ERIC Educational Resources Information Center

Raggi, Alberto

2010-01-01

The World Health Organization Disability Assessment Schedule II (WHO-DAS II) is a non-disease-specific International Classification of Functioning, Disability, and Health-based disability assessment instrument developed to measure activity limitations and restrictions to participation. The aim of this pilot study is to evaluate WHO-DAS II…

Content Validity of the Comprehensive ICF Core Set for Multiple Sclerosis from the Perspective of Speech and Language Therapists

ERIC Educational Resources Information Center

Renom, Marta; Conrad, Andrea; Bascuñana, Helena; Cieza, Alarcos; Galán, Ingrid; Kesselring, Jürg; Coenen, Michaela

2014-01-01

Background: The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning,…

Multiple Sclerosis and Employment: A Research Review Based on the International Classification of Function

ERIC Educational Resources Information Center

Frain, Michael P.; Bishop, Malachy; Rumrill, Phillip D., Jr.; Chan, Fong; Tansey, Timothy N.; Strauser, David; Chiu, Chung-Yi

2015-01-01

Multiple sclerosis (MS) is an unpredictable, sometimes progressive chronic illness affecting people in the prime of their working lives. This article reviews the effects of MS on employment based on the World Health Organization's International Classification of Functioning, Disability and Health model. Correlations between employment and…

Classification in childhood disability: focusing on function in the 21st century.

PubMed

Rosenbaum, Peter; Eliasson, Ann-Christin; Hidecker, Mary Jo Cooley; Palisano, Robert J

2014-08-01

Classification systems in health care are usually based on current understanding of the condition. They are often derived empirically and adopted applying sound principles of measurement science to assess whether they are reliable (consistent) and valid (true) for the purposes to which they are applied. In the past 15 years, the authors have developed and validated classification systems for specific aspects of everyday function in people with cerebral palsy--gross motor function, manual abilities, and communicative function. This article describes the approaches used to conceptualize each aspect of function, develop the tools, and assess their reliability and validity. We report on the utility of each system with respect to clinical applicability, use of these tools for research, and the uptake and impact that they have had around the world. We hope that readers will find these accounts interesting, relevant, and applicable to their daily work with children and youth with disabilities. © The Author(s) 2014.

Emotional Health of Canadian and Finnish Students with Disabilities or Chronic Conditions

ERIC Educational Resources Information Center

Boyce, William F.; Davies, Diane; Raman, Sudha R.; Tynjala, Jorma; Valimaa, Raili; King, Matt; Gallupe, Owen; Kannas, Lasse

2009-01-01

The purpose of this study was to investigate the dimensions of emotional health in two population-based groups (Finland and Canada) of adolescents (ages 13 and 15 years) who self-identify as having a disability or chronic condition, as conceptualized by the WHO International Classification of Functioning, Disability and Health. Data from the 2002…

The holistic claims of the biopsychosocial conception of WHO's International Classification of Functioning, Disability, and Health (ICF): a conceptual analysis on the basis of a pluralistic-holistic ontology and multidimensional view of the human being.

PubMed

Solli, Hans Magnus; da Silva, António Barbosa

2012-06-01

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF's claim to holism. The following components of the ICF's complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic-holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b).

Prevalence of disability in a composite ≥75 year-old population in Spain: A screening survey based on the International Classification of Functioning

PubMed Central

2011-01-01

Background The prevalence and predictors of functional status and disability of elderly people have been studied in several European countries including Spain. However, there has been no population-based study incorporating the International Classification of Functioning, Disability and Health (ICF) framework as the basis for assessing disability. The present study reports prevalence rates for mild, moderate, and severe/extreme disability by the domains of activities and participation of the ICF. Methods Nine populations surveyed in previous prevalence studies contributed probabilistic and geographically defined samples in June 2005. The study sample was composed of 503 subjects aged ≥75 years. We implemented a two-phase screening design using the MMSE and the World Health Organization-Disability Assessment Schedule 2nd edition (WHO-DAS II, 12 items) as cognitive and disability screening tools, respectively. Participants scoring within the positive range of the disability screening were administered the full WHO-DAS II (36 items; score range: 0-100) assessing the following areas: Understanding and communication, Getting along with people, Life activities, Getting around, Participation in society, and Self-care. Each disability area assessed by WHO-DAS II (36 items) was reported according to the ICF severity ranges (No problem, 0-4; Mild disability, 5-24; Moderate disability, 25-49; Severe/Extreme disability, 50-100). Results The age-adjusted disability prevalence figures were: 39.17 ± 2.18%, 15.31 ± 1.61%, and 10.14 ± 1.35% for mild, moderate, and severe/extreme disability, respectively. Severe and extreme disability prevalence in mobility and life activities was three times higher than the average, and highest among women. Sex variations were minimal, although life activities for women of 85 years and over had more severe/extreme disability as compared to men (OR = 5.15 95% CI 3.19-8.32). Conclusions Disability is highly prevalent among the Spanish elderly. Sex- and age-specific variations of disability are associated with particular disability domains. PMID:21429194

Description of Functional Disability among Younger Stroke Patients: Exploration of Activity and Participation and Environmental Factors

ERIC Educational Resources Information Center

Snogren, Maria; Sunnerhagen, Katharina Stibrant

2009-01-01

The aim of the study is to describe disability among younger stroke patients by analyzing activity and participation and the environmental aspect as well as to compare assessed and self-perceived problems after stroke. International Classification of Functioning and Health (ICF) is a tool that provides a scientific basis for understanding and…

The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention--feasibility and usefulness as a common language and frame of reference for practice.

PubMed

Björck-Åkesson, Eva; Wilder, Jenny; Granlund, Mats; Pless, Mia; Simeonsson, Rune; Adolfsson, Margareta; Almqvist, Lena; Augustine, Lilly; Klang, Nina; Lillvist, Anne

2010-01-01

Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

Cross-Cultural Perspectives on the Classification of Children with Disabilities: Part I. Issues in the Classification of Children with Disabilities

ERIC Educational Resources Information Center

Florian, Lani; Hollenweger, Judith; Simeonsson, Rune J.; Wedell, Klaus; Riddell, Sheila; Terzi, Lorella; Holland, Anthony

2006-01-01

This article is the first of a 2-part synthesis of an international seminar on the classification of children with disabilities. It synthesizes 6 papers that address broad questions relating to disability classification and categorization, cross-national comparisons on disability in education, the World Health Organization's "International…

Functional Capacity Evaluation & Disability

PubMed Central

Chen, Joseph J

2007-01-01

Function, Impairment, and Disability are words in which many physicians have little interest. Most physicians are trained to deal with structure and physiology and not function and disability. The purpose of this article is to address some of the common questions that many physicians have with the use of functional capacity evaluation and disability and also to provide a unifying model that can explain the medical and societal variables in predicting disability. We will first define the functional capacity evaluation (FCE) and explore the different types available as well as their uses. We will review several studies exploring the validity and reliability of the FCE on healthy and chronic pain patients. We will examine the few studies that look into whether an FCE is predictive of return to work and whether an FCE is predictive of disability. In the second half of this article, we will focus on the Assessment of Disability from the origins of the United States Social Security Administration to a bold new concept, the World Health Organization's International Classification of Function, Disability and Health. PMID:17907444

Use of a New International Classification of Health Interventions for Capturing Information on Health Interventions Relevant to People with Disabilities.

PubMed

Fortune, Nicola; Madden, Richard; Almborg, Ann-Helene

2018-01-17

Development of the World Health Organization's International Classification of Health Interventions (ICHI) is currently underway. Once finalised, ICHI will provide a standard basis for collecting, aggregating, analysing, and comparing data on health interventions across all sectors of the health system. In this paper, we introduce the classification, describing its underlying tri-axial structure, organisation and content. We then discuss the potential value of ICHI for capturing information on met and unmet need for health interventions relevant to people with a disability, with a particular focus on interventions to support functioning and health promotion interventions. Early experiences of use of the Swedish National Classification of Social Care Interventions and Activities, which is based closely on ICHI, illustrate the value of a standard classification to support practice and collect statistical data. Testing of the ICHI beta version in a wide range of countries and contexts is now needed so that improvements can be made before it is finalised. Input from those with an interest in the health of people with disabilities and health promotion more broadly is welcomed.

Identification of aspects of functioning, disability and health relevant to patients experiencing vertigo: a qualitative study using the international classification of functioning, disability and health

PubMed Central

2012-01-01

Purpose Aims of this study were to identify aspects of functioning and health relevant to patients with vertigo expressed by ICF categories and to explore the potential of the ICF to describe the patient perspective in vertigo. Methods We conducted a series of qualitative semi-structured face-to-face interviews using a descriptive approach. Data was analyzed using the meaning condensation procedure and then linked to categories of the International Classification of Functioning, Disability and Health (ICF). Results From May to July 2010 12 interviews were carried out until saturation was reached. Four hundred and seventy-one single concepts were extracted which were linked to 142 different ICF categories. 40 of those belonged to the component body functions, 62 to the component activity and participation, and 40 to the component environmental factors. Besides the most prominent aspect “dizziness” most participants reported problems within “Emotional functions (b152), problems related to mobility and carrying out the daily routine. Almost all participants reported “Immediate family (e310)” as a relevant modifying environmental factor. Conclusions From the patients’ perspective, vertigo has impact on multifaceted aspects of functioning and disability, mainly body functions and activities and participation. Modifying contextual factors have to be taken into account to cover the complex interaction between the health condition of vertigo on the individuals’ daily life. The results of this study will contribute to developing standards for the measurement of functioning, disability and health relevant for patients suffering from vertigo. PMID:22738067

Feasibility and Reliability of the Modified Berg Balance Scale in Persons with Severe Intellectual and Visual Disabilities

ERIC Educational Resources Information Center

Waninge, A.; van Wijck, R.; Steenbergen, B.; van der Schans, C. P.

2011-01-01

Background: The purpose of this study was to determine the feasibility and reliability of the modified Berg Balance Scale (mBBS) in persons with severe intellectual and visual disabilities (severe multiple disabilities, SMD) assigned Gross Motor Function Classification System (GMFCS) grades I and II. Method: Thirty-nine participants with SMD and…

Effects of Dog-Assisted Therapy on Communication and Basic Social Skills of Adults with Intellectual Disabilities: A Pilot Study

ERIC Educational Resources Information Center

Scorzato, Ivano; Zaninotto, Leonardo; Romano, Michela; Menardi, Chiara; Cavedon, Lino; Pegoraro, Alessandra; Socche, Laura; Zanetti, Piera; Coppiello, Deborah

2017-01-01

Thirty-nine adults with severe to profound intellectual disability (ID) were randomly assigned to either an experimental group (n = 21) or a control group (n = 18). Assessment was blinded and included selected items from the International Classification of Functioning, Disability and Health (ICF), the Behavioral Assessment Battery (BAB), and the…

The Application of the International Classification of Functioning, Disability and Health to Functional Auditory Consequences of Mild Traumatic Brain Injury

PubMed Central

Werff, Kathy R. Vander

2016-01-01

This article reviews the auditory consequences of mild traumatic brain injury (mTBI) within the context of the International Classification of Functioning, Disability and Health (ICF). Because of growing awareness of mTBI as a public health concern and the diverse and heterogeneous nature of the individual consequences, it is important to provide audiologists and other health care providers with a better understanding of potential implications in the assessment of levels of function and disability for individual interdisciplinary remediation planning. In consideration of body structures and function, the mechanisms of injury that may result in peripheral or central auditory dysfunction in mTBI are reviewed, along with a broader scope of effects of injury to the brain. The activity limitations and participation restrictions that may affect assessment and management in the context of an individual's personal factors and their environment are considered. Finally, a review of management strategies for mTBI from an audiological perspective as part of a multidisciplinary team is included. PMID:27489400

Accommodation Outcomes and the ICF Framework

ERIC Educational Resources Information Center

Schreuer, Naomi

2009-01-01

Accommodation of the environment and technology is one of the key mediators of adjustment to disability and participation in community. In this article, accommodations are tested empirically as facilitators of return to work and participation, as defined by the "International Classification of Disability, Function, and Health" (ICF) and…

Two steps forward, one step back? A commentary on the disease-specific core sets of the International Classification of Functioning, Disability and Health (ICF).

PubMed

McIntyre, Anne; Tempest, Stephanie

2007-09-30

The International Classification of Functioning, Disability and Health (ICF) has been received favourably by health care professionals, disability rights organizations and proponents of the social model of disability. The success of the ICF largely depends on its uptake in practice and is considered unwieldy in its full format. To enhance the application of the ICF in practice, disease and site-specific core sets have been developed. The objective of this paper is to stimulate thought and discussion about the place of the ICF core sets in rehabilitation practice. The authors' review of the literature uses the ICF core sets (especially stroke), to debate if the ICF is at risk of taking two steps forward, one step back in its holistic portrayal of health. ICF disease specific core sets could be seen as taking two steps forward to enhance the user friendliness of the ICF and evidence-based practice in rehabilitation. However, there is a danger of taking one step back in reverting to a disease-specific classification. It is too early to conclude the efficacy of the disease-specific core sets, but there is an opportunity to debate where the next steps may lead.

What Is the International Classification of Functioning, Disability and Health and Why Is It Relevant to Audiology?

PubMed Central

Meyer, Carly; Grenness, Caitlin; Scarinci, Nerina; Hickson, Louise

2016-01-01

The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is widely used in disability and health sectors as a framework to describe the far-reaching effects of a range of health conditions on individuals. This biopsychosocial framework can be used to describe the experience of an individual in the components of body functions, body structures, and activities and participation, and it considers the influence of contextual factors (environmental and personal) on these components. Application of the ICF in audiology allows the use of a common language between health care professionals in both clinical and research settings. Furthermore, the ICF is promoted as a means of facilitating patient-centered care. In this article, the relevance and application of the ICF to audiology is described, along with clinical examples of its application in the assessment and management of children and adults with hearing loss. Importantly, the skills necessary for clinicians to apply the ICF effectively are discussed. PMID:27489397

Effects of short-term active video game play on community adults: under International Classification of Functioning, Disability and Health consideration.

PubMed

Tseng, Wei-Che; Hsieh, Ru-Lan

2013-06-01

The effects of active video game play on healthy individuals remain uncertain. A person's functional health status constitutes a dynamic interaction between components identified in the International Classification of Functioning, Disability, and Health (ICF). The aim of this study was to investigate the short-term effects of active video game play on community adults using the ICF. Sixty community adults with an average age of 59.3 years and without physical disabilities were recruited. Over 2 weeks, each adult participated in six sessions of active video game play lasting 20 minutes each. Participants were assessed before and after the intervention. Variables were collected using sources related to the ICF components, including the Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Biodex Stability System, chair- rising time, Frenchay Activity Index, Rivermead Mobility Index, Chronic Pain Grade Questionnaire, Work Ability Index, and World Health Organization Quality of Life-Brief Version. Compared to baseline data, significantly reduced risk of a fall measured by Biodex Stability System and improvements in disability scores measured by the Chronic Pain Grade Questionnaire were noted. There was no significant change in the other variables measured. Short-term, active video game play reduces fall risks and ameliorates disabilities in community adults.

Changing beliefs for changing movement and pain: Classification-based cognitive functional therapy (CB-CFT) for chronic non-specific low back pain.

PubMed

Meziat Filho, N

2016-02-01

This case report presents the effect of classification-based cognitive functional therapy in a patient with chronic disabling low back pain. The patient was assessed using a multidimensional biopsychosocial classification system and was classified as having flexion pattern of movement impairment disorder. Management of this patient was to change her belief that bending over and sitting would cause damage to her disc, combined with active exercises for graded exposure to lumbar flexion to restore normal movement. Three months after the first appointment, the treatment resulted in reduced pain, the mitigation of fear avoidance beliefs and the remediation of functional disability. The patient returned to work and was walking for one hour a day on a treadmill. The cognitive intervention to change the patient's negative beliefs related to the biomedical model was important to make the graded exercises and the lifestyle changes possible. Copyright © 2015 Elsevier Ltd. All rights reserved.

A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning, Disability and Health

PubMed Central

Sinclair, Lisa Bundara; Fox, Michael H.; Betts, Donald R.

2015-01-01

SUMMARY This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. This article is a US Government work and is in the public domain in the USA. PMID:23147247

A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning, Disability and Health.

PubMed

Sinclair, Lisa Bundara; Fox, Michael H; Betts, Donald R

2013-01-01

This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. Published 2012. This article is a US Government work and is in the public domain in the USA.

Linking of the quality of life in neurological disorders (Neuro-QoL) to the international classification of functioning, disability and health.

PubMed

Wong, Alex W K; Lau, Stephen C L; Cella, David; Lai, Jin-Shei; Xie, Guanli; Chen, Lidian; Chan, Chetwyn C H; Heinemann, Allen W

2017-09-01

The quality of life in neurological disorders (Neuro-QoL) is a U.S. National Institutes of Health initiative that produced a set of self-report measures of physical, mental, and social health experienced by adults or children who have a neurological condition or disorder. To describe the content of the Neuro-QoL at the item level using the World Health Organization's international classification of functioning, disability and health (ICF). We assessed the Neuro-QoL for its content coverage of functioning and disability relative to each of the four ICF domains (i.e., body functions, body structures, activities and participation, and environment). We used second-level ICF three-digit codes to classify items into categories within each ICF domain and computed the percentage of categories within each ICF domain that were represented in the Neuro-QoL items. All items of Neuro-QoL could be mapped to the ICF categories at the second-level classification codes. The activities and participation domain and the mental functions category of the body functions domain were the areas most often represented by Neuro-QoL. Neuro-QoL provides limited coverage of the environmental factors and body structure domains. Neuro-QoL measures map well to the ICF. The Neuro-QoL-ICF-mapped items provide a blueprint for users to select appropriate measures in ICF-based measurement applications.

Factors Associated with Leisure Activity among Young Adults with Developmental Disabilities

ERIC Educational Resources Information Center

Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn; Lollar, Donald

2006-01-01

The framework of the International Classification of Functioning, Disability, and Health (ICF) was applied to examine the factors associated with childhood impairment and leisure activity. Information on leisure activity was obtained using a structured questionnaire from a population-based cohort of young adults with childhood impairment. The…

Disability reconsidered: the paradox of physical therapy.

PubMed

Roush, Susan E; Sharby, Nancy

2011-12-01

The purposes of this perspective article are: (1) to explore models of disability from the perspective of the academic discipline of disability studies (DS), (2) to consider the paradox of improving functional capacities while valuing disability as diversity, (3) to identify how physical therapy's use of the International Classification of Functioning, Disability and Health (ICF) disablement model intersects with various disability models, and (4) to apply this broader understanding of disability to physical therapist practice, education, and research. The DS literature has been critical of rehabilitation professionals, particularly targeting the medical model of disability. In contrast, advocates for a social model of disability recognize disability as diversity. It is paradoxical for physical therapy to simultaneously work to ameliorate disability while celebrating it as diversity. The ICF biopsychosocial disablement model offers a mechanism to practice within this paradox and suggests that it is no longer sufficient to conceptualize disability as a purely individual matter that requires attention in isolation from the impact of the larger society.

Progressive intervention strategy for the gait of sub-acute stroke patient using the International Classification of Functioning, Disability, and Health tool.

PubMed

Kang, Tae-Woo; Cynn, Heon-Seock

2017-01-01

The International Classification of Functioning, Disability, and Health (ICF) provides models for functions and disabilities. The ICF is presented as a frame that enables organizing physical therapists' clinical practice for application. The purpose of the present study was to describe processes through which stroke patients are assessed and treated based on the ICF model. The patient was a 65-year-old female diagnosed with right cerebral artery infarction with left hemiparesis. Progressive interventions were applied, such as those aiming at sitting and standing for the first two weeks, gait intervention for the third and fourth weeks, and those aiming at sitting from a standing position for the fifth and sixth weeks. The ICF model provides rehabilitation experts with a frame that enables them to accurately identify and understand their patients' problems. The ICF model helps the experts understand not only their patients' body structure, function, activity, and participation, but also their problems related to personal and environmental factors. The experts could efficiently make decisions and provide optimum treatment at clinics using the ICF model.

Mapping SAGE questionnaire to the International Classification of Functioning, Disability and Health (ICF).

PubMed

Raggi, Alberto; Quintas, Rui; Russo, Emanuela; Martinuzzi, Andrea; Costardi, Daniela; Frisoni, Giovanni Battista; Franco, Maria Grazia; Andreotti, Alessandra; Ojala, Matti; Peña, Sebastián; Perales, Jaime; Chatterji, Somnath; Miret, Marta; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Frattura, Lucilla; Leonardi, Matilde

2014-01-01

The collaborative research on ageing in Europe protocol was based on that of the World Health Organization Study on global AGEing and adult health (SAGE) project that investigated the relationship between health and well-being and provided a set of instruments that can be used across countries to monitor health and health-related outcomes of older populations as well as the strategies for addressing issues concerning the ageing process. To evaluate the degree to which SAGE protocol covered the spectrum of disability given the scope of the World Health Organization International Classification of Functioning, Disability and Health (ICF), a mapping exercise was performed with SAGE protocol. Results show that the SAGE protocol covers ICF domains in a non-uniform way, with environmental factors categories being underrepresented, whereas mental, cardiovascular, sensory functions and mobility were overrepresented. To overcome this partial coverage of ICF functioning categories, new assessment instruments have been developed. PRACTITIONER MESSAGE: Mapping exercises are valid procedures to understand the extent to which a survey protocol covers the spectrum of functioning. The mapping exercise with SAGE protocol shows that it provides only a partial representation of body functions and activities and participation domains, and the coverage of environmental factors is poor. New instruments are therefore needed for researchers to properly understand the health and disability of ageing populations. Copyright © 2013 John Wiley & Sons, Ltd.

International Classification of Functioning, Disability and Health in subjects with alternating hemiplegia of childhood.

PubMed

Montirosso, Rosario; Ceppi, Elisa; D'aloisio, Chiara; Zucca, Claudio; Borgatti, Renato

2009-01-01

To examine the functioning of patients with alternating hemiplegia of childhood (AHC), a very rare clinical condition manifesting with recurrent episodes of hemiplegia lasting from few minutes to several days, paroxysmal occurrence of tonic/dystonic attacks and other autonomic disturbances. Furthermore, patients exhibit chronic disabilities as well as mental retardation, epilepsy and motor disorders that affect the patients' everyday functioning to a considerable extent. Data about 25 patients with AHC (F = 13) aged 3-34 years were collected with International Classification of Functioning Disability and Health (ICF) questionnaires. Data analysis was carried out on four age groups: 3-6, 7-12, 13-18 and >18 years, using only the ICF questionnaires' cross-age items. In the body functions component, paying attention, seeing, muscle tones were common problems for all age groups. In the activity and participation component, all participants showed problems in basic interpersonal interactions. Finally, in the environmental factors component, barriers concern the climate and health services. On the other hand, families reported adequate support from social services. Although these findings must be validated, they appear to be promising and can contribute to understanding the daily functioning features of patients with AHC.

A Population Survey in Italy Based on the ICF Classification: Recognizing Persons with Severe Disability

PubMed Central

Leonardi, Matilde; Martinuzzi, Andrea; Meucci, Paolo; Sala, Marina; Russo, Emanuela; Buffoni, Mara; Raggi, Alberto

2012-01-01

Aim of this paper is to describe functioning of subjects with “severe disability” collected with a protocol based on the International Classification of Functioning, Disability, and Health. It included sections on body functions and structures (BF and BS), activities and participation (A&P), and environmental factors (EF). In A&P, performance without personal support (WPS) was added to standard capacity and performance. Persons with severe disability were those reporting a number of very severe/complete problems in BF or in A&P-capacity superior to mean + 1SD. Correlations between BF and A&P and differences between capacity, performance-WPS, and performance were assessed with Spearman's coefficient. Out of 1051, 200 subjects were considered as severely disabled. Mild to moderate correlations between BF and A&P were reported (between 0.148 and 0.394 when the full range of impairments/limitations was taken into account; between 0.198 and 0.285 when only the severe impairments/limitations were taken into account); performance-WPS was less similar to performance than to capacity. Our approach enabled identifying subjects with “severe disability” and separating the effect of personal support from that of devices, policies, and service provision. PMID:22454601

The rediscovery of the social side of medicine: philosophy and value of the International Classification of Functioning, Disability and Health (ICF).

PubMed

Seger, Wolfgang

2018-03-01

Medicine is at risk of sliding into a sole repair service for the malfunction of organs. But the patients' hope and confidence towards doctors practicing this repair work go far beyond that: after acute medical treatment many patients suffer from chronic impairments due to the natural course of the disease or as a result of medical interventions. Despite resulting handicaps, patients aim at participating in family and social life, retaining a workplace and receiving support to remain a valued member of the family and the community. Doctors should therefore not only concentrate on the natural science and technological part of medicine, but also consider the background of their patients, their involvement in life situations including environmental and personal factors, as these may influence functioning and disability as facilitators or barriers. Health Insurances Companies must organize, finance and control the achievements of the post-acute treatment process with the goal of participation. "Public Health" must combine and assess individual views to prepare reasonable population based social, economic and political decisions. The philosophy and structure of the International Classification of Functioning, Disability and Health (ICF) is supporting this attitude of medicine, to complement the International Classification of Diseases (ICD) as a basis for health reports.

Using the International Classification of Functioning, Disability and Health (ICF) to address facilitators and barriers to participation at work.

PubMed

Martins, Anabela Correia

2015-01-01

The International Classification of Functioning, Disability and Health (ICF) was approved by the World Health Assembly in 2001. Ten years later, strong arguments have arisen regarding the added value of ICF to the policies on employment and the outcomes at the workplace. As a conceptual framework, ICF has universality because of its inclusive and comprehensive view of human functioning. At a practical level ICF can be used to quantify the impact of impairment on an individual's ability to act in his/her environment and to assess interventions to minimize the impact of disability and maximize functioning. To explore key indicators of social participation (life habits) of persons with disabilities, particularly related to work, among environmental and personal factors. Data were collected by self-administered questionnaires from a convenience sample of 149 working-age persons with disabilities. Social participation is a construct composed by multiple components and employment domain is the strongest indicator of participation. Correlations between social participation and personal factors, such as self-efficacy and attitudes towards disability were moderate. Those who are employed scored higher quality of life in terms of satisfaction with life, more positive attitudes toward disabilities and higher self-efficacy than the ones who are retired or unemployed. Persons using adapted wheelchair and those who were involved in wheelchair selection scored higher in social participation in general, performance at work, and quality of life. Age and disability duration were not associated with participants' employment status. These findings suggest that rehabilitation and vocational agents, like physiotherapists and other professionals, should have knowledge and understanding of the multiple factors that influence persons with disabilities' participation at work. Programs should provide appropriate wheelchairs, skills training, empowerment and problem-solving strategies in labour activities and occupational environment to promote employment of working-age persons with disabilities.

Measuring patterns of disability using the International Classification of Functioning, Disability and Health in the post-acute stroke rehabilitation setting.

PubMed

Goljar, Nika; Burger, Helena; Vidmar, Gaj; Leonardi, Matilde; Marincek, Crt

2011-06-01

To determine whether the International Classification of Functioning, Disability and Health (ICF) model is adequate for assessing disability patterns in stroke survivors in the sub-acute rehabilitation setting in terms of potential changes in functional profiles over time. Functional profiles of 197 stroke patients were assessed using the ICF Checklist and the Functional Independence Measure (FIMTM) at admission and discharge from rehabilitation hospital. The ICF Checklist was applied based on medical documentation and rehabilitation team meetings. Descriptive analyses were performed to identify changes in ICF categories and qualifiers from admission to discharge, and correlations between different improvement measures were calculated. Mean rehabilitation duration was 60 days; patients' mean age was 60 years, with mean FIM-score 75 at admission. Mean FIM-score improvement at discharge was 12.5. Within Body Functions, changes in at least 10% of patients were found regarding 13 categories; no categories within Body Structures, 24 within Activities and Participation, and 2 within Environmental Factors. Changes were mostly due to improvement in qualifiers, except for within Environmental Factors, where they were due to use of additional categories. Correlations between improvements in Body Functions and Activities and Participation (regarding capacity and performance), as well as between capacity and performance within Activities and Participation, were approximately 0.4. Rating ICF categories with qualifiers enables the detection of changes in functional profiles of stroke patients who underwent an inpatient rehabilitation programme. :

Implementing disability evaluation and welfare services based on the framework of the international classification of functioning, disability and health: experiences in Taiwan

PubMed Central

2013-01-01

Background Before 2007, the disability evaluation was based on the medical model in Taiwan. According to the People with Disabilities Rights Protection Act, from 2012 the assessment of a person’s eligibility for disability benefits has to be determined based on the International Classification of Functioning, Disability, and Health (ICF) framework nationwide. The purposes of this study were to: 1) design the evaluation tools for disability eligibility system based on the ICF/ICF-Children and Youth; 2) compare the differences of grades of disability between the old and new evaluation systems; 3) analyse the outcome of the new disability evaluation system. Methods To develop evaluation tools and procedure for disability determination, we formed an implementation taskforce, including 199 professional experts, and conducted a small-scale field trial to examine the feasibility of evaluation tools in Phase I. To refine the evaluation tools and process and to compare the difference of the grades of disability between new and old systems, 7,329 persons with disabilities were randomly recruited in a national population-based study in Phase II. To implement the new system smoothly and understand the impact of the new system, the collaboration mechanism was established and data of 168,052 persons who applied for the disability benefits was extracted from the information system and analysed in Phase III. Results The measures of the 43 categories for body function/structure components, the Functioning Scale of Disability Evaluation System for activities/participation components, and the needs assessment have been developed and used in the field after several revisions. In Phase II, there was 49.7% agreement of disability grades between the old and new systems. In Phase III, 110,667 persons with a disability received their welfare services through the new system. Among them, 77% received basic social welfare support, 89% financial support, 24% allowance for assistive technology, 7% caregiver support, 8% nursing care and rehabilitation services at home, and 47% were issued parking permits for persons with disability. Conclusion This study demonstrated that disability evaluation system based on the ICF could provide a common language between disability assessment, needs assessment and welfare services. However, the proposed assessment protocol and tools require additional testing and validation. PMID:24125482

Examining transgender health through the International Classification of Functioning, Disability, and Health's (ICF) Contextual Factors.

PubMed

Jacob, Melissa; Cox, Steven R

2017-12-01

For many transgender individuals, medical intervention is necessary to live as their desired gender. However, little is known about Contextual Factors (i.e., Environmental and Personal) that may act as facilitators and barriers in the health of transgender individuals. Therefore, this paper sought to examine Contextual Factors of the World Health Organization's International Classification of Functioning, Disability, and Health that may facilitate or negatively impact the physical, psychological, and social functioning of transgender individuals. A literature review was conducted to identify Environmental and Personal Factors that may influence transgender individuals' physical, psychological, and social functioning. Seven electronic databases were searched. In total, 154 records were reviewed, and 41 articles and other records met inclusion criteria. Three general themes emerged for Environmental Factors: family and social networks, education, and health care. Three general themes also emerged for Personal Factors: socioeconomic status, race, and age. Transgender individuals benefit from gender-affirming services, improved family and social support systems, and competent provider care. Educational training programs, including medical curricula or workshops, might provide the greatest benefit in improving transgender health by increasing the knowledge and cultural competency of health professionals working with this population. Given the diversity of gender expression, differences in lived experiences, and potential for enduring persistent "double discrimination" due to the intersectional relationships between socioeconomic status, race, and/or age, health professionals must approach transgender health using a holistic lens such as the World Health Organization's International Classification of Functioning, Disability, and Health.

Medical, environmental and personal factors of disability in the elderly in Spain: a screening survey based on the International Classification of Functioning.

PubMed

Virués-Ortega, Javier; de Pedro-Cuesta, Jesús; del Barrio, Jose Luis; Almazan-Isla, Javier; Bergareche, Alberto; Bermejo-Pareja, Felix; Fernández-Mayoralas, Gloria; García, Francisco Jose; Garre-Olmo, Josep; Gascon-Bayarri, Jordi; Mahillo, Ignacio; Martínez-Martín, Pablo; Mateos, Raimundo; Rodríguez, Fernanda; Rojo-Pérez, Fermina; Avellanal, Fuencisla; Saz, Pedro; Seijo-Martínez, Manuel

2011-12-01

The International Classification of Functioning, Disability and Health (ICF) advocates a multifactorial and multifaceted conceptualization of disability. The objective of this study was to ascertain major medical, environmental and personal determinants of severe/extreme disability among the elderly population in Spain. The assessment scheme was consistent with the ICF model of disability. Nine populations contributed probabilistic or geographically-defined samples following a two-phase screening design. The Mini-Mental State Examination and the 12-item version of the World Health Organization-Disability Assessment Schedule, 2(nd) ed. (WHO-DAS II), were used as cognitive and disability screening tools, respectively. Positively screened individuals underwent clinical work-up for dementia and were administered the 36-item version of the WHO-DAS II to estimate ICF disability levels. We used logistic regression for the purposes of data combination, adjusted for age and sex in all analyses. The sample was composed of 503 participants aged ≥ 75 years. Alzheimeŕs disease and depression were highly predictive of severe/extreme disability (OR: 17.40, 3.71). Good access to social services was strongly associated with a low level or absence of disability (OR: 0.05 to 0.18). Very difficult access to services and having dementia or another psychiatric disorder were associated with an increase in disability (OR: 66.06). There was also a significant interaction effect between access to services and neurological disorders (OR: 12.74). Disability is highly prevalent among the Spanish elderly and is influenced by medical, social and personal factors. Disability could potentially be reduced by ensuring access to social services, preventing dementia and stroke, and treating depression. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

A comprehensive scoping review of ability and disability in ADHD using the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY).

PubMed

de Schipper, Elles; Lundequist, Aiko; Wilteus, Anna Löfgren; Coghill, David; de Vries, Petrus J; Granlund, Mats; Holtmann, Martin; Jonsson, Ulf; Karande, Sunil; Levy, Florence; Al-Modayfer, Omar; Rohde, Luis; Tannock, Rosemary; Tonge, Bruce; Bölte, Sven

2015-08-01

This is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Attention Deficit Hyperactivity Disorder (ADHD). The objective here was to use a comprehensive scoping review approach to identify the concepts of functional ability and disability used in the scientific ADHD literature and link these to the nomenclature of the ICF-CY. Systematic searches were conducted using Medline/PubMed, PsycINFO, ERIC and Cinahl, to extract the relevant concepts of functional ability and disability from the identified outcome studies of ADHD. These concepts were then linked to ICF-CY by two independent researchers using a standardized linking procedure. Data from identified studies were analysed until saturation of ICF-CY categories was reached. Eighty studies were included in the final analysis. Concepts contained in these studies were linked to 128 ICF-CY categories. Of these categories, 68 were considered to be particularly relevant to ADHD (i.e., identified in at least 5 % of the studies). Of these, 32 were related to Activities and participation, 31 were related to Body functions, and five were related to environmental factors. The five most frequently identified categories were school education (53 %), energy and drive functions (50 %), psychomotor functions (50 %), attention functions (49 %), and emotional functions (45 %). The broad variety of ICF-CY categories identified in this study underlines the necessity to consider ability and disability in ADHD across all dimensions of life, for which the ICF-CY provides a valuable and universally applicable framework. These results, in combination with three additional preparatory studies (expert survey, focus groups, clinical study), will provide a scientific basis to define the ICF Core Sets for ADHD for multi-purpose use in basic and applied research, and every day clinical practice.

Health problems and disability in long-term sickness absence: ICF coding of medical certificates.

PubMed

Morgell, Roland; Backlund, Lars G; Arrelöv, Britt; Strender, Lars-Erik; Nilsson, Gunnar H

2011-11-11

The purpose of this study was to test the feasibility of International Classification of Functioning, Disability and Health (ICF) and to explore the distribution, including gender differences, of health problems and disabilities as reflected in long-term sickness absence certificates. A total of 433 patients with long sick-listing periods, 267 women and 166 men, were included in the study. All certificates exceeding 28 days of sick-listing sent to the local office of the Swedish Social Insurance Administration of a municipality in the Stockholm area were collected during four weeks in 2004-2005. ICD-10 medical diagnosis codes in the certificates were retrieved and free text information on disabilities in body function, body structure or activity and participation were coded according to ICF short version. In 89.8% of the certificates there were descriptions of disabilities that readily could be classified according to ICF. In a reliability test 123/131 (94%) items of randomly chosen free text information were identically classified by two of the authors. On average 2.4 disability categories (range 0-9) were found per patient; the most frequent were 'Sensation of pain' (35.1% of the patients), 'Emotional functions' (34.1%), 'Energy and drive functions' (22.4%), and 'Sleep functions' (16.9%). The dominating ICD-10 diagnostic groups were 'Mental and behavioural disorders' (34.4%) and 'Diseases of the musculoskeletal system and connective tissue' (32.8%). 'Reaction to severe stress and adjustment disorders' (14.7%), and 'Depressive episode' (11.5%) were the most frequent diagnostic codes. Disabilities in mental functions and activity/participation were more commonly described among women, while disabilities related to the musculoskeletal system were more frequent among men. Both ICD-10 diagnoses and ICF categories were dominated by mental and musculoskeletal health problems, but there seems to be gender differences, and ICF classification as a complement to ICD-10 could provide a better understanding of the consequences of diseases and how individual patients can cope with their health problems. ICF is feasible for secondary classifying of free text descriptions of disabilities stated in sick-leave certificates and seems to be useful as a complement to ICD-10 for sick-listing management and research.

Looking at the ICF and human communication through the lens of classification theory.

PubMed

Walsh, Regina

2011-08-01

This paper explores the insights that classification theory can provide about the application of the International Classification of Functioning, Disability and Health (ICF) to communication. It first considers the relationship between conceptual models and classification systems, highlighting that classification systems in speech-language pathology (SLP) have not historically been based on conceptual models of human communication. It then overviews the key concepts and criteria of classification theory. Applying classification theory to the ICF and communication raises a number of issues, some previously highlighted through clinical application. Six focus questions from classification theory are used to explore these issues, and to propose the creation of an ICF-related conceptual model of communicating for the field of communication disability, which would address some of the issues raised. Developing a conceptual model of communication for SLP purposes closely articulated with the ICF would foster productive intra-professional discourse, while at the same time allow the profession to continue to use the ICF for purposes in inter-disciplinary discourse. The paper concludes by suggesting the insights of classification theory can assist professionals to apply the ICF to communication with the necessary rigour, and to work further in developing a conceptual model of human communication.

A systematic literature review of the situation of the International Classification of Functioning, Disability, and Health and the International Classification of Functioning, Disability, and Health-Children and Youth version in education: a useful tool or a flight of fancy?

PubMed

Moretti, Marta; Alves, Ines; Maxwell, Gregor

2012-02-01

This article presents the outcome of a systematic literature review exploring the applicability of the International Classification of Functioning, Disability, and Health (ICF) and its Children and Youth version (ICF-CY) at various levels and in processes within the education systems in different countries. A systematic database search using selected search terms has been used. The selection of studies was then refined further using four protocols: inclusion and exclusion protocols at abstract and full text and extraction levels along with a quality protocol. Studies exploring the direct relationship between education and the ICF/ICF-CY were sought.As expected, the results show a strong presence of studies from English-speaking countries, namely from Europe and North America. The articles were mainly published in noneducational journals. The most used ICF/ICF-CY components are activity and participation, participation, and environmental factors. From the analysis of the papers included, the results show that the ICF/ICF-CY is currently used as a research tool, theoretical framework, and tool for implementing educational processes. The ICF/ICF-CY can provide a useful language to the education field where there is currently a lot of disparity in theoretical, praxis, and research issues. Although the systematic literature review does not report a high incidence of the use of the ICF/ICF-CY in education, the results show that the ICF/ICF-CY model and classification have potential to be applied in education systems.

Systemic Analysis of Brain Mechanisms Underlying Learning Disabilities: An Introduction to the Brain Behavior Relationship.

ERIC Educational Resources Information Center

Scaramella-Nowinski, Valerie L.

The paper presents a discussion of human mental processes as they relate to learning disabilities. Pathognomonic symptoms associated with disturbances to brain areas or functional systems are discussed, as well as treatment procedures. This brain behavior relationship is offered as a basis for a classification system that is seen to more clearly…

What Influences Participation in Leisure Activities of Children and Youth with Physical Disabilities? A Systematic Review

ERIC Educational Resources Information Center

Bult, M. K.; Verschuren, O.; Jongmans, M. J.; Lindeman, E.; Ketelaar, M.

2011-01-01

In 2001 the International Classification of Functioning (ICF) defined participation as "someone's involvement in life situations". Participation in leisure activities contributes to the development of children and their quality of life. Children with physical disabilities are known to be at risk for participation in fewer activities. The group of…

A case study on the application of International Classification of Functioning, Disability and Health (ICF)-based tools for vocational rehabilitation in spinal cord injury.

PubMed

Glässel, Andrea; Rauch, Alexandra; Selb, Melissa; Emmenegger, Karl; Lückenkemper, Miriam; Escorpizo, Reuben

2012-01-01

Vocational rehabilitation (VR) plays a key role in bringing persons with acquired disabilities back to work, while encouraging employment participation. The purpose of this case study is to illustrate the systematic application of International Classification of Functioning, Disability, and Health (ICF)-based documentation tools by using ICF Core Sets in VR shown with a case example of a client with traumatic spinal cord injury (SCI). The client was a 26-year-old male with paraplegia (7th thoracic level), working in the past as a mover. This case study describes the integration of the ICF Core Sets for VR into an interdisciplinary rehabilitation program by using ICF-based documentation tools. Improvements in the client's impairments, activity limitations, and participation restrictions were observed following rehabilitation. Goals in different areas of functioning were achieved. The use of the ICF Core Sets in VR allows a comprehensive assessment of the client's level of functioning and intervention planning. Specifically, the Brief ICF Core Set in VR can provide domains for intervention relevant to each member of an interdisciplinary team and hence, can facilitate the VR management process in a SCI center in Switzerland.

Intellectual developmental disorders: towards a new name, definition and framework for "mental retardation/intellectual disability" in ICD-11.

PubMed

Salvador-Carulla, Luis; Reed, Geoffrey M; Vaez-Azizi, Leila M; Cooper, Sally-Ann; Martinez-Leal, Rafael; Bertelli, Marco; Adnams, Colleen; Cooray, Sherva; Deb, Shoumitro; Akoury-Dirani, Leyla; Girimaji, Satish Chandra; Katz, Gregorio; Kwok, Henry; Luckasson, Ruth; Simeonsson, Rune; Walsh, Carolyn; Munir, Kemir; Saxena, Shekhar

2011-10-01

Although "intellectual disability" has widely replaced the term "mental retardation", the debate as to whether this entity should be conceptualized as a health condition or as a disability has intensified as the revision of the World Health Organization (WHO)'s International Classification of Diseases (ICD) advances. Defining intellectual disability as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. This paper presents the consensus reached to date by the WHO ICD Working Group on the Classification of Intellectual Disabilities. Literature reviews were conducted and a mixed qualitative approach was followed in a series of meetings to produce consensus-based recommendations combining prior expert knowledge and available evidence. The Working Group proposes replacing mental retardation with intellectual developmental disorders, defined as "a group of developmental conditions characterized by significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills". The Working Group further advises that intellectual developmental disorders be incorporated in the larger grouping (parent category) of neurodevelopmental disorders, that current subcategories based on clinical severity (i.e., mild, moderate, severe, profound) be continued, and that problem behaviours be removed from the core classification structure of intellectual developmental disorders and instead described as associated features.

Developing the World Health Organization Disability Assessment Schedule 2.0

PubMed Central

Chatterji, Somnath; Kostanjsek, Nenad; Rehm, Jürgen; Kennedy, Cille; Epping-Jordan, Joanne; Saxena, Shekhar; von Korff, Michael; Pull, Charles

2010-01-01

Abstract Objective To describe the development of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for measuring functioning and disability in accordance with the International Classification of Functioning, Disability and Health. WHODAS 2.0 is a standard metric for ensuring scientific comparability across different populations. Methods A series of studies was carried out globally. Over 65 000 respondents drawn from the general population and from specific patient populations were interviewed by trained interviewers who applied the WHODAS 2.0 (with 36 items in its full version and 12 items in a shortened version). Findings The WHODAS 2.0 was found to have high internal consistency (Cronbach's alpha, α: 0.86), a stable factor structure; high test-retest reliability (intraclass correlation coefficient: 0.98); good concurrent validity in patient classification when compared with other recognized disability measurement instruments; conformity to Rasch scaling properties across populations, and good responsiveness (i.e. sensitivity to change). Effect sizes ranged from 0.44 to 1.38 for different health interventions targeting various health conditions. Conclusion The WHODAS 2.0 meets the need for a robust instrument that can be easily administered to measure the impact of health conditions, monitor the effectiveness of interventions and estimate the burden of both mental and physical disorders across different populations. PMID:21076562

Applying the International Classification of Functioning, Disability and Health to guide home health care services planning and delivery in Thailand.

PubMed

Pimdee, Atipong; Nualnetr, Nomjit

2017-01-01

Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.

The Determinants of Daily Function in Children with Cerebral Palsy

ERIC Educational Resources Information Center

Tseng, Mei-Hui; Chen, Kuan-Lin; Shieh, Jeng-Yi; Lu, Lu; Huang, Chien-Yu

2011-01-01

The aim of this study was to identify determinants of daily function in a population-based sample of children with cerebral palsy (CP). The study took into consideration factors from the entire scope of the International Classification of Functioning, Disability, and Health (ICF). Furthermore, the determinants of daily function were examined from…

Ability and Disability in Autism Spectrum Disorder: A Systematic Literature Review Employing the International Classification of Functioning, Disability and Health-Children and Youth Version.

PubMed

de Schipper, Elles; Lundequist, Aiko; Coghill, David; de Vries, Petrus J; Granlund, Mats; Holtmann, Martin; Jonsson, Ulf; Karande, Sunil; Robison, John E; Shulman, Cory; Singhal, Nidhi; Tonge, Bruce; Wong, Virginia C N; Zwaigenbaum, Lonnie; Bölte, Sven

2015-12-01

This study is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The objective was to use a systematic review approach to identify, number, and link functional ability and disability concepts used in the scientific ASD literature to the nomenclature of the ICF-CY (Children and Youth version of the ICF, covering the life span). Systematic searches on outcome studies of ASD were carried out in Medline/PubMed, PsycINFO, ERIC and Cinahl, and relevant functional ability and disability concepts extracted from the included studies. These concepts were then linked to the ICF-CY by two independent researchers using a standardized linking procedure. New concepts were extracted from the studies until saturation of identified ICF-CY categories was reached. Seventy-one studies were included in the final analysis and 2475 meaningful concepts contained in these studies were linked to 146 ICF-CY categories. Of these, 99 categories were considered most relevant to ASD (i.e., identified in at least 5% of the studies), of which 63 were related to Activities and Participation, 28 were related to Body functions, and 8 were related to Environmental factors. The five most frequently identified categories were basic interpersonal interactions (51%), emotional functions (49%), complex interpersonal interactions (48%), attention functions (44%), and mental functions of language (44%). The broad variety of ICF-CY categories identified in this study reflects the heterogeneity of functional differences found in ASD--both with respect to disability and exceptionality--and underlines the potential value of the ICF-CY as a framework to capture an individual's functioning in all dimensions of life. The current results in combination with three additional preparatory studies (expert survey, focus groups, and clinical study) will provide the scientific basis for defining the ICF Core Sets for ASD for multipurpose use in basic and applied research and every day clinical practice of ASD. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

Developing applications of the ICF in education systems: addressing issues of knowledge creation, management and transfer.

PubMed

Hollenweger, Judith

2013-06-01

Since its endorsement, the International Classification of Functioning, Disability and Health (ICF) has been applied in many policy contexts, including education. While so far the focus has been on showing ways in which it can be used to describe functioning and disability, this article seeks to focus on its value to represent knowledge. Two applications of the ICF and ICF-CY in the context of the Swiss education system highlight ways in which the classification can be used to assist multidisciplinary teams in acquiring and mapping existing knowledge, in creating new knowledge and in applying it for specific purposes. The conceptual analysis illustrates that "disability in education" is a hybrid conceptual world that needs to bridge disability-related information with information relevant for learning and education. The ICF can be used to adequately map such knowledge in complex social settings. More attention needs to be paid to the ICF as an information system to help negotiate between different views on reality and different areas of expertise. The selection of content and ways of representing it need to be considered in the light of the specific purposes during collaborative knowledge creation processes.

Towards the system-wide implementation of the International Classification of Functioning, Disability and Health in routine practice: Lessons from a pilot study in China.

PubMed

Li, Jianan; Prodinger, Birgit; Reinhardt, Jan D; Stucki, Gerold

2016-06-13

In 2011 the Chinese leadership in rehabilitation, in collaboration with the International Classification of Functioning, Disability and Health (ICF) Research Branch, embarked on an effort towards the system-wide implementation of the ICF in the healthcare system in China. We report here on the lessons learned from the pilot phase of testing the ICF Generic Set, a parsimonious set of 7 ICF categories, which have been shown to best describe functioning across the general population and people with various health conditions, for use in routine clinical practice in China. The paper discusses whether classification and measurement are compatible, what number of ICF categories should be included in data collection in routine practice, and the usefulness of a functioning profile and functioning score in clinical practice and health research planning. In addition, the paper reflects on the use of ICF qualifiers in a rating scale and the particularities of certain ICF categories contained in the ICF Generic Set when used as items in the context of Chinese rehabilitation and healthcare. Finally, the steps required to enhance the utility of system-wide implementation of the ICF in rehabilitation and healthcare services are set out.

Functioning and Disability Analysis of Patients with Traumatic Brain Injury and Spinal Cord Injury by Using the World Health Organization Disability Assessment Schedule 2.0

PubMed Central

Kuo, Chia-Ying; Liou, Tsan-Hon; Chang, Kwang-Hwa; Chi, Wen-Chou; Escorpizo, Reuben; Yen, Chia-Feng; Liao, Hua-Fang; Chiou, Hung-Yi; Chiu, Wen-Ta; Tsai, Jo-Ting

2015-01-01

The purpose of this study is to compare traumatic brain injuries (TBI) and spinal cord injuries (SCI) patients’ function and disability by using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); and to clarify the factors that contribute to disability. We analyzed data available between September 2012 and August 2013 from Taiwan’s national disability registry which is based on the International Classification of Functioning, Disability, and Health (ICF) framework. Of the 2664 cases selected for the study, 1316 pertained to TBI and 1348 to SCI. A larger percentage of patients with TBI compared with those with SCI exhibited poor cognition, self-care, relationships, life activities, and participation in society (all p < 0.001). Age, sex, injury type, socioeconomic status, place of residence, and severity of impairment were determined as factors that independently contribute to disability (all p < 0.05). The WHODAS 2.0 is a generic assessment instrument which is appropriate for assessing the complex and multifaceted disability associated with TBI and SCI. Further studies are needed to validate the WHODAS 2.0 for TBI and SCI from a multidisciplinary perspective. PMID:25874682

Exploring participatory behaviour of disability benefit claimants from an insurance physician's perspective.

PubMed

Sjobbema, Christiaan; van der Mei, Sijrike; Cornelius, Bert; van der Klink, Jac; Brouwer, Sandra

2018-08-01

In the Dutch social security system, insurance physicians (IPs) assess participatory behaviour as part of the overall disability claim assessment. This study aims to explore the views and opinions of IPs regarding participatory behaviour as well as factors related to inadequate participatory behaviour, and to incorporate these factors in the International Classification of Functioning, Disability and Health (ICF) biopsychosocial framework. This qualitative study collected data by means of open-ended questions in 10 meetings of local peer review groups (PRGs) which included a total of 78 IPs of the Dutch Social Security Institute. In addition, a concluding discussion meeting with 8 IPs was organized. After qualitative data analyses, four major themes emerged: (1) participation as an outcome, (2) efforts of disability benefit claimants in the process of participatory behaviour, (3) beliefs of disability benefit claimants concerning participation, and (4) recovery behaviour. Identified factors of inadequate participatory behaviour covered all ICF domains, including activities, environmental, and personal factors, next to factors related to health condition and body functions or structures. Outcomes of the discussion meeting indicated the impossibility of formulating general applicable criteria for quantifying and qualifying participatory behaviour. Views of IPs on disability benefit claimants' (in)adequate participatory behaviour reflect a broad biopsychosocial perspective. IPs adopt a nuanced tailor-made approach during assessment of individual disability benefit claimants' participatory behaviour and related expected activities aimed at recovery of health and RTW. Implications for Rehabilitation Within a biopsychosocial perspective, it is not possible to formulate general criteria for the assessment of participatory behaviour for each unique case. Individual disability benefit claimant characteristics and circumstances are taken into account. To optimize the return-to-work (RTW) process, insurance physicians (IPs) assess participatory behaviour according to the International Classification of Functioning, Disability and Health, including medical, personal, and environmental factors. Some aspects within the concept of participatory behaviour extend beyond the boundaries of the domain where IPs operate because opinions in society on personal and societal responsibility influence participatory behaviour.

The role of the International Classification of Functioning, Disability, and Health and quality criteria for improving assistive technology service delivery in Europe.

PubMed

Steel, Emily J; Gelderblom, Gert Jan; de Witte, Luc P

2012-02-01

People with disabilities are entitled to access assistive technology (AT) to facilitate their full and effective participation in society and may reasonably expect to be central to the decision-making processes of services that provide these technologies. European projects have improved the knowledge and resources available for AT service delivery in many countries, but the outputs are not consistently implemented or published in scientific literature. This article examines European developments in AT service delivery and the barriers to its effective provision. Specifically, it analyzes the role of the International Classification of Functioning, Disability, and Health in service delivery improvement. Published scientific papers, as well as reports from and descriptions of European projects related to AT service delivery, were reviewed. The publications were analyzed in relation to six criteria for AT service delivery described in an earlier, major European project. The findings and recommendations from the publications are synthesized in this article to identify advances and gaps in AT service delivery and to assess the current status and direction of AT service delivery improvement in Europe. Multicountry projects have brought together AT researchers from across Europe to work together and produced promising results that are contextually relevant. Access to AT information and training of practitioners has improved, and efforts are being made to facilitate user involvement. More effort should be put into integrating research and resources from European projects into practice. Use of the International Classification of Functioning, Disability, and Health model and terminology may support coordination of service delivery systems. The AT research and practice communities in Europe may be able to learn from developments in North America, while continuing to work together, sharing resources and strategies, and communicating results internationally.

Using social capital to construct a conceptual International Classification of Functioning, Disability, and Health Children and Youth version-based framework for stronger inclusive education policies in Europe.

PubMed

Maxwell, Gregor; Koutsogeorgou, Eleni

2012-02-01

Inclusive education is part of social inclusion; therefore, social capital can be linked to an inclusive education policy and practice. This association is explored in this article, and a practical measure is proposed. Specifically, the World Health Organization's International Classification of Functioning, Disability and Health Children and Youth Version (ICF-CY) is proposed as the link between social capital and inclusive education. By mapping participation and trust indicators of social capital to the ICF-CY and by using the Matrix to Analyse Functioning in Education Systems (MAFES) to analyze the functioning of inclusive education policies and systems, a measure for stronger inclusive education policies is proposed. Such a tool can be used for policy planning and monitoring to ensure better inclusive education environments. In conclusion, combining enhanced social capital linked to stronger inclusive education policies, by using the ICF-CY, can lead to better health and well-being for all.

Classification/Categorization Model of Instruction for Learning Disabled Students.

ERIC Educational Resources Information Center

Freund, Lisa A.

1987-01-01

Learning-disabled students deficient in classification and categorization require specific instruction in these skills. Use of a classification/categorization instructional model improved the questioning strategies of 60 learning-disabled students, aged 10 to 12. The use of similar models is discussed as a basis for instruction in science, social…

Feasibility of a Smartphone-Based Exercise Program for Office Workers With Neck Pain: An Individualized Approach Using a Self-Classification Algorithm.

PubMed

Lee, Minyoung; Lee, Sang Heon; Kim, TaeYeong; Yoo, Hyun-Joon; Kim, Sung Hoon; Suh, Dong-Won; Son, Jaebum; Yoon, BumChul

2017-01-01

To explore the feasibility of a newly developed smartphone-based exercise program with an embedded self-classification algorithm for office workers with neck pain, by examining its effect on the pain intensity, functional disability, quality of life, fear avoidance, and cervical range of motion (ROM). Single-group, repeated-measures design. The laboratory and participants' home and work environments. Offices workers with neck pain (N=23; mean age ± SD, 28.13±2.97y; 13 men). Participants were classified as having 1 of 4 types of neck pain through a self-classification algorithm implemented as a smartphone application, and conducted corresponding exercise programs for 10 to 12min/d, 3d/wk, for 8 weeks. The visual analog scale (VAS), Neck Disability Index (NDI), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Fear-Avoidance Beliefs Questionnaire (FABQ), and cervical ROM were measured at baseline and postintervention. The VAS (P<.001) and NDI score (P<.001) indicated significant improvements in pain intensity and functional disability. Quality of life showed significant improvements in the physical functioning (P=.007), bodily pain (P=.018), general health (P=.022), vitality (P=.046), and physical component scores (P=.002) of the SF-36. The FABQ, cervical ROM, and mental component score of the SF-36 showed no significant improvements. The smartphone-based exercise program with an embedded self-classification algorithm improves the pain intensity and perceived physical health of office workers with neck pain, although not enough to affect their mental and emotional states. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Intellectual disability: definition, etiological factors, classification, diagnosis, treatment and prognosis.

PubMed

Katz, Gregorio; Lazcano-Ponce, Eduardo

2008-01-01

ETIOLOGY AND CLASSIFICATION: Causal factors related with cognitive disability are multiples and can be classified as follows: Genetic, acquired (congenital and developmental), environmental and sociocultural. Likewise, in relation to the classification, cognitive disability has as a common denominator a subnormal intellectual functioning level; nevertheless, the extent to which an individual is unable to face the demands established by society for the individuals age group has brought about four degrees of severity: Mild, moderate, severe and profound. The clinical history must put an emphasis on healthcare during the prenatal, perinatal and postnatal period and include the results of all previous studies, including a genealogical tree for at least three generations and an intentional search for family antecedents of mental delay, psychiatric illnesses and congenital abnormalities. The physical exam should focus on secondary abnormalities and congenital malformations, somatometric measurements and neurological and behavioral phenotype evaluations. If it is not feasible to establish a clinical diagnosis, it is necessary to conduct high-resolution cytogenetic studies in addition to metabolic clinical evaluations. In the next step, if no abnormal data are identified, submicroscopic chromosomal disorders are evaluated. Intellectual disability is not curable; and yet, the prognostic in general terms is good when using the emotional wellbeing of the individual as a parameter. Intellectual disability should be treated in a comprehensive manner. Nevertheless, currently, the fundamental task and perhaps the only one that applies is the detection of the limitation and abilities as a function of subjects age and expectations for the future, with the only goal being to provide the support necessary for each one of the dimensions or areas in which the persons life is expressed and exposed.

How Do Changes in Body Functions and Structures, Activity, and Participation Relate in Children with Cerebral Palsy?

ERIC Educational Resources Information Center

Wright, F. Virginia; Rosenbaum, Peter L.; Goldsmith, Charles H.; Law, Mary; Fehlings, Darcy L.

2008-01-01

Rehabilitation increasingly addresses the International Classification of Functioning, Disability and Health's (ICF) concepts of activity and participation, but little is known about associations between changes in body functions and structures, activity, and participation. We conducted a before-and-after study of 35 ambulatory children with…

Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy.

PubMed

Prodinger, Birgit; Cieza, Alarcos; Oberhauser, Cornelia; Bickenbach, Jerome; Üstün, Tevfik Bedirhan; Chatterji, Somnath; Stucki, Gerold

2016-06-01

To develop a comprehensive set of the International Classification of Functioning, Disability and Health (ICF) categories as a minimal standard for reporting and assessing functioning and disability in clinical populations along the continuum of care. The specific aims were to specify the domains of functioning recommended for an ICF Rehabilitation Set and to identify a minimal set of environmental factors (EFs) to be used alongside the ICF Rehabilitation Set when describing disability across individuals and populations with various health conditions. Secondary analysis of existing data sets using regression methods (Random Forests and Group Lasso regression) and expert consultations. Along the continuum of care, including acute, early postacute, and long-term and community rehabilitation settings. Persons (N=9863) with various health conditions participated in primary studies. The number of respondents for whom the dependent variable data were available and used in this analysis was 9264. Not applicable. For regression analyses, self-reported general health was used as a dependent variable. The ICF categories from the functioning component and the EF component were used as independent variables for the development of the ICF Rehabilitation Set and the minimal set of EFs, respectively. Thirty ICF categories to be complemented with 12 EFs were identified as relevant to the identified ICF sets. The ICF Rehabilitation Set constitutes of 9 ICF categories from the component body functions and 21 from the component activities and participation. The minimal set of EFs contains 12 categories spanning all chapters of the EF component of the ICF. The identified sets proposed serve as minimal generic sets of aspects of functioning in clinical populations for reporting data within and across heath conditions, time, clinical settings including rehabilitation, and countries. These sets present a reference framework for harmonizing existing information on disability across general and clinical populations. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

[Descriptive study about social and demographical characteristic of the disability in Latin America].

PubMed

Neves-Silva, Priscila; Alvarez-Martín, Elena

2014-12-01

The objective of this study was to ascertain the social and demographical characteristics of disability in Latin America and verify the methodology used in the survey by questionnaires for the analysis of disabilities. It is a descriptive study that analyzed the data and methodology of disability surveys conducted in Latin America after 2001. It was noted that there is a big difference in the prevalence of disability found in the surveys that used the International Classification of Functioning, Disability and Health (ICF) for statistical analysis of people with disabilities. It was also shown that in Latin America motor disabilities are more prevalent in men over 65 years old and with a low educational level. The main cause is chronic disease. The conclusion is that ICF is a good methodological tool to use in disability survey questionnaires.

Health professionals identify components of the International Classification of Functioning, Disability and Health (ICF) in questionnaires for the upper limb

PubMed Central

Philbois, Stella V.; Martins, Jaqueline; Souza, Cesário S.; Sampaio, Rosana F.; Oliveira, Anamaria S.

2016-01-01

BACKGROUND: Several Brazilian studies have addressed the International Classification of Functioning, Disability and Health (ICF), but few have analyzed the knowledge of the health professionals with regards to the ICF. OBJECTIVE: To verify whether the classification of the items in the Brazilian-Portuguese versions of The Shoulder Pain and Disability Index (SPADI) and The Disabilities Arm, Shoulder and Hand (DASH) questionnaires, obtained from health professionals who worked with patients having upper limb injuries, could be related to ICF components as defined by others studies. METHOD: There were 4 participants for the group "professionals with high familiarity of the ICF (PHF)" and 19 for the group of "professionals with some or no familiarity of the ICF (PSNF)". The participants judged whether the items on the two questionnaires belonged to the ICF body function, body structure or activity-participation component, and marked a confidence level for each trial using a numerical scale ranging from zero to 10. The items were classified by the discriminant content validity method using the Student'st-test and the Hochberg correction. The ratings were compared to the literature by the percentage of agreement and Kappa coefficient. RESULTS: The percentage of agreement of the rating from the PSNF and the PHF groups with the literature was equal to or greater than 77%. For the DASH, the agreement of the PSNF and PHF groups with the literature were, respectively, moderate (Kappa=0.46 to 0.48) and substantial (Kappa=0.62 to 0.70). CONCLUSIONS: Health professionals were able to correlate the three components of the ICF for most items on the 2 questionnaires, demonstrating some ease of understanding the ICF components. However, the relation of concept of pain with body function component is not clear for professional and deserves a more attentive approach. PMID:26786076

Development of the Arab Heritage Activity Card Sort

ERIC Educational Resources Information Center

Hamed, Razan; AlHeresh, Rawan; Dahab, Sana Abu; Collins, Brittany; Fryer, Jasmine; Holm, Margo B.

2011-01-01

Participation is an indicator of healthy functioning and well-being, as emphasized by the International Classification of Functioning, Disability, and Health (World Health Organization, 2001). The Activity Card Sort (ACS) is a valid and reliable assessment tool that measures participation. This study describes the process of developing the Arab…

"I Am Not a Tragedy. I Am Full of Hope": Communication Impairment Narratives in Newspapers

ERIC Educational Resources Information Center

O Malley-Keighran, Mary-Pat; Coleman, Mary

2014-01-01

Background: Individual attitudes and more general attitudes in society can negatively influence the functioning of people with communication disorders according to the World Health Organisation's (WHO) "International Classification of Functioning, Disability, and Health" (ICF) (2002). Personal narratives have been recommended as the best…

The evolving understanding of the construct of intellectual disability.

PubMed

Schalock, Robert L

2011-12-01

This article addresses two major areas concerned with the evolving understanding of the construct of intellectual disability. The first part of the article discusses current answers to five critical questions that have revolved around the general question, "What is Intellectual Disability?" These five are what to call the phenomenon, how to explain the phenomenon, how to define the phenomenon and determine who is a member of the class, how to classify persons so defined and identified, and how to establish public policy regarding such persons. The second part of the article discusses four critical issues that will impact both our future understanding of the construct and the approach taken to persons with intellectual disability. These four critical issues relate to the conceptualisation and measurement of intellectual functioning, the constitutive definition of intellectual disability, the alignment of clinical functions related to diagnosis, classification, and planning supports, and how the field resolves a number of emerging epistemological issues.

Mapping the Content of the Patient Reported Outcomes Measurement Information System (PROMIS®) Using the International Classification of Functioning, Health and Disability

PubMed Central

Tucker, Carole A; Escorpizo, Reuben; Cieza, Alarcos; Lai, Jin Shei; Stucki, Gerold; Ustun, T. Bedirhan; Kostanjsek, Nenad; Cella, David; Forrest, Christopher B.

2014-01-01

Background The Patient Reported Outcomes Measurement Information System (PROMIS®) is a U.S. National Institutes of Health initiative that has produced self-reported item banks for physical, mental, and social health. Objective To describe the content of PROMIS at the item level using the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Methods All PROMIS adult items (publicly available as of 2012) were assigned to relevant ICF concepts. The content of the PROMIS adult item banks were then described using the mapped ICF code descriptors. Results The 1006 items in the PROMIS instruments could all be mapped to ICF concepts at the second level of classification, with the exception of 3 items of global or general health that mapped across the first-level classification of ICF activity and participation component (d categories). Individual PROMIS item banks mapped from 1 to 5 separate ICF codes indicating one-to-one, one-to-many and many-to-one mappings between PROMIS item banks and ICF second level classification codes. PROMIS supports measurement of the majority of major concepts in the ICF Body Functions (b) and Activity & Participation (d) components using PROMIS item banks or subsets of PROMIS items that could, with care, be used to develop customized instruments. Given the focus of PROMIS is on measurement of person health outcomes, concepts in body structures (s) and some body functions (b), as well as many ICF environmental factor have minimal coverage in PROMIS. Discussion The PROMIS-ICF mapped items provide a basis for users to evaluate the ICF related content of specific PROMIS instruments, and to select PROMIS instruments in ICF based measurement applications. PMID:24760532

Parents' Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life.

PubMed

Illum, Niels Ove; Gradel, Kim Oren

2017-01-01

To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were -1.10 (range: -5.31 to 5.25) and -1.11 (range: -5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions. Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis.

Parents’ Assessments of Disability in Their Children Using World Health Organization International Classification of Functioning, Disability and Health, Child and Youth Version Joined Body Functions and Activity Codes Related to Everyday Life

PubMed Central

Illum, Niels Ove; Gradel, Kim Oren

2017-01-01

AIM To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. METHOD Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. RESULTS The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were −1.10 (range: −5.31 to 5.25) and −1.11 (range: −5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions. CONCLUSIONS Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis. PMID:28680270

International classification of functioning, disability and health categories for spinal cord injury nursing in China.

PubMed

Li, Kun; Yan, Tiebin; You, Liming; Li, Rui; Ross, Amy Miner

2015-01-01

To explore a set of International Classification of Functioning, Disability and Health (ICF) categories that cover the spinal cord injury (SCI) nursing practice in China through a national expert survey. An internet-based email survey was used. An original set of ICF categories specifically for SCI nursing has been developed from the preliminary studies based on an international perspective. For cultural adaptation in China, a national expert survey was conducted with Chinese experts on SCI nursing to identify the ICF categories that were specifically for SCI nursing in China. The ICF categories which received more than 80% support from the experts would be reported. Twenty-nine Chinese experts on SCI nursing participated. There were 81 ICF categories which received more than 80% agreement among the experts, including 33 Body Functions categories, eight Body Structures, 24 Activities and Participation, six Environmental Factors and 10 Personal Factors items. A set of ICF categories that cover the SCI nursing practice in China was identified. It reflects the main issues that Chinese nurses focus on in caring SCI patients. These categories can facilitate Chinese nurses to use the ICF in multidisciplinary teamwork and improve the participation of nurses in the team. Implications for Rehabilitation In China, nurses lack of an effective model or tool to communicate with the other health professionals in the rehabilitation team for spinal cord injury (SCI) patients. International Classification of Functioning, Disability and Health (ICF) is a tool for multidisciplinary use, which can promote the communication and collaboration in the healthcare team by establishing a common language across different disciplines and sectors. This set of ICF categories developed from this study can serve as a roadmap for important items for use in clinical practice of Chinese SCI nursing.

Determinants of Activity and Participation in Preschoolers with Developmental Delay

ERIC Educational Resources Information Center

Leung, Grantiana P. K.; Chan, Chetwyn C. H.; Chung, Raymond C. K.; Pang, Marco Y. C.

2011-01-01

According to the International Classification of Functioning, Disability and Health model endorsed by the World Health Organization, activity (the execution of a task or action by an individual), and participation (involvement in a life situation) are important components in the assessment of health and functioning of an individual. The purpose of…

Alignment of Outcome Instruments Used in Hand Therapy With the Occupational Therapy Practice Framework: Domain and Process and the International Classification of Functioning, Disability and Health: A Scoping Review.

PubMed

Lesher, Danielle Ann-Marie; Mulcahey, M J; Hershey, Peter; Stanton, Donna Breger; Tiedgen, Andrea C

We sought to identify outcome instruments used in rehabilitation of the hand and upper extremity; to determine their alignment with the constructs of the International Classification of Functioning, Disability and Health (ICF) and the Occupational Therapy Practice Framework: Domain and Process; and to report gaps in the constructs measured by outcome instruments as a basis for future research. We searched CINAHL, MEDLINE, OTseeker, and the Cochrane Central Register of Controlled Trials using scoping review methodology and evaluated outcome instruments for concordance with the ICF and the Framework. We identified 18 outcome instruments for analysis. The findings pertain to occupational therapists' focus on body functions, body structures, client factors, and activities of daily living; a gap in practice patterns in use of instruments; and overestimation of the degree to which instruments used are occupationally based. Occupational therapy practitioners should use outcome instruments that embody conceptual frameworks for classifying function and activity. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Functional range of motion of the hand joints in activities of the International Classification of Functioning, Disability and Health.

PubMed

Gracia-Ibáñez, Verónica; Vergara, Margarita; Sancho-Bru, Joaquín L; Mora, Marta C; Piqueras, Catalina

Cross-sectional research design. Active range of motion (AROM) is used as indicator of hand function. However, functional range of motion (FROM) data are limited, and fail to represent activities of daily living (ADL). To estimate dominant hand FROM in flexion, abduction and palmar arching in people under 50 years of age performing ADL. AROMs and hand postures in 24 representative ADL of the International Classification of Functioning, Disability and Health (ICF) were recorded in 12 men and 12 women. FROM data were reported by activity and ICF area, and compared with AROMs. The relationship between ROM measures to gender and hand size was analyzed by correlation. FROM was 5° to 28° less than available AROM depending on the joint and movement performed. Joints do not necessarily move through full AROM while performing ADL which has benefits in retaining function despite loss of motion. This may also suggest that ADL alone are insufficient to retain or restore full AROM. Therapists should consider FROM requirements and normal AROM when defining hand therapy goals, interventions and evaluating the success of treatment. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Assessment of functional outcomes in patients with head and neck cancer according to the International Classification of Functioning, Disability and Health Core Sets from the perspective of the multi-professional team: results of 4 Delphi surveys.

PubMed

Kirschneck, Michaela; Sabariego, Carla; Singer, Susanne; Tschiesner, Uta

2014-07-01

The International Classification of Functioning, Disability and Health Core Set for Head and Neck Cancer (ICF-HNC) covers the typical spectrum of problems in functioning in head and neck cancer. This study is part of a multistep process to develop practical guidelines in Germany. The purpose of this study was to identify instruments for the assessment of functioning using the ICF-HNC as reference. Four Delphi surveys with physicians, physiotherapists, psychologists, and social workers were performed to identify which aspects of the ICF-HNC are being treated and which assessment tools are recommended for the assessment of functioning. Ninety-seven percent categories of the ICF-HNC were treated by healthcare professionals participating in the current study. Altogether, 33 assessment tools were recommended for therapy monitoring, food intake, pain, further organic problems/laboratory tests, and psychosocial areas. Although the ICF-HNC is being currently implemented by the head and neck cancer experts, several areas are not covered regularly. Additionally, validated tools were rarely recommended. Copyright © 2013 Wiley Periodicals, Inc.

Impairments, activity limitations, and participation restrictions of the international classification of functioning, disability, and health model in children with ambulatory cerebral palsy

PubMed Central

Mutlu, Akmer; Büğüsan, Sema; Kara, Özgün K.

2017-01-01

Objectives: To examine the impairments, activity limitations, and participation restrictions in children with spastic unilateral and bilateral cerebral palsy (CP). We investigated the relationship between these factors according to the international classification of functioning, disability, and health (ICF) model. Methods: This prospective cross sectional study included 60 children aged between 4-18 years with spastic CP (30 unilateral, 30 bilateral involvement) classified as Levels I and II on the gross motor function classification system. Children had been referred to the Pediatric Rehabilitation Unit in the Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey between March 2014 and March 2015. The Physician Rating scale was used to assess body functions and structures. The Gillette Functional Assessment Questionnaire 22-item skill set, Pediatric Functional Independence Measure, and Pediatric Outcomes Data Collection Instrument were used to assess activity and participation levels. Results: There was a significant positive correlation between impairments and activity limitations (r=0.558; p=0.000), as well as between activity limitations and participation restrictions (r=0.354, p=0.005). Conclusion: These results show that activity limitations in children with unilateral and bilateral ambulatory CP may be related to their impairments and participation restrictions, although the sample size of our study is not large enough for generalizations. Overall, our study highlights the need for up-to-date, practical evaluation methods according to the ICF model. PMID:28133691

Content validation of the international classification of functioning, disability and health core set for stroke from gender perspective using a qualitative approach.

PubMed

Glässel, A; Coenen, M; Kollerits, B; Cieza, A

2014-06-01

The extended ICF Core Set for stroke is an application of the International Classification of Functioning, Disability and Health (ICF) of the World Health Organisation (WHO) with the purpose to represent the typical spectrum of functioning of persons with stroke. The objective of the study is to add evidence to the content validity of the extended ICF Core Set for stroke from persons after stroke taking into account gender perspective. A qualitative study design was conducted by using individual interviews with women and men after stroke in an in- and outpatient rehabilitation setting. The sampling followed the maximum variation strategy. Sample size was determined by saturation. Concepts from qualitative data analysis were linked to ICF categories and compared to the extended ICF Core Set for stroke. Twelve women and 12 men participated in 24 individual interviews. In total, 143 out of 166 ICF categories included in the extended ICF Core Set for stroke were confirmed (women: N.=13; men: N.=17; both genders: N.=113). Thirty-eight additional categories that are not yet included in the extended ICF Core Set for stroke were raised by women and men. This study confirms that the experience of functioning and disability after stroke shows communalities and differences for women and men. The validity of the extended ICF Core Set for stroke could be mostly confirmed, since it does not only include those areas of functioning and disability relevant to both genders but also those exclusively relevant to either women or men. Further research is needed on ICF categories not yet included in the extended ICF Core Set for stroke.

[Disability studies: social exclusion a research subject].

PubMed

Zander, Michael

2016-09-01

The article presents disability studies and elaborates, as their central feature, the distinction between societal disability and impairment which can be described on an individual and medical level. Disability studies define disability as socially caused exclusion. Participation and inclusion, seen as sociopolitical control and counter-terms, do, in fact, have a different content, depending on usage and context. Using the example of the International Classification of Functioning (ICF) and the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD), the respective understanding of disability is depicted. Against this background, the deficits of implementation of the UN CRPD, as criticized by the responsible UN Committee, are shown. Finally, a research agenda for disability studies is outlined, that deals with, among other things, implementation strategies and conflicts of interest in terms of inclusion, furthering widely unquestioned economic conditions and especially the negative impact of European austerity politics.

Integrating medical, assistive, and universally designed products and technologies: assistive technology device classification (ATDC).

PubMed

Bauer, Stephen; Elsaesser, Linda-Jeanne

2012-09-01

ISO26000:2010 International Guidance Standard on Organizational Social Responsibility requires that effective organizational performance recognize social responsibility, including the rights of persons with disabilities (PWD), engage stakeholders and contribute to sustainable development. Millennium Development Goals 2010 notes that the most vulnerable people require special attention, while the World Report on Disability 2011 identifies improved data collection and removal of barriers to rehabilitation as the means to empower PWD. The Assistive Technology Device Classification (ATDC), Assistive Technology Service Method (ATSM) and Matching Person and Technology models provide an evidence-based, standardized, internationally comparable framework to improve data collection and rehabilitation interventions. The ATDC and ATSM encompass and support universal design (UD) principles, and use the language and concepts of the International Classification of Functioning, Disability and Health (ICF). Use ATDC and ICF concepts to differentiate medical, assistive and UD products and technology; relate technology "types" to markets and costs; and support provision of UD products and technologies as sustainable and socially responsible behavior. Supply-side and demand-side incentives are suggested to foster private sector development and commercialization of UD products and technologies. Health and health-related professionals should be knowledgeable of UD principles and interventions.

Psychometric properties of the International Classification of Functioning, Disability and Health set for spinal cord injury nursing based on Rasch analysis.

PubMed

Li, Kun; Yan, Tiebin; You, Liming; Xie, Sumei; Li, Yun; Tang, Jie; Wang, Yingmin; Gao, Yan

2018-02-01

To examine the psychometric properties of the International Classification of Functioning, Disability and Health (ICF) set for spinal cord injury nursing (ICF-SCIN) using Rasch analysis. A total of 140 spinal cord injury patients were recruited between December 2013 and March 2014 through convenience sampling. Nurses used the components body functions (BF), body structures (BS), and activities and participation (AP) of the ICF-SCIN to rate the patients' functioning. Rasch analysis was performed using RUMM 2030 software. In each component, categories were rescored from 01234 to 01112 because of reversed thresholds. Nine testlets were created to overcome local dependency. Four categories which fit to the Rasch model poorly were deleted. After modification, the components BF, BS, and AP showed good fit to the Rasch model with a Bonferroni-adjusted significant level (χ 2  =   86.29, p = 0.006; χ 2  =   22.44, p = 0.130; χ 2  =   39.92, p = 0.159). The person separation indices (PSIs) for the three components were 0.80, 0.54, and 0.97, respectively. No differential item functioning (DIF) was detected across age, gender, or educational level. The fit properties of the ICF set were satisfactory after modifications. The ICF-SCIN has the potential as a nursing assessment instrument for measuring the functioning of patients with spinal cord injury. Implications for rehabilitation The International Classification of Functioning, Disability and Health (ICF) set for spinal cord injury nursing contains a group of categories which can reflect the functioning of spinal cord injury patients from the perspective of nurses. The components body functions (BF), body structures (BS), and activities and participation (AP) of the ICF set for spinal cord injury achieved the fit to the Rasch model through rescoring, generating testlets, and deleting categories with poor fit. The ICF set for spinal cord injury nursing (ICF-SCIN) has the potential to be used as a clinical nursing assessment tool in measuring the functioning of patients with spinal cord injury.

[Shoulder disability questionnaires: a systematic review].

PubMed

Fayad, F; Mace, Y; Lefevre-Colau, M M

2005-07-01

To identify all available shoulder disability questionnaires designed to measure physical functioning and to examine those with satisfactory clinimetric quality. We used the Medline database and the "Guide des outils de mesure de l'évaluation en médecine physique et de réadaptation" textbook to search for questionnaires. Analysis took into account the development methodology, clinimetric quality of the instruments and frequency of their utilization. We classified the instruments according to the International Classification of Functioning, Disability and Health. Thirty-eight instruments have been developed to measure disease-, shoulder- or upper extremity-specific outcome. Four scales assess upper-extremity disability and 3 others shoulder disability. We found 6 scales evaluating disability and shoulder pain, 7 scales measuring the quality of life in patients with various conditions of the shoulder, 14 scales combining objective and subjective measures, 2 pain scales and 2 unclassified scales. Older instruments developed before the advent of modern measurement development methodology usually combine objective and subjective measures. Recent instruments were designed with appropriate methodology. Most are self-administered questionnaires. Numerous shoulder outcome measure instruments are available. There is no "gold standard" for assessing shoulder function outcome in the general population.

International Classification of Impairments, Disabilities, and Handicaps: A Manual of Classification Relating to the Consequences of Disease.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

The manual contains three classifications (impairments, disabilities, and handicaps), each relating to a different plane of experience consequent upon disease. Section 1 attempts to clarify the nature of health related experiences by addressing reponse to acute and chronic illness; the unifying framework for classification (principle events in the…

An ontology-based exploration of the concepts and relationships in the activities and participation component of the international classification of functioning, disability and health.

PubMed

Della Mea, Vincenzo; Simoncello, Andrea

2012-02-28

The International Classification of Functioning, Disability and Health (ICF) is a classification of health and health-related issues, aimed at describing and measuring health and disability at both individual and population levels. Here we discuss a preliminary qualitative and quantitative analysis of the relationships used in the Activities and Participation component of ICF, and a preliminary mapping to SUMO (Suggested Upper Merged Ontology) concepts. The aim of the analysis is to identify potential logical problems within this component of ICF, and to understand whether activities and participation might be defined more formally than in the current version of ICF. In the relationship analysis, we used four predicates among those available in SUMO for processes (Patient, Instrument, Agent, and subProcess). While at the top level subsumption was used in most cases (90%), at the lower levels the percentage of other relationships rose to 41%. Chapters were heterogeneous in the relationships used and some of the leaves of the tree seemed to represent properties or parts of the parent concept rather than subclasses. Mapping of ICF to SUMO proved partially feasible, with the activity concepts being mapped mostly (but not totally) under the IntentionalProcess concept in SUMO. On the other hand, the participation concept has not been mapped to any upper level concept. Our analysis of the relationships within ICF revealed issues related to confusion between classes and their properties, incorrect classifications, and overemphasis on subsumption, confirming what already observed by other researchers. However, it also suggested some properties for Activities that could be included in a more formal model: number of agents involved, the instrument used to carry out the activity, the object of the activity, complexity of the task, and an enumeration of relevant subtasks.

Advances in rehabilitation medicine.

PubMed

Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

2013-10-01

Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

International Classification of Functioning, Disability and Health core set for physical health of older adults.

PubMed

Ruaro, João A; Ruaro, Marinêz B; Guerra, Ricardo O

2014-01-01

To facilitate a systematic, comprehensive description of functioning and to enable the use of the International Classification of Functioning, Disability and Health (ICF) in clinical practice and research, core sets have been developed. The aim of this study was to propose a version of the ICF core set to classify the physical health of older adults. The proposition of the ICF core set was based on the Delphi technique. The panel of experts included 8 Brazilian researchers (physical therapists, medical doctors, nurses, and physical educators). The communication was wholly electronic. In total, there were 5 rounds of interactivity between the participants to arrive at the final version of the construct. The ICF core set presented 30 categories (14 on body functions, 4 on body structures, 9 on activities or participation, and 3 on environmental factors) and had a Cronbach α of 0.964. The presented core set is a secure, fast, and accurate instrument for assessing the physical health and engagement of older adults. It defines points related to functioning and health that are relevant when evaluating this population, as well as when reevaluating it and monitoring changes.

International Classification of Functioning, Disability and Health categories explored for self-rated participation in Swedish adolescents and adults with a mild intellectual disability.

PubMed

Arvidsson, Patrik; Granlund, Mats; Thyberg, Ingrid; Thyberg, Mikael

2012-06-01

To explore internal consistency and correlations between perceived ability, performance and perceived importance in a preliminary selection of self-reported items representing the activity/participation component of the International Classification of Functioning, Disability and Health (ICF). Structured interview study. Fifty-five Swedish adolescents and adults with a mild intellectual disability. Questions about perceived ability, performance and perceived importance were asked on the basis of a 3-grade Likert-scale regarding each of 68 items representing the 9 ICF domains of activity/participation. Internal consistency for perceived ability (Cronbach's alpha for all 68 items): 0.95 (values for each domain varied between 0.57 and 0.85), for performance: 0.86 (between 0.27 and 0.66), for perceived importance: 0.84 (between 0.27 and 0.68). Seventy-two percent of the items showed correlations >0.5 (mean=0.59) for performance vs perceived importance, 41% >0.5 (mean=0.47) for perceived ability vs performance and 12% >0.5 (mean=0.28) for perceived ability vs perceived importance. Measures of performance and perceived importance may have to be based primarily on their estimated clinical relevance for describing aspects of the ICF participation concept. With a clinimetric approach, parts of the studied items and domains may be used to investigate factors related to different patterns and levels of participation, and outcomes of rehabilitation.

Cross-Cultural Perspectives on the Classification of Children with Disabilities: Part II. Implementing Classification Systems in Schools

ERIC Educational Resources Information Center

McLaughlin, Margaret J.; Dyson, Alan; Nagle, Katherine; Thurlow, Martha; Rouse, Martyn; Hardman, Michael; Norwich, Brahm; Burke, Phillip J.; Perlin, Michael

2006-01-01

This article is the second in a 2-part synthesis of an international comparative seminar on the classification of children with disabilities. In this article, the authors discuss classification frameworks used in identifying children for the purpose of providing special education and related services. The authors summarize 7 papers that addressed…

[Constructing a tool for certifying handicap / disability in Colombia].

PubMed

Moreno-Angarita, Marisol; Cortés-Reyes, Edgar; Cárdenas-Jiménez, Andrea; Mena-Ortiz, Luz Z; Giraldo-Rátiva, Zulma

2013-01-01

Describing how a tool was created/constructed for certifying Colombian people's disability status. This was a descriptive study involving a five-phase, multi-method design. It sought to identify needs, background, categories and procedures from differing view points, using participatory methodology, for identifying and certifying disabled people in Colombia. The study led to an international classification of functioning, disability and health (ICF)-based certification tool which can be used by a multi-professional team in healthcare institution settings to guarantee access to benefits approved by Colombian disability law. Certification (even when voluntary) can be the key to enjoying all the benefits designed for Colombian people suffering disability; such people are not the subjects of mercy and compassion anymore. Certification seeks to identify people suffering disabilities as holders of rights under Colombian law, as clear evidence of Colombian state commitment to ensuring an inclusive society.

Obesity: the new childhood disability?

PubMed

Tsiros, M D; Coates, A M; Howe, P R C; Grimshaw, P N; Buckley, J D

2011-01-01

This review addresses the impact of obesity on paediatric physical functioning utilizing the World Health Organization International Classification of Functioning, Disability and Health Framework (ICF). The ICF encompasses functioning (as it relates to all body functions and structures), activities (undertaking a particular task) and participation (in a life situation) with disability referring to impairments in body functions/structures, activity restrictions or participation limitations. Electronic databases were searched for peer-reviewed studies published in English prior to May 2009 that examined aspects of physical functioning in children (≤18 years). Eligible studies (N = 104) were ranked by design and synthesized descriptively. Childhood obesity was found to be associated with deficits in function, including impaired cardiorespiratory fitness and performance of motor tasks; and there was some limited evidence of increased musculoskeletal pain and decrements in muscle strength, gait and balance. Health-related quality of life and the subset of physical functioning was inversely related to weight status. However, studies investigating impacts of obesity on wider activity and participation were lacking. Further research utilizing the ICF is required to identify and better characterize the effects of paediatric obesity on physical function, activity and participation, thereby improving targets for intervention to reduce disability in this population. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

Classification Framework for ICT-Based Learning Technologies for Disabled People

ERIC Educational Resources Information Center

Hersh, Marion

2017-01-01

The paper presents the first systematic approach to the classification of inclusive information and communication technologies (ICT)-based learning technologies and ICT-based learning technologies for disabled people which covers both assistive and general learning technologies, is valid for all disabled people and considers the full range of…

Nurse practitioners' focus on health care in terms of cure and care: analysis of graduate theses using the International Classification of Functioning, Disability and Health.

PubMed

Stallinga, Hillegonda A; Jansen, Gerard J; Kastermans, Marijke C; Pranger, Albert; Dijkstra, Pieter U; Roodbol, Petrie F

2016-07-01

To explore the focus of nurse practitioners on health care in terms of cure and care. Nurse practitioners are expected to act on the intersection of cure and care. However, in clinical practice and education, a clear model covering this area is lacking; therefore, it is unknown to what extent nurse practitioners are focused on this specific area. Graduate theses may reflect the focus of nurse practitioners. Sequential exploratory mixed method. In total, 413 published abstracts of graduate theses of a Dutch Master of Advanced Nursing Practice (2000-2015) were analysed using the International Classification of Functioning, Disability and Health. Data source included aim, question and outcome of each thesis and graduates' characteristics. A qualitative deductive approach was used for the analyses. Theses were classified as focused on cure, care, or on the intersection of cure and care. A small majority of 53% (N = 219) of the graduate theses addressed patient's health status and could be classified in the International Classification of Functioning, Disability and Health. Of the classified theses, 48% were focused on cure, 39% on the intersection of cure and care and 13% on care. While the percentage of theses addressing health status increased significantly over the 15-year period, the percentage of theses focused on cure, care and on the intersection of cure and care remained the same. The graduate theses reflected that nurse practitioners are increasingly oriented towards patients' health status. However, their focus is predominantly on cure rather than on the intersection of cure and care. © 2016 John Wiley & Sons Ltd.

Classification of intellectual disability using the Wechsler Intelligence Scale for Children: Full Scale IQ or General Abilities Index?

PubMed

Koriakin, Taylor A; McCurdy, Mark D; Papazoglou, Aimilia; Pritchard, Alison E; Zabel, T Andrew; Mahone, E Mark; Jacobson, Lisa A

2013-09-01

We examined the implications of using the Full Scale IQ (FSIQ) versus the General Abilities Index (GAI) for determination of intellectual disability using the Wechsler Intelligence Scales for Children, fourth edition (WISC-IV). Children referred for neuropsychological assessment (543 males, 290 females; mean age 10y 5mo, SD 2y 9mo, range 6-16y) were administered the WISC-IV and the Adaptive Behavior Assessment System, second edition (ABAS-II). GAI and FSIQ were highly correlated; however, fewer children were identified as having intellectual disability using GAI (n=159) than when using FSIQ (n=196). Although the 44 children classified as having intellectual disability based upon FSIQ (but not GAI) had significantly higher adaptive functioning scores than those meeting intellectual disability criteria based upon both FSIQ and GAI, mean adaptive scores still fell within the impaired range. FSIQ and GAI were comparable in predicting impairments in adaptive functioning. Using GAI rather than FSIQ in intellectual disability diagnostic decision-making resulted in fewer individuals being diagnosed with intellectual disability; however, the mean GAI of the disqualified individuals was at the upper end of criteria for intellectual impairment (standard score 75), and these individuals remained adaptively impaired. As GAI and FSIQ were similarly predictive of overall adaptive functioning, the use of GAI for intellectual disability diagnostic decision-making may be of limited value. © 2013 Mac Keith Press.

Leg pain and psychological variables predict outcome 2-3 years after lumbar fusion surgery.

PubMed

Abbott, Allan D; Tyni-Lenné, Raija; Hedlund, Rune

2011-10-01

Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework.

PubMed

Mahdi, Soheil; Albertowski, Katja; Almodayfer, Omar; Arsenopoulou, Vaia; Carucci, Sara; Dias, José Carlos; Khalil, Mohammad; Knüppel, Ane; Langmann, Anika; Lauritsen, Marlene Briciet; da Cunha, Graccielle Rodrigues; Uchiyama, Tokio; Wolff, Nicole; Selb, Melissa; Granlund, Mats; de Vries, Petrus J; Zwaigenbaum, Lonnie; Bölte, Sven

2018-06-01

This is the fourth international preparatory study designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF-CY) Core Sets for Autism Spectrum Disorder (ASD). Examine functioning of individuals diagnosed with ASD as documented by the ICF-CY in a variety of clinical settings. A cross-sectional study was conducted, involving 11 units from 10 countries. Clinical investigators assessed functioning of 122 individuals with ASD using the ICF-CY checklist. In total, 139 ICF-CY categories were identified: 64 activities and participation, 40 body functions and 35 environmental factors. The study results reinforce the heterogeneity of ASD, as evidenced by the many functional and contextual domains impacting on ASD from a clinical perspective.

Capturing the psychologic-personal perspective in spinal cord injury.

PubMed

Geyh, Szilvia; Müller, Rachel; Peter, Claudio; Bickenbach, Jerome E; Post, Marcel W M; Stucki, Gerold; Cieza, Alarcos

2011-11-01

The overall objective of this study was to illustrate a systematic approach for capturing the psychologic-personal perspective in International Classification of Functioning, Disability and Health-based comprehensive research on spinal cord injury (SCI) in terms of what and how to measure. The specific aims were to identify (1) relevant areas of research for capturing the psychologic-personal factors in a study that is planned and conceptualized according to the comprehensive context of the International Classification of Functioning, Disability and Health, using SCI as a case in point; (2) a set of domains relevant for SCI research from a psychologic-personal perspective; and (3) suitable measurement instruments that can be considered for the assessment of those identified domains based on a set of predefined guiding principles. The psychologic-personal factor structure was developed based on an item pool of 1246 entries from secondary analyses of available data from SCI studies. The domain set for psychologic-personal factors was identified through reviewing the scientific literature in PubMed and PsycInfo. The set of measurement instruments was collected using available measurement reviews, searches in the literature, instrument databases, and further sources and was selected using guiding principles. Forty specific psychologic-personal factors, subdivided into seven areas of research, were identified: (1) sociodemographic personal characteristics, (2) the position in the immediate social and physical context, (3) personal history and biography, (4) feelings, (5) thoughts and beliefs, (6) motives, and (7) patterns of experience and behavior. The psychologic-personal factors domain set contains both cross-cutting outcome domains, namely quality-of-life, life satisfaction, subjective well-being, and sociodemographic personal characteristics, life events, positive and negative affect, perceived stress, locus of control, self-efficacy, purpose in life, coping, lifestyle, and personality. For each of the identified domains, a pool of measurement instruments was listed, and the application of predefined guiding principles for measurement instrument selection was exemplified for self-efficacy. It resulted in the selection of the General Self-Efficacy Scale by Schwarzer and Jerusalem (Measures in Health Psychology: A User's Portfolio. Causal and Control Beliefs. pp. 35-37; 1995). The results of the current article contributed to creating a transparent protocol for the Swiss Spinal Cord Injury Cohort study, coordinated by the Swiss Paraplegic Research in Nottwil, Switzerland. This article also stresses the relevance of the comprehensive approach to SCI and the consideration of the psychologic-personal perspective in this approach. The study, therefore, hopes to encourage scientists to use the International Classification of Functioning, Disability and Health and the psychologic-personal perspective as a frame of reference for their research. Furthermore, the research reported in this article can inform the World Health Organization's future development of the personal factors classification in the International Classification of Functioning, Disability and Health.

Utility of the International Classification of Functioning, Disability and Health (ICF) for educational psychologists’ work

PubMed Central

Aljunied, Mariam; Frederickson, Norah

2014-01-01

Despite embracing a bio-psycho-social perspective, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists’ work with children who have Autism Spectrum Disorders (ASD). Mothers of 40 children with ASD aged eight to 12 years were interviewed using a structured protocol based on the ICF framework. The Diagnostic Interview for Social and Communication Disorder (DISCO) was completed with a subset of 19 mothers. Internal consistency and inter-rater reliability of the interview assessments were found to be acceptable and there was evidence for concurrent and discriminant validity. Despite some limitations, initial support for the utility of the ICF model suggests its potential value across educational, health and care fields. Further consideration of its relevance to educational psychologists in new areas of multi-agency working is warranted. PMID:26157197

Classification of self-injurious behaviour across the continuum of relative environmental-biological influence.

PubMed

Hagopian, L P; Frank-Crawford, M A

2017-10-13

Self-injurious behaviour (SIB) is generally considered to be the product of interactions between dysfunction stemming from the primary developmental disability and experiences that occasion and reinforce SIB. As a result of these complex interactions, SIB presents as a heterogeneous problem. Recent research delineating subtypes of SIB that are nonsocially mediated, including one that is amenable to change and one that is highly invariant, enables classification of SIB across a broader continuum of relative environmental-biological influence. Directly examining how the functional classes of SIB differ has the potential to structure research, will improve our understanding this problem, and lead to more targeted behavioural and pharmacological interventions. Recognising that SIB is not a single entity but is composed of distinct functional classes would better align research with conceptual models that view SIB as the product of interactions between environmental and biological variables. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

The Consequences of the Consequences

PubMed Central

Carragher, Marcella; Foster, Abby

2017-01-01

Understanding the impact of the environment on the participation of people with aphasia depends on one's perspective. A long-term perspective provides a unique insight into the myriad of ways in which the environment can influence the participation of people living with aphasia over decades. In this article, the authors present the real-life story of “Hank,” who has lived with aphasia for more than 15 years. The authors consider how 2 different conceptual frameworks—the International Classification of Functioning, Disability and Health and the Social Determinants of Health—account for Hank's experience. The International Classification of Functioning, Disability and Health is useful to conceptualize the range of factors that influence living with aphasia at a particular point in time. In contrast, the Social Determinants of Health is useful to conceptualize the cumulative impact of living with aphasia on long-term health and well-being. Viewing aphasia as a social condition that impacts social determinants of health has potentially wide ranging implications for service design and delivery and the role of speech–language pathologists. PMID:28232769

Using International Classification of Functioning, Disability and Health to understand challenges in community reintegration of injured veterans.

PubMed

Resnik, Linda J; Allen, Susan M

2007-01-01

This pilot study used the framework of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to understand the challenges faced by Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans as they reintegrate into the community. We conducted semistructured interviews with 14 injured veterans, 12 caregivers, and 14 clinicians. We used ICF taxonomy to code data and identify issues. We identified challenges in the following ICF domains: learning and applying knowledge; general tasks and demands; communication; mobility; self-care; domestic life; interpersonal interactions, major life areas; and community, social, and civic life. We found many similarities between the challenges faced by veterans with and without polytraumatic injuries, although veterans with polytraumatic injuries faced challenges of greater magnitude. Identifying community reintegration challenges early and promoting reintegration are important mandates for the Department of Veterans Affairs. The findings of this study are useful in understanding the needs of OEF/OIF veterans.

The International Classification of Functioning, Disability and Health as a Framework for Providing Patient- and Family-Centered Audiological Care for Older Adults and Their Significant Others.

PubMed

Grenness, Caitlin; Meyer, Carly; Scarinci, Nerina; Ekberg, Katie; Hickson, Louise

2016-08-01

Hearing impairment is highly prevalent in the older population, and it impacts communication and quality of life for both the people with the hearing difficulties and their significant others. In this article, typical audiological assessment and management of an older adult is contrasted with a best practice approach wherein the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework is applied. The aim of the comparison is to demonstrate how the ICF expands our focus: rather than merely focusing on impairment, we also consider the activities, participation, and contextual factors for both the person with the hearing impairment and his or her family. A case example of an older patient and her spouse is provided, and their shared experience of the patient's hearing impairment is mapped onto the ICF framework. Family-centered hearing care is recommended for individualizing care and improving outcomes for older patients and their families.

Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles.

PubMed

Goh, Yu-Ra; Choi, Ja Young; Kim, Seon Ah; Park, Jieun; Park, Eun Sook

2018-01-01

This study aimed to investigate the relationships between various classification systems assessing the severity of oropharyngeal dysphagia and communication function and other functional profiles in children with cerebral palsy (CP). This is a prospective, cross-sectional, study in a university-affiliated, tertiary-care hospital. We recruited 151 children with CP (mean age 6.11 years, SD 3.42, range 3-18yr). The Eating and Drinking Ability Classification System (EDACS) and the dysphagia scales of Functional Oral Intake Scale (FOIS), Swallow Function Scales (SFS), and Food Intake Level Scale (FILS) were used. The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) were employed to classify communication function and speech intelligibility, respectively. The Pediatric Evaluation of Disability Inventory (PEDI) with the Gross Motor Function Classification System (GFMCS) and the Manual Ability Classification System (MACS) level were also assessed. Spearman correlation analysis to investigate the associations between measures and univariate and multivariate logistic regression models to identify significant factors were used. Median GMFCS level of participants was III (interquartile range II-IV). Significant dysphagia based on EDACS level III-V was noted in 23 children (15.2%). There were strong to very strong relationships between the EDACS level with the dysphagia scales. The EDACS presented strong associations with MACS, CFCS, and VSS, a moderate association with GMFCS level, and a moderate to strong association with each domain of the PEDI. In multivariate analysis, poor functioning in EDACS were associated with poor functioning in gross motor and communication functions. Copyright © 2017. Published by Elsevier Ltd.

Classification and Identification of Reading and Math Disabilities: The Special Case of Comorbidity

ERIC Educational Resources Information Center

Branum-Martin, Lee; Fletcher, Jack M.; Stuebing, Karla K.

2013-01-01

Much of learning disabilities research relies on categorical classification frameworks that use psychometric tests and cut points to identify children with reading or math difficulties. However, there is increasing evidence that the attributes of reading and math learning disabilities are dimensional, representing correlated continua of severity.…

Low Back Pain in 17 Countries, a Rasch Analysis of the ICF Core Set for Low Back Pain

ERIC Educational Resources Information Center

Roe, Cecilie; Bautz-Holter, Erik; Cieza, Alarcos

2013-01-01

Previous studies indicate that a worldwide measurement tool may be developed based on the International Classification of Functioning Disability and Health (ICF) Core Sets for chronic conditions. The aim of the present study was to explore the possibility of constructing a cross-cultural measurement of functioning for patients with low back pain…

Comparison of the ICF Core Set for Cardiopulmonary Conditions in the Acute Hospital Setting among Different Types of Transplant Patients

ERIC Educational Resources Information Center

Ding, Xinhua

2010-01-01

To compare the functioning profiles of patients receiving different types of organ transplants using the International Classification of Functioning, Disability, and Health. The patients (n=102) were enrolled between days 5 and 10 after discharge following receipt of an organ transplant, and assessed for sociodemographic variables, the Functional…

Changing Perspectives for Practice in Stuttering: Echoes from a Celtic Past, when Wordlessness Was Entitled to Time

ERIC Educational Resources Information Center

Leahy, Margaret M.

2005-01-01

Changing perspectives for practice in stuttering therapy are informed by the changes in knowledge, social values, and belief systems of a society. The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) has a sociological emphasis with a focus on the ability and functioning of the person, and…

Measuring body structures and body functions from the International Classification of Functioning, Disability, and Health perspective: considerations for biomedical parameters in spinal cord injury research.

PubMed

Eriks-Hoogland, Inge E; Brinkhof, Martin W G; Al-Khodairy, Abdul; Baumberger, Michael; Brechbühl, Jörg; Curt, Armin; Mäder, Mark; Stucki, Gerold; Post, Marcel W M

2011-11-01

The aims of this study were to provide a selection of biomedical domains based on the comprehensive International Classification of Functioning, Disability, and Health (ICF) core sets for spinal cord injury (SCI) and to present an overview of the corresponding measurement instruments. Based on the Biomedical Domain Set, the SCI literature, the International Spinal Cord Society international data sets, and the Spinal Cord Injury Rehabilitation Evidence project publications were used to derive category specifications for use in SCI research. Expert opinion was used to derive a priority selection. The same sources were used to determine candidate measurement instruments for the specification of body functions and body structures using an example, and guiding principles were applied to select the most appropriate biomedical measurement instrument(s) for use in an SCI research project. Literature searches were performed for 41 second-level ICF body functions categories and for four second-level ICF body structures categories. For some of these categories, only a few candidate measurement instruments were found with limited variation in the type of measurement instruments. An ICF-based measurement set for biomedical aspects of functioning with SCI was established. For some categories of the ICF core sets for SCI, there is a need to develop measurement instruments.

Physical activity, body functions and disability among middle-aged and older Spanish adults.

PubMed

Caron, Alexandre; Ayala, Alba; Damián, Javier; Rodriguez-Blazquez, Carmen; Almazán, Javier; Castellote, Juan Manuel; Comin, Madgalena; Forjaz, Maria João; de Pedro, Jesús

2017-07-18

Physical activity (PA) is a health determinant among middle-aged and older adults. In contrast, poor health is expected to have a negative impact on PA. This study sought to assess to what extent specific International Classification of Functioning, Disability and Health (ICF) health components were associated with PA among older adults. We used a sample of 864 persons aged ≥50 years, positively screened for disability or cognition in a cross-sectional community survey in Spain. Weekly energy expenditure during PA was measured with the Yale Physical Activity Survey (YPAS) scale. The associations between body function impairment, health conditions or World Health Organization Disability Assessment Schedule (WHODAS 2.0) disability scores and energy expenditure were quantified using negative-binomial regression, and expressed in terms of adjusted mean ratios (aMRs). Mean energy expenditure was 4542 Kcal/week. A lower weekly energy expenditure was associated with: severe/extreme impairment of mental functions, aMR 0.38, 95% confidence interval, CI (0.21-0.68), and neuromusculoskeletal and movement functions, aMR 0.50 (0.35-0.72); WHODAS 2.0 disability, aMR 0.55 (0.34-0.91); dementia, aMR 0.45 (0.31-0.66); and heart failure, aMR 0.54 (0.34-0.87). In contrast, people with arthritis/osteoarthritis had a higher energy expenditure, aMR 1.27 (1.07-1.51). Our results suggest that there is a strong relationship between selected body function impairments, mainly mental, and PA. Although more research is needed to fully understand causal relationships, strategies to improve PA among the elderly may require targeting mental, neuromusculoskeletal and movement functions, disability determinants (including barriers), and specific approaches for persons with dementia or heart failure.

Development of an Instrument for Assessing Elder Care Needs

ERIC Educational Resources Information Center

Åhsberg, Elizabeth; Fahlström, Gunilla; Rönnbäck, Eva; Granberg, Ann-Kristin; Almborg, Ann-Helene

2017-01-01

Objective: To construct a needs assessment instrument for older people using a standardized terminology (International classification of functioning, disability, and health [ICF]) and assess its psychometrical properties. Method: An instrument was developed comprising questions to older people regarding their perceived care needs. The instrument's…

Comprehensive Stuttering Treatment or Adolescents: A Case Study

ERIC Educational Resources Information Center

Coleman, Craig E.

2018-01-01

Purpose: This article will focus on a hypothetical case study to highlight comprehensive assessment and treatment for adolescent children who stutter. Method: Assessment and treatment are laid out with a literature review utilizing the components of the International Classification of Functioning, Disability and Health model. Specific assessment…

A Conceptual Foundation for Measures of Physical Function and Behavioral Health Function for Social Security Work Disability Evaluation

PubMed Central

Marfeo, Elizabeth E.; Haley, Stephen M.; Jette, Alan M.; Eisen, Susan V.; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M.; Chan, Leighton; Brandt, Diane E.; Rasch, Elizabeth K.

2014-01-01

Physical and mental impairments represent the two largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person’s underlying capabilities as well as activity demands relevant to the context of work. The objective of this paper is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, two content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability, and Health (ICF) as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies five major domains (1) Behavior Control, (2) Basic Interactions, (3) Temperament and Personality, (4) Adaptability, and (5) Workplace Behaviors. The content model describing physical functioning includes three domains (1) Changing and Maintaining Body Position, (2) Whole Body Mobility, and (3) Carrying, Moving and Handling Objects. These content models informed subsequent measurement properties including item development, measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. PMID:23548543

Which factors most influence referral for restorative dental treatment under sedation and general anaesthesia in children with complex disabilities: caries severity, child functioning, or dental service organisation?

PubMed

Norderyd, Johanna; Faulks, Denise; Molina, Gustavo; Granlund, Mats; Klingberg, Gunilla

2018-01-01

The UN Convention on the Rights of the Child gives all children right to the highest standard of services for treatment and rehabilitation. For children with disabilities, sedation and general anaesthesia (GA) are often indicated for dental treatment; however, accessibility to this varies. The International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) enables a biopsychosocial description of children undergoing dental treatment. To investigate conscious sedation and GA in children with complex disabilities and manifest caries and analyse how caries, child functioning, and dental service organisation relate to dental GA (DGA), comparing Argentina, France, and Sweden using the ICF-CY. Quantitative, cross-sectional; data collected through structured interviews, observation, and dental records. Sedation and DGA were common. Children with limitations in interpersonal interactions and relationships were more likely to have had DGA (OR: 5.3, P = 0.015). Level of caries experience was strongly correlated with experience of DGA. There were significant differences between countries regarding caries prevalence, sedation, DGA, and functional and environmental factors. Although caries experience and child functioning are important, dental health service organisation had the most impact on the incidence of DGA, and for the use of conscious sedation, for children with complex disabilities. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The International Classification of Functioning, Disability and Health (ICF) in vocational rehabilitation and disability assessment in Slovenia: state of law and users' perspective.

PubMed

Ptyushkin, Pavel; Vidmar, Gaj; Burger, Helena; Marinček, Crt; Escorpizo, Reuben

2011-01-01

This study illustrates the use of the ICF in vocational rehabilitation and disability assessment in Slovenia. A review of the Slovenian law about vocational rehabilitation was performed. A survey was developed and group and individual interviews were conducted with professionals involved in vocational rehabilitation who use the ICF. The vast majority of the respondents believe that ICF helps to create a common language for multidisciplinary communication. The main advantages of the ICF identified by the respondents are that it provides a holistic view of the person, assesses complexities of functioning, provides a unified language and offers a quick and easy insight into functioning. The disadvantages of ICF are complicated terminology and subjectivity of the assessor. A difficulty encountered by the users is that by law, only body functions of the ICF are assessed. Additional qualitative analysis of the users' understanding of ICF and its purpose revealed heterogeneity. Significant differences between public and private organisations were found. ICF is a promising tool for use in vocational rehabilitation and disability assessment in Slovenia. A major challenge is the lack of interface between ICF and policies on vocational rehabilitation in Slovenia.

I-CAN: the classification and prediction of support needs.

PubMed

Arnold, Samuel R C; Riches, Vivienne C; Stancliffe, Roger J

2014-03-01

Since 1992, the diagnosis and classification of intellectual disability has been dependent upon three constructs: intelligence, adaptive behaviour and support needs (Luckasson et al. 1992. Mental Retardation: Definition, Classification and Systems of Support. American Association on Intellectual and Developmental Disability, Washington, DC). While the methods and instruments to measure intelligence and adaptive behaviour are well established and generally accepted, the measurement and classification of support needs is still in its infancy. This article explores the measurement and classification of support needs. A study is presented comparing scores on the ICF (WHO, 2001) based I-CAN v4.2 support needs assessment and planning tool with expert clinical judgment using a proposed classification of support needs. A logical classification algorithm was developed and validated on a separate sample. Good internal consistency (range 0.73-0.91, N = 186) and criterion validity (κ = 0.94, n = 49) were found. Further advances in our understanding and measurement of support needs could change the way we assess, describe and classify disability. © 2013 John Wiley & Sons Ltd.

Burn patients' return to daily activities and participation as defined by the International Classification of Functioning, Disability and Health: A systematic review.

PubMed

Osborne, Candice L; Meyer, Walter J; Ottenbacher, Kenneth J; Arcari, Christine M

2017-06-01

The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a universal classification system of health and health-related domains. The ICF has been successfully applied to a wide range of health conditions and diseases; however, its application in the field of burn recovery has been minimal. This systematic review uses the domains of the ICF component 'activities and participation' to explore: (1) the extent to which return to daily activities and community participation after burn has been examined in the pediatric population, (2) the most common assessments used to determine activity and participation outcomes, and (3) what activity and participation areas are most affected in the pediatric burn population after discharge from acute care. Results determined that it is difficult to draw overarching conclusions in the area of return to 'activities and participation' for children with burn based on the paucity of current evidence. Of the studies conducted, few examined the same subtopics or used similar measurements. This suggests a need for more robust studies in this area in order to inform and improve burn rehabilitation practices to meet the potential needs of burn patients beyond an acute care setting. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Classification of intellectual disability using the Wechsler Intelligence Scale for Children: Full Scale IQ or General Abilities Index?

PubMed Central

KORIAKIN, TAYLOR A; MCCURDY, MARK D; PAPAZOGLOU, AIMILIA; PRITCHARD, ALISON E; ZABEL, T ANDREW; MAHONE, E MARK; JACOBSON, LISA A

2013-01-01

Aim We examined the implications of using the Full Scale Intelligence Quotient (FSIQ) versus the General Abilities Index (GAI) for determination of intellectual disability using the Wechsler Intelligence Scales for Children, fourth edition (WISC-IV). Method Children referred for neuropsychological assessment (543 males, 290 females; mean age 10y 5mo, SD 2y 9mo, range 6–16y) were administered the WISC-IV and the Adaptive Behavior Assessment System, Second Edition (ABAS-II). Results GAI and FSIQ were highly correlated; however, fewer children were identified as having intellectual disability using GAI (n=159) than when using FSIQ (n=196). Although the 44 children classified as having intellectual disability based upon FSIQ (but not GAI) had significantly higher adaptive functioning scores than those meeting intellectual disability criteria based upon both FSIQ and GAI, mean adaptive scores still fell within the impaired range. FSIQ and GAI were comparable in predicting impairments in adaptive functioning. Interpretation Using GAI rather than FSIQ in intellectual disability diagnostic decision making resulted in fewer individuals being diagnosed with intellectual disability; however, the mean GAI of the disqualified individuals was at the upper end of criteria for intellectual impairment (standard score 75), and these individuals remained adaptively impaired. As GAI and FSIQ were similarly predictive of overall adaptive functioning, the use of GAI for intellectual disability diagnostic decision making may be of limited value. PMID:23859669

[Disability as a restriction on social participation: challenges in evaluation since the Brazilian Inclusion of People with Disabilities Act].

PubMed

Santos, Wederson

2016-10-01

This article discusses the main advances and challenges for understanding and evaluating disability as a restriction for social participation. This new understanding has its origins in the 2006 WHO International Classification of Functioning, Disability, and Health - ICF, the 2001 UN Convention on the Rights of Persons with Disabilities, and more recently, the July 2015 Brazilian Inclusion of People with Disabilities Act (IPDA), also known as the Statute on Persons with Disabilities. The change in the understanding of disability from a merely biomedical perspective, to an understanding that is based on oppression and social inequality reinforces the idea that disability is not an individual attribute, but the result of a society that is not prepared for human diversity. Based on a legislative analysis of the many documents on policies regarding persons with disabilities, notably the IPDA and the evaluations of disability that the ICF already uses in Brazil, the main contention proposed is that classifying and valuing disability is challenging for professional evaluators as well as for Brazilian public policy. This is mainly due to the challenges of recognizing the barriers and environmental factors that hamper the full participation in society of people with disabilities.

Effects of Dog-Assisted Therapy on Communication and Basic Social Skills of Adults With Intellectual Disabilities: A Pilot Study.

PubMed

Scorzato, Ivano; Zaninotto, Leonardo; Romano, Michela; Menardi, Chiara; Cavedon, Lino; Pegoraro, Alessandra; Socche, Laura; Zanetti, Piera; Coppiello, Deborah

2017-06-01

Thirty-nine adults with severe to profound intellectual disability (ID) were randomly assigned to either an experimental group (n = 21) or a control group (n = 18). Assessment was blinded and included selected items from the International Classification of Functioning, Disability and Health (ICF), the Behavioral Assessment Battery (BAB), and the Learning Accomplishment Profile (LAP). The experimental group, who attended a dog-assisted treatment intervention over a 20-week period, showed significant improvements in several cognitive domains, including attention to movement (BAB-AM), visuomotor coordination (BAB-VM), exploratory play (BAB-EP), and motor imitation (BAB-CO-MI), as well as in some social skills, as measured by LAP items. Effects were specific to the intervention and independent of age or basic level of disability.

Understanding Intellectual Disability through Rasopathies

PubMed Central

Alvaro, San Martín; Rafael, Pagani Mario

2014-01-01

Intellectual disability, commonly known as mental retardation in the International Classification of Disease from World Health Organization, is the term that describes an intellectual and adaptive cognitive disability that begins in early life during the developmental period. Currently the term intellectual disability is the preferred one. Although our understanding of the physiological basis of learning and learning disability is poor, a general idea is that such condition is quite permanent. However, investigations in animal models suggest that learning disability can be functional in nature and as such reversible through pharmacology or appropriate learning paradigms. A fraction of the cases of intellectual disability is caused by point mutations or deletions in genes that encode for proteins of the RAS/MAP Kinase signaling pathway known as RASopathies. Here we examined the current understanding of the molecular mechanisms involved in this group of genetic disorders focusing in studies which provide evidence that intellectual disability is potentially treatable and curable. The evidence presented supports the idea that with the appropriate understanding of the molecular mechanisms involved, intellectual disability could be treated pharmacologically and perhaps through specific mechanistic-based teaching strategies. PMID:24859216

Understanding intellectual disability through RASopathies.

PubMed

San Martín, Alvaro; Pagani, Mario Rafael

2014-01-01

Intellectual disability, commonly known as mental retardation in the International Classification of Disease from World Health Organization, is the term that describes an intellectual and adaptive cognitive disability that begins in early life during the developmental period. Currently the term intellectual disability is the preferred one. Although our understanding of the physiological basis of learning and learning disability is poor, a general idea is that such condition is quite permanent. However, investigations in animal models suggest that learning disability can be functional in nature and as such reversible through pharmacology or appropriate learning paradigms. A fraction of the cases of intellectual disability is caused by point mutations or deletions in genes that encode for proteins of the RAS/MAP kinase signaling pathway known as RASopathies. Here we examined the current understanding of the molecular mechanisms involved in this group of genetic disorders focusing in studies which provide evidence that intellectual disability is potentially treatable and curable. The evidence presented supports the idea that with the appropriate understanding of the molecular mechanisms involved, intellectual disability could be treated pharmacologically and perhaps through specific mechanistic-based teaching strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neuropsychological Aspects of Developmental Dyscalculia.

ERIC Educational Resources Information Center

Shalev, R. S.; Manor, O.; Gross-Tsur, V.

1997-01-01

Classification of arithmetic disorders is predicated on neuropsychological features and associated learning disabilities. Assesses the compatibility of these classifications on a nonreferred, population-based cohort of children (N=139) with developmental dyscalculia. Concludes that children with dyscalculia and disabilities in reading and/or…

Physical 'disability' in Bantu languages: understanding the relativity of classification and meaning.

PubMed

Devlieger, P J

1998-03-01

The terminology related to 'physical disability' in proto-Bantu and in contemporary Bantu languages of Zone L are examined for a better understanding of African classification and meaning. The methods used in the examination include 'words and things' and ethnographic fieldwork. In proto-Bantu, nominal classes are used to categorize disability as both human and non-human. Based on the distribution of terminology, a support for differing regional and historical meaning is developed. The most ancient meaning links physical disability to 'becoming heavy' out of which variants developed. In contemporary Bantu languages in Zone L, the widespread use of the term -lema reemphasizes categorization in both human and non-human, and the use of meaning found in proto-Bantu is evident. However, ethnographic work in the same language area indicates that other terms are important to an understanding of classification and meaning related to physical disability in Zone L. These terms relate to sorcery or reincarnation as meanings attached to disability.

Usability of World Health Organization Disability Assessment Schedule in chronic traumatic brain injury.

PubMed

Tarvonen-Schröder, Sinikka; Tenovuo, Olli; Kaljonen, Anne; Laimi, Katri

2018-06-15

To investigate functioning measured with the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) in patients with mild, moderate and severe traumatic brain injury, and to compare patients' experiences with assessments made by their significant others and by consultant neurologists. A total of 112 consecutive patients with traumatic brain injury (29 mild, 43 moderate, 40 severe) and their significant others completed a 12-item WHODAS 2.0 survey. A neurologist assessed functioning with the International Classification of Functioning, Disability and Health minimal generic set. The total patient and proxy WHODAS 2.0 sum score was rated as severe, and impairments in household tasks, learning, community life, emotional functions, concentrating, dealing with strangers, maintaining friendships, and working ability as around moderate in all 3 severity groups. In standing, walking, washing, and dressing oneself the reported impairments increased from mild in mild traumatic brain injury to moderate in severe traumatic brain injury. A neurologist rated the overall functioning, working ability, and motor activities most impaired in severe traumatic brain injury, while there were no between-group differences in energy and drive functions and emotional functions. Patients with chronic traumatic brain injury perceive a diversity of significant difficulties in activities and participation irrespective of the severity of the injury. We recommend assessing disability in traumatic brain injury with the short and understandable WHODAS 2.0 scale, when planning client-oriented services.

Clinical utility and validity of the Functional Disability Inventory (FDI) among a multicenter sample of youth with chronic pain

PubMed Central

Kashikar-Zuck, Susmita; Flowers, Stacy R.; Claar, Robyn Lewis; Guite, Jessica W.; Logan, Deirdre E.; Lynch-Jordan, Anne M; Palermo, Tonya M.; Wilson, Anna C.

2011-01-01

The Functional Disability Inventory (FDI) is a well-established and commonly used measure of physical functioning and disability in youth with chronic pain. Further validation of the measure has been called for, in particular, examination of the clinical utility and factor structure of the measure. To address this need, we utilized a large multicenter dataset of pediatric patients with chronic pain who had completed the FDI and other measures assessing pain and emotional functioning. Clinical reference points to allow for interpretation of raw scores were developed to enhance clinical utility of the measure and exploratory factor analysis was performed to examine its factor structure. Participants included 1300 youth ages 8 to 18 years (M=14.2 years; 76% female) with chronic pain. Examination of the distribution of FDI scores and validation with measures of depressive symptoms and pain intensity yielded three distinct categories of disability: No/Minimal Disability, Moderate Disability and Severe Disability. Factor analysis of FDI scores revealed a two-factor solution representing vigorous Physical Activities and non-physically strenuous Daily Activities. The three-level classification system and factor structure were further explored via comparison across the four most commonly encountered pain conditions in clinical settings (head, back, abdominal and widespread pain). Our findings provide important new information regarding the clinical utility and validity of the FDI. This will greatly enhance the interpretability of scores for research and clinical use in a wide range of pediatric pain conditions. In particular these findings will facilitate use of the FDI as an outcome measure in future clinical trials. PMID:21458162

Mapping the Mayo-Portland adaptability inventory to the international classification of functioning, disability and health.

PubMed

Lexell, Jan; Malec, James F; Jacobsson, Lars J

2012-01-01

To examine the contents of the Mayo-Portland Adaptability Inventory (MPAI-4) by mapping it to the International Classification of Functioning, Disability and Health (ICF). Each of the 30 scoreable items in the MPAI-4 was mapped to the most precise ICF categories. All 30 items could be mapped to components and categories in the ICF. A total of 88 meaningful concepts were identified. There were, on average, 2.9 meaningful concepts per item, and 65% of all concepts could be mapped. Items in the Ability and Adjustment subscales mapped to categories in both the Body Functions and Activity/Participation components of the ICF, whereas all except 1 in the Participation subscale were to categories in the Activity/Participation component. The items could also be mapped to 34 (13%) of the 258 Environmental Factors in the ICF. This mapping provides better definition through more concrete examples (as listed in the ICF) of the types of body functions, activities, and participation indicators that are represented by the 30 scoreable MPAI-4 items. This may assist users throughout the world in understanding the intent of each item, and support further development and the possibility to report results in the form of an ICF categorical profile, making it universally interpretable.

Racial/Ethnic Disparities in Disability Prevalence.

PubMed

Goyat, Rashmi; Vyas, Ami; Sambamoorthi, Usha

2016-12-01

Worldwide, the number of disabled individuals is used as a marker for population health status because of high morbidity and mortality burden associated with disability. The primary objective of the current study is to use the 2012 NHIS disability supplement and examine racial/ethnic disparities in disability after controlling for a comprehensive list of factors, using the World Health Organization's International Classification of Functioning, Disability, and Health (WHO-ICF). A retrospective cross-sectional study design with data from 7993 individuals aged above 21 years from the 2012 National Health Interview Survey (NHIS) was adopted. Disability was defined based on a standard set of questions related to mobility, self-care, and cognition from the "Functioning and Disability" supplement of 2012 NHIS. Chi-squared tests and multinomial logistic regressions were conducted to examine the association between race/ethnicity and disability. There were statistically significant racial/ethnic differences in disability status; 10.2 % non-Hispanic whites, 14.8 % non-Hispanic African Americans, 8.1 % Latino, and 6.7 % other racial minorities had severe disability. Non-Hispanic African Americans were more likely to have severe disability than were non-Hispanic whites (OR = 1.56, 95 % CI = 1.24, 1.95), and Latinos were less likely to have severe disability (OR = 0.70, 95 % CI = 0.55, 0.90) in the unadjusted model. There was no difference in disability status among non-Hispanic African Americans and non-Hispanic whites after adjusting for socio-economic status. The study findings highlighted the role of socio-economic characteristics in reducing disparities in disability between non-Hispanic African Americans and non-Hispanic whites. As SES can affect health through a complex interaction of biological, psychological, lifestyle, environmental, social, and neighborhood factors, a multipronged approach that focuses on primary, secondary, and territory prevention of disability is needed.

Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey.

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kostanjsek, Nenad; Kowal, Paul; Officer, Alana; Chatterji, Somnath

2016-04-01

Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.

Social Recognition, Participation, and the Dynamic between the Environment and Personal Factors of Students with Deafblindness

ERIC Educational Resources Information Center

Moller, Kerstin; Danermark, Berth

2007-01-01

The study describes environmental and personal factors that, from the student perspective, impede participation in education in secondary upper schools by students with postlingual deafblindness. The discussion is framed by the International Classification of Functioning, Disability, and Health. The researchers use the theory of social recognition…

Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children With Language Impairments.

PubMed

Westby, Carol; Washington, Karla N

2017-07-26

The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment. This tutorial reviews the framework of the ICF, describes the implications of the ICF for SLPs, distinguishes between students' capacity to perform a skill in a structured context and the actual performance of that skill in naturalistic contexts, and provides a case study of an elementary school child to demonstrate how the principles of the ICF can guide assessment and intervention. The Scope of Practice and Preferred Practice documents for the American Speech-Language-Hearing Association identify the ICF as the framework for practice in speech-language pathology. This tutorial will facilitate clinicians' ability to identify personal and environmental factors that influence students' skill capacity and skill performance, assess students' capacity and performance, and develop impairment-based and socially based language goals linked to Common Core State Standards that build students' language capacity and their communicative performance in naturalistic contexts.

Hearing and Cognitive Impairment and the Role of the International Classification of Functioning, Disability and Health as a Rehabilitation Framework

PubMed Central

Lind, Christopher; Meyer, Carly; Young, Jessica

2016-01-01

The International Classification of Functioning, Disability and Health (ICF) has been applied widely in the literature to describe and differentiate the broad implications of hearing impairment (HI) and cognitive impairment (CI) on communication. As CI and HI are largely age-related conditions, the likelihood of comorbidity of these conditions is high. In the context of an aging population, the prevalence of comorbidity is likely to rise, yet much of the clinical assessment and intervention in HI and CI occur separately. The benefit of addressing the dual impact of these conditions is of increasing clinical importance for all clinicians working with older adults and for audiologists and speech pathologists in particular. In this article, the ICF model will be applied to explore the everyday implications of HI and CI. Furthermore, the clinical implications of the ICF model are explored with particular respect to communication assessment and intervention options. The potential benefit of combining activity- and participation-focused interventions currently offered for HI and CI independently is examined. PMID:27489399

Juvenile idiopathic arthritis in adulthood: fulfilment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage.

PubMed

Oliveira-Ramos, Filipa; Eusébio, Mónica; M Martins, Fernando; Mourão, Ana Filipa; Furtado, Carolina; Campanilho-Marques, Raquel; Cordeiro, Inês; Ferreira, Joana; Cerqueira, Marcos; Figueira, Ricardo; Brito, Iva; Canhão, Helena; Santos, Maria José; Melo-Gomes, José A; Fonseca, João Eurico

2016-01-01

To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage. Patients with JIA registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index-articular (JADI-A) and Juvenile Arthritis Damage Index-extra-articular (JADI-E) damage index and disease activity were analysed. 426 patients were included. Most of patients with systemic JIA fulfilled criteria for Adult Still's disease. 95.6% of the patients with rheumatoid factor (RF)-positive polyarthritis and 57.1% of the patients with RF-negative polyarthritis matched criteria for rheumatoid arthritis (RA). 38.9% of the patients with extended oligoarthritis were classified as RA while 34.8% of the patients with persistent oligoarthritis were classified as spondyloarthritis. Patients with enthesitis-related arthritis fulfilled criteria for spondyloarthritis in 94.7%. Patients with psoriatic arthritis maintained this classification. Patients with inactive disease had lower disease duration, lower diagnosis delay and corticosteroids exposure. Longer disease duration was associated with higher HAQ, JADI-A and JADI-E. Higher JADI-A was also associated with biological treatment and retirement due to JIA disability and higher JADI-E with corticosteroids exposure. Younger age at disease onset was predictive of higher HAQ, JADI-A and JADI-E and decreased the chance of inactive disease. Most of the included patients fulfilled classification criteria for adult rheumatic diseases, maintain active disease and have functional impairment. Younger age at disease onset was predictive of higher disability and decreased the chance of inactive disease.

Impaired Kidney Function and Associated Factors Among Rural Adults With Disabilities in Taiwan.

PubMed

Chen, Chu-Yeh; Chiu, Wen-Nan; Lin, Yu-Chen; Jane, Sui-Hwi; Chiang, Hsin-Hung; Chen, Mei-Yen

2017-04-01

The results of numerous studies indicate that people with disabilities seek more healthcare than those who are not disabled, particularly for conditions such as chronic kidney disease, cardiovascular disease, and obesity. However, little is known about the incidence of impaired kidney function and its associated factors among adults with disabilities in Taiwan. The aim of this study was to explore the prevalence and factors associated with impaired kidney function among adults with disabilities. This descriptive study was nurse led and was conducted as part of a health promotion program for disadvantaged rural adults with disabilities in Chiayi County, Taiwan. Health screening and a health needs survey were conducted between July and December 2013. Kidney function, physiological biomarkers, health-related behaviors, and demographic characteristics were examined. Eight hundred ten rural adults with disabilities were enrolled. The most common disabilities included physical-related disability (33.1%), intellectual-related disability (26.7%), and hearing and vision impairment (18.6%). The prevalence of impaired kidney function in this population was 85%. According to classification for chronic kidney disease, 68.6% were in Stages 1-2, and 16.8% were in Stages 3-4. Univariate analysis showed that impaired kidney function was significantly associated with lower educational level (p < .001), hearing or vision impairment (p < .001), being overweight or obese (p < .05), high systolic blood pressure (p < .01), fasting blood glucose (p < .001), total cholesterol (p < .001), total triglyceride (p < .05), older age (p < .001), smoking (p < .05), chewing betel nuts (p = .001), and low levels of participation in social activities (p < .05). The final logistic regression model showed that residents with disabilities who were older or had less education, high fasting blood glucose, and high total cholesterol tended to have impaired kidney function after adjustment for other potential confounding variables. Most participants showed impaired kidney function. The factors that were found to relate significantly to this impairment include being overweight, having hyperlipidemia, having hypertension, having high fasting blood glucose, and having an unhealthy lifestyle. Because of the lack of symptoms during the early stages of chronic kidney disease, a community-based health promotion program for these factors is an important element in health advocacy for this vulnerable population.

Searching for disability in electronic databases of published literature.

PubMed

Walsh, Emily S; Peterson, Jana J; Judkins, Dolores Z

2014-01-01

As researchers in disability and health conduct systematic reviews with greater frequency, the definition of disability used in these reviews gains importance. Translating a comprehensive conceptual definition of "disability" into an operational definition that utilizes electronic databases in the health sciences is a difficult step necessary for performing systematic literature reviews in the field. Consistency of definition across studies will help build a body of evidence that is comparable and amenable to synthesis. To illustrate a process for operationalizing the World Health Organization's International Classification of Disability, Functioning, and Health concept of disability for MEDLINE, PsycINFO, and CINAHL databases. We created an electronic search strategy in conjunction with a reference librarian and an expert panel. Quality control steps included comparison of search results to results of a search for a specific disabling condition and to articles nominated by the expert panel. The complete search strategy is presented. Results of the quality control steps indicated that our strategy was sufficiently sensitive and specific. Our search strategy will be valuable to researchers conducting literature reviews on broad populations with disabilities. Copyright © 2014 Elsevier Inc. All rights reserved.

Intellectual developmental disorders: towards a new name, definition and framework for “mental retardation/intellectual disability” in ICD-11

PubMed Central

CARULLA, LUIS SALVADOR; REED, GEOFFREY M.; VAEZ-AZIZI, LEILA M.; COOPER, SALLY-ANN; LEAL, RAFAEL MARTINEZ; BERTELLI, MARCO; ADNAMS, COLLEEN; COORAY, SHERVA; DEB, SHOUMITRO; DIRANI, LEYLA AKOURY; GIRIMAJI, SATISH CHANDRA; KATZ, GREGORIO; KWOK, HENRY; LUCKASSON, RUTH; SIMEONSSON, RUNE; WALSH, CAROLYN; MUNIR, KEMIR; SAXENA, SHEKHAR

2011-01-01

Although “intellectual disability” has widely replaced the term “mental retardation”, the debate as to whether this entity should be conceptualized as a health condition or as a disability has intensified as the revision of the World Health Organization (WHO)’s International Classification of Diseases (ICD) advances. Defining intellectual disability as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. This paper presents the consensus reached to date by the WHO ICD Working Group on the Classification of Intellectual Disabilities. Literature reviews were conducted and a mixed qualitative approach was followed in a series of meetings to produce consensus-based recommendations combining prior expert knowledge and available evidence. The Working Group proposes replacing mental retardation with intellectual developmental disorders, defined as “a group of developmental conditions characterized by significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills”. The Working Group further advises that intellectual developmental disorders be incorporated in the larger grouping (parent category) of neurodevelopmental disorders, that current subcategories based on clinical severity (i.e., mild, moderate, severe, profound) be continued, and that problem behaviours be removed from the core classification structure of intellectual developmental disorders and instead described as associated features. PMID:21991267

Conceptual foundation for measures of physical function and behavioral health function for Social Security work disability evaluation.

PubMed

Marfeo, Elizabeth E; Haley, Stephen M; Jette, Alan M; Eisen, Susan V; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M; Chan, Leighton; Brandt, Diane E; Rasch, Elizabeth K

2013-09-01

Physical and mental impairments represent the 2 largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person's underlying capabilities as well as activity demands relevant to the context of work. The objective of this article is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, 2 content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability and Health as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies 5 major domains: (1) behavior control, (2) basic interactions, (3) temperament and personality, (4) adaptability, and (5) workplace behaviors. The content model describing physical functioning includes 3 domains: (1) changing and maintaining body position, (2) whole-body mobility, and (3) carrying, moving, and handling objects. These content models informed subsequent measurement properties including item development and measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review.

PubMed

Calder, Samuel; Ward, Roslyn; Jones, Megan; Johnston, Jenelle; Claessen, Mary

2017-07-18

Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as multidisciplinary outcome measures for children with developmental disability. The selection of an appropriate outcome measure depends on the age of the child, individual goals of the family, and the type of intervention. This requires the combination of measures as no one measure alone will capture all components of the International Classification of Functioning-Child & Youth.

Validation of environmental content in the Young Children's Participation and Environment Measure.

PubMed

Khetani, Mary A

2015-02-01

To evaluate the concurrent validity of the environment content in the newly developed Young Children's Participation and Environment Measure (YC-PEM). Cross-sectional study. Data were collected online. Convenience and snowball sampling methods were used to survey caregivers of children (N=381; 85 children with developmental disabilities and delays and 296 children without developmental disabilities and delays) aged 0 and 5 years (mean age, 36.49±20.18 mo). Not applicable. The YC-PEM includes an assessment of the effect of environment on children's participation for 3 settings: home, daycare/preschool, and community. Pearson and Spearman correlational analyses were used to examine the concurrent validity of the YC-PEM environmental content according to a criterion measure, the Craig Hospital Inventory of Environmental Factors-Child and Parent Version (CHIEF-CP). The YC-PEM and the CHIEF-CP items were first mapped to the International Classification of Functioning, Disability, and Health-Children and Youth Version to identify items for pairwise comparison. We found small to moderate negative associations for 51 of 66 pairwise comparisons involving CHIEF-CP and YC-PEM environment items (r=-.13 to -.39; P<.01). Significant associations were found for items in all 5 International Classification of Functioning, Disability and Health-Children and Youth Version environmental domains. Results lend further support for the use of the YC-PEM for valid caregiver assessment of the physical, social, attitudinal, and institutional features of environments in terms of their effect on young children's participation within the home, daycare/preschool, and community settings. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Associations among occupational roles, independence, assistive technology, and purchasing power of individuals with physical disabilities.

PubMed

da Cruz, Daniel Marinho Cezar; Emmel, Maria Luisa Guillaumon

2013-01-01

to verify whether there are associations among occupational roles, independence to perform Activities of Daily Living, purchasing power, and assistive technology for individuals with physical disabilities. 91 individuals with physical disabilities participated in the study. The instruments used were: Role Checklist, Brazilian Economic Classification Criterion, Barthel Index, and a Questionnaire to characterize the subjects. an association with a greater number of roles was found among more independent individuals using a lower number of technological devices. Higher purchasing power was associated with a lower functional status of dependence. even though technology was not directly associated with independence, the latter was associated with a greater number of occupational roles, which requires reflection upon independence issues when considering the participation in occupational roles. These findings support interdisciplinary actions designed to promote occupational roles in individuals with physical disabilities.

Cost-effectiveness of a classification-based system for sub-acute and chronic low back pain.

PubMed

Apeldoorn, Adri T; Bosmans, Judith E; Ostelo, Raymond W; de Vet, Henrica C W; van Tulder, Maurits W

2012-07-01

Identifying relevant subgroups in patients with low back pain (LBP) is considered important to guide physical therapy practice and to improve outcomes. The aim of the present study was to assess the cost-effectiveness of a modified version of Delitto's classification-based treatment approach compared with usual physical therapy care in patients with sub-acute and chronic LBP with 1 year follow-up. All patients were classified using the modified version of Delitto's classification-based system and then randomly assigned to receive either classification-based treatment or usual physical therapy care. The main clinical outcomes measured were; global perceived effect, intensity of pain, functional disability and quality of life. Costs were measured from a societal perspective. Multiple imputations were used for missing data. Uncertainty surrounding cost differences and incremental cost-effectiveness ratios was estimated using bootstrapping. Cost-effectiveness planes and cost-effectiveness acceptability curves were estimated. In total, 156 patients were included. The outcome analyses showed a significantly better outcome on global perceived effect favoring the classification-based approach, and no differences between the groups on pain, disability and quality-adjusted life-years. Mean total societal costs for the classification-based group were 2,287, and for the usual physical therapy care group 2,020. The difference was 266 (95% CI -720 to 1,612) and not statistically significant. Cost-effectiveness analyses showed that the classification-based approach was not cost-effective in comparison with usual physical therapy care for any clinical outcome measure. The classification-based treatment approach as used in this study was not cost-effective in comparison with usual physical therapy care in a population of patients with sub-acute and chronic LBP.

Beyond diagnosis: the Core Sets for persons with schizophrenia based on the World Health Organization's International Classification of Functioning, Disability, and Health.

PubMed

Gómez-Benito, Juana; Guilera, Georgina; Barrios, Maite; Rojo, Emilio; Pino, Oscar; Gorostiaga, Arantxa; Balluerka, Nekane; Hidalgo, María Dolores; Padilla, José Luis; Benítez, Isabel; Selb, Melissa

2017-07-30

Based on the International Classification of Functioning, Disability and Health (ICF), this paper presents the results of the process to develop the Comprehensive and Brief Core Sets for schizophrenia that allow to comprehensively describe functioning in persons with schizophrenia. Twenty health professionals from diverse backgrounds participated in a formal and iterative decision-making process during an international consensus conference to develop these Core Sets. The conference was carried out based on evidence gathered from four preparatory studies (systematic literature review, qualitative study, expert survey, and empirical study). The first step of this decision-making and consensus process comprised of discussions and voting in working groups and plenary sessions to develop the comprehensive version. The categories of the Comprehensive ICF Core Set for schizophrenia served as the basis for the second step -a ranking and cutoff procedure to decide on the brief version. Of the 184 candidate categories identified in the preparatory studies, 97 categories were included in the Comprehensive Core Set for schizophrenia. A total of 25 categories were selected to constitute the Brief Core Set. The formal decision-making and consensus process integrating evidence from four preparatory studies and expert opinion led to the first version of the Core Sets for schizophrenia. Comprehensive and Brief Core Sets for schizophrenia may provide a common language among different health professionals and researchers, and a basic international standard of what to measure, report, and assess the functioning of persons with schizophrenia. Implications for rehabilitation Schizophrenia is a chronic mental disorder that has a tremendous impact on functioning and daily life of persons living with the disorder. The International Classification of Functioning, Disability and Health (ICF) offers an internationally recognized standard for describing the functioning status of these individuals. The Core Sets for schizophrenia have potential use in supporting rehabilitation practice such as for planning mental health services and other interventions or defining rehabilitation goals, and documenting patient care. The Core Sets for schizophrenia may also be used to promote interdisciplinary coordination and facilitate communication between members of a multidisciplinary rehabilitation team. Rehabilitation research is another potential area of application of the Core Sets for schizophrenia. This is valuable, since rehabilitation research provides crucial evidence for optimizing rehabilitation practice.

Musculoskeletal system problems and quality of life of mothers of children with cerebral palsy with different levels of disability.

PubMed

Kavlak, Erdoğan; Altuğ, Filiz; Büker, Nihal; Şenol, Hande

2015-01-01

The objective of this study is to investigate musculoskeletal system problems and quality of life of mothers of children with cerebral palsy with different levels of disability. 100 children (37 girls and 63 boys) with cerebral palsy (CP) and their mothers were included in this study. Functional levels of children with CP were assessed by using the Gross Motor Function Classification System (GMFCS) and the Pediatric Functional Independence Measure (WeeFIM). Quality of life of mothers regarding health was assessed by using the Nottingham Health Profile (NHP). Musculoskeletal system problems of mothers were assessed by using the Neck Disability Index (NDI) and the Roland-Morris Disability Questionnaire (RMDQ). No statistical significance was found when GMFCS levels of children with CP and the NHP, DASH-T, RMDQ, NDI and the BAE values of mothers were compared in an inter-group way (p> 0.05). When the NHP parameters and the existence of lower and arm pains of mothers were compared with their BAI, NDI, RMDQ and DASH-T scores, a statistically significant relationship was found among them (p< 0.05). As functional levels of children with CP get worse, upper extremity, lower back and neck problems and anxiety levels of mothers increase and this situation negatively affects mothers' quality of life.

Using the International Classification of Functioning, Disability and Health (ICF) to describe children referred to special care or paediatric dental services.

PubMed

Faulks, Denise; Norderyd, Johanna; Molina, Gustavo; Macgiolla Phadraig, Caoimhin; Scagnet, Gabriela; Eschevins, Caroline; Hennequin, Martine

2013-01-01

Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child's capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child's real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ± 3.6 yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were 'Intellectual functions', 'High-level cognitive functions', and 'Attention functions'. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including 'Handling stress', 'Caring for body parts', 'Looking after one's health' and 'Speaking'. In the Environment domain, facilitating items included 'Support of friends', 'Attitude of friends' and 'Support of immediate family'. One item was reported as an environmental barrier - 'Societal attitudes'. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might be used to develop an ICF-CY Core Set for Oral Health - a holistic but practical tool for clinical and epidemiological use.

Should Schools Expect Poor Physical and Mental Health, Social Adjustment, and Participation Outcomes in Students with Disability?

PubMed Central

Vaz, Sharmila; Cordier, Reinie; Falkmer, Marita; Ciccarelli, Marina; Parsons, Richard; McAuliffe, Tomomi; Falkmer, Torbjorn

2015-01-01

The literature on whether students with disabilities have worse physical and mental health, social adjustment, and participation outcomes when compared to their peers without disabilities is largely inconclusive. While the majority of case control studies showed significantly worse outcomes for students with disabilities; the proportion of variance accounted for is rarely reported. The current study used a population cross-sectional approach to determine the classification ability of commonly used screening and outcome measures in determining the disability status. Furthermore, the study aimed to identify the variables, if any, that best predicted the presence of disability. Results of univariate discriminant function analyses suggest that across the board, the sensitivity of the outcome/screening tools to correctly identify students with a disability was 31.9% higher than the related Positive Predictive Value (PPV). The lower PPV and Positive Likelihood Ratio (LR+) scores suggest that the included measures had limited discriminant ability (17.6% to 40.3%) in accurately identifying students at-risk for further assessment. Results of multivariate analyses suggested that poor health and hyperactivity increased the odds of having a disability about two to three times, while poor close perceived friendship and academic competences predicted disability with roughly the same magnitude. Overall, the findings of the current study highlight the need for researchers and clinicians to familiarize themselves with the psychometric properties of measures, and be cautious in matching the function of the measures with their research and clinical needs. PMID:25965845

Should schools expect poor physical and mental health, social adjustment, and participation outcomes in students with disability?

PubMed

Vaz, Sharmila; Cordier, Reinie; Falkmer, Marita; Ciccarelli, Marina; Parsons, Richard; McAuliffe, Tomomi; Falkmer, Torbjorn

2015-01-01

The literature on whether students with disabilities have worse physical and mental health, social adjustment, and participation outcomes when compared to their peers without disabilities is largely inconclusive. While the majority of case control studies showed significantly worse outcomes for students with disabilities; the proportion of variance accounted for is rarely reported. The current study used a population cross-sectional approach to determine the classification ability of commonly used screening and outcome measures in determining the disability status. Furthermore, the study aimed to identify the variables, if any, that best predicted the presence of disability. Results of univariate discriminant function analyses suggest that across the board, the sensitivity of the outcome/screening tools to correctly identify students with a disability was 31.9% higher than the related Positive Predictive Value (PPV). The lower PPV and Positive Likelihood Ratio (LR+) scores suggest that the included measures had limited discriminant ability (17.6% to 40.3%) in accurately identifying students at-risk for further assessment. Results of multivariate analyses suggested that poor health and hyperactivity increased the odds of having a disability about two to three times, while poor close perceived friendship and academic competences predicted disability with roughly the same magnitude. Overall, the findings of the current study highlight the need for researchers and clinicians to familiarize themselves with the psychometric properties of measures, and be cautious in matching the function of the measures with their research and clinical needs.

Socioeconomic position, psychosocial work environment and disability in an ageing workforce: a longitudinal analysis of SHARE data from 11 European countries.

PubMed

Reinhardt, Jan D; Wahrendorf, Morten; Siegrist, Johannes

2013-03-01

Prevention of disability in the ageing workforce is essential for sustaining economic growth in Europe. In order to provide information on entry points for preventive measures, it is important to better understand sociodemographic, socioeconomic and work-related determinants of disability in older employees. We aimed to test the hypothesis that low socioeconomic position and exposure to a stressful psychosocial work environment at baseline contribute to later disability. We further assumed that the association of socioeconomic position with disability is partly mediated by exposure to adverse working conditions. We studied longitudinal data from the first two waves of the Survey on Health, Ageing and Retirement in Europe comprising 11 European countries. Sociodemographic, socioeconomic and work-related factors (low control, effort-reward imbalance) and baseline disability of 2665 male and 2209 female employees aged between 50 and 64 years were used to predict disability 2 years later. Following the International Classification of Functioning (ICF), disability was subdivided into the components 'impairment' and 'restriction in activities and participation'. Two multilevel Poisson regressions were fitted to the data. After adjusting for baseline disability and relevant confounding variables, low socioeconomic position and chronic stress at work exerted significant effects on disability scores 2 years later. We found some support for the hypothesis that the association of socioeconomic position with disability is partly mediated by work stress. Investing in reduction of work stress and reducing social inequalities in health functioning are relevant entry points of policies that aim at maintaining work ability in early old age.

What is the gap in activity and participation between people with disability and the general population in Taiwan?

PubMed

Chiu, Tzu-Ying; Yen, Chia-Feng; Escorpizo, Reuben; Chi, Wen-Chou; Liou, Tsan-Hon; Liao, Hua-Fang; Chou, Cheng-Hsiu; Fang, Wen-Hui

2017-08-01

In 2010, the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed, based on the concept of the International Classification of Functioning, Disability and Health (ICF). The ICF provides a common language and framework for health and health-related status and attempts to integrate the biopsychosocial model as a multidimensional perspective in understanding functioning. Activities and participation (AP) is one salient component of the ICF refers to the execution of a task by an individual, and how such tasks are involved in their daily life. It is essential to examine the gap between the general adult population and adults with disabilities. This gap may be attributed to health status, personal factors, and natural and social environments, which include social and health services and policies. The purposes: (1) To develop a normative activity and participation (AP) value for the adult population and people with disabilities; and (2) to compare the gap in AP normative values between the two groups in Taiwan. We use the WHODAS 2.0 to survey and develop a normative AP value for the general adult population, and used secondary data from National Disability Eligibility Determination System (NDEDS) of Taiwan to describe the AP functioning distribution of adult with disability. There were 1100 participants, selected by stratified proportional sampling from two cities. There were also 144,850 participants who were adults with disability, selected from the secondary database in Taiwan. The AP curve for the disabled population increased rapidly at the beginning. The summary score was 13.21 in the performance at 90 percentile for the general population and 82.61 score for disabled adults that the similar gap in every domain, its means that there are significant functioning difference and health equality in general adults population and adults with disabilities. This presents a substantial challenge for both the government and the whole population of Taiwan, to begin considering how to reduce the gap in AP functioning and promote equality for people with disabilities, using social welfare policy. It is important to make sure disabled people have the same rights to be included in society as anybody else and better access to things in all areas of life that are according to Convention on the Rights of Persons with Disabilities (CRPD).

The International Classification of Function Disability and Health (ICF) in adults visiting the HIV outpatient clinic at a regional hospital in Johannesburg, South Africa.

PubMed

Van As, Melissa; Myezwa, Hellen; Stewart, Aimee; Maleka, Douglas; Musenge, Eustasius

2009-01-01

In 2005, 16.6% of South Africans between 15 and 49 years of age were HIV positive. The advent of anti-retroviral therapy has led to improved longevity, CD4 counts and clinical well-being of people living with HIV/AIDS (PLWHA). Physical impairments, activity limitations and participation restrictions of PLWHA have profound effects on the Health-related Quality of Life and functional abilities of those with the disease, and understanding thereof may assist in the formulation of rehabilitation protocols, health care interventions as well as vocational and legislative policies. The International Classification of Function, Disability and Health (ICF) is a standardised tool, endorsed by the World Health Assembly for international use, which aims to classify functioning and disability. It is structured to assess body functions and structure, functional activities and associated personal and environmental factors.This study aimed to develop a profile of the level of functional activity, using the ICF Checklist, of an urban cohort of 45 South African individuals who are HIV positive attending an outpatient clinic at the Helen Joseph Memorial Hospital, Gauteng, South Africa. The results showed a high prevalence of physical impairments, participation restrictions and selective activity limitations and that environmental factors influence their level of ability. Specific impairments where patients had problems were mental functions (69% (n=31), sensory and pain -- 71% (n=32), digestive and metabolic functions 45% (n=20) and neuromuscular 27% (n=12). Activity limitations included major life areas' 58% (n=26), interpersonal relationships 56% (n=25), mobility 40% (n=18) and general tasks and demands 38% (n=17). Limitations in mobility were significantly associated with problems of sensory functions (p=0.05), pain (p=0.006), neuromusculoskeletal and movement-related functions (p=0.006), muscle power (p=0.006) as well as energy and drive functions (p=0.001). The study identifies the level of function and ability of PLWHA, clinical markers, and how these affect the physical, psychological and social functioning of this population.

The Development of an ICF-Oriented, Adaptive Physician Assessment Instrument of Mobility, Self-care, and Domestic Life

ERIC Educational Resources Information Center

Farin, Erik; Fleitz, Annette

2009-01-01

The objective of this study was development and psychometric testing of an adaptive, International Classification of Functioning, Disability, and Health (ICF)-oriented questionnaire to be processed by the rehabilitation physician that aids in assessing mobility, self-care, and domestic life (Moses-Physician). The intent is to develop a physician…

Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

ERIC Educational Resources Information Center

Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

2010-01-01

Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

Assessments Used to Diagnose Developmental Coordination Disorder: Do Their Underlying Constructs Match the Diagnostic Criteria?

ERIC Educational Resources Information Center

Darsaklis, Vasiliki; Snider, Laurie M.; Majnemer, Annette; Mazer, Barbara

2013-01-01

This study examined the constructs underlying the Movement Assessment Battery for Children-2 (M-ABC-2), Bruninks-Oseretsky Test of Motor Proficiency (BOTMP) and Vineland Adaptive Behavior Scale-2 (VABS-2) using the framework of the International Classification of Functioning Disability and Health--Child Youth version (ICF-CY) and the diagnostic…

A Nationally Representative Study of the Association between Communication Impairment at 4-5 Years and Children's Life Activities at 7-9 Years

ERIC Educational Resources Information Center

McCormack, Jane; Harrison, Linda J.; McLeod, Sharynne; McAllister, Lindy

2011-01-01

Purpose: To examine the longitudinal association between communication impairment (primary or secondary diagnosis) and children's Activities and Participation (International Classification of Functioning, Disability and Health-Children and Youth [ICF-CY]; World Health Organization [WHO], 2007). Method: Participants were 4,329 children in the…

Motor Ability and Weight Status Are Determinants of Out-of-School Activity Participation for Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Fong, Shirley S. M.; Lee, Velma Y. L.; Chan, Nerita N. C.; Chan, Rachel S. H.; Chak, Wai-Kwong; Pang, Marco Y. C.

2011-01-01

According to the International Classification of Functioning, Disability and Health model endorsed by the World Health Organization, participation in everyday activities is integral to normal child development. However, little is known about the influence of motor ability and weight status on physical activity participation in children with…

Using the International Classification of Functioning to Conceptualize and Measure Quality of Life among Individuals with Disabilities

ERIC Educational Resources Information Center

Fleming, Allison R.

2012-01-01

Quality of life (QOL) is the underlying goal of all rehabilitation interventions. Researchers and policy makers have proposed that QOL is an important and useful way to measure the impact of services. However, conceptual ambiguity, difficulty with operational definitions and measurement, and the inherent vulnerability to value bias have challenged…

The Activities and Participation of Adolescents with Autism Spectrum Disorders in Singapore: Findings from an ICF-Based Instrument

ERIC Educational Resources Information Center

Poon, K. K.

2011-01-01

Background: This study sought to describe the activities and participation of adolescents with autism spectrum disorders (ASD) in Singapore and to examine the suitability of the Activity and Participation component of the International Classification of Functioning, Disability and Health for achieving this purpose. This information may guide the…

Current Methods of Evaluating Speech-Language Outcomes for Preschoolers with Communication Disorders: A Scoping Review Using the ICF-CY

ERIC Educational Resources Information Center

Cunningham, Barbara Jane; Washington, Karla N.; Binns, Amanda; Rolfe, Katelyn; Robertson, Bernadette; Rosenbaum, Peter

2017-01-01

Purpose: The purpose of this scoping review was to identify current measures used to evaluate speech-language outcomes for preschoolers with communication disorders within the framework of the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY; World Health Organization, 2007). Method: The review…

Linking Frailty Instruments to the International Classification of Functioning, Disability, and Health: A Systematic Review.

PubMed

Azzopardi, Roberta Vella; Vermeiren, Sofie; Gorus, Ellen; Habbig, Ann-Katrin; Petrovic, Mirko; Van Den Noortgate, Nele; De Vriendt, Patricia; Bautmans, Ivan; Beyer, Ingo

2016-11-01

To date, the major dilemma concerning frailty is the lack of a standardized language regarding its operationalization. Considering the demographic challenge that the world is facing, standardization of frailty identification is indeed the first step in tackling the burdensome consequences of frailty. To demonstrate this diversity in frailty assessment, the available frailty instruments have been linked to the International Classification of Functioning, Disability, and Health (ICF): a standardized and hierarchically coded language developed by World Health Organization regarding health conditions and their positive (functioning) and negative (disability) consequences. A systematic review on frailty instruments was carried out in PubMed, Web of Knowledge, and PsycINFO. The items of the identified frailty instruments were then linked to the ICF codes. 79 original or adapted frailty instruments were identified and categorized into single (n = 25) and multidomain (n = 54) groups. Only 5 frailty instruments (indexes) were linked to all 5 ICF components. Whereas the ICF components Body Functions and Activities and Participation were frequently linked to the frailty instruments, Body Structures, Environmental and Personal factors were sparingly represented mainly in the multidomain frailty instruments. This review highlights the heterogeneity in frailty operationalization. Environmental and personal factors should be given more thought in future frailty assessments. Being unambiguous, structured, and neutral, the ICF language allows comparing observations made with different frailty instruments. In conclusion, this systematic overview and ICF translation can be a cornerstone for future standardization of frailty assessment. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Developing and validating the Communication Function Classification System for individuals with cerebral palsy

PubMed Central

HIDECKER, MARY JO COOLEY; PANETH, NIGEL; ROSENBAUM, PETER L; KENT, RAYMOND D; LILLIE, JANET; EULENBERG, JOHN B; CHESTER, KEN; JOHNSON, BRENDA; MICHALSEN, LAUREN; EVATT, MORGAN; TAYLOR, KARA

2011-01-01

Aim The purpose of this study was to create and validate a Communication Function Classification System (CFCS) for children with cerebral palsy (CP) that can be used by a wide variety of individuals who are interested in CP. This paper reports the content validity, interrater reliability, and test–retest reliability of the CFCS for children with CP. Method An 11-member development team created comprehensive descriptions of the CFCS levels, and four nominal groups comprising 27 participants critiqued these levels. Within a Delphi survey, 112 participants commented on the clarity and usefulness of the CFCS. Interrater reliability was completed by 61 professionals and 68 parents/relatives who classified 69 children with CP aged 2 to 18 years. Test–retest reliability was completed by 48 professionals who allowed at least 2 weeks between classifications. The participants who assessed the CFCS were all relevant stakeholders: adults with CP, parents of children with CP, educators, occupational therapists, physical therapists, physicians, and speech–language pathologists. Results The interrater reliability of the CFCS was 0.66 between two professionals and 0.49 between a parent and a professional. Professional interrater reliability improved to 0.77 for classification of children older than 4 years. The test–retest reliability was 0.82. Interpretation The CFCS demonstrates content validity and shows very good test–retest reliability, good professional interrater reliability, and moderate parent–professional interrater reliability. Combining the CFCS with the Gross Motor Function Classification System and the Manual Ability Classification System contributes to a functional performance view of daily life for individuals with CP, in accordance with the World Health Organization’s International Classification of Functioning, Disability and Health. PMID:21707596

Do patient-reported outcome measures cover personal factors important to people with rheumatoid arthritis? A mixed methods design using the International Classification of Functioning, Disability and Health as frame of reference.

PubMed

Dür, Mona; Coenen, Michaela; Stoffer, Michaela Alexandra; Fialka-Moser, Veronika; Kautzky-Willer, Alexandra; Kjeken, Ingvild; Drăgoi, Răzvan Gabriel; Mattsson, Malin; Boström, Carina; Smolen, Josef; Stamm, Tanja Alexandra

2015-02-25

Personal factors (PFs) are internal factors that determine functioning and the individuals' experience of disability. Their coverage by patient-reported outcome measures (PROMs) has not been examined in rheumatoid arthritis (RA) so far. The aims of this study were to identify PFs important in the life stories of people with RA and to determine their coverage by PROMs used in RA. The qualitative data of people with RA was explored to identify PFs. Additionally a systematic literature search was conducted to find PROMs used in RA. PROMs items were linked to the components, domains and categories of the International Classification of Functioning, Disability and Health (ICF) to determine the coverage of important PFs by PROMs. Twelve PFs were found to be important in the life stories of people with RA. The PFs coping and reflecting about one's life in an optimistic way were covered most frequently, each by 14 of the 42 explored PROMs, while job satisfaction was not covered at all. The London Coping with Rheumatoid Arthritis Questionnaire, General Self-Efficacy Scale, Arthritis Self-Efficacy Scale, Rheumatoid Arthritis Self-Efficacy Questionnaire and Revised Ways of Coping Inventory covered most PFs. Nineteen PROMs did not cover any of the PFs. Several PFs were identified as important in the life stories of people with RA, but only 55% of the PROMS covered some of these PFs. When evaluating PFs important to people with RA, health professionals should be alert on which PROMs can be used to assess which PFs.

Using the international classification of functioning, disability and health to expand understanding of paralysis in the United States through improved surveillance.

PubMed

Fox, Michael H; Krahn, Gloria L; Sinclair, Lisa B; Cahill, Anthony

2015-07-01

Surveillance on paralysis prevalence has been conceptually and methodologically challenging. Numerous methods have been used to approximate population-level paralysis prevalence estimates leading to widely divergent prevalence estimates. To describe three phases in use of the International Classification of Functioning, Disability and Health (ICF) as a framework and planning tool for defining paralysis and developing public health surveillance of this condition. Description of the surveillance methodology covers four steps: an assessment of prior data collection efforts that included a review of existing surveys, registries and other data collection efforts designed to capture both case definitions in use and prevalence of paralysis; use of a consensus conference of experts to develop a case definition of paralysis based on the ICF rather than medical diagnostic criteria; explanation of use of the ICF framework for domains of interest to develop, cognitively test, validate and administer a brief self-report questionnaire for telephone administration on a population; and development and administration of a Paralysis Prevalence and Health Disparities Survey that used content mapping to back code items from existing national surveys to operationalize key domains. ICF coding led to a national population-based survey of paralysis that produced accurate estimates of prevalence and identification of factors related to the health of people in the U.S. living with paralysis. The ICF can be a useful tool for developing valid and reliable surveillance strategies targeting subgroups of individuals with functional disabilities such as people with paralysis and others. Published by Elsevier Inc.

Compiling standardized information from clinical practice: using content analysis and ICF Linking Rules in a goal-oriented youth rehabilitation program.

PubMed

Lustenberger, Nadia A; Prodinger, Birgit; Dorjbal, Delgerjargal; Rubinelli, Sara; Schmitt, Klaus; Scheel-Sailer, Anke

2017-09-23

To illustrate how routinely written narrative admission and discharge reports of a rehabilitation program for eight youths with chronic neurological health conditions can be transformed to the International Classification of Functioning, Disability and Health. First, a qualitative content analysis was conducted by building meaningful units with text segments assigned of the reports to the five elements of the Rehab-Cycle ® : goal; assessment; assignment; intervention; evaluation. Second, the meaningful units were then linked to the ICF using the refined ICF Linking Rules. With the first step of transformation, the emphasis of the narrative reports changed to a process oriented interdisciplinary layout, revealing three thematic blocks of goals: mobility, self-care, mental, and social functions. The linked 95 unique ICF codes could be grouped in clinically meaningful goal-centered ICF codes. Between the two independent linkers, the agreement rate was improved after complementing the rules with additional agreements. The ICF Linking Rules can be used to compile standardized health information from narrative reports if prior structured. The process requires time and expertise. To implement the ICF into common practice, the findings provide the starting point for reporting rehabilitation that builds upon existing practice and adheres to international standards. Implications for Rehabilitation This study provides evidence that routinely collected health information from rehabilitation practice can be transformed to the International Classification of Functioning, Disability and Health by using the "ICF Linking Rules", however, this requires time and expertise. The Rehab-Cycle ® , including assessments, assignments, goal setting, interventions and goal evaluation, serves as feasible framework for structuring this rehabilitation program and ensures that the complexity of local practice is appropriately reflected. The refined "ICF Linking Rules" lead to a standardized transformation process of narrative text and thus a higher quality with increased transparency. As a next step, the resulting format of goal codes supplemented by goal-clarifying codes could be validated to strengthen the implementation of the International Classification of Functioning, Disability and Health into rehabilitation routine by respecting the variety of clinical practice.

Disability and recovery in schizophrenia: a systematic review of cognitive behavioral therapy interventions.

PubMed

Nowak, Izabela; Sabariego, Carla; Świtaj, Piotr; Anczewska, Marta

2016-07-11

Schizophrenia is a disabling disease that impacts all major life areas. There is a growing need for meeting the challenge of disability from a perspective that extends symptomatic reduction. Therefore, this study aimed to systematically review the extent to which traditional and "third wave" cognitive - behavioral (CBT) interventions address the whole scope of disabilities experienced by people with lived experience of schizophrenia using the WHO's International Classification of Functioning, Disability and Health (ICF) as a frame of reference. It also explores if current CBT interventions focus on recovery and what is their impact on disability domains. Medline and PsycINFO databases were searched for studies published in English between January 2009 and December 2015. Abstracts and full papers were screened against pre-defined selection criteria by two reviewers. Methodological quality of included studies was assessed by two independent raters using the Effective Public Health Practice Project Quality assessment tool for quantitative studies (EPHPP) guidelines. A total of 50 studies were included, 35 studies evaluating traditional CBT interventions and 15 evaluating "third wave" approaches. Overall, traditional CBT interventions addressed more disability domains than "third wave" approaches and mostly focused on mental functions reflecting schizophrenia psychopathology. Seven studies met the inclusion criteria of recovery-oriented interventions. The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive. Traditional CBT interventions address more disability domains than "third wave" therapies, however both approaches focus mostly on mental functions that reflect schizophrenia psychopathology. There are also few interventions that focus on recovery. These results indicate that CBT interventions going beyond symptom reduction are still needed. Recovery-focused CBT interventions seem to be a promising treatment approach as they target disability from a broader perspective including activity and participation domains. Although their effectiveness is inconclusive, they reflect users' views of recovery and trends towards improvement of mood, negative symptoms and functioning are shown.

The multicenter benchmarking study of burn injury: A content analysis of the outcome measures using the international classification of functioning, disability and health.

PubMed

Osborne, Candice L; Petersson, Christina; Graham, James E; Meyer, Walter J; Simeonsson, Rune J; Suman, Oscar E; Ottenbacher, Kenneth J

2016-11-01

To link, classify and describe the content of the Multicenter Benchmarking Study Burn Outcomes Questionnaires (BOQ) using the International Classification of Functioning, Disability and Health (ICF) to determine if the information garnered provides researchers with the data necessary to develop a comprehensive understanding of life after burns. Two ICF linking experts used a standardized linking technique endorsed by the World Health Organization to link all BOQ concepts to the ICF. Linking results were analyzed to determine the comprehensiveness of each of the five measures. The activities and participation component was most frequently addressed followed by the body functions component. Environmental factors are not extensively covered and body structures are not addressed. ICF chapter and category distribution were skewed and varied between assessments. The majority of BOQ items are of the health status perspective. BOQ item composition could be improved with a more even distribution of pertinent ICF topics. Assessment authors may consider addressing the impact of environmental factors on participation. Including body structure concepts would allow investigators to track structural deformation and/or developmental delay. Generally speaking, this data should not be used to examine quality of life outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

The ICF has made a difference to functioning and disability measurement and statistics.

PubMed

Madden, Rosamond H; Bundy, Anita

2018-02-12

Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics. In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge. The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation. The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of rehabilitation planning.

Spirituality and the International Classification of Functioning, Disability and Health: content comparison of questionnaires measuring mindfulness based on the International Classification of Functioning.

PubMed

Offenbächer, Martin; Sauer, Sebastian; Hieblinger, Robin; Hufford, David J; Walach, Harald; Kohls, Niko

2011-01-01

To identify and compare the concepts contained in questionnaires measuring mindfulness using the International Classification of Functioning (ICF) as external reference. Questionnaires which are published in peer-reviewed journals and listed in Pubmed or PsycInfo were included. The questionnaires were analysed and, using a content-analytical approach, the respective items were categorised and linked to the ICF. Ten questionnaires were included. Ninety-four per cent (N = 341) of the concepts could be linked to 37 different ICF categories. One hundred and seventy-one (50.1%) concepts were linked to ICF categories of the component Body Function, 74 (21.7%) to categories of the component Activity and Participation and none to categories of the component Environmental Factors. In total, 28.2% of the linked concepts belonged to Personal factors, which are not yet classified in the ICF. The questionnaires exhibited considerable differences regarding content density (i.e. the average number of concepts per item) and content diversity (i.e. the number of ICF categories per concept). The ICF provides an useful external reference to identify and compare the concepts contained in mindfulness questionnaires. Also, mindfulness questionnaire concepts suggest potentially useful factors for classification within the ICF.

Multiprofessional evaluation in clinical practice: establishing a core set of outcome measures for children with cerebral palsy.

PubMed

Mäenpää, Helena; Autti-Rämö, Ilona; Varho, Tarja; Forsten, Wivi; Haataja, Leena

2017-03-01

To develop a national consensus on outcome measures that define functional ability in children with cerebral palsy (CP) according to the International Classification of Functioning, Disability and Health (ICF) framework. The project started in 2008 in neuropaediatric units of two university hospitals and one outpatient clinic. Each professional group selected representatives to be knowledge brokers for their own specialty. Based on the evidence, expert opinion, and the ICF framework, multiprofessional teams selected the most valid measures used in clinical practice (2009-2010). Data from 269 children with CP were analysed, classified by the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System, and evaluated. The process aimed at improving and unifying clinical practice in Finland through a national consensus on the core set of measures. The selected measures were presented by professional groups, and consensus was reached on the recommended core set of measures to be used in all hospitals treating children with CP in Finland. A national consensus on relevant and feasible measures is essential for identifying differences in the effectiveness of local practices, and for conducting multisite intervention studies. This project showed that multiprofessional rehabilitation practices can be improved through respect for and inclusion of everyone involved. © 2016 Mac Keith Press.

Constructing the 'Transitional Problem' for Young Disabled People Leaving School: Comparing Policy and Practice in Ontario and Scotland.

ERIC Educational Resources Information Center

Tisdall, E. K. M.

1997-01-01

Explores how the "transitional question" of young disabled people leaving school is constructed. Describes and evaluates D. L. Kirp's classification system of social problems as applied to the "transition question." Reports case studies from Ontario (Canada) and Scotland. Concludes that Kirp's classification system is not…

Using Simulations to Investigate the Longitudinal Stability of Alternative Schemes for Classifying and Identifying Children with Reading Disabilities

ERIC Educational Resources Information Center

Schatschneider, Christopher; Wagner, Richard K.; Hart, Sara A.; Tighe, Elizabeth L.

2016-01-01

The present study employed data simulation techniques to investigate the 1-year stability of alternative classification schemes for identifying children with reading disabilities. Classification schemes investigated include low performance, unexpected low performance, dual-discrepancy, and a rudimentary form of constellation model of reading…

A Qualitative Study of Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Malawi.

PubMed

White, Sian; Kuper, Hannah; Itimu-Phiri, Ambumulire; Holm, Rochelle; Biran, Adam

2016-01-01

Globally, millions of people lack access to improved water, sanitation and hygiene (WASH). Disabled people, disadvantaged both physically and socially, are likely to be among those facing the greatest inequities in WASH access. This study explores the WASH priorities of disabled people and uses the social model of disability and the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to look at the relationships between impairments, contextual factors and barriers to WASH access. 36 disabled people and 15 carers from urban and rural Malawi were purposively selected through key informants. The study employed a range of qualitative methods including interviews, emotion mapping, free-listing of priorities, ranking, photo voice, observation and WASH demonstrations. A thematic analysis was conducted using nVivo 10. WASH access affected all participants and comprised almost a third of the challenges of daily living identified by disabled people. Participants reported 50 barriers which related to water and sanitation access, personal and hand hygiene, social attitudes and participation in WASH programs. No two individuals reported facing the same set of barriers. This study found that being female, being from an urban area and having limited wealth and education were likely to increase the number and intensity of the barriers faced by an individual. The social model proved useful for classifying the majority of barriers. However, this model was weaker when applied to individuals who were more seriously disabled by their body function. This study found that body function limitations such as incontinence, pain and an inability to communicate WASH needs are in and of themselves significant barriers to adequate WASH access. Understanding these access barriers is important for the WASH sector at a time when there is a global push for equitable access.

A Qualitative Study of Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Malawi

PubMed Central

Kuper, Hannah; Itimu-Phiri, Ambumulire; Holm, Rochelle; Biran, Adam

2016-01-01

Globally, millions of people lack access to improved water, sanitation and hygiene (WASH). Disabled people, disadvantaged both physically and socially, are likely to be among those facing the greatest inequities in WASH access. This study explores the WASH priorities of disabled people and uses the social model of disability and the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework to look at the relationships between impairments, contextual factors and barriers to WASH access. 36 disabled people and 15 carers from urban and rural Malawi were purposively selected through key informants. The study employed a range of qualitative methods including interviews, emotion mapping, free-listing of priorities, ranking, photo voice, observation and WASH demonstrations. A thematic analysis was conducted using nVivo 10. WASH access affected all participants and comprised almost a third of the challenges of daily living identified by disabled people. Participants reported 50 barriers which related to water and sanitation access, personal and hand hygiene, social attitudes and participation in WASH programs. No two individuals reported facing the same set of barriers. This study found that being female, being from an urban area and having limited wealth and education were likely to increase the number and intensity of the barriers faced by an individual. The social model proved useful for classifying the majority of barriers. However, this model was weaker when applied to individuals who were more seriously disabled by their body function. This study found that body function limitations such as incontinence, pain and an inability to communicate WASH needs are in and of themselves significant barriers to adequate WASH access. Understanding these access barriers is important for the WASH sector at a time when there is a global push for equitable access. PMID:27171520

Disability, Diversity, and Autism: Philosophical Perspectives on Health.

PubMed

Ripamonti, Lidia

2016-04-01

This paper aims to explore the connection between health and developmental disorders, particularly in regard to the notion of 'neurodiversity', which considers high-functioning autism not as a lifelong disability but a neurological form within a diversity of human minds. In recent years, autistic activist movements have called for a more positive, humanizing, identity-first language when describing this condition, rejecting negative language such as 'disorder', 'deficit', and 'impairment', and instead describing autism as a way of being, part of one's personal identity, which does not always need to be cured. Is a different form of neurodevelopment necessarily a degenerate one? Is well-being mostly affected by disability itself or by its being classified as abnormality? Drawing on philosophical insights, as well as autism research papers and popular science, I explore advantages and disadvantages of these classifications and the connections between health, autism, personhood, and disability.

The functional aptitude of a natural sample of population. A new approach to handicap (Saint Cyr-sur-le-Rhône, Sept. 1984).

PubMed

Minaire, P; Flores, J L; Cherpin, J; Weber, D

1987-01-01

A survey of the total population of a small rural village was undertaken to discern the amount of impairment and disability present, using both questionnaire and examination techniques. It was confirmed that the concept of disability was applicable to such populations and that it was related to age, at both extremes of life. There was a good correlation between self-reporting and examination of locomotor and sensory impairments but it was poor when applied to prehensile or dexterity skills. This survey showed that such techniques can be applied to populations. As yet the handicap code in the International Classification of Impairment, Disability and Handicap has not been related to this population but this is seen as an important next step in the proper understanding of chronic disability in the community.

[Participatory research : Meaning, concept, objectives and methods].

PubMed

Brütt, Anna Levke; Buschmann-Steinhage, Rolf; Kirschning, Silke; Wegscheider, Karl

2016-09-01

Shaping one's own life and feeling equal in society is an essential aspect of participation. Based on the UN Convention on the Rights of Persons with Disabilities, the Social Security Code IX and the International Classification of Functioning, Disability and Health (ICF), participation is relevant for the German health system. The cross-sectional discipline of participation research investigates conditions for self-determined and equal participation in society. Research results can reinforce and promote the participation of humans with disabilities. Participation research uses established quantitative and qualitative approaches. Moreover, participatory research is a relevant approach that demands involving persons with disabilities in decisions in the research process. In the future, it will be important to concentrate findings and to connect researchers. The participation research action alliance (Aktionsbündnis Teilhabeforschung), which was established in 2015, aims to make funding accessible as well as strengthen and profile participation research.

Comparison of subjective and objective assessments of outcome after traumatic brain injury using the International Classification of Functioning, Disability and Health (ICF).

PubMed

Koskinen, Sanna; Hokkinen, Eeva-Maija; Wilson, Lindsay; Sarajuuri, Jaana; Von Steinbüchel, Nicole; Truelle, Jean-Luc

2011-01-01

The aim is to examine two aspects of outcome after traumatic brain injury (TBI). Functional outcome was assessed by the Glasgow Outcome Scale - Extended (GOSE) and by clinician ratings, while health-related quality of life (HRQoL) was assessed by the Quality of Life after Brain Injury (QOLIBRI). The GOSE and the QOLIBRI were linked to the International Classification of Functioning, Disability and Health (ICF) to analyse their content. Functional outcome on ICF categories was assessed by rehabilitation clinicians in 55 participants with TBI and was compared to the participants' own judgements of their HRQoL. The QOLIBRI was linked to 42 and the GOSE to 57 two-level ICF categories covering 78% of the categories on the ICF brief core set for TBI. The closest agreement in the views of the professionals and the participants was found on the Physical Problems and Cognition scales of the QOLIBRI. The problems encountered after TBI are well covered by the QOLIBRI and the GOSE. They capture important domains that are not traditionally sufficiently documented, especially in the domains of interpersonal relationships, social and leisure activities, self and the environment. The findings indicate that they are useful and complementary outcome measures for TBI. In rehabilitation, they can serve as tools in assessment, setting meaningful goals and creating therapeutic alliance.

Success in the workplace: From the voice of (dis)abled to the voice of enabled

PubMed Central

2014-01-01

The intention of this article is twofold; first to encourage a shift in seeing ‘the disabled’ not as people with disabilities but rather as people with unique abilities. Secondly, to explore ways of facilitating gainful employment for these uniquely abled people. The term disability is examined against a backdrop of definitions including the definition postulated by the International Classification of Functioning. In this article, the life experiences of a purposive sample of people with (dis)abilities who have been successful in the world of work are explored. A narrative approach gives voice to their experiences. Quotes from the participants’ responses are used to illustrate the common themes that emerged relating to their experiences. These themes are resonated against a backdrop of relevant literature. If disabled people are enabled to recognize and use their unique abilities, as well as develop various self-determination skills, imagine the endless possibilities which could arise for them and society in general. PMID:28729997

Measuring health and disability: supporting policy development. The European MHADIE project.

PubMed

Leonardi, Matilde

2010-01-01

Disability is a multi-dimensional phenomenon arising out of an interaction between the individual's health status and his environment: disability data must reflect this bio-psychosocial model. WHO's International Classification of Functioning, Disability and Health (ICF) provides the framework for documenting the interaction between health status and environmental features. MHADIE, a 3-year project supported by a EC 6th Framework Programme Grant, aimed at demonstrating the feasibility and utility of the ICF model in the measurement and description of disability. The ICF model was used as the structure for analysing existing population health surveys and education statistics data. ICF-based tools were used to describe disability in selected health conditions. MHADIE researchers showed that the ICF model is adequate for describing and measuring patterns of disability in clinical samples from different countries cross-sectionally and over time as well as feasible and useful in educational sectors. Valid and reliable information are essential to design, implement or evaluate policies to combat discrimination, promote integration and enhance opportunities. Results made it possible to produce a definition of disability as well as policy recommendations concerning how, in Europe and internationally, the existing sources of data can be harmonized with the ICF model.

The measurement of disability in the elderly: a systematic review of self-reported questionnaires.

PubMed

Yang, Ming; Ding, Xiang; Dong, Birong

2014-02-01

To analyze the contents and formats of general self-reported questionnaires on disability that are designed for and/or are widely applied in the elderly population to depict a complete picture of this field and help researchers to choose proper tools more efficiently. A broad systematic literature search was performed in September 2013 and included the following databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and PROQOLID. The publication language was limited to English and Chinese. Two review authors independently performed the study selection and data extraction. All of the included instruments were extracted and classified using the International Classification of Functioning, Disability, and Health framework. Of 5569 articles retrieved from the searches and 156 articles retrieved from the pearling, 22 studies (including 24 questionnaires) fulfilled the inclusion criteria. From these, 42 different domains and 458 items were extracted. The most frequently used questionnaire was the Barthel Index followed by the Lawton and Brody Instrumental Activities of Daily Living Scale and the Katz Index of Activities of Daily Living, respectively. The contents and formats of the questionnaires varied considerably. Activities and participation were the most commonly assessed dimensions. In addition, the Activities of Daily Living, mobility and the Instrumental Activities of Daily Living Scale were the most common domains assessed among the included questionnaires. Among the 24 included questionnaires, the most frequently used questionnaires were the Barthel Index, Lawton and Brody Instrumental Activities of Daily Living Scale, and Katz Index of Activities of Daily Living. The content and format of the questionnaires varied considerably, but none of the questionnaires covered all essential dimensions of the International Classification of Functioning, Disability, and Health framework. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

The Impact of Speech Impairment in Early Childhood: Investigating Parents' and Speech-Language Pathologists' Perspectives Using the ICF-CY

ERIC Educational Resources Information Center

McCormack, Jane; McLeod, Sharynne; Harrison, Linda J.; McAllister, Lindy

2010-01-01

Purpose: To explore the application of the Activities and Participation component of the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY, World Health Organization, 2007) as a framework for investigating the perceived impact of speech impairment in childhood. Method: A 32-item questionnaire based on…

Adolescents with Hearing Loss and the International Classification of Functioning, Health, and Disability: Children & Youth Version

PubMed Central

English, Kris; Pajevic, Emily

2016-01-01

In 2007, the World Health Organization published a set of International Classification of Functioning, Disability and Health (ICF) codes designed for children and youth (ICF-CY version). The ICF-CY considers typical developmental changes associated with childhood while describing health status and the effects of intervention. In this article we will describe how a specific intervention (transition planning for adolescents) can be documented with the ICF-CY. Transition planning in health care prepares adolescents and their families for the transfer from pediatric to adult health services and has been demonstrated to be an effective practice for adolescents with many types of chronic health conditions (e.g., cystic fibrosis, epilepsy, diabetes). Audiology has not yet addressed transition planning for adolescents with hearing loss; therefore, we propose using the ICF-CY to design a pathway of care. The ICF-CY can standardize transition planning to the benefit of both teen patients and audiologists: teens and their families would gradually acquire necessary knowledge and skills, and audiologists would develop a meaningful data set to help further inform our pediatric practices, as well as give more structure, depth, and accountability to our role in rehabilitation. PMID:27489402

In praise of sport: promoting sport participation as a mechanism of health among persons with a disability.

PubMed

Wilhite, Barbara; Shank, John

2009-07-01

Achieving and maintaining health are no less important to people with a disability than they are to anyone else; it is just typically more challenging. This report explores sport as a mechanism of health for people with a disability. The International Classification of Functioning, Disability and Health (ICF) is used to frame the analysis and discussion of the narratives of 12 women and men with a disability who participate in sport. The goal was to describe how participating in sport, broadly defined, helps persons with a disability achieve and maintain health and health-related components of well-being. The ICF was used to frame a secondary analysis and discussion of participant narratives. Participants with physical or sensory disabilities responded to a request for participation in in-depth interviews to explore their sport participation; snowball sampling was used to ensure maximum variation in demographic characteristics. Interviews were transcribed verbatim and analyzed using a grounded theory approach. A secondary analysis was conducted that focused on the relationship of the data categories to the ICF. Sport benefits included enhanced functional capacity, health promotion, relationship development, increased optimism, and inclusion in meaningful life activities and roles. Health professionals were vital in introducing and encouraging people with disabilities to participate in sport. Sport is a valuable and promising mechanism for fostering physical and emotional health and building valuable social connections. Health professionals, in concert with individual, family, and community members, may use the framework of the ICF to guide their clinical and educational reasoning for enhancing sport participation among persons with a disability.

A transversal multicenter study assessing functioning, disability and environmental factors with the comprehensive ICF core set for low back pain in Brazil.

PubMed

Riberto, M; Chiappetta, L M; Lopes, K A; Chiappetta, L R

2014-04-01

Low back pain is a leading cause of disability in Brazil. The multiple aspects of disability in these patients require comprehensive tools for their assessment. The International Classification of Functioning, Disability, and Health (ICF) core set for low back pain is designed to comprehensively describe the experience of such patients with their functioning. This study aimed to describe functioning and contextual factors and to empirically validate the ICF core set for low back pain. Cross sectional study. Three outpatient clinics in Manaus, Maceio and São Paulo, Brazil. Population. 135 low back pain outpatients under rehabilitation. Data concerning diagnosis, personal features, and the 78 ICF core set categories for low back pain were collected from clinical charts, physical examinations, tests, and interviews with patients from rehabilitation services in three parts of Brazil. 7.7% of the categories (6 body functions and 10 activity and participation) were affected in less than 20% of the sample, and were thus considered not validated. Pain and other sensations related to the musculoskeletal system were the body most frequently impaired functions. Mobility and domestic life were the chapters of activity and limitation most often described as limited. All environmental factors were qualified as either facilitators or barriers and acted as modulators of disability. The comprehensive ICF core sets for low back pain can be used to describe the living experience of such individuals, although efforts to make it operational and enhance the reproducibility of the results are needed to warrant its reliable routine use. This study highlights the importance of a complete assessment of chronic low back pain and demonstrate the need for multidisciplinary approach.

Content comparison of occupation-based instruments in adult rheumatology and musculoskeletal rehabilitation based on the International Classification of Functioning, Disability and Health.

PubMed

Stamm, Tanja A; Cieza, Alarcos; Machold, Klaus P; Smolen, Josef S; Stucki, Gerold

2004-12-15

To compare the content of clinical, occupation-based instruments that are used in adult rheumatology and musculoskeletal rehabilitation in occupational therapy based on the International Classification of Functioning, Disability and Health (ICF). Clinical instruments of occupational performance and occupation in adult rehabilitation and rheumatology were identified in a literature search. All items of these instruments were linked to the ICF categories according to 10 linking rules. On the basis of the linking, the content of these instruments was compared and the relationship between the capacity and performance component explored. The following 7 instruments were identified: the Canadian Occupational Performance Measure, the Assessment of Motor and Process Skills, the Sequential Occupational Dexterity Assessment, the Jebson Taylor Hand Function Test, the Moberg Picking Up Test, the Button Test, and the Functional Dexterity Test. The items of the 7 instruments were linked to 53 different ICF categories. Five items could not be linked to the ICF. The areas covered by the 7 occupation-based instruments differ importantly: The main focus of all 7 instruments is on the ICF component activities and participation. Body functions are covered by 2 instruments. Two instruments were linked to 1 single ICF category only. Clinicians and researchers who need to select an occupation-based instrument must be aware of the areas that are covered by this instrument and the potential areas that are not covered at all.

A Systematic Approach to Subgroup Classification in Intellectual Disability

ERIC Educational Resources Information Center

Schalock, Robert L.; Luckasson, Ruth

2015-01-01

This article describes a systematic approach to subgroup classification based on a classification framework and sequential steps involved in the subgrouping process. The sequential steps are stating the purpose of the classification, identifying the classification elements, using relevant information, and using clearly stated and purposeful…

Treatment of Cerebral Palsy with Stem Cells: A Report of 17 Cases.

PubMed

Abi Chahine, Nassim H; Wehbe, Tarek W; Hilal, Ramzi A; Zoghbi, Victoria V; Melki, Alia E; Habib, Emil B Bou

2016-05-30

Cerebral Palsy (CP) is a disabling condition that affects a child's life and his/her family irreversibly. It is usually a non-progressive condition but improvement over time is rarely seen. The condition can be due to prenatal hypoxia, metabolic, genetic, infectious, traumatic or other causes. It is therefore a heterogeneous group that results in functional motor disability associated with different degrees of cognitive abnormalities. There are no treatments that can cure or even improve CP and the best available approach aims at functional, social and nutritional supportive care and counseling. In this paper, we report 17 sequential patients with CP treated with intrathecal administration of Bone Marrow Mononuclear Cells (BMMC). All patients had an uneventful post-injection course with 73% of the evaluable patients treated having a good response using the Gross Motor Function Classification System (GMFCS). The average improvement was 1.3 levels on the GMFCS with cognitive improvements as well.

Better Understanding Learning Disabilities: New Views from Research and Their Implications for Education and Public Policies.

ERIC Educational Resources Information Center

Lyon, G. Reid, Ed.; And Others

This book examines critical issues in classification and definition of learning disabilities; the development of theory in learning disabilities; the development of cognitive, developmental, and educational models of learning disabilities; and social and public policy in learning disabilities. After an introductory chapter by G. Reid Lyon and…

20 CFR 410.418 - Irrebuttable presumption of total disability due to pneumoconiosis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Classification of Radiographs of Pneumoconioses, 1971, or (2) The International Classification of the Radiographs of the Pneumoconioses of the International Labour Office, Extended Classification (1968) (which may be referred to as the “ILO Classification (1968)”), or (3) The Classification of the Pneumoconiosis...

An alternative perspective on assistive technology: the Person-Environment-Tool (PET) model.

PubMed

Jarl, Gustav; Lundqvist, Lars-Olov

2018-04-20

The medical and social models of disability are based on a dichotomy that categorizes people as able-bodied or disabled. In contrast, the biopsychosocial model, which forms the basis for the International Classification of Functioning, Disability and Health (ICF), suggests a universalistic perspective on human functioning, encompassing all human beings. In this article we argue that the artificial separation of function-enhancing technology into assistive technology (AT) and mainstream technology might be one of the barriers to a universalistic view of human functioning. Thus, an alternative view of AT is needed. The aim of this article was to construct a conceptual model to demonstrate how all human activities and participation depend on factors related to the person, environment, and tools, emphasizing a universalistic perspective on human functioning. In the Person-Environment-Tool (PET) model, a person's activity and participation are described as a function of factors related to the person, environment, and tool, drawing on various ICF components. Importantly, the PET model makes no distinction between people of different ability levels, between environmental modifications intended for people of different ability levels, or between different function-enhancing technologies (AT and mainstream technology). A fictive patient case is used to illustrate how the universalistic view of the PET model lead to a different approach in rehabilitation. The PET model supports a universalistic view of technology use, environmental adaptations, and variations in human functioning.

17-year outcome of preterm infants with diverse neonatal morbidities: part 2, impact on activities and participation.

PubMed

Sullivan, Mary C; Miller, Robin J; Msall, Michael E

2012-10-01

To examine functioning and participation in a diverse U.S. sample of 180 infants at age 17 years. The World Health Organization International Classification of Functioning, Disability and Health model framed functioning and participation domains and contextual factors. Assessment included cognition, executive functioning, academic achievement, personal functioning, community participation, and social involvement. Socioeconomic status, not prematurity, impacted cognitive and academic outcomes. Across neonatal morbidities, male gender and social disadvantage are key determinants of cognitive, academic, and social functioning. Interventions addressing academic and social-behavioral competencies in early school years may potentially optimize long-term preterm outcomes. © 2012, Wiley Periodicals, Inc.

Disability associated with exposure to traumatic events: results from a cross-sectional community survey in South Sudan.

PubMed

Ayazi, Touraj; Lien, Lars; Eide, Arne Henning; Jenkins, Rachel; Albino, Rita Amok; Hauff, Edvard

2013-05-14

There is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting. We conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity-based scale derived from the WHO's International Classification of Disability, Functioning and Health. The estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability. The finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events.

Connecting impairment, disability, and handicap in immune mediated polyneuropathies

PubMed Central

Merkies, I; Schmitz, P; van der Meche, F G A; Samijn, J; van Doorn, P A

2003-01-01

Background: In the World Health Organisation (WHO) International Classification of Impairments, Disabilities, and Handicaps (ICIDH), it is suggested that various levels of outcome are associated with one another. However, the ICIDH has been criticised on the grounds that it only represents a general, non-specific relation between its entities. Objective: To examine the significance of the ICIDH in immune mediated polyneuropathies. Methods: Four impairment measures (fatigue severity scale, MRC sum score, "INCAT" sensory sum score, grip strength with the Vigorimeter), five disability scales (nine hole peg test, 10 metres walking test, an overall disability sum score (ODSS), Hughes functional grading scale, Rankin scale), and a handicap scale (Rotterdam nine items handicap scale (RIHS9)) were assessed in 113 clinically stable patients (83 with Guillain–Barré syndrome, 22 with chronic inflammatory demyelinating polyneuropathy, eight with a gammopathy related polyneuropathy). Regression analyses with backward and forward stepwise strategies were undertaken to determine the correlation between the various levels of outcome (impairment on disability, impairment on handicap, disability leading to handicap, and impairment plus disability on handicap). Results: Impairment measures explained a substantial part of disability (R2 = 0.64) and about half of the variance in handicap (R2 = 0.52). Disability measures showed a stronger association with handicap (R2 = 0.76). Combining impairment and disability scales accounted for 77% of the variance in handicap (RIHS9) scores. Conclusions: In contrast to some suggestions, support for the ICIDH model is found in the current study because significant associations were shown between its various levels in patients with immune mediated polyneuropathies. Further studies are required to examine other possible contributors to deficits in daily life and social functioning in these conditions. PMID:12486276

Does Classification of Chronic Musculoskeletal Disorder Patients Into Psychosocial Subgroups Predict Differential Treatment Responsiveness and 1-Year Outcomes After a Functional Restoration Program?

PubMed

Asih, Sali; Mayer, Tom G; Williams, Mark; Choi, Yun Hee; Gatchel, Robert J

2015-12-01

The objectives of this study: (1) to assess whether Multidimensional Pain Inventory (MPI) profiles predicted differential responses to a functional restoration program (FRP) in chronic disabling occupational musculoskeletal disorder (CDOMD) patients; (2) to examine whether coping style improves following FRP; and (3) to determine whether discharge MPI profiles predict discharge psychosocial and 1-year socioeconomic outcomes. Consecutive CDOMD patients (N=716) were classified into Adaptive Coper (AC, n=209), Interpersonally Distressed (ID, n=154), Dysfunctional (DYS, n=310), and Anomalous (n=43) using the MPI, and reclassified at discharge. Profiles were compared on psychosocial measures and 1-year socioeconomic outcomes. An intent-to-treat sample analyzed the effect of drop-outs on treatment responsiveness. The MPI classification significantly predicted program completion (P=0.001), although the intent-to-treat analyses found no significant effects of drop-out on treatment responsiveness. There was a significant increase in the number of patients who became AC or Anomalous at FRP discharge and a decrease in those who were ID or DYS. Patients who changed or remained as DYS at FRP discharge reported the highest levels of pain, disability, and depression. No significant interaction effect was found between MPI group and time for pain intensity or disability. All groups improved on psychosocial measures at discharge. DYS patients had decreased work retention and a greater health care utilization at 1 year. An FRP was clinically effective for CDOMD patients regardless of initial MPI profiles. The FRP modified profiles, with patients changing from negative to positive profiles. Discharge DYS were more likely to have poor 1-year outcomes. Those classified as Anomalous had a good prognosis for functional recovery similar to ACs.

American Association on Mental Retardation's "Definition, Classification, and System of Supports" and Its Relation to International Trends and Issues in the Field of Intellectual Disabilities

ERIC Educational Resources Information Center

Schalock, Robert L.; Luckasson, Ruth

2004-01-01

This article provides an overview of the 2002 American Association on Mental Retardation's (AAMR's) "Definition, Classification, and Systems of Supports" (the 2002 System) and discusses its relationship to salient international trends and several scientific and judgmental issues currently impacting the field of intellectual disabilities (ID). Five…

[The International Classification of Functioning, Disability and Health (ICF) : The implementation of the ICF Core Sets for Hand Conditions in clinical routine as an example of application].

PubMed

Coenen, Michaela; Rudolf, Klaus-Dieter; Kus, Sandra; Dereskewitz, Caroline

2018-05-24

The International Classification of Functioning, Disability and Health (ICF) provides a standardized language of almost 1500 ICF categories for coding information about functioning and contextual factors. Short lists (ICF Core Sets) are helpful tools to support the implementation of the ICF in clinical routine. In this paper we report on the implementation of ICF Core Sets in clinical routine using the "ICF Core Sets for Hand Conditions" and the "Lighthouse Project Hand" as an example. Based on the ICF categories of the "Brief ICF Core Set for Hand Conditions", the ICF-based assessment tool (ICF Hand A ) was developed aiming to guide the assessment and treatment of patients with injuries and diseases located at the hand. The ICF Hand A facilitates the standardized assessment of functioning - taking into consideration of a holistic view of the patients - along the continuum of care ranging from acute care to rehabilitation and return to work. Reference points for the assessment of the ICF Hand A are determined in treatment guidelines for selected injuries and diseases of the hand along with recommendations for acute treatment and care, procedures and interventions of subsequent treatment and rehabilitation. The assessment of the ICF Hand A according to the defined reference points can be done using electronic clinical assessment tools and allows for an automatic generation of a timely medical report of a patient's functioning. In the future, the ICF Hand A can be used to inform the coding of functioning in ICD-11.

Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

PubMed

Stucki, Gerold; Zampolini, Mauro; Juocevicius, Alvydas; Negrini, Stefano; Christodoulou, Nicolas

2017-04-01

Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

Subtyping Patients with Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) By Course of Illness.

PubMed

Stoothoff, Jamie; Gleason, Kristen; McManimen, Stephanie; Thorpe, Taylor; Jason, Leonard A

2017-01-01

Past research has subtyped patients with Myalgic Encephalolyelitis (ME) and Chronic Fatigue Syndrome (CFS) according to factors related to illness onset, illness duration, and age. However, no classification system fully accounts for the wide range of symptom severity, functional disability, progression, and prognosis seen among patients. This study examined whether illness trajectories among individuals with CFS were predictive of different levels of symptomology, functional disability, and energy expenditure. Of the participants ( N=541 ), the majority described their illness as Fluctuating (59.7%), with 15.9% Constantly Getting Worse, 14.1% Persisting, 8.5% Relapsing and Remitting, and 1.9% Constantly Getting Better. The illness courses were associated with significant differences in symptomology on select domains of the DSQ, functioning on select subscales of the SF-36, and on overall levels of energy expenditure. The significant symptomatic and functional differences between groups suggest that subtyping patients with CFS according to illness course is a promising method for creating more homogeneous groups of patients.

Validation of a systems-actuarial computer process for multidimensional classification of child psychopathology.

PubMed

McDermott, P A; Hale, R L

1982-07-01

Tested diagnostic classifications of child psychopathology produced by a computerized technique known as multidimensional actuarial classification (MAC) against the criterion of expert psychological opinion. The MAC program applies series of statistical decision rules to assess the importance of and relationships among several dimensions of classification, i.e., intellectual functioning, academic achievement, adaptive behavior, and social and behavioral adjustment, to perform differential diagnosis of children's mental retardation, specific learning disabilities, behavioral and emotional disturbance, possible communication or perceptual-motor impairment, and academic under- and overachievement in reading and mathematics. Classifications rendered by MAC are compared to those offered by two expert child psychologists for cases of 73 children referred for psychological services. Experts' agreement with MAC was significant for all classification areas, as was MAC's agreement with the experts held as a conjoint reference standard. Whereas the experts' agreement with MAC averaged 86.0% above chance, their agreement with one another averaged 76.5% above chance. Implications of the findings are explored and potential advantages of the systems-actuarial approach are discussed.

Health, function and disability in stroke patients in the community

PubMed Central

Carvalho-Pinto, Bárbara P. B.; Faria, Christina D. C. M.

2016-01-01

ABSTRACT Background Stroke patients commonly have impairments associated with reduction in functionality. Among these impairments, the motor impairments are the most prevalent. The functional profile of these patients living in the community who are users of the primary health-care services in Brazil has not yet been established Objective To describe the functional profile of stroke patients who are users of the primary health-care services in Brazil, looking at one health-care unit in the city of Belo Horizonte, Brazil. Method From medical records and home visits, data were collected regarding health status, assistance received following the stroke, personal and environmental contextual factors, function and disability, organized according to the conceptual framework of the International Classification of Functioning, Disability and Health (ICF). Test and instruments commonly applied in the assessment of stroke patients were used. Results Demographic data from all stroke patients who were users of the health-care unit (n=44, age: 69.23±13.12 years and 67±66.52 months since the stroke) participated of this study. Most subjects presented with disabilities, as changes in emotional function, muscle strength, and mobility, risks of falling during functional activities, negative self-perception of quality of life, and perception of the environment factors were perceived as obstacles. The majority of the patients used the health-care unit to renew drug prescriptions, and did not receive any information on stroke from health professionals, even though patients believed it was important for patients to receive information and to provide clarifications. Conclusion Stroke patients who used primary health-care services in Brazil have chronic disabilities and health needs that require continuous health attention from rehabilitation professionals. All of these health needs should be considered by health professionals to provide better management as part of the integral care of stroke patients, as recommended by the clinical practice guidelines for stroke rehabilitation. PMID:27556392

ICF-CY code set for infants with early delay and disabilities (EDD Code Set) for interdisciplinary assessment: a global experts survey.

PubMed

Pan, Yi-Ling; Hwang, Ai-Wen; Simeonsson, Rune J; Lu, Lu; Liao, Hua-Fang

2015-01-01

Comprehensive description of functioning is important in providing early intervention services for infants with developmental delay/disabilities (DD). A code set of the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY) could facilitate the practical use of the ICF-CY in team evaluation. The purpose of this study was to derive an ICF-CY code set for infants under three years of age with early delay and disabilities (EDD Code Set) for initial team evaluation. The EDD Code Set based on the ICF-CY was developed on the basis of a Delphi survey of international professionals experienced in implementing the ICF-CY and professionals in early intervention service system in Taiwan. Twenty-five professionals completed the Delphi survey. A total of 82 ICF-CY second-level categories were identified for the EDD Code Set, including 28 categories from the domain Activities and Participation, 29 from body functions, 10 from body structures and 15 from environmental factors. The EDD Code Set of 82 ICF-CY categories could be useful in multidisciplinary team evaluations to describe functioning of infants younger than three years of age with DD, in a holistic manner. Future validation of the EDD Code Set and examination of its clinical utility are needed. The EDD Code Set with 82 essential ICF-CY categories could be useful in the initial team evaluation as a common language to describe functioning of infants less than three years of age with developmental delay/disabilities, with a more holistic view. The EDD Code Set including essential categories in activities and participation, body functions, body structures and environmental factors could be used to create a functional profile for each infant with special needs and to clarify the interaction of child and environment accounting for the child's functioning.

Validity of the Children's Social Behavior Questionnaire (CSBQ) in Children with Intellectual Disability: Comparing the CSBQ with ADI-R, ADOS, and Clinical DSM-IV-TR Classification

ERIC Educational Resources Information Center

de Bildt, Annelies; Mulder, Erik J.; Hoekstra, Pieter J.; van Lang, Natasja D. J.; Minderaa, Ruud B.; Hartman, Catharina A.

2009-01-01

The Children's Social Behavior Questionnaire (CSBQ) was compared with the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), and clinical classification in children with mild and moderate intellectual disability (ID), to investigate its criterion related validity. The contribution of the CSBQ to a…

Disability and schizophrenia: a systematic review of experienced psychosocial difficulties

PubMed Central

2012-01-01

Background Schizophrenia is a significantly disabling disease that affects all major areas of life. There is a lack of comprehensive synthesis of research findings on the full extent of psychosocial difficulties (PSDs) experienced by people living with schizophrenia. This paper provides a systematic review of the literature concerning PSDs and their associated factors in schizophrenia. PSDs were conceptualized in accordance with the International Classification of Functioning, Disability and Health (ICF) as disabilities, in particular impairments of mental functions, activity limitations and participation restrictions. Methods An electronic search using MEDLINE and PsychINFO plus a manual search of the literature was performed for qualitative and longitudinal studies published in English between 2005 and 2010 that examined PSDs in persons with schizophrenia. The ICF was used as a conceptual framework. Results A total of 104 papers were included. The most frequent PSDs addressed in the literature were not specific ones, directly linkable to the ICF categories of mental functions, activity limitations or participation restrictions, but broad areas of psychosocial functioning, such as psychopathological symptoms (53% of papers) or global disability and functioning (37%). Among mental functions, the most extensively studied were cognitive functions (27%) and emotional functions (27%). Within the domain of activities and participation, the most widely investigated were difficulties in relationships with others (31%) and employment (20%). Of the factors associated with the intensity or course of PSDs, the most commonly identified were treatment modalities (56%), psychopathological symptoms (26%), and socio-demographic variables (24%). Medication tended to improve the most relevant PSD, but at the same time was the only consistently reported determinant of onset of PSDs (emerging as unwanted side-effects). Conclusions The present review illustrates the remarkably broad scope and diversity of psychosocial areas affected in schizophrenia and shows how these areas are interconnected and how they interact with contextual factors. The need for a shift in focus of schizophrenia research is suggested – from an excessive reliance on global measures of psychopathology and disability for defining outcomes to the creation of profiles of specific PSDs that have a more direct bearing on the disabling experience and real-world functioning of patients and can serve to guide interventions and monitoring over time. PMID:23137171

Enacting Disability Policy through Unseen Support: The Everyday Use of Disability Classifications by University Administrators

ERIC Educational Resources Information Center

Cox, Nigel

2017-01-01

In the United Kingdom (UK), Higher Education Institutions share with other educational providers the duty to provide reasonable adjustments for students who disclose disabilities. The role of academic administrators in the operationalisation of legislation-driven policy related to disability within the university context is overlooked within…

20 CFR 718.304 - Irrebuttable presumption of total disability or death due to pneumoconiosis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... International Classification of Radiographs of the Pneumoconioses, 1971, or subsequent revisions thereto; or (2) The International Classification of the Radiographs of the Pneumoconioses of the International Labour Office, Extended Classification (1968) (which may be referred to as the “ILO Classification (1968)”); or...

Correlates and determinants of physical activity in persons with spinal cord injury: A review using the International Classification of Functioning, Disability and Health as reference framework.

PubMed

Fekete, Christine; Rauch, Alexandra

2012-07-01

Participation in physical activity (PA) decreases after the onset of a spinal cord injury (SCI) and is generally low in persons with SCI. To provide an overview of findings on correlates/determinants of PA in persons with SCI applying the International Classification of Functioning, Disability and Health (ICF) to analyze and report results. A systematic literature review using the databases MEDLINE, PsycINFO, SSCI, and CINHAL was conducted. Independent variables were extracted and linked to ICF codes. Quality of evidence was rated using internationally accepted standards. Overall, evidence quality of the 25 included studies is low. Environmental Factors were consistently found as correlates of PA, whereas Personal Factors (socio-demographics and psychological constructs) were weakly associated with PA in the SCI population. Associations with Body Functions, Body Structures, Activities and Participation and Health Conditions were less frequently studied. Although quality of evidence of reviewed literature is low, results indicate that rather environmental barriers than the 'classical' socio-demographic factors known from social epidemiology correlate with PA in persons with SCI. There is insufficient evidence to draw conclusions concerning the association of Body Functions and Structures and Activity and Participation with PA. Future research is encouraged to better understand the interplay between functioning, contextual factors, health conditions and PA in SCI to establish a sound basis for intervention planning in this special needs population. In addition, our experience showed that linking study results to the ICF facilitates data analysis and reporting. Copyright © 2012 Elsevier Inc. All rights reserved.

The Bobath Concept in Walking Activity in Chronic Stroke Measured Through the International Classification of Functioning, Disability and Health.

PubMed

Benito García, Miguel; Atín Arratibel, María Ángeles; Terradillos Azpiroz, Maria Estíbaliz

2015-12-01

The aim of this study is to evaluate the effectiveness of a rehabilitation programme based on the Bobath concept in order to improve walking activity in patients with chronic stroke and to show the usefulness of the International Classification of Functioning, Disability and Health (ICF) as a tool for gathering functioning information. This study is a repeated measures study. The setting of this study is an outpatient neurological rehabilitation centre based on a multidisciplinary approach. Twenty-four participants suffering from chronic stroke (>1 year and a half and <5 years post-stroke) and mean age of 65.58 (standard deviation 10.73) were the participants of the study. Multidisciplinary approach based on the Bobath concept principles with three weekly individual physiotherapy sessions of 45 min each over a 6-month period was the intervention for this study. The measures used were Modified Emory Functional Ambulation Profile, 10-m walk test, 6-min walk test, muscle strength testing and subsequent codification of these results into ICF qualifiers. The results of the study showed significant improvement in activities of walking long distances, on different surfaces and around obstacles. There was no significant improvement in the activity of walking short distances or for muscle power functions. A rehabilitation programme based on the Bobath Concept improved walking activities in people with chronic stroke. For this intervention, the use of the ICF qualifiers was sensitive in perceiving post-treatment changes. Copyright © 2014 John Wiley & Sons, Ltd.

Understanding recovery: changes in the relationships of the International Classification of Functioning (ICF) components over time.

PubMed

Davis, A M; Perruccio, A V; Ibrahim, S; Hogg-Johnson, S; Wong, R; Badley, E M

2012-12-01

The International Classification of Functioning, Disability and Health framework describes human functioning through body structure and function, activity and participation in the context of a person's social and physical environment. This work tested the temporal relationships of these components. Our hypotheses were: 1) there would be associations among physical impairment, activity limitations and participation restrictions within time; 2) prior status of a component would be associated with future status; 3) prior status of one component would influence status of a second component (e.g. prior activity limitations would be associated with current participation restrictions); and, 4) the magnitude of the within time relationships of the components would vary over time. Participants from Canada with primary hip or knee joint replacement (n = 931), an intervention with predictable improvement in pain and disability, completed standardized outcome measures pre-surgery and five times in the first year post-surgery. These included physical impairment (pain), activity limitations and participation restrictions. ICF component relationships were evaluated cross-sectionally and longitudinally using path analysis adjusting for age, sex, BMI, hip vs. knee, low back pain and mood. All component scores improved significantly over time. The path coefficients supported the hypotheses in that both within and across time, physical impairment was associated with activity limitation and activity limitation was associated with participation restriction; prior status and change in a component were associated with current status in another component; and, the magnitude of the path coefficients varied over time with stronger associations among components to three months post surgery than later in recovery with the exception of the association between impairment and participation restrictions which was of similar magnitude at all times. This work enhances understanding of the complexities of the ICF component relationships in evaluating disability over time. Further longitudinal studies including evaluation of contextual factors are required. Copyright © 2012 Elsevier Ltd. All rights reserved.

Functioning and disability in autism spectrum disorder: A worldwide survey of experts

PubMed Central

de Schipper, Elles; Mahdi, Soheil; de Vries, Petrus; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Almodayfer, Omar; Shulman, Cory; Tonge, Bruce; Wong, Virginia V.C.N.; Zwaigenbaum, Lonnie

2016-01-01

Objective: This study is the second of four to prepare International Classification of Functioning, Disability and Health (ICF; and Children and Youth version, ICF(‐CY)) Core Sets for Autism Spectrum Disorder (ASD).The objective of this study was to survey the opinions and experiences of international experts on functioning and disability in ASD. Methods: Using a protocol stipulated by the World Health Organization (WHO) and monitored by the ICF Research Branch, an email‐based questionnaire was circulated worldwide among ASD experts, and meaningful functional ability and disability concepts were extracted from their responses. These concepts were then linked to the ICF(‐CY) by two independent researchers using a standardized linking procedure. Results: N = 225 experts from 10 different disciplines and all six WHO‐regions completed the survey. Meaningful concepts from the responses were linked to 210 ICF(‐CY) categories. Of these, 103 categories were considered most relevant to ASD (i.e., identified by at least 5% of the experts), of which 37 were related to Activities and Participation, 35 to Body functions, 22 to Environmental factors, and 9 to Body structures. A variety of personal characteristics and ASD‐related functioning skills were provided by experts, including honesty, loyalty, attention to detail and creative talents. Reported gender differences in ASD comprised more externalizing behaviors among males and more internalizing behaviors in females. Conclusion: The ICF(‐CY) categories derived from international expert opinions indicate that the impact of ASD on functioning extends far beyond core symptom domains. Autism Res 2016, 9: 959–969. © 2016 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research PMID:26749373

International Classification of Functioning, Disability and Health: Catalyst for interprofessional education and collaborative practice.

PubMed

Snyman, Stefanus; Von Pressentin, Klaus B; Clarke, Marina

2015-01-01

Patient-centred and community-based care is required for promotion of health equity. To enhance patient-centred interprofessional care, the World Health Organization recommends using the framework of the International Classification of Functioning, Disability and Health (ICF). Stellenbosch University's Interprofessional Education and Collaborative Practice (IPECP) strategy has promoted using ICF since 2010. Undergraduate medical students on rural clinical placements are expected to use ICF in approaching and managing patients. Students' ability to develop interprofessional care plans using ICF is assessed by a team of preceptors representing various health professions. This study explored the experiences of medical students and their preceptors using ICF in IPECP, and how patients perceived care received. Associative Group Analysis methodology was used to collect data for this study. In total, 68 study participants were enrolled of which 37 were medical students, 16 preceptors and 15 patients. Students found ICF enabled a patient-centred approach and reinforce the importance of context. Patients felt listened to and cared for. Preceptors, obliged to use ICF, came to appreciate the advantages of interprofessional care, promoting mutually beneficial teamwork and job satisfaction. The value of integrating IPECP as an authentic learning experience was demonstrated as was ICF as a catalyst in pushing boundaries for change.

Exploring changes over time in habilitation professionals' perceptions and applications of the International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY).

PubMed

Adolfsson, Margareta; Granlund, Mats; Björck-Akesson, Eva; Ibragimova, Nina; Pless, Mia

2010-07-01

This study explored how professionals in inter-disciplinary teams perceived the implementation of the World Health Organization's International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services. Descriptive longitudinal mixed-methods design. Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years. Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children's needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation. Professionals indicated that the ICF-CY enhanced their awareness of families' views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation.

Development of the International Classification of Functioning, Disability and Health core sets for hand conditions--results of the World Health Organization International Consensus process.

PubMed

Rudolf, Klaus-Dieter; Kus, Sandra; Chung, Kevin C; Johnston, Marie; LeBlanc, Monique; Cieza, Alarcos

2012-01-01

A formal decision-making and consensus process was applied to develop the first version of the International Classification on Functioning, Disability and Health (ICF) Core Sets for Hand Conditions. To convene an international panel to develop the ICF Core Sets for Hand Conditions (HC), preparatory studies were conducted, which included an expert survey, a systematic literature review, a qualitative study and an empirical data collection process involving persons with hand conditions. A consensus conference was convened in Switzerland in May 2009 that was attended by 23 healthcare professionals, who treat hand conditions, representing 22 countries. The preparatory studies identified a set of 743 ICF categories at the second, third or fourth hierarchical level. Altogether, 117 chapter-, second-, or third-level categories were included in the comprehensive ICF Core Set for HC. The brief ICF Core Set for HC included a total of 23 chapter- and second-level categories. A formal consensus process integrating evidence and expert opinion based on the ICF led to the formal adoption of the ICF Core Sets for Hand Conditions. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings.

Intelligence, Functioning, and Related Factors in Children with Cerebral Palsy.

PubMed

Türkoğlu, Gözde; Türkoğlu, Serhat; Çelik, Canan; Uçan, Halil

2017-03-01

Cerebral palsy (CP) is the most common significant motor impairment in childhood. CP is defined as a primary disorder of posture and movement; however, intellectual impairment is prevalent in children with CP. The purpose of this study was to examine the intelligence level associated with gross motor function and hand function, type of CP, the presence of comorbid disorders such as epilepsy, and other factors. In total, 107 children with CP were included. Age, gender, prenatal/natal/postnatal risk factors, type of CP, and presence of other neurodevelopmental disorders were recorded as demographic findings. Intellectual functions of the patients were determined by clinical assessment, adaptive function of daily life, and individualized, standardized intelligence testing. The gross motor function and hand function of the patients were classified using the "Gross Motor Function Classification System" and "Bimanual Fine Motor Function" measurements, respectively. The mean age of the patients was 8.10±3.43 years (2-16 years). The study included 63 (58.9%) male patients and 44 (41.1%) female patients. During clinical typing, 80.4% of the patients were spastic, 11.2% were mixed, 4.7% were dyskinetic, and 3.7% were ataxic. Intellectual functioning tests found 26.2% of the children within the intellectual norm and that 10% of the children had a borderline intellectual disability, 16% of them had a mild intellectual disability, 17% of them had a moderate intellectual disability, and 30.8% of them had a severe intellectual disability. No significant relationship was determined between the CP type and intellectual functioning (p>0.05). Intellectual functioning was found to be significantly correlated with hand functions and motor levels (p<0.001). Factors related with intellectual functioning were neonatal convulsion, epilepsy, and speech disorders. Intelligence assessment should be an essential part of CP evaluation and research. There is not enough reliable knowledge, unanimity regarding validity data, and population-specific norms in the intelligence assessments of children with CP. Research is required to assess properly intelligence for children with CP.

Classification of upper limb disability levels of children with spastic unilateral cerebral palsy using K-means algorithm.

PubMed

Raouafi, Sana; Achiche, Sofiane; Begon, Mickael; Sarcher, Aurélie; Raison, Maxime

2018-01-01

Treatment for cerebral palsy depends upon the severity of the child's condition and requires knowledge about upper limb disability. The aim of this study was to develop a systematic quantitative classification method of the upper limb disability levels for children with spastic unilateral cerebral palsy based on upper limb movements and muscle activation. Thirteen children with spastic unilateral cerebral palsy and six typically developing children participated in this study. Patients were matched on age and manual ability classification system levels I to III. Twenty-three kinematic and electromyographic variables were collected from two tasks. Discriminative analysis and K-means clustering algorithm were applied using 23 kinematic and EMG variables of each participant. Among the 23 kinematic and electromyographic variables, only two variables containing the most relevant information for the prediction of the four levels of severity of spastic unilateral cerebral palsy, which are fixed by manual ability classification system, were identified by discriminant analysis: (1) the Falconer index (CAI E ) which represents the ratio of biceps to triceps brachii activity during extension and (2) the maximal angle extension (θ Extension,max ). A good correlation (Kendall Rank correlation coefficient = -0.53, p = 0.01) was found between levels fixed by manual ability classification system and the obtained classes. These findings suggest that the cost and effort needed to assess and characterize the disability level of a child can be further reduced.

Monitoring My Multiple Sclerosis

PubMed Central

Namey, Marie; Halper, June

2011-01-01

Optimal health of people with multiple sclerosis (MS) can be promoted by patients' sharing of health information gained through periodic self-monitoring with their health-care providers. The purpose of this study was to develop a valid and reliable self-administered scale to obtain information about MS patients' health status and the impact of the disease on their daily lives. We named this scale “Monitoring My Multiple Sclerosis” (MMMS). A cross-sectional survey was conducted of 171 MS patients who completed the MMMS and Patient-Determined Disease Steps (PDDS) scales and provided information on their MS disease classification and demographic characteristics. Data analysis included several parametric procedures. Factor analysis of the 26-item MMMS resulted in four factors with satisfactory α reliability coefficients for the total scale (0.90) and factored subscales: Physical (0.85), Relationships (0.80), Energy (0.70), and Cognitive/Mental (0.67). Analysis of variance demonstrated that the total scale and the Physical subscale, but not the Relationships subscale, showed significantly worse functioning for patients with either moderate or severe disability as measured by the PDDS than for patients with mild disability (P < .001). The Cognitive/Mental subscale showed significantly worse functioning for patients with moderate disability than for patients with mild disability (P < .05). However, the Energy subscale showed significantly worse functioning among moderately disabled patients than among severely disabled patients (P < .01). Independent t tests demonstrated that patients classified as having secondary progressive multiple sclerosis had significantly worse scores on the total MMMS (P < .05) and the Physical subscale (P < .001) than those classified as having relapsing-remitting multiple sclerosis. The MMMS demonstrated satisfactory reliability and validity and is recommended for use by MS patients and their health-care providers as a mechanism to promote the sharing of health information, to the benefit of both patients and providers. PMID:24453717

Contribution of mental and physical disorders to disability in military personnel.

PubMed

Beliveau, P J H; Boulos, D; Zamorski, M A

2018-05-19

Combat operations in Southwest Asia have exposed millions of military personnel to risk of mental disorders and physical injuries, including traumatic brain injury (TBI). The contribution of specific disorders to disability is, however, uncertain. To estimate the contributions of mental and physical health conditions to disability in military personnel. The sample consisted of military personnel who participated in the cross-sectional 2013 Canadian Forces Mental Health Survey. Disability was measured using the World Health Organization Disability Assessment. The International Classification of Functioning, Disability, and Health was used to classify participants with moderate/severe disability. Chronic mental disorders and physical conditions were measured by self-reported health professional diagnoses, and their contribution to disability was assessed using logistic regression and resulting population attributable fractions. Data were collected from 6696 military members. The prevalence of moderate/severe disability was 10%. Mental disorders accounted for 27% (95% confidence interval [CI] 23-31%) and physical conditions 62% (95% CI 56-67%) of the burden of disability. Chronic musculoskeletal problems 33% (95% CI 26-39%), back problems 29% (95% CI 23-35%), mood disorders 16% (95% CI 11-19%) and post-traumatic stress disorder (PTSD) 9% (95% CI 5-12%) were the leading contributors to disability. After-effects of TBI accounted for only 3% (95% CI 1-4%) of disability. Mental and physical health interacted broadly, such that those with mental disorders experienced disproportionate disability in the presence of physical conditions. Chronic musculoskeletal conditions, back problems, mood disorders and PTSD are primary areas of focus in prevention and control of disability in military personnel.

Psychometric properties of the WHODASII in rehabilitation patients.

PubMed

Pösl, Miriam; Cieza, Alarcos; Stucki, Gerold

2007-11-01

To evaluate function and disability, the WHO has developed the WHO Disability Assessment Schedule II (WHODASII), an instrument arising from the same conceptual basis as the International Classification of Functioning, Disability, and Health (ICF). The general objective of this study was to investigate whether the WHODASII--German version-is a valid instrument to measure functioning and disability across various conditions. Specific aims were (1) to assess its psychometric properties (reliability, validity, and sensitivity to change) based on the traditional test theory and (2) to compare its sensitivity to change after a rehabilitative intervention to the Short Form 36 (SF-36). This was a multi-center study with convenience samples of patients with different chronic conditions undergoing rehabilitation. Patients completed the WHODASII and the SF-36 before and after a rehabilitation treatment. Health professionals rated in cooperation with the patients the pain of the patients based on the ICF category "sensation of pain." 904 patients were included in the study. The Cronbach's range from 0.70 to 0.97 for the different subscales of WHODASII. With exception of the subscale Activities, the exploratory-factor structure of the WHODASII corresponds highly with the original structure. The effect size (ES) of the WHODASII total score ranged from 0.16 to 0.69 depending on the subgroup. The ES of the SF-36 summary scores ranged from 0.03 to 1.40. The WHODAS II (German version) is a useful instrument for measuring functioning and disability in patients with musculoskeletal diseases, internal diseases, stroke, breast cancer, and depressive disorder. The results of this study support the reliability, validity, dimensionality, and responsiveness of the German version of the WHODASII. However, the reproducibility in test-retest samples of stable patients, as well as the question to what extent a summary score can be constructed, requires further investigation.

Do community-based rehabilitation programmes promote the participation of persons with disabilities? A case control study from Mandya District, in India.

PubMed

Biggeri, Mario; Deepak, Sunil; Mauro, Vincenzo; Trani, Jean-Francois; Kumar, Jayanth; Ramasamy, Parthipan

2014-01-01

In this paper, we measure the effectiveness of Community-Based Rehabilitation (CBR) programmes in promoting the well-being of people with disabilities and removing the barriers to their participation in family and community decision-making processes. To evaluate the impact of the CBR programme, we use data from a large-scale control study in Karnataka, India. Propensity score matching is used to evaluate the impacts on disabled persons after 2, 4 and 7 years of entering the CBR. The theoretical framework for the analysis is based on the CBR guidelines, which are combined with the International Classification of Functionings (ICF), the United Nations Convention on the Rights of People with Disabilities (UN CRPD) and Amartya Sen's capability approach. CBR has a positive impact on the well-being of persons with disabilities participating in the programme and particularly on their participation within the family and the society at large. CBR programmes have a multidimensional and positive impact on individual and collective capabilities; on individual, agency and social empowerment. Implications for Rehabilitation Community-Based Rehabilitation (CBR) can make a lasting difference in the life of persons with disabilities. CBR improves participation and inclusion of persons with disabilities in the family and in the community.

Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

PubMed

Stucki, Gerold; Bickenbach, Jerome; Melvin, John

2017-09-01

A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

Using the RUG-III classification system for understanding the resource intensity of persons with intellectual disability residing in nursing homes.

PubMed

Martin, Lynn; Fries, Brant E; Hirdes, John P; James, Mary

2011-06-01

Since 1991, the Minimum Data Set 2.0 (MDS 2.0) has been the mandated assessment in US nursing homes. The Resource Utilization Groups III (RUG-III) case-mix system provides person-specific means of allocating resources based on the variable costs of caring for persons with different needs. Retrospective analyses of data collected on a sample of 9707 nursing home residents (2.4% had an intellectual disability) were used to examine the fit of the RUG-III case-mix system for determining the cost of supporting persons with intellectual disability (intellectual disability). The RUG-III system explained 33.3% of the variance in age-weighted nursing time among persons with intellectual disability compared to 29.6% among other residents, making it a good fit among persons with intellectual disability in nursing homes. The RUG-III may also serve as the basis for the development of a classification system that describes the resource intensity of persons with intellectual disability in other settings that provide similar types of support.

I-CAN: The Classification and Prediction of Support Needs

ERIC Educational Resources Information Center

Arnold, Samuel R. C.; Riches, Vivienne C.; Stancliffe, Roger J.

2014-01-01

Background: Since 1992, the diagnosis and classification of intellectual disability has been dependent upon three constructs: intelligence, adaptive behaviour and support needs (Luckasson "et al." 1992. Mental Retardation: Definition, Classification and Systems of Support. American Association on Intellectual and Developmental…

Treatment of Cerebral Palsy with Stem Cells: A Report of 17 Cases

PubMed Central

Abi Chahine, Nassim H.; Wehbe, Tarek W.; Hilal, Ramzi A.; Zoghbi, Victoria V.; Melki, Alia E.; Bou Habib, Emil B.

2016-01-01

Cerebral Palsy (CP) is a disabling condition that affects a child’s life and his/her family irreversibly. It is usually a non-progressive condition but improvement over time is rarely seen. The condition can be due to prenatal hypoxia, metabolic, genetic, infectious, traumatic or other causes. It is therefore a heterogeneous group that results in functional motor disability associated with different degrees of cognitive abnormalities. There are no treatments that can cure or even improve CP and the best available approach aims at functional, social and nutritional supportive care and counseling. In this paper, we report 17 sequential patients with CP treated with intrathecal administration of Bone Marrow Mononuclear Cells (BMMC). All patients had an uneventful post-injection course with 73% of the evaluable patients treated having a good response using the Gross Motor Function Classification System (GMFCS). The average improvement was 1.3 levels on the GMFCS with cognitive improvements as well. PMID:27426090

Nursing Students with Learning Disabilities.

ERIC Educational Resources Information Center

Selekman, Janice

2002-01-01

Discusses the following topics: identification and classification of learning disabilities (LD), effects of LD on nursing students, teaching and learning, LD legislation, and academic interventions for nursing students with LD. (SK)

Seated limits-of-stability of athletes with disabilities with regard to competitive levels and sport classification.

PubMed

Santos, P B R; Vigário, P S; Mainenti, M R M; Ferreira, A S; Lemos, T

2017-12-01

In this study, we asked whether wheelchair rugby (WR) classification and competitive level influence trunk function of athletes with disabilities, in terms of seated limits-of-stability (LoS). Twenty-eight athletes were recruited from international- and national-level WR teams, with each group exhibiting marked differences in years of sports practice and training volume. Athletes were also distributed into three groups according their classification: low-point (0.5-1.5-point); mid-point (2.0-2.5-point); and high-point (3.0-3.5-point). Athletes were asked to sit on a force platform and to lean the body as far as possible in eight predefined directions. Center of pressure (COP) coordinates were calculated from the ground reaction forces acquired with the force platform. LoS were computed as the area of ellipse adjusted to maximal COP excursion achieved for the eight directions. ANOVAs reveal that LoS were not different when international- and national-level players were compared (P=.744). Nevertheless, LoS were larger in players from the high-point group than from the low-point group (P=.028), with the mid-point group being not different from both (P>.194). In summary, (i) competitive level does not impact LoS measures and (ii) LoS are remarkably distinct when comparing both extremes of the WR classification range. Our results suggest that, as a training-resistant measure, LoS could be a valid assessment of trunk impairment, potentially contributing to the development of an evidence-based WR classification. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Learning Disabilities

ERIC Educational Resources Information Center

Sittiprapaporn, Wichian, Ed.

2012-01-01

Learning disability is a classification that includes several disorders in which a person has difficulty learning in a typical manner. Depending on the type and severity of the disability, interventions may be used to help the individual learn strategies that will foster future success. Some interventions can be quite simplistic, while others are…

Learning Disabilities. Final Report.

ERIC Educational Resources Information Center

Delaware State Dept. of Education, Dover.

This report responds to Delaware state legislation requiring the development of proposed revised regulations for the classification of students as learning disabled (LD). The report first describes the current system, noting that in 1997 15 percent of the student population were served under the Individuals with Disabilities Education Act and over…

Associations between disability and employment 1 year after traumatic brain injury in a working age population.

PubMed

Andelic, Nada; Stevens, Lillian Flores; Sigurdardottir, Solrun; Arango-Lasprilla, Juan Carlos; Roe, Cecilie

2012-01-01

To investigate associations between disability and employment 1 year after traumatic brain injury (TBI) using the International Classification of Functioning, Disability and Health (ICF) as a conceptual model. A prospective study including 93 patients with moderate-to-severe TBI (aged 16-55 year). Disability components of the ICF model (impairments, activity limitations and participation restrictions) and personal factors (age, gender, pre-injury employment status) were used as independent variables. The outcome measure was employment at 1 year post-injury categorized into unemployed and employed groups. Personal factors, impairments (brain injury severity, overall trauma severity and number of impaired body functions) and activity limitations (motor and cognitive abilities) accounted for 57% of the variance in employment outcome. Multivariate analyses showed that the probabilities of being employed 1 year post-injury were 95% lower for patients who were unemployed pre-injury (OR = 0.05), 74% lower for those with more severe brain injury (OR = 0.26) and 82% lower for those with more cognitive limitations (OR = 0.18). Rehabilitation professionals should take into account the importance of the ICF model when planning vocational rehabilitation interventions for individuals with TBI and focus on targeting modifiable aspects related to employment outcome, such as the individual's cognitive ability.

Examining Functioning and Contextual Factors in Individuals with Joint Contractures from the Health Professional Perspective Using the ICF: An International Internet-Based Qualitative Expert Survey.

PubMed

Fischer, Uli; Müller, Martin; Strobl, Ralf; Bartoszek, Gabriele; Meyer, Gabriele; Grill, Eva

2016-01-01

The aim of this study was to identify disease-related aspects of functioning and disability in people with joint contractures from a health professionals' perspective and to describe the findings, using categories of the International Classification of Functioning, Disability, and Health (ICF). An Internet-based expert survey. We asked international health professionals for typical problems in functioning and important contextual factors of individuals with joint contractures using an Internet-based open-ended questionnaire. All answers were linked to the ICF according to established rules. Absolute and relative frequencies of the linked ICF categories were reported. Eighty experts named 1785 meaning units which could be linked to 256 ICF categories. Among the categories, 24.2% belonged to the component Body Functions, 20.7% to Body Structures, 36.3% to Activities and Participation, and 18.8% to Environmental Factors. Health professionals addressed a large variety of functional problems and multifaceted aspects due to the symptom joint contractures. International health professionals reported a large variety of aspects of functioning and health, which are related to joint contractures. © 2014 Association of Rehabilitation Nurses.

Third-party disability in carers of people with dysphagia following non-surgical management for head and neck cancer.

PubMed

Nund, Rebecca L; Scarinci, Nerina A; Cartmill, Bena; Ward, Elizabeth C; Kuipers, Pim; Porceddu, Sandro V

2016-01-01

Third-party disability pertains to the consequences of a person's impairment which impacts on the functioning and ability of their family members or significant others. With the emergence of research demonstrating the pervasive effects of dysphagia following head and neck cancer (HNC) on the carer, the aim of this study was to identify the International Classification of Functioning, Disability and Health (ICF) domains and categories that describe the third-party disability of carers of people with dysphagia following HNC. Twelve carers of people with dysphagia following HNC participated in individual semi-structured, in-depth interviews. Categories and sub-categories identified from the qualitative analysis were mapped to the ICF using the established linking rules. The majority of the categories and sub-categories from the qualitative analysis were successfully linked to the ICF with most linking to the Activities and Participation component. A number of contextual factors were also identified as impacting on the functioning of carers. The ICF can be successfully used to describe the third-party disability in carers of people with dysphagia following HNC management. This information could be used by clinicians, researchers and policy makers to help establish evidence-based guidelines that include carers in the assessment and management of dysphagia associated with HNC. Clinical levels of distress and reduced quality of life have been associated with caring for a person with dysphagia following head and neck cancer. The flow-on effects of dysphagia experienced by a carer or close family member can be understood as a third-party disability, which impacts on their functioning, activities and participation in the context of the environment and personal factors. Using the ICF to describe the indirect effects of dysphagia on the carer may help to guide the assessment and support of this population, and advocate for the inclusion of the concerns of the carer in dysphagia management.

Families' perception of children / adolescents with language impairment through the International Classification of Functioning, Disability, and Health (ICF-CY).

PubMed

Ostroschi, Daniele Theodoro; Zanolli, Maria de Lurdes; Chun, Regina Yu Shon

2017-05-22

To investigate the perception of family members regarding linguistic conditions and social participation of children and adolescents with speech and language impairments using the International Classification of Functioning, Disability and Health - Children and Youth Version (ICF-CY). Quali-quantitative approach research, in which a survey of medical records of 24 children/adolescents undergoing speech-language therapy and interviews with their family members was conducted. A descriptive analysis of the participants' profiles was performed, followed by a categorization of responses using the ICF-CY. All family members mentioned various aspects of speech/language categorized by the ICF-CY. Initially, they approached it as an organic issue, categorized under the component of Body Functions and Structures. Most reported different repercussions of the speech-language impairments on the domains, such as dealing with stress and speaking, qualified from mild to severe. Participants reported Environmental Factors categorized as facilitators in the immediate family's attitudes and as barriers in the social attitudes. These findings, according to the use of the ICF-CY, demonstrate that the children/adolescents' speech-language impairments, from the families' perception, are primarily understood in the body dimension. However, guided by a broader approach to health, the findings in the Activities and Participation and Environmental Factors demonstrate a broader understanding of the participants of the speech-language impairments. The results corroborate the importance of using the ICF-CY as a health care analysis tool, by incorporating functionality and participation aspects and providing subsidies for the construction of unique therapeutic projects in a broader approach to the health of the group studied.

Application of the International Classification of Functioning, Disability and Health (ICF) to people with dysphagia following non-surgical head and neck cancer management.

PubMed

Nund, Rebecca L; Scarinci, Nerina A; Cartmill, Bena; Ward, Elizabeth C; Kuipers, Pim; Porceddu, Sandro V

2014-12-01

The International Classification of Functioning, Disability, and Health (ICF) is an internationally recognized framework which allows its user to describe the consequences of a health condition on an individual in the context of their environment. With growing recognition that dysphagia can have broad ranging physical and psychosocial impacts, the aim of this paper was to identify the ICF domains and categories that describe the full functional impact of dysphagia following non-surgical head and neck cancer (HNC) management, from the perspective of the person with dysphagia. A secondary analysis was conducted on previously published qualitative study data which explored the lived experiences of dysphagia of 24 individuals with self-reported swallowing difficulties following HNC management. Categories and sub-categories identified by the qualitative analysis were subsequently mapped to the ICF using the established linking rules to develop a set of ICF codes relevant to the impact of dysphagia following HNC management. The 69 categories and sub-categories that had emerged from the qualitative analysis were successfully linked to 52 ICF codes. The distribution of these codes across the ICF framework revealed that the components of Body Functions, Activities and Participation, and Environmental Factors were almost equally represented. The findings confirm that the ICF is a valuable framework for representing the complexity and multifaceted impact of dysphagia following HNC. This list of ICF codes, which reflect the diverse impact of dysphagia associated with HNC on the individual, can be used to guide more holistic assessment and management for this population.

Disability pride protects self-esteem through the rejection-identification model.

PubMed

Bogart, Kathleen R; Lund, Emily M; Rottenstein, Adena

2018-02-01

The rejection-identification model (RIM) argues that the negative impacts of stigma, such as decreased self-esteem, may be mitigated when members of the stigmatized group choose to identify with each other rather than with the majority culture. A previously unstudied potential RIM stigma-reduction mechanism is disability pride, which views disability as a source of valuable, enriching, and positive experience. Impairment, personal, and environmental factors based on the International Classification of Functioning, Disability and Health (ICF) predict whether people will categorize themselves as disabled, but predictors of pride have received little examination. The purpose of this study was to (a) explore whether ICF factors predict disability pride, and (b) assess whether disability pride mediates a relationship between stigma and self-esteem, supporting RIM. Research Method/Design: Participants completed an Internet-based survey assessing pride, self-esteem, and ICF factors. Disability was not mentioned in recruitment materials to prevent selection biases. People who reported at least 1 impairment (n = 710) were included in analyses. ICF personal and environmental factors (stigma, social support, and being a person of color), but not impairment factors, predicted disability pride. Supporting RIM, disability pride partially mediated the relationship between stigma and self-esteem. Disability pride is a promising way to protect self-esteem against stigma. Disability pride is still a rare phenomenon. Given that pride is associated with social support, stigma, and, to a lesser extent, ethnicity, but not impairment characteristics, interventions might focus on personal and environmental factors like these to promote pride. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Communication Problems of Learning Disabled Children.

ERIC Educational Resources Information Center

Bryan, Tanis

The presentation reviews the empirical data concerning the existence and types of language problems experienced by learning disabled (LD) and reading disabled (RD) children. An introductory section provides criteria for classification as LD in research samples and a discussion of research data sources in the field of language assessment. Section…

EEG classification for motor imagery and resting state in BCI applications using multi-class Adaboost extreme learning machine

NASA Astrophysics Data System (ADS)

Gao, Lin; Cheng, Wei; Zhang, Jinhua; Wang, Jue

2016-08-01

Brain-computer interface (BCI) systems provide an alternative communication and control approach for people with limited motor function. Therefore, the feature extraction and classification approach should differentiate the relative unusual state of motion intention from a common resting state. In this paper, we sought a novel approach for multi-class classification in BCI applications. We collected electroencephalographic (EEG) signals registered by electrodes placed over the scalp during left hand motor imagery, right hand motor imagery, and resting state for ten healthy human subjects. We proposed using the Kolmogorov complexity (Kc) for feature extraction and a multi-class Adaboost classifier with extreme learning machine as base classifier for classification, in order to classify the three-class EEG samples. An average classification accuracy of 79.5% was obtained for ten subjects, which greatly outperformed commonly used approaches. Thus, it is concluded that the proposed method could improve the performance for classification of motor imagery tasks for multi-class samples. It could be applied in further studies to generate the control commands to initiate the movement of a robotic exoskeleton or orthosis, which finally facilitates the rehabilitation of disabled people.

A Cross-sectional Survey of Disability Attributed to Mental Disorders and Service Use in China

PubMed Central

Shang, Li-Li; Huang, Yue-Qin; Liu, Zhao-Rui; Chen, Hong-Guang

2017-01-01

Background: Mental disorders are strongly associated with disabilities. National survey on disability could provide a reliable basis for policymaking in care and rehabilitation of disabled persons. This study aimed to describe the disability prevalence rates attributed to mental disorders, their distribution by sociodemographic factors, and utilizations of service. Methods: This study is a secondary data analysis of the Second National Sample Survey on Disability in 2006. The disability and severity were assessed using the World Health Organization Disability Assessment Schedule 2.0. Mental disorders were diagnosed according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision Classification of Mental and Behavioral Disorders. Using descriptive and analytic epidemiological methods, prevalence rates of disability attributed to mental disorders and service use were calculated. Results: Data of 2,526,145 respondents were analyzed. The disability prevalence rate attributed to mental disorders in China was 6.3‰, accounting for 9.9% of all disabled people. Regarding disability prevalence attributed to mental disorders, it showed that gender, residential area, marital status, education level, and economic area were related to the prevalence distributions. The proportions of mild disability were highest in the disabled people with onset age of 18–64 years, while the proportion of extremely severe disability was highest in the disabled people with onset age of 65 years and above. Only 58.6% of disabled people attributed to mental disorders used some of the services. Conclusions: There are statistical differences of disability prevalence attributed to mental disorders by people and region in China. Service use in disabled people with mental disorders is insufficient. PMID:28584207

Work disabilities and unmet needs for health care and rehabilitation among jobseekers: a community-level investigation using multidimensional work ability assessments

PubMed Central

Kerätär, Raija; Taanila, Anja; Jokelainen, Jari; Soukainen, Jouko; Ala-Mursula, Leena

2016-01-01

Objective Comprehensive understanding of the prevalence and quality of work disabilities and unmet needs for health care and rehabilitation to support return to work (RTW) among jobseekers. Design Community-level, cross-sectional analysis with multidimensional clinical work ability assessments. Setting Paltamo, Finland. Participants Unemployed citizens either participating in the Full-Employment Project or long-term unemployed (n = 230, 81%). Main outcome measures Based on data from theme interviews, patient records, supervisors’ observations of work performance and clinical examinations, a physician concluded the individual’s work ability, categorised into four groups: good work ability, good work ability expected after RTW support, able to transitional work only or unable to work. These groups were cross tabulated with primary diagnoses, types of plans to support RTW, as well as categories of social functioning and motivation, for which sensitivity and specificity scores in detecting work disability were calculated. Results Only about half of the jobseekers had good work ability, 27% were found unable to work in the open labour market and 15% even eligible for a disability pension. For 20%, care or rehabilitation was seen necessary to enable RTW. Poor supervisor- and self-rated performance at work or poor social functioning appeared as sensitive measures in detecting work disability. Conclusions Work disabilities and unmet needs for health care and rehabilitation are highly prevalent among jobseekers, as depicted using a multidimensional work ability assessment procedure inspired by the International Classification of Functioning (ICF). Further development of work ability assessment practices is clearly needed. KEY POINTSAlthough the association of unemployment with poor health is well known, evidence on the work ability of the unemployed remains scarce.Work disabilities are common among the unemployed.Multidimensional work ability assessment among the unemployed reveals unmet needs for care and rehabilitation to support return to work.Context sensitivity may add to the accuracy of the doctor’s conclusions on work ability. PMID:27804309

Work disabilities and unmet needs for health care and rehabilitation among jobseekers: a community-level investigation using multidimensional work ability assessments.

PubMed

Kerätär, Raija; Taanila, Anja; Jokelainen, Jari; Soukainen, Jouko; Ala-Mursula, Leena

2016-12-01

Comprehensive understanding of the prevalence and quality of work disabilities and unmet needs for health care and rehabilitation to support return to work (RTW) among jobseekers. Community-level, cross-sectional analysis with multidimensional clinical work ability assessments. Paltamo, Finland. Unemployed citizens either participating in the Full-Employment Project or long-term unemployed (n = 230, 81%). Based on data from theme interviews, patient records, supervisors' observations of work performance and clinical examinations, a physician concluded the individual's work ability, categorised into four groups: good work ability, good work ability expected after RTW support, able to transitional work only or unable to work. These groups were cross tabulated with primary diagnoses, types of plans to support RTW, as well as categories of social functioning and motivation, for which sensitivity and specificity scores in detecting work disability were calculated. Only about half of the jobseekers had good work ability, 27% were found unable to work in the open labour market and 15% even eligible for a disability pension. For 20%, care or rehabilitation was seen necessary to enable RTW. Poor supervisor- and self-rated performance at work or poor social functioning appeared as sensitive measures in detecting work disability. Work disabilities and unmet needs for health care and rehabilitation are highly prevalent among jobseekers, as depicted using a multidimensional work ability assessment procedure inspired by the International Classification of Functioning (ICF). Further development of work ability assessment practices is clearly needed. KEY POINTS Although the association of unemployment with poor health is well known, evidence on the work ability of the unemployed remains scarce. Work disabilities are common among the unemployed. Multidimensional work ability assessment among the unemployed reveals unmet needs for care and rehabilitation to support return to work. Context sensitivity may add to the accuracy of the doctor's conclusions on work ability.

Secondary mediation and regression analyses of the PTClinResNet database: determining causal relationships among the International Classification of Functioning, Disability and Health levels for four physical therapy intervention trials.

PubMed

Mulroy, Sara J; Winstein, Carolee J; Kulig, Kornelia; Beneck, George J; Fowler, Eileen G; DeMuth, Sharon K; Sullivan, Katherine J; Brown, David A; Lane, Christianne J

2011-12-01

Each of the 4 randomized clinical trials (RCTs) hosted by the Physical Therapy Clinical Research Network (PTClinResNet) targeted a different disability group (low back disorder in the Muscle-Specific Strength Training Effectiveness After Lumbar Microdiskectomy [MUSSEL] trial, chronic spinal cord injury in the Strengthening and Optimal Movements for Painful Shoulders in Chronic Spinal Cord Injury [STOMPS] trial, adult stroke in the Strength Training Effectiveness Post-Stroke [STEPS] trial, and pediatric cerebral palsy in the Pediatric Endurance and Limb Strengthening [PEDALS] trial for children with spastic diplegic cerebral palsy) and tested the effectiveness of a muscle-specific or functional activity-based intervention on primary outcomes that captured pain (STOMPS, MUSSEL) or locomotor function (STEPS, PEDALS). The focus of these secondary analyses was to determine causal relationships among outcomes across levels of the International Classification of Functioning, Disability and Health (ICF) framework for the 4 RCTs. With the database from PTClinResNet, we used 2 separate secondary statistical approaches-mediation analysis for the MUSSEL and STOMPS trials and regression analysis for the STEPS and PEDALS trials-to test relationships among muscle performance, primary outcomes (pain related and locomotor related), activity and participation measures, and overall quality of life. Predictive models were stronger for the 2 studies with pain-related primary outcomes. Change in muscle performance mediated or predicted reductions in pain for the MUSSEL and STOMPS trials and, to some extent, walking speed for the STEPS trial. Changes in primary outcome variables were significantly related to changes in activity and participation variables for all 4 trials. Improvement in activity and participation outcomes mediated or predicted increases in overall quality of life for the 3 trials with adult populations. Variables included in the statistical models were limited to those measured in the 4 RCTs. It is possible that other variables also mediated or predicted the changes in outcomes. The relatively small sample size in the PEDALS trial limited statistical power for those analyses. Evaluating the mediators or predictors of change between each ICF level and for 2 fundamentally different outcome variables (pain versus walking) provided insights into the complexities inherent across 4 prevalent disability groups.

Influence of visual impairment and hearing impairment on functional dependence status among people in Taiwan-An evaluation using the WHODAS 2.0 score.

PubMed

Chang, Ko-Fang; Chang, Kwang-Hwa; Chi, Wen-Chou; Huang, Shih-Wei; Yen, Chia-Feng; Liao, Hua-Fang; Liou, Tsan-Hon; Chao, Pin-Zhir; Lin, I-Chan

2018-04-01

Visual impairment (VI) and hearing impairment (HI) are the two most common types of sensory disability encountered clinically. However, VI and HI result in different limitations in daily life. We assessed the level of functioning in patients with VI or HI based on the International Classification of Functioning, Disability, and Health. This nationwide, cross-sectional study included 312 people with VI and 540 people with HI. Each participant's degree of functioning and disability was evaluated using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). The standardized WHODAS 2.0 scores ranged from 0 (least difficulty) to 100 (most difficulty). Patients with VI and those with HI had a mean (±standard error) 32-item WHODAS 2.0 score of 42.4 ± 2.9 and 27.1 ± 1.6, respectively. The degree of restriction was positively related to the level of VI. Specifically, the patients with VI and a WHODAS 2.0 score of 33.7-35.3 or higher were likely to experience barriers to accessing mobility products, communication products, and education products. Furthermore, patients with a score of 42.9 or higher might experience barriers to accessing ingestion products and living products. WHODAS 2.0 scores are strongly correlated with the severity of VI. Mild VI should be targeted for treatment and referral as early as possible. Compared with the patients with HI, the patients with VI more frequently experience barriers to accessing environmental factors. Copyright © 2017. Published by Elsevier Taiwan LLC.

Moderators, mediators, and bidirectional relationships in the International Classification of Functioning, Disability and Health (ICF) framework: An empirical investigation using a longitudinal design and Structural Equation Modeling (SEM).

PubMed

Rouquette, Alexandra; Badley, Elizabeth M; Falissard, Bruno; Dub, Timothée; Leplege, Alain; Coste, Joël

2015-06-01

The International Classification of Functioning, Disability and Health (ICF) published in 2001 describes the consequences of health conditions with three components of impairments in body structures or functions, activity limitations and participation restrictions. Two of the new features of the conceptual model were the possibility of feedback effects between each ICF component and the introduction of contextual factors conceptualized as moderators of the relationship between the components. The aim of this longitudinal study is to provide empirical evidence of these two kinds of effect. Structural equation modeling was used to analyze data from a French population-based cohort of 548 patients with knee osteoarthritis recruited between April 2007 and March 2009 and followed for three years. Indicators of the body structure and function, activity and participation components of the ICF were derived from self-administered standardized instruments. The measurement model revealed four separate factors for body structures impairments, body functions impairments, activity limitations and participation restrictions. The classic sequence from body impairments to participation restrictions through activity limitations was found at each assessment time. Longitudinal study of the ICF component relationships showed a feedback pathway indicating that the level of participation restrictions at baseline was predictive of activity limitations three years later. Finally, the moderating role of personal (age, sex, mental health, etc.) and environmental factors (family relationships, mobility device use, etc.) was investigated. Three contextual factors (sex, family relationships and walking stick use) were found to be moderators for the relationship between the body impairments and the activity limitations components. Mental health was found to be a mediating factor of the effect of activity limitations on participation restrictions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Therapeutic effects of short-term monochromatic infrared energy therapy on patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study.

PubMed

Hsieh, Ru-Lan; Lo, Min-Tzu; Lee, Wen-Chung; Liao, Wei-Cheng

2012-11-01

Randomized, double-blind, placebo-controlled study. To examine the short-term therapeutic effects of monochromatic infrared energy (MIRE) on participants with knee osteoarthritis (OA). Patients were assessed according to the International Classification of Functioning, Disability and Health. MIRE is commonly used in therapy for patients with peripheral neuropathies. However, research has not focused intensively on the therapeutic effects of MIRE in patients with knee OA. This study enrolled 73 participants with knee OA. Participants received six 40-minute sessions of active or placebo MIRE treatment (890-nm wavelength; power, 6.24 W; energy density, 2.08 J/cm2/min; total energy, 83.2 J/cm2) over the knee joints for 2 weeks. International Classification of Functioning, Disability and Health-related outcomes were collected weekly over 4 weeks using the Knee injury and Osteoarthritis Outcome Score, Lysholm Knee Scale, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Chronic Pain Grade questionnaire, World Health Organization Quality of Life-brief version, and OA Quality of Life Questionnaire. Data were analyzed by repeated-measures analysis of variance. No statistically significant differences were found for the interaction of group by time for Knee injury and Osteoarthritis Outcome Score scores, including pain, other symptoms, function in daily living, function in sport and recreation, and knee-related quality of life. Scores on the Lysholm Knee Scale, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Chronic Pain Grade questionnaire, World Health Organization Quality of Life-brief version, and OA Quality of Life Questionnaire also showed no significant differences between the 2 groups at any of the 4 follow-up assessments. Short-term MIRE therapy provided no beneficial effects to body functions, activities, participation, and quality of life in patients with knee OA.

A Comprehensive Rehabilitation Approach in a Patient With Serious Neuropsychiatric Systemic Lupus Erythematosus.

PubMed

Ko, Yong Jae; Lee, Yang Gyun; Park, Ji Woong; Ahn, Sung Ho; Kwak, Jin Myoung; Choi, Yoon-Hee

2016-08-01

Neuropsychiatric systemic lupus erythematosus (NPSLE) involves the central and peripheral nervous system in patients with systemic lupus erythematosus (SLE). It is essential to specify the problems faced by patients with NPSLE because it causes diverse disabilities and impairs quality of life. After performing a comprehensive evaluation, tailored management should be provided for the patient's specific problems. We report here the case of a 30-year-old female with SLE who experienced serious neuropsychiatric symptoms cerebral infarction followed by posterior reversible encephalopathy syndrome and peripheral polyneuropathy. We systemically assessed the patient using the International Classification of Functioning, Disability and Health model as a clinical problem-solving tool and provided comprehensive rehabilitation by focusing on her problems.

The application of the International Classification of Functioning, Disability, and Health in psychiatry: possible reasons for the lack of implementation.

PubMed

Álvarezz, Ana Sabela

2012-02-01

The purpose of this article was to examine the application of the International Classification of Functioning, Disability, and Health (ICF) in the field of psychiatry in the last 10 yrs since the ICF was launched. The hypothesis is that the application of the ICF in the field of psychiatry has not been yet much explored. Therefore, the objective of this article was to provide reasons to explain the difficult implementation of the ICF in this field, which in turn, might account for the lack of studies. A literature search was conducted using the terms ICF AND mental illness OR mental disorders OR psychiatry in titles, abstracts, and key words of articles collected in the databases ISI Web of Knowledge, ScienceDirect and Medline from 2001 to 2010. A total of 64 full-length articles were retrieved and reviewed, and among them, 13 were eventually included in this review because they were related to the ICF in psychiatry. Of the 13 studies identified concerning the ICF and mental disorders, 7 focus on the implementation of the ICF in the clinical practice, and 6 are theoretical papers discussing the potential benefits of the ICF for the field of psychiatry. A number of reasons can be suggested to explain the paucity of studies on the use of the ICF in psychiatry in the last 10 yrs: (1) the novelty of the ICF and the dominance of the medical model, (2) the belief that disability is just about physical conditions, (3) the influence of medication on capacity and performance, (4) the complex structure of the ICF, (5) the intrinsic limitations of the ICF, and (6) limitations in the accessibility of the ICF to some medical professionals.

The Role of the World Health Organization's International Classification of Functioning, Health and Disability in Models of Infant Cochlear Implant Management

PubMed Central

Psarros, Colleen; Love, Sarah

2016-01-01

Newborn hearing screening has led to the early diagnosis of hearing loss in neonates and early device fitting is common, based primarily on electrophysiologic and radiologic information, with some supplementary behavioral measures. Such early fitting of hearing devices, in particular cochlear implants (CIs), has been beneficial to the majority of children implanted under the age of 12 months who meet the cochlear implant candidacy criteria. Comorbidities are common in children with hearing loss, although they may not be evident in neonates and may not emerge until later in infants. Evidence suggests that the child's outcomes are strongly influenced by a range of environmental factors including emotional and social support from the immediate and extended family. Consequently, such factors are important in service planning and service delivery for babies and children receiving CIs. The World Health Organization's International Classification of Functioning, Health and Disability (ICF) can provide a framework to facilitate the holistic management of pediatric cochlear implant recipients. The ICF also can be used to map the progress of recipients over time to highlight emerging issues that require intervention. This article will discuss our preliminary use of the ICF to establish clinical practice; develop advocacy skills among clients and their families; identify eligibility for services such as support in educational settings; enable access to modes of service delivery such as telepractice; provide a conceptual framework for policy and program development for pediatric cochlear implant recipients (i.e., in both disability and health services); and, most importantly, establish a clear pathway for the longitudinal management of the cochlear implant in a child's future. It is anticipated that this model will be applied to other populations receiving cochlear implants through our program. PMID:27489404

Health promotion and education: application of the ICF in the US and Canada using an ecological perspective.

PubMed

Howard, David; Nieuwenhuijsen, Els R; Saleeby, Patricia

2008-01-01

Health promotion is an issue comprised of complex and multi-layered concepts that involves a process of enabling people to increase control over and improve their health. The aims and applications of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), with its focus on components of functioning, activities and participation, and environmental factors are salient to health promotion and health education efforts. For individuals with or without disabilities, health promotion occurs within the community in which they reside and is influenced by a complex interaction of personal and environmental factors. The aim of this paper is to discuss how the ICF can be useful in enhancing social change through health promotion and health education for all people, in particular those with disabilities and chronic conditions. In doing so health promotion concepts and the ecological approach linked with the ICF, the relationship of social change and social support to the ICF, the potential role of the ICF for national and local (city) policies, and the role of health professionals in this process will be examined. Building on this body of knowledge, the authors recommend that future research should focus on the relationship between policies and the social participation of people with disabilities in the community, the use of ICF measurement tools to improve the indicators established by the National Organization on Disability, the development of a new ICF core set for community accessibility and inclusion, better interventions to enhance social support, and enhancing the role of professionals in health promotion for people with disabilities or chronic health conditions.

Reading Profiles in Multi-Site Data With Missingness.

PubMed

Eckert, Mark A; Vaden, Kenneth I; Gebregziabher, Mulugeta

2018-01-01

Children with reading disability exhibit varied deficits in reading and cognitive abilities that contribute to their reading comprehension problems. Some children exhibit primary deficits in phonological processing, while others can exhibit deficits in oral language and executive functions that affect comprehension. This behavioral heterogeneity is problematic when missing data prevent the characterization of different reading profiles, which often occurs in retrospective data sharing initiatives without coordinated data collection. Here we show that reading profiles can be reliably identified based on Random Forest classification of incomplete behavioral datasets, after the missForest method is used to multiply impute missing values. Results from simulation analyses showed that reading profiles could be accurately classified across degrees of missingness (e.g., ∼5% classification error for 30% missingness across the sample). The application of missForest to a real multi-site dataset with missingness ( n = 924) showed that reading disability profiles significantly and consistently differed in reading and cognitive abilities for cases with and without missing data. The results of validation analyses indicated that the reading profiles (cases with and without missing data) exhibited significant differences for an independent set of behavioral variables that were not used to classify reading profiles. Together, the results show how multiple imputation can be applied to the classification of cases with missing data and can increase the integrity of results from multi-site open access datasets.

Using the International Classification of Functioning, Disability and Health (ICF) to Describe Children Referred to Special Care or Paediatric Dental Services

PubMed Central

Faulks, Denise; Norderyd, Johanna; Molina, Gustavo; Macgiolla Phadraig, Caoimhin; Scagnet, Gabriela; Eschevins, Caroline; Hennequin, Martine

2013-01-01

Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child’s capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child’s real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ±3.6yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were ‘Intellectual functions’, ‘High-level cognitive functions’, and ‘Attention functions’. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including ‘Handling stress’, ‘Caring for body parts’, ‘Looking after one’s health’ and ‘Speaking’. In the Environment domain, facilitating items included ‘Support of friends’, ‘Attitude of friends’ and ‘Support of immediate family’. One item was reported as an environmental barrier – ‘Societal attitudes’. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might be used to develop an ICF-CY Core Set for Oral Health - a holistic but practical tool for clinical and epidemiological use. PMID:23614000

The Characteristics of Learning Disabled and Other Handicapped Students Referred for Evaluation in the State of Iowa.

ERIC Educational Resources Information Center

Wilson, Lonny; And Others

1986-01-01

Demographic data, IQ, achievement, perceptual-motor, behavior ratings, and diagnostic classification (learning, mental, emotional disability or no handicap) were analyzed for all children (N=2002) referred for complete psychological evaluation during one school year in Iowa. Learning disabled children showed a distinct pattern different from…

Considering Context: An Integrative Concept for Promoting Outcomes in the Intellectual Disability Field

ERIC Educational Resources Information Center

Shogren, Karrie A.

2013-01-01

In light of the rapid evolution of research, policy, and practice in the intellectual disability (ID) field resulting from shifts in our conceptualization of disability and in frameworks for the diagnosis and classification of ID, systematic consideration of the multiple, interrelated contextual factors that impact research, policy, and practice…

The Rehabilitation Process for Clients with Specific Learning Disabilities: Trainer's Manual.

ERIC Educational Resources Information Center

Gladden, Bonnie; And Others

This document presents the manual for a training workshop for rehabilitation counselors on the delivery of services to persons with learning disabilities. It describes how counselors are trained in the workshop to: (1) use five criteria to establish eligibility; (2) apply the case management system to the classification of learning disabilities as…

Developmental Disabilities: A Summary of Major Classifications and Glossary of Terms. Parent Awareness Program, 1982-1983. Revised.

ERIC Educational Resources Information Center

Knudstrup, Katherine; And Others

Designed for use in adult education courses for parents of developmentally disabled children, this manual provides basic information about major categories of disabilities and a glossary of commonly encountered terms. After an introductory overview, the manual provides information about the characteristics and etiology of five disabling…

Using Video Modeling and Video Prompting to Teach Core Academic Content to Students with Learning Disabilities

ERIC Educational Resources Information Center

Kellems, Ryan O.; Edwards, Sean

2016-01-01

Practitioners are constantly searching for evidence-based practices that are effective in teaching academic skills to students with learning disabilities (LD). Video modeling (VM) and video prompting have become popular instructional interventions for many students across a wide range of different disability classifications, including those with…

Perception of the influence of environmental factors in the use of electronic planning devices in adults with cognitive disabilities.

PubMed

Adolfsson, Päivi; Lindstedt, Helena; Pettersson, Ingvor; Hermansson, Liselotte Norling; Janeslätt, Gunnel

2016-08-01

Adults with cognitive disabilities often have difficulties in dealing with the complexity of everyday life. With cognitive assistive technology (e.g. electronic planning devices [EPDs] and individual support), they can bring order to their often chaotic life. Assumptions are that environmental factors influence with non-use of EPDs. To explore how adults with cognitive disabilities perceive the influence of environmental factors in the use of EPDs. A reference group with experience of use of EPDs assisted the researchers. Twelve adults with cognitive disabilities and experience of using EPDs participated. An interview guide was implemented covering environmental factors according to the International Classification of Functioning, Disability and Health. Qualitative content analysis was applied in the analyses. Five categories and two themes emerged, which were integrated into a model of facilitating factors influencing the use of EPDs. Measures to prevent or eliminate negative influences of the device use are important to be taken. Professionals need more knowledge about EPDs, while users need individual adaption of the EPDs. EPDs need to be user-friendly, manageable and work in any seasons. Implications for Rehabilitation The users should have access to specially trained prescribers. There is a need for development of user-friendly and manageable products to function in any climate. Knowledge is lacking on how to implement the users in all stages of the prescribing process. Prescribers should increase knowledge in the use of EPDs to influence the attitudes of the social environment.

Increased risk of unintentional injuries in adults with disabilities: a systematic review and meta-analysis.

PubMed

Shi, Xiuquan; Wheeler, Krista K; Shi, Junxin; Stallones, Lorann; Ameratunga, Shanthi; Shakespeare, Tom; Xiang, Huiyun

2015-04-01

An increased risk of unintentional injuries among individuals with disability has been reported in many studies, yet quantitative syntheses of findings from previous studies have not been done. We conducted a systematic review and meta-analysis to characterize the relationship between pre-existing disability and unintentional injuries. We searched 14 electronic databases to identify original research published between Jan 1, 1990 and Feb 28, 2013. Included studies reported the odds ratio (OR) or relative risk (RR) of unintentional injuries in adults 18+ years of age with pre-existing disabilities compared with adults without disabilities. Twenty six eligible studies were included covering 54,586 individuals with disabilities. We conducted quality assessments and then analyzed the pooled effects using random-effect models. The pooled OR of unintentional injuries was 1.77 (95% CI 1.51-2.07) for all studies in individuals with disabilities compared with individuals without disabilities. The pooled ORs were 1.87 (95% CI 1.52-2.30) for overall unintentional injuries, 1.64 (95% CI 1.39-1.94) for falls-related injuries, 1.62 (95% CI 1.24-2.13) for occupational injuries, and 1.91 (95% CI 1.59-2.30) for non-occupational injuries. Compared with adults without disabilities, individuals with disabilities are at a significantly higher risk of unintentional injuries. Evidence about the association between cognitive disabilities and unintentional injuries is weak. Future researchers are encouraged to use International Classification of Functioning, Disability and Health (ICF) to classify disability and use rigorous evaluation methods to assess and implement the most appropriate injury prevention efforts to mitigate the risks identified. Copyright © 2015 Elsevier Inc. All rights reserved.

Classification and identification of reading and math disabilities: the special case of comorbidity.

PubMed

Branum-Martin, Lee; Fletcher, Jack M; Stuebing, Karla K

2013-01-01

Much of learning disabilities research relies on categorical classification frameworks that use psychometric tests and cut points to identify children with reading or math difficulties. However, there is increasing evidence that the attributes of reading and math learning disabilities are dimensional, representing correlated continua of severity. We discuss issues related to categorical and dimensional approaches to reading and math disabilities, and their comorbid associations, highlighting problems with the use of cut points and correlated assessments. Two simulations are provided in which the correlational structure of a set of cognitive and achievement data are simulated from a single population with no categorical structures. The simulations produce profiles remarkably similar to reported profile differences, suggesting that the patterns are a product of the cut point and the correlational structure of the data. If dimensional approaches better fit the attributes of learning disability, new conceptualizations and better methods to identification and intervention may emerge, especially for comorbid associations of reading and math difficulties.

Employing the International Classification of Functioning, Disability and Health framework to capture user feedback in the design and testing stage of development of home-based arm rehabilitation technology.

PubMed

Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andrew; O'Connor, Rory; Levesley, Martin

2016-01-01

The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health (ICF) as a framework to ensure that key aspects of user feedback are identified in the design and testing stages of development of a home-based upper limb rehabilitation system. Seventeen stroke survivors with residual upper limb weakness, and seven healthcare professionals with expertise in stroke rehabilitation, were enrolled in the user-centered design process. Through semi-structured interviews, they provided feedback on the hardware, software and impact of a home-based rehabilitation device to facilitate self-managed arm exercise. Members of the multidisciplinary clinical and engineering research team, based on previous experience and existing literature in user-centred design, developed the topic list for the interviews. Meaningful concepts were extracted from participants' interviews based on existing ICF linking rules and matched to categories within the ICF Comprehensive Core Set for stroke. Most of the interview concepts (except personal factors) matched the existing ICF Comprehensive Core Set categories. Personal factors that emerged from interviews e.g. gender, age, interest, compliance, motivation, choice and convenience that might determine device usability are yet to be categorised within the ICF framework and hence could not be matched to a specific Core Set category.

Towards system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in routine practice: Developing simple, intuitive descriptions of ICF categories in the ICF Generic and Rehabilitation Set.

PubMed

Prodinger, Birgit; Reinhardt, Jan D; Selb, Melissa; Stucki, Gerold; Yan, Tiebin; Zhang, Xia; Li, Jianan

2016-06-13

A national, multi-phase, consensus process to develop simple, intuitive descriptions of International Classification of Functioning, Disability and Health (ICF) categories contained in the ICF Generic and Rehabilitation Sets, with the aim of enhancing the utility of the ICF in routine clinical practice, is presented in this study. A multi-stage, national, consensus process was conducted. The consensus process involved 3 expert groups and consisted of a preparatory phase, a consensus conference with consecutive working groups and 3 voting rounds (votes A, B and C), followed by an implementation phase. In the consensus conference, participants first voted on whether they agreed that an initially developed proposal for simple, intuitive descriptions of an ICF category was in fact simple and intuitive. The consensus conference was held in August 2014 in mainland China. Twenty-one people with a background in physical medicine and rehabilitation participated in the consensus process. Four ICF categories achieved consensus in vote A, 16 in vote B, and 8 in vote C. This process can be seen as part of a larger effort towards the system-wide implementation of the ICF in routine clinical and rehabilitation practice to allow for the regular and comprehensive evaluation of health outcomes most relevant for the monitoring of quality of care.

A comparison of participation outcome measures and the International Classification of Functioning, Disability and Health Core Sets for traumatic brain injury.

PubMed

Chung, Pearl; Yun, Sarah Jin; Khan, Fary

2014-02-01

To compare the contents of participation outcome measures in traumatic brain injury with the International Classification of Functioning, Disability and Health (ICF) Core Sets for traumatic brain injury. A systematic search with an independent review process selected relevant articles to identify outcome measures in participation in traumatic brain injury. Instruments used in two or more studies were linked to the ICF categories, which identified categories in participation for comparison with the ICF Core Sets for traumatic brain injury. Selected articles (n = 101) identified participation instruments used in two or more studies (n = 9): Community Integration Questionnaire, Craig Handicap Assessment and Reporting Technique, Mayo-Portland Adaptability Inventory-4 Participation Index, Sydney Psychosocial Reintegration Scale Version-2, Participation Assessment with Recombined Tool-Objective, Community Integration Measure, Participation Objective Participation Subjective, Community Integration Questionnaire-2, and Quality of Community Integration Questionnaire. Each instrument was linked to 4-35 unique second-level ICF categories, of which 39-100% related to participation. Instruments addressed 86-100% and 50-100% of the participation categories in the Comprehensive and Brief ICF Core Sets for traumatic brain injury, respectively. Participation measures in traumatic brain injury were compared with the ICF Core Sets for traumatic brain injury. The ICF Core Sets for traumatic brain injury could contribute to the development and selection of participation measures.

Full-participation of students with physical disabilities in science and engineering laboratories.

PubMed

Jeannis, Hervens; Joseph, James; Goldberg, Mary; Seelman, Katherine; Schmeler, Mark; Cooper, Rory A

2018-02-01

To conduct a literature review identifying barriers and facilitators students with physical disabilities (SwD-P) may encounter in science and engineering (S&E) laboratories. Publications were identified from 1991 to 2015 in ERIC, web of science via web of knowledge, CINAHL, SCOPUS, IEEEXplore, engineering village, business source complete and PubMed databases using search terms and synonyms for accommodations, advanced manufacturing, additive manufacturing, assistive technology (AT), barriers, engineering, facilitators, instructor, laboratory, STEM education, science, students with disabilities and technology. Twenty-two of the 233 publications that met the review's inclusion criteria were examined. Barriers and facilitators were grouped based on the international classification of functioning, disability and health framework (ICF). None of the studies directly found barriers or facilitators to SwD-P in science or engineering laboratories within postsecondary environments. The literature is not clear on the issues specifically related to SwD-P. Given these findings, further research (e.g., surveys or interviews) should be conducted to identify more details to obtain more substantial information on the barriers that may prevent SwD-P from fully participating in S&E instructional laboratories. Implications for Rehabilitation Students with disabilities remain underrepresented going into STEM careers. A need exist to help uncover barriers students with disabilities encounter in STEM laboratory. Environments. Accommodations and strategies that facilitate participation in STEM laboratory environments are promising for students with disabilities.

Examining the similarities and differences of OMERACT core sets using the ICF: first step towards an improved domain specification and development of an item pool to measure functioning and health.

PubMed

Escorpizo, Reuben; Boers, Maarten; Stucki, Gerold; Boonen, Annelies

2011-08-01

To contribute to the discussion on a common approach for domain selection in the Outcomes in Rheumatology Clinical Trials (OMERACT) process. First, this article reports on the consistency in the selection and names of the domains of the current OMERACT core set, and next on the comparability of the specifications of concepts that are relevant within the domains. For this purpose, a convenience sample of 4 OMERACT core sets was used: rheumatoid arthritis (RA), psoriatic arthritis (PsA), longitudinal observational studies (LOS) in rheumatology, and ankylosing spondylitis (AS). Domains from the different core sets were compared directly. To be able to compare the specific content of the domains, the concepts contained in the questionnaires that were considered or proposed to measure the domains were identified and linked to the category of the International Classification of Functioning, Disability, and Health (ICF) that best fit that construct. Large differences in the domains, and lack of domain definitions, were noted among the 4 OMERACT core sets. When comparing the concepts in the questionnaires that represent the domains, core sets differed also in the number and type of constructs that were addressed within each of the domains. Especially for the specification of the concepts within the domains Discomfort and Disability, the ICF proved to be useful as external reference to classify the different constructs. Our exercise suggests that the OMERACT process could benefit from a standardized approach to select, define, and specify domains, and demonstrated that the ICF is useful for further classification of the more specific concepts of "what to measure" within the domains. A clear definition and classification of domains and their specification can be useful as a starting point to build a pool of items that could then be used to develop new instruments to assess functioning and health for rheumatological conditions.

Perspectives on “Disease” and “Disability” in Child Health: The Case of Childhood Neurodisability

PubMed Central

Miller, Anton Rodney; Rosenbaum, Peter

2016-01-01

Chronic health conditions are often associated with what is termed disability. Traditional thinking has focused on diagnosis and treatment of chronic diseases and disorders, with less attention to people’s functional abilities and their contextual determinants. Understanding all of these factors is integral to addressing the predicaments and needs of persons with chronic conditions. However, these complementary yet distinct “worldviews” reflected in what we call disease and disability perspectives often remain, at best, only vaguely articulated. In this paper, we explore and expand on these perspectives in light of conceptual advances, specifically the framework of the World Health Organization’s International Classification of Functioning, Disability and Health, and their epistemic underpinnings with reference to Wilhelm Windelband’s notions of nomothetic and idiographic types of knowledge. Our primary focus is the children with neurodisability – life-long conditions that onset early in life and have functional consequences that impact developmental trajectories. We critically review and analyze conceptual material, along with clinical and research evidence relevant to the experiential and clinical realities of this population, to demonstrate the limitations of a biomedically based diagnostic–therapeutic paradigm at the expense of a developmental and disability-oriented perspective. Our main aim in this paper is to argue for an explicit recognition of both disease and disability perspectives, and a more balanced and appropriate deployment of these concepts across the continuum of clinical services, research, policy-making and professional and public education in relation to children with neurodisability; we also provide concrete recommendations to advance this progressive strategy. The relevance of these aims and strategies, however, extends beyond this particular population. PMID:27833905

Meeting the criteria of a nursing diagnosis classification: Evaluation of ICNP, ICF, NANDA and ZEFP.

PubMed

Müller-Staub, Maria; Lavin, Mary Ann; Needham, Ian; van Achterberg, Theo

2007-07-01

Few studies described nursing diagnosis classification criteria and how classifications meet these criteria. The purpose was to identify criteria for nursing diagnosis classifications and to assess how these criteria are met by different classifications. First, a literature review was conducted (N=50) to identify criteria for nursing diagnoses classifications and to evaluate how these criteria are met by the International Classification of Nursing Practice (ICNP), the International Classification of Functioning, Disability and Health (ICF), the International Nursing Diagnoses Classification (NANDA), and the Nursing Diagnostic System of the Centre for Nursing Development and Research (ZEFP). Using literature review based general and specific criteria, the principal investigator evaluated each classification, applying a matrix. Second, a convenience sample of 20 nursing experts from different Swiss care institutions answered standardized interview forms, querying current national and international classification state and use. The first general criterion is that a diagnosis classification should describe the knowledge base and subject matter for which the nursing profession is responsible. ICNP) and NANDA meet this goal. The second general criterion is that each class fits within a central concept. The ICF and NANDA are the only two classifications built on conceptually driven classes. The third general classification criterion is that each diagnosis possesses a description, diagnostic criteria, and related etiologies. Although ICF and ICNP describe diagnostic terms, only NANDA fulfils this criterion. The analysis indicated that NANDA fulfilled most of the specific classification criteria in the matrix. The nursing experts considered NANDA to be the best-researched and most widely implemented classification in Switzerland and internationally. The international literature and the opinion of Swiss expert nurses indicate that-from the perspective of classifying comprehensive nursing diagnoses-NANDA should be recommended for nursing practice and electronic nursing documentation. Study limitations and future research needs are discussed.

The Australian National Sub-acute and Non-acute Patient Casemix Classification (AN-SNAP): its application and value in a stroke rehabilitation programme.

PubMed

Lowthian, P; Disler, P; Ma, S; Eagar, K; Green, J; de Graaff, S

2000-10-01

To investigate whether the Australian National Sub-acute and Non-acute Patient Casemix Classification (SNAP) and Functional Independence Measure and Functional Related Group (Version 2) (FIM-FRG2) casemix systems can be used to predict functional outcome, and reduce the variance of length of stay (LOS) of patients undergoing rehabilitation after strokes. The study comprised a retrospective analysis of the records of patients admitted to the Cedar Court Healthsouth Rehabilitation Hospital for rehabilitation after stroke. The sample included 547 patients (83.3% of those admitted with stroke during this period). Patient data were stratified for analysis into the five SNAP or nine FIM-FRG2 groups, on the basis of the admission FIM scores and age. The AN-SNAP classification accounted for a 30.7% reduction of the variance of LOS, and 44.2% of motor FIM, and the FIM-FRG2 accounts for 33.5% and 56.4% reduction respectively. Comparison of the Cedar Court with the national AN-SNAP data showed differences in the LOS and functional outcomes of older, severely disabled patients. Intensive rehabilitation in selected patients of this type appears to have positive effects, albeit with a slightly longer period of inpatient rehabilitation. Casemix classifications can be powerful management tools. Although FIM-FRG2 accounts for more reduction in variance than SNAP, division into nine groups meant that some contained few subjects. This paper supports the introduction of AN-SNAP as the standard casemix tool for rehabilitation in Australia, which will hopefully lead to rational, adequate funding of the rehabilitation phase of care.

Logistic regression analysis of psychosocial correlates associated with recovery from schizophrenia in a Chinese community.

PubMed

Tse, Samson; Davidson, Larry; Chung, Ka-Fai; Yu, Chong Ho; Ng, King Lam; Tsoi, Emily

2015-02-01

More mental health services are adopting the recovery paradigm. This study adds to prior research by (a) using measures of stages of recovery and elements of recovery that were designed and validated in a non-Western, Chinese culture and (b) testing which demographic factors predict advanced recovery and whether placing importance on certain elements predicts advanced recovery. We examined recovery and factors associated with recovery among 75 Hong Kong adults who were diagnosed with schizophrenia and assessed to be in clinical remission. Data were collected on socio-demographic factors, recovery stages and elements associated with recovery. Logistic regression analysis was used to identify variables that could best predict stages of recovery. Receiver operating characteristic curves were used to detect the classification accuracy of the model (i.e. rates of correct classification of stages of recovery). Logistic regression results indicated that stages of recovery could be distinguished with reasonable accuracy for Stage 3 ('living with disability', classification accuracy = 75.45%) and Stage 4 ('living beyond disability', classification accuracy = 75.50%). However, there was no sufficient information to predict Combined Stages 1 and 2 ('overwhelmed by disability' and 'struggling with disability'). It was found that having a meaningful role and age were the most important differentiators of recovery stage. Preliminary findings suggest that adopting salient life roles personally is important to recovery and that this component should be incorporated into mental health services. © The Author(s) 2014.

The Legal Meaning of Specific Learning Disability for IDEA Eligibility: The Latest Case Law

ERIC Educational Resources Information Center

Zirkel, Perry A.

2013-01-01

Specific learning disability (SLD), although moderately declining in recent years, continues to be the largest of the eligibility classifications under the Individuals with Disabilities Education Act (IDEA; NCES, 2012). The recognition of response to intervention (RTI) in the 2004 amendments of the IDEA as an approach for identifying students with…

Comparison of Classification Methods for P300 Brain-Computer Interface on Disabled Subjects

PubMed Central

Manyakov, Nikolay V.; Chumerin, Nikolay; Combaz, Adrien; Van Hulle, Marc M.

2011-01-01

We report on tests with a mind typing paradigm based on a P300 brain-computer interface (BCI) on a group of amyotrophic lateral sclerosis (ALS), middle cerebral artery (MCA) stroke, and subarachnoid hemorrhage (SAH) patients, suffering from motor and speech disabilities. We investigate the achieved typing accuracy given the individual patient's disorder, and how it correlates with the type of classifier used. We considered 7 types of classifiers, linear as well as nonlinear ones, and found that, overall, one type of linear classifier yielded a higher classification accuracy. In addition to the selection of the classifier, we also suggest and discuss a number of recommendations to be considered when building a P300-based typing system for disabled subjects. PMID:21941530

Disability weights based on patient-reported data from a multinational injury cohort

PubMed Central

Lyons, Ronan A; Simpson, Pamela M; Rivara, Frederick P; Ameratunga, Shanthi; Polinder, Suzanne; Derrett, Sarah; Harrison, James E

2016-01-01

Abstract Objective To create patient-based disability weights for individual injury diagnosis codes and nature-of-injury classifications, for use, as an alternative to panel-based weights, in studies on the burden of disease. Methods Self-reported data based on the EQ-5D standardized measure of health status were collected from 29 770 participants in the Injury-VIBES injury cohort study, which covered Australia, the Netherlands, New Zealand, the United Kingdom of Great Britain and Northern Ireland and the United States of America. The data were combined to calculate new disability weights for each common injury classification and for each type of diagnosis covered by the 10th revision of the International statistical classification of diseases and related health problems. Weights were calculated separately for hospital admissions and presentations confined to emergency departments. Findings There were 29 770 injury cases with at least one EQ-5D score. The mean age of the participants providing data was 51 years. Most participants were male and almost a third had road traffic injuries. The new disability weights were higher for admitted cases than for cases confined to emergency departments and higher than the corresponding weights used by the Global Burden of Disease 2013 study. Long-term disability was common in most categories of injuries. Conclusion Injury is often a chronic disorder and burden of disease estimates should reflect this. Application of the new weights to burden studies would substantially increase estimates of disability-adjusted life-years and provide a more accurate reflection of the impact of injuries on peoples’ lives. PMID:27821883

Intelligence, Functioning, and Related Factors in Children with Cerebral Palsy

PubMed Central

TÜRKOĞLU, Gözde; TÜRKOĞLU, Serhat; ÇELİK, Canan; UÇAN, Halil

2017-01-01

Introduction Cerebral palsy (CP) is the most common significant motor impairment in childhood. CP is defined as a primary disorder of posture and movement; however, intellectual impairment is prevalent in children with CP. The purpose of this study was to examine the intelligence level associated with gross motor function and hand function, type of CP, the presence of comorbid disorders such as epilepsy, and other factors. Methods In total, 107 children with CP were included. Age, gender, prenatal/natal/postnatal risk factors, type of CP, and presence of other neurodevelopmental disorders were recorded as demographic findings. Intellectual functions of the patients were determined by clinical assessment, adaptive function of daily life, and individualized, standardized intelligence testing. The gross motor function and hand function of the patients were classified using the “Gross Motor Function Classification System” and “Bimanual Fine Motor Function” measurements, respectively. Results The mean age of the patients was 8.10±3.43 years (2–16 years). The study included 63 (58.9%) male patients and 44 (41.1%) female patients. During clinical typing, 80.4% of the patients were spastic, 11.2% were mixed, 4.7% were dyskinetic, and 3.7% were ataxic. Intellectual functioning tests found 26.2% of the children within the intellectual norm and that 10% of the children had a borderline intellectual disability, 16% of them had a mild intellectual disability, 17% of them had a moderate intellectual disability, and 30.8% of them had a severe intellectual disability. No significant relationship was determined between the CP type and intellectual functioning (p>0.05). Intellectual functioning was found to be significantly correlated with hand functions and motor levels (p<0.001). Factors related with intellectual functioning were neonatal convulsion, epilepsy, and speech disorders. Conclusion Intelligence assessment should be an essential part of CP evaluation and research. There is not enough reliable knowledge, unanimity regarding validity data, and population-specific norms in the intelligence assessments of children with CP. Research is required to assess properly intelligence for children with CP. PMID:28566956

Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice.

PubMed

de Jong, Lex D; van Wijck, Frederike; Stewart, Roy E; Geurts, Alexander C H; Dijkstra, Pieter U

2018-01-01

Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions. Design: This is a retrospective analysis of randomized trial data. 46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands. PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories. PTs and OTs spent on average 4-7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79% of their arm treatment time on body functions, OTs 41%. OTs spent significantly more time on "moving around using transportation," "self care," and "household tasks" categories. Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm-oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries. Copyright © 2017 John Wiley & Sons, Ltd.

Aphasia and Auditory Processing after Stroke through an International Classification of Functioning, Disability and Health Lens

PubMed Central

Purdy, Suzanne C.; Wanigasekara, Iruni; Cañete, Oscar M.; Moore, Celia; McCann, Clare M.

2016-01-01

Aphasia is an acquired language impairment affecting speaking, listening, reading, and writing. Aphasia occurs in about a third of patients who have ischemic stroke and significantly affects functional recovery and return to work. Stroke is more common in older individuals but also occurs in young adults and children. Because people experiencing a stroke are typically aged between 65 and 84 years, hearing loss is common and can potentially interfere with rehabilitation. There is some evidence for increased risk and greater severity of sensorineural hearing loss in the stroke population and hence it has been recommended that all people surviving a stroke should have a hearing test. Auditory processing difficulties have also been reported poststroke. The International Classification of Functioning, Disability and Health (ICF) can be used as a basis for describing the effect of aphasia, hearing loss, and auditory processing difficulties on activities and participation. Effects include reduced participation in activities outside the home such as work and recreation and difficulty engaging in social interaction and communicating needs. A case example of a young man (M) in his 30s who experienced a left-hemisphere ischemic stroke is presented. M has normal hearing sensitivity but has aphasia and auditory processing difficulties based on behavioral and cortical evoked potential measures. His principal goal is to return to work. Although auditory processing difficulties (and hearing loss) are acknowledged in the literature, clinical protocols typically do not specify routine assessment. The literature and the case example presented here suggest a need for further research in this area and a possible change in practice toward more routine assessment of auditory function post-stroke. PMID:27489401

HIV/AIDS: use of the ICF in Brazil and South Africa--comparative data from four cross-sectional studies.

PubMed

Myezwa, H; Buchalla, C M; Jelsma, J; Stewart, A

2011-03-01

Human immunodeficiency virus (HIV) is a serious disease which can be associated with various activity limitations and participation restrictions. The aim of this paper was to describe how HIV affects the functioning and health of people within different environmental contexts, particularly with regard to access to medication. Four cross-sectional studies, three in South Africa and one in Brazil, had applied the International Classification of Functioning, Disability and Health (ICF) as a classification instrument to participants living with HIV. Each group was at a different stage of the disease. Only two groups had had continuing access to antiretroviral therapy. The existence of these descriptive sets enabled comparison of the disability experienced by people living with HIV at different stages of the disease and with differing access to antiretroviral therapy. Common problems experienced in all groups related to weight maintenance, with two-thirds of the sample reporting problems in this area. Mental functions presented the most problems in all groups, with sleep (50%, 92/185), energy and drive (45%, 83/185), and emotional functions (49%, 90/185) being the most affected. In those on long-term therapy, body image affected 93% (39/42) and was a major problem. The other groups reported pain as a problem, and those with limited access to treatment also reported mobility problems. Cardiopulmonary functions were affected in all groups. Functional problems occurred in the areas of impairment and activity limitation in people at advanced stages of HIV, and more limitations occurred in the area of participation for those on antiretroviral treatment. The ICF provided a useful framework within which to describe the functioning of those with HIV and the impact of the environment. Given the wide spectrum of problems found, consideration could be given to a number of ICF core sets that are relevant to the different stages of HIV disease. Copyright © 2010 Chartered Society of Physiotherapy. All rights reserved.

Comparison of physical activity questionnaires for the elderly with the International Classification of Functioning, Disability and Health (ICF)--an analysis of content.

PubMed

Eckert, Katharina G; Lange, Martin A

2015-03-14

Physical activity questionnaires (PAQ) have been extensively used to determine physical activity (PA) levels. Most PAQ are derived from an energy expenditure-based perspective and assess activities with a certain intensity level. Activities with a moderate or vigorous intensity level are predominantly used to determine a person's PA level in terms of quantity. Studies show that the time spent engaging in moderate and vigorous intensity PA does not appropriately reflect the actual PA behavior of older people because they perform more functional, everyday activities. Those functional activities are more likely to be considered low-intense and represent an important qualitative health-promoting activity. For the elderly, functional, light intensity activities are of special interest but are assessed differently in terms of quantity and quality. The aim was to analyze the content of PAQ for the elderly. N = 18 sufficiently validated PAQ applicable to adults (60+) were included. Each item (N = 414) was linked to the corresponding code of the International Classification of Functioning, Disability and Health (ICF) using established linking rules. Kappa statistics were calculated to determine rater agreement. Items were linked to 598 ICF codes and 62 different ICF categories. A total of 43.72% of the codes were for sports-related activities and 14.25% for walking-related activities. Only 9.18% of all codes were related to household tasks. Light intensity, functional activities are emphasized differently and are underrepresented in most cases. Additionally, sedentary activities are underrepresented (5.55%). κ coefficients were acceptable for n = 16 questionnaires (0.48-1.00). There is a large inconsistency in the understandings of PA in elderly. Further research should focus (1) on a conceptual understanding of PA in terms of the behavior of the elderly and (2) on developing questionnaires that inquire functional, light intensity PA, as well as sedentary activities more explicitly.

Comprehension of spoken language in non-speaking children with severe cerebral palsy: an explorative study on associations with motor type and disabilities.

PubMed

Geytenbeek, Joke J M; Vermeulen, R Jeroen; Becher, Jules G; Oostrom, Kim J

2015-03-01

To assess spoken language comprehension in non-speaking children with severe cerebral palsy (CP) and to explore possible associations with motor type and disability. Eighty-seven non-speaking children (44 males, 43 females, mean age 6y 8mo, SD 2y 1mo) with spastic (54%) or dyskinetic (46%) CP (Gross Motor Function Classification System [GMFCS] levels IV [39%] and V [61%]) underwent spoken language comprehension assessment with the computer-based instrument for low motor language testing (C-BiLLT), a new and validated diagnostic instrument. A multiple linear regression model was used to investigate which variables explained the variation in C-BiLLT scores. Associations between spoken language comprehension abilities (expressed in z-score or age-equivalent score) and motor type of CP, GMFCS and Manual Ability Classification System (MACS) levels, gestational age, and epilepsy were analysed with Fisher's exact test. A p-value <0.05 was considered statistically significant. Chronological age, motor type, and GMFCS classification explained 33% (R=0.577, R(2) =0.33) of the variance in spoken language comprehension. Of the children aged younger than 6 years 6 months, 52.4% of the children with dyskinetic CP attained comprehension scores within the average range (z-score ≥-1.6) as opposed to none of the children with spastic CP. Of the children aged older than 6 years 6 months, 32% of the children with dyskinetic CP reached the highest achievable age-equivalent score compared to 4% of the children with spastic CP. No significant difference in disability was found between CP-related variables (MACS levels, gestational age, epilepsy), with the exception of GMFCS which showed a significant difference in children aged younger than 6 years 6 months (p=0.043). Despite communication disabilities in children with severe CP, particularly in dyskinetic CP, spoken language comprehension may show no or only moderate delay. These findings emphasize the importance of introducing alternative and/or augmentative communication devices from early childhood. © 2014 Mac Keith Press.

Outcome measures in older persons with acquired joint contractures: a systematic review and content analysis using the ICF (International Classification of Functioning, Disability and Health) as a reference.

PubMed

Bartoszek, Gabriele; Fischer, Uli; Müller, Martin; Strobl, Ralf; Grill, Eva; Nadolny, Stephan; Meyer, Gabriele

2016-02-09

Joint contractures are a common health problem in older persons with significant impact on activities of daily living. We aimed to retrieve outcome measures applied in studies on older persons with joint contractures and to identify and categorise the concepts contained in these outcome measures using the ICF (International Classification of Functioning, Disability and Health) as a reference. Electronic searches of Medline, EMBASE, CINAHL, Pedro and the Cochrane Library were conducted (1/2002-8/2012). We included studies in the geriatric rehabilitation and nursing home settings with participants aged ≥ 65 years and with acquired joint contractures. Two independent reviewers extracted the outcome measures and transferred them to concepts using predefined conceptual frameworks. Concepts were subsequently linked to the ICF categories. From the 1057 abstracts retrieved, 60 studies met the inclusion criteria. We identified 52 single outcome measures and 24 standardised assessment instruments. A total of 1353 concepts were revealed from the outcome measures; 96.2% could be linked to 50 ICF categories in the 2nd level; 3.8% were not categorised. Fourteen of the 50 categories (28%) belonged to the component Body Functions, 4 (8%) to the component Body Structures, 26 (52%) to the component Activities and Participation, and 6 (12%) to the component Environmental Factors. The ICF is a valuable reference for identifying and quantifying the concepts of outcome measures on joint contractures in older people. The revealed ICF categories remain to be validated in populations with joint contractures in terms of clinical relevance and personal impact.

An international qualitative study of ability and disability in ADHD using the WHO-ICF framework.

PubMed

Mahdi, Soheil; Viljoen, Marisa; Massuti, Rafael; Selb, Melissa; Almodayfer, Omar; Karande, Sunil; de Vries, Petrus J; Rohde, Luis; Bölte, Sven

2017-10-01

This is the third in a series of four cross-cultural empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF(-CY) Core Sets for Attention-Deficit Hyperactivity Disorder (ADHD). To explore the perspectives of individuals diagnosed with ADHD, self-advocates, immediate family members and professional caregivers on relevant areas of impairment and functional abilities typical for ADHD across the lifespan as operationalized by the ICF(-CY). A qualitative study using focus group discussions or semi-structured interviews of 76 participants, divided into 16 stakeholder groups. Participants from five countries (Brazil, India, Saudi Arabia, South Africa and Sweden) were included. A deductive qualitative content analysis was conducted to extract meaningful functioning and disability concepts from verbatim material. Extracted concepts were then linked to ICF(-CY) categories by independent researchers using a standardized linking procedure. In total, 82 ICF(-CY) categories were identified, of which 32 were related to activities and participation, 25 to environmental factors, 23 to body functions and 2 to body structures. Participants also provided opinions on experienced positive sides to ADHD. A high level of energy and drive, creativity, hyper-focus, agreeableness, empathy, and willingness to assist others were the most consistently reported strengths associated with ADHD. Stakeholder perspectives highlighted the need to appraise ADHD in a broader context, extending beyond diagnostic criteria into many areas of ability and disability as well as environmental facilitators and barriers. This qualitative study, along with three other studies (comprehensive scoping review, expert survey and clinical study), will provide the scientific basis to define ICF(-CY) Core Sets for ADHD, from which assessment tools can be derived for use in clinical and research setting, as well as in health care administration.

Sensory modulation and sleep quality among adults with learning disabilities: a quasi-experimental case-control design study.

PubMed

Sharfi, Kineret; Rosenblum, Sara

2015-01-01

Following the International Classification of Functioning, Disability and Health (ICF) concepts, this study examines body functions such as sensory modulation and sleep quality among adults with learning disabilities (LD). One hundred and ten participants, 55 adults with LD and 55 matched controls (mean age 30 years) filled in a socio-demographic questionnaire, the Adults/Adolescents Sensory Profile (AASP), and the Mini Sleep Questionnaire (MSQ). Chi-tests, Mann-Whitney tests, and Kolmogorov-Smirnov tests were conducted to examine group differences related to socio-demographic characteristics and body functions. Correlation and regression analyses were conducted to examine relationships between body functions. Significant differences were found between the groups in: (a) unique socio-demographic variables: high-schools attended, family status and number of children; (b) body functions: low registration and sensory sensitivity (p < .001), sensory avoiding (p = .002), sensory seeking (p = .021) and sleep quality (p < .001). Significant correlations were found between AASP subscale scores and the MSQ final score in each group. Regression analysis revealed that for the entire sample (N = 108), low registration accounted for 10.2% of the variance of sleep quality above group membership (p < .001), while in a separate examination of adults with LD (n = 53), low registration accounted for 19.9% of the variance of sleep quality (p < .001). Adults with LD need to be studied through a health-related perspective such as the ICF model to gain further understanding of their unique characteristics and daily needs. Sensory and sleep functions of adults with LD should be further studied in the context of health related quality of life.

A machine learning framework involving EEG-based functional connectivity to diagnose major depressive disorder (MDD).

PubMed

Mumtaz, Wajid; Ali, Syed Saad Azhar; Yasin, Mohd Azhar Mohd; Malik, Aamir Saeed

2018-02-01

Major depressive disorder (MDD), a debilitating mental illness, could cause functional disabilities and could become a social problem. An accurate and early diagnosis for depression could become challenging. This paper proposed a machine learning framework involving EEG-derived synchronization likelihood (SL) features as input data for automatic diagnosis of MDD. It was hypothesized that EEG-based SL features could discriminate MDD patients and healthy controls with an acceptable accuracy better than measures such as interhemispheric coherence and mutual information. In this work, classification models such as support vector machine (SVM), logistic regression (LR) and Naïve Bayesian (NB) were employed to model relationship between the EEG features and the study groups (MDD patient and healthy controls) and ultimately achieved discrimination of study participants. The results indicated that the classification rates were better than chance. More specifically, the study resulted into SVM classification accuracy = 98%, sensitivity = 99.9%, specificity = 95% and f-measure = 0.97; LR classification accuracy = 91.7%, sensitivity = 86.66%, specificity = 96.6% and f-measure = 0.90; NB classification accuracy = 93.6%, sensitivity = 100%, specificity = 87.9% and f-measure = 0.95. In conclusion, SL could be a promising method for diagnosing depression. The findings could be generalized to develop a robust CAD-based tool that may help for clinical purposes.

"Intellectual developmental disorders": reflections on the international consensus document for redefining "mental retardation-intellectual disability" in ICD-11.

PubMed

Bertelli, Marco O; Munir, Kerim; Harris, James; Salvador-Carulla, Luis

The debate as to whether intellectual disability (ID) should be conceptualized as a health condition or as a disability has intensified as the revision of World Health Organization's (WHO's) International Classification of Diseases (ICD) is being finalized. Defining ID as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. The purpose of this paper is to include some reflections on the consensus document produced by the first WHO Working Group on the Classification of MR (WHO WG-MR) and on the process that was followed to realize it. The consensus report was the basis for the development of official recommendations sent to the WHO Advisory Group for ICD-11. A mixed qualitative approach was followed in a series of meetings leading to the final consensus report submitted to the WHO Advisory group. These recommendations combined prior expert knowledge with available evidence; a nominal approach was followed throughout with face-to-face conferences. The WG recommended a synonym set ("synset") ontological approach to the conceptualisation of this health condition underlying a clinical rationale for its diagnosis. It proposed replacing MR with Intellectual Developmental Disorders (IDD) in ICD-11, defined as "a group of developmental conditions characterized by a significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills". The WG further advised that IDD be included under the parent category of neurodevelopmental disorders, that current distinctions (mild, moderate, severe and profound) be continued as severity qualifiers, and that problem behaviours removed from its core classification structure and instead described as associated features. Within the ID/IDD synset two different names combine distinct aspects under a single construct that describes its clinical as well as social, educational and policy utilities. The single construct incorporates IDD as a clinical meta-syndrome, and ID as its functioning and disability counterpart. IDD and ID are not synonymous or mirror concepts as they have different scientific, social and policy applications. New diagnostic criteria for IDD should be based on a developmental approach, which accounts for the complex causal factors known to impact the acquisition of specific cognitive abilities and adaptive behaviours. The paper focuses on a new clinical framework for the diagnosis of IDD that also includes and complements the existing social, educational and policy components inherent in ID.

Unintentional injuries in children with disabilities: a systematic review and meta-analysis.

PubMed

Shi, Xiuquan; Shi, Junxin; Wheeler, Krista K; Stallones, Lorann; Ameratunga, Shanthi; Shakespeare, Tom; Smith, Gary A; Xiang, Huiyun

2015-12-01

Children with disabilities are thought to have an increased risk of unintentional injuries, but quantitative syntheses of findings from previous studies have not been done. We conducted a systematic review and meta-analysis to assess whether pre-existing disability can increase the risk of unintentional injuries among children when they are compared to children without disability. We searched 13 electronic databases to identify original research published between 1 January 1990 and 28 February 2013. We included those studies that reported on unintentional injuries among children with pre-existing disabilities compared with children without disabilities. We conducted quality assessments and then calculated pooled odds ratios of injury using random-effects models. Fifteen eligible studies were included from 24,898 references initially identified, and there was a total sample of 83,286 children with disabilities drawn from the eligible studies. When compared with children without disabilities, the pooled OR of injury was 1.86 (95 % CI 1.65-2.10) in children with disabilities. The pooled ORs of injury were 1.28, 1.75, and 1.86 in the 0-4 years, 5-9 years, and ≥10 years of age subgroups, respectively. Compared with children without disabilities, the pooled OR was 1.75 (95 % CI 1.26-2.43) among those with International Classification of Functioning (ICF) limitations. When disability was defined as physical disabilities, the pooled OR was 2.39 (95 % CI 1.43-4.00), and among those with cognitive disabilities, the pooled OR was 1.77 (95 % CI 1.49-2.11). There was significant heterogeneity in the included studies. Compared with peers without disabilities, children with disabilities are at a significantly higher risk of injury. Teens with disabilities may be an important subgroup for future injury prevention efforts. More data are needed from low- and middle-income countries.

Racial and ethnic disparities in stroke outcomes: a scoping review of post-stroke disability assessment tools.

PubMed

Burns, Suzanne Perea; White, Brandi M; Magwood, Gayenell; Ellis, Charles; Logan, Ayaba; Jones Buie, Joy N; Adams, Robert J

2018-03-23

To identify how post-stroke disability outcomes are assessed in studies that examine racial/ethnic disparities and to map the identified assessment content to the International Classification of Functioning, Disability, and Health (ICF) across the time course of stroke recovery. We conducted a scoping review of the literature. Articles published between January 2001 and July 2017 were identified through Scopus, PubMed, CINAHL, and PsycINFO according to predefined inclusion and exclusion criteria. We identified 1791 articles through database and hand-searching strategies. Of the articles, 194 met inclusion criteria for full-text review, and 41 met inclusion criteria for study inclusion. The included studies used a variety of outcome measures encompassing domains within the ICF: body functions, activities, participation, and contextual factors across the time course of stroke recovery. We discovered disproportionate representation among racial/ethnic groups in the post-stroke disability disparities literature. A wide variety of assessments are used to examine disparities in post-stroke disability across the time course of stroke recovery. Several studies have identified disparities through a variety of assessments; however, substantial problems abound from the assessments used including inconsistent use of assessments, lacking evidence on the validity of assessments among racial/ethnic groups, and inadequate representation among all racial/ethnic populations comprising the US. Implications for Rehabilitation An enhanced understanding of racial/ethnic disparities in post-stroke disability outcomes is inherently important among rehabilitation practitioners who frequently engage with racial/ethnic minority populations across the time course of stroke recovery. Clinicians should carefully consider the psychometric properties of assessment tools to counter potential racial bias. Clinicians should be aware that many assessments used in stroke rehabilitation lack cultural sensitivity and could result in inaccurate assessment findings.

Adverse events following cervical manipulative therapy: consensus on classification among Dutch medical specialists, manual therapists, and patients.

PubMed

Kranenburg, Hendrikus A; Lakke, Sandra E; Schmitt, Maarten A; Van der Schans, Cees P

2017-12-01

To obtain consensus-based agreement on a classification system of adverse events (AE) following cervical spinal manipulation. The classification system should be comprised of clear definitions, include patients' and clinicians' perspectives, and have an acceptable number of categories. Design : A three-round Delphi study. Participants : Thirty Dutch participants (medical specialists, manual therapists, and patients) participated in an online survey. Procedure : Participants inventoried AE and were asked about their preferences for either a three- or a four-category classification system. The identified AE were classified by two analysts following the International Classification of Functioning, Disability and Health (ICF), and the International Classification of Diseases and Related Health Problems (ICD-10). Participants were asked to classify the severity for all AE in relation to the time duration. Consensus occurred in a three-category classification system. There was strong consensus for 16 AE in all severities (no, minor, and major AE) and all three time durations [hours, days, weeks]. The 16 AE included anxiety, flushing, skin rash, fainting, dizziness, coma, altered sensation, muscle tenderness, pain, increased pain during movement, radiating pain, dislocation, fracture, transient ischemic attack, stroke, and death. Mild to strong consensus was reached for 13 AE. A consensus-based classification system of AE is established which includes patients' and clinicians' perspectives and has three categories. The classification comprises a precise description of potential AE in accordance with internationally accepted classifications. After international validation, clinicians and researchers may use this AE classification system to report AE in clinical practice and research.

International Classification of Impairments, Disabilities, and Handicaps: A Manual of Classification Relating to the Consequences of Disease.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

This classification system is intended to offer a conceptual framework for information; the framework is relevant to the long-term consequences of disease, injuries or disorders, and applicable both to personal health care, including early identification and prevention, and to the mitigation of environmental and societal barriers. It begins with…

41 CFR Appendix B to Part 60 - 300-Sample Invitation to Self-Identify

Code of Federal Regulations, 2014 CFR

2014-07-01

... classifications are defined as follows: • A “disabled veteran” is one of the following: • a veteran of the U.S...). THE DEFINITIONS OF THE SEPARATE CLASSIFICATIONS OF PROTECTED VETERANS SET FORTH IN PARAGRAPH 1 MUST... CLASSIFICATIONS OFPROTECTED VETERAN LISTED ABOVE [ ]I AM NOT A PROTECTED VETERAN [THE FOLLOWING TEXT SHOULD BE...

Disability, Home Physical Environment and Non-Fatal Injuries among Young Children in China

PubMed Central

Xiang, Hui-yun; Yu, Chuan-hua; Du, Yu-kai

2012-01-01

Objectives We compared the patterns of medically attended injuries between children with and without disabilities and explored the residential environment risks in five counties of Hubei Province in the People's Republic of China by a 1∶1 matched case-control study based on the biopsychosocial model of the International Classification of Functioning, Disability and Health – ICF. Methods 1201 children aged 1–14 with disabilities and 1201 their healthy counterparts matched as having the same gender, same age, and lived in the same neighborhood were recruited in our study. Characteristics of injuries in the past 12 months were compared between children with and without disabilities. The associations among disability status, home environment factors and injuries were examined in logistic regression analysis taking into account sociodemographic factors. Results Children with disabilities had a significantly higher prevalence of injury than children without disabilities (10.2% vs. 4.4%; P<.001). The two groups differed significantly in terms of number of injury episodes, injury place and activity at time of injury. Falls were the leading mechanism of injury regardless of disability status. Most of the injury events happened inside the home and leisure activities were the most reported activity when injured for both groups. The univariate OR for injury was 4.46 (2.57–7.74) for the disabled children compared with the non-disabled children. Disabled children whose family raised cat/dog(s) were 76% more likely to be injured during the last 12 months (OR = 1.76; 95% CI = 1.02, 3.02),comparing with those whose family did not have any cat/dog. And for children without disabilities, those whose family had cat/dog(s) were over 3 times more likely to having injuries comparing with those whose family did not have any cat/dog. Conclusions Children with disabilities had a significantly increased risk for injury. Interventions to prevent residential injury are an important public health priority in children with disabilities. PMID:22624063

Measuring disability and monitoring the UN Convention on the Rights of Persons with Disabilities: the work of the Washington Group on Disability Statistics

PubMed Central

2011-01-01

The Washington Group on Disability Statistics is a voluntary working group made up of representatives of over 100 National Statistical Offices and international, non-governmental and disability organizations that was organized under the aegis of the United Nations Statistical Division. The purpose of the Washington Group is to deal with the challenge of disability definition and measurement in a way that is culturally neutral and reasonably standardized among the UN member states. The work, which began in 2001, took on added importance with the passage and ratification of the UN Convention on the Rights of Persons with Disabilities since the Convention includes a provision for monitoring whether those with and without disabilities have equal opportunities to participate in society and this will require the identification of persons with disabilities in each nation. The International Classification of Functioning, Disability and Health (ICF) developed by the World Health Organization provided a framework for conceptualizing disability. Operationalizing an ICF-based approach to disability has required the development of new measurement tools for use in both censuses and surveys. To date, a short set of six disability-related questions suitable for use in national censuses has been developed and adopted by the Washington Group and incorporated by the United Nations in their Principles and Recommendations for Population and Housing Censuses. A series of extended sets of questions is currently under development and some of the sets have been tested in several countries. The assistance of many National and International organizations has allowed for cognitive and field testing of the disability questionnaires in multiple languages and locations. This paper will describe the work of the Washington Group and explicate the applicability of its approach and the questions developed for monitoring the UN Convention on the Rights of Persons with Disabilities. PMID:21624190

A comparative review of measurement instruments to inform and evaluate effectiveness of disability inclusive development.

PubMed

Goujon, Nicolas; Devine, Alexandra; Baker, Sally M; Sprunt, Beth; Edmonds, Tanya J; Booth, Jennifer K; Keeffe, Jill E

2014-01-01

A review of existing measurement instruments was conducted to examine their suitability to measure disability prevalence and assess quality of life, protection of disability rights and community participation by people with disabilities, specifically within the context of development programs in low and middle-income countries. From a search of PubMed and the grey literature, potentially relevant measurement instruments were identified and examined for their content and psychometric properties, where possible. Criteria for inclusion were: based on the WHO's International Classification of Functioning Disability and Health (ICF), used quantitative methods, suitable for population-based studies of disability inclusive development in English and published after 1990. Characteristics of existing instruments were analysed according to components of the ICF and quality of life domains. Ten instruments were identified and reviewed according to the criteria listed above. Each version of instruments was analysed separately. Only three instruments included a component on quality of life. Domains from the ICF that were addressed by some but not all instruments included the environment, technology and communication. The measurement instruments reviewed covered the range of elements required to measure disability-inclusion within development contexts. However no single measurement instrument has the capacity to measure both disability prevalence and changes in quality of life according to contemporary disability paradigms. The review of measurement instruments supports the need for developing an instrument specifically intended to measure disability inclusive practice within development programs. Implications for Rehabilitation Surveys and tools are needed to plan disability inclusive development. Existing measurement tools to determine prevalence of disability, wellbeing, rights and access to the community were reviewed. No single validated tool exists for population-based studies, uses quantitative methods and the components of the ICF to measure prevalence of disability, well-being of people with disability and their access to their communities. A measurement tool that reflects the UNCRPD and addresses all components of the ICF is needed to assist in disability inclusive development, especially in low and mid resource countries.

Measuring disability and monitoring the UN Convention on the Rights of Persons with Disabilities: the work of the Washington Group on Disability Statistics.

PubMed

Madans, Jennifer H; Loeb, Mitchell E; Altman, Barbara M

2011-05-31

The Washington Group on Disability Statistics is a voluntary working group made up of representatives of over 100 National Statistical Offices and international, non-governmental and disability organizations that was organized under the aegis of the United Nations Statistical Division. The purpose of the Washington Group is to deal with the challenge of disability definition and measurement in a way that is culturally neutral and reasonably standardized among the UN member states. The work, which began in 2001, took on added importance with the passage and ratification of the UN Convention on the Rights of Persons with Disabilities since the Convention includes a provision for monitoring whether those with and without disabilities have equal opportunities to participate in society and this will require the identification of persons with disabilities in each nation. The International Classification of Functioning, Disability and Health (ICF) developed by the World Health Organization provided a framework for conceptualizing disability. Operationalizing an ICF-based approach to disability has required the development of new measurement tools for use in both censuses and surveys. To date, a short set of six disability-related questions suitable for use in national censuses has been developed and adopted by the Washington Group and incorporated by the United Nations in their Principles and Recommendations for Population and Housing Censuses. A series of extended sets of questions is currently under development and some of the sets have been tested in several countries. The assistance of many National and International organizations has allowed for cognitive and field testing of the disability questionnaires in multiple languages and locations. This paper will describe the work of the Washington Group and explicate the applicability of its approach and the questions developed for monitoring the UN Convention on the Rights of Persons with Disabilities.

Clinical Assessment of the Infant and Child Following Perinatal Brachial Plexus Injury

PubMed Central

Duff, Susan V.; DeMatteo, Carol

2015-01-01

STUDY DESIGN Literature review INTRODUCTION After perinatal brachial plexus injury (PBPI), clinicians play an important role in injury classification as well as the assessment of recovery and secondary conditions. Early assessment guides the initial plan of care and influences follow-up and long-term outcome. PURPOSE To review methods used to assess, classify and monitor the extent and influence of PBPI with an emphasis on guidelines for clinicians. METHODS We use The International Classification of Functioning, Disability, and Health (ICF) model to provide a guide to assessment after PBPI for rehabilitation clinicians. DISCUSSION With information gained from targeted assessments, clinicians can design interventions to increase the opportunities infants and children have for optimal recovery and to attain skills that allow participation in areas of interest. PMID:25840493

Advances in the understanding of headache.

PubMed

Goadsby, Peter J

2005-01-01

Primary headache disorders account for a substantial part of the morbidity seen in medical practice and so advances in their understanding and management are of general importance. The classification of headache disorders has recently been revised, and the importance of frequent migraine, chronic (transformed) migraine and some important, albeit rarer, conditions that were previously not included has been recognized. Identification of the first genes for a migraine syndrome, namely familial hemiplegic migraine, and their classification as channelopathies opens up new understanding of these disorders and their possible pathophysiology. Functional brain imaging of migraine and cluster headache has placed the pathophysiology of these disorders firmly and clearly in the brain. As our understanding of migraine and related syndromes has increased, new therapies have been developed which reduce the significant disability associated with these important neurological disorders.

Functioning and Disability Profile of Children with Microcephaly Associated with Congenital Zika Virus Infection.

PubMed

Ferreira, Haryelle Náryma Confessor; Schiariti, Veronica; Regalado, Isabelly Cristina Rodrigues; Sousa, Klayton Galante; Pereira, Silvana Alves; Fechine, Carla Patrícia Novaes Dos Santos; Longo, Egmar

2018-05-29

The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information, based on the ICF, for multiprofessional teams, administrators, family members, and children.

Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project.

PubMed

Gimigliano, Francesca; De Sire, Alessandro; Gastaldo, Marco; Maghini, Irene; Paoletta, Marco; Pasquini, Andrea; Boldrini, Paolo; Selb, Melissa; Prodinger, Birgit

2018-06-11

The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice. 1) To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool. Multicenter cross-sectional study. Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM. Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID. Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS). Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001). The most common disease was the back pain (9.6%) and the most common altered ICF categories were b280 (76.3%) and b710 (72.9%). This multicenter cross-sectional study shown that the ICF Generic-30 Set is a valuable instrument for reporting and assessing functioning and disability in clinical populations with different health conditions and along the continuum of care and that SID facilitate the understanding of the ICF categories and therefore their use in clinical practice. This National survey, improving the knowledge of ICF among Italian PRM residents, represents an important step towards the system-wide implementation of ICF in the healthcare system.

Using the international classification of functioning to examine the impact of trigger finger.

PubMed

Langer, Danit; Maeir, Adina; Michailevich, Michael; Applebaum, Yael; Luria, Shai

2016-12-01

To evaluate the impact of trigger finger (TF) on hand motor function, activity and participation (A&P) and quality of life (QOL), and to evaluate the association between personal factors (age and gender, disease severity) and body functions (dexterity and strength) with A&P and QOL in patients with TF. Sixty-six patients with TF (study group) and 66 healthy volunteers (control group) participated in the study. TF symptoms were graded using the Quinnell classification. A&P was evaluated using the Disabilities of Arm Shoulder and Hand questionnaire and the QOL using the World Health Organization Quality of Life questionnaire. Dexterity was evaluated using the Functional Dexterity Test and the Purdue Pegboard Test; hand strength was evaluated using the Jamar Dynamometer and Pinch Gauge. The comparisons between the study and control groups revealed significant differences in all measures. The study group reported lower perceived QOL, A&P and reduced hand strength and dexterity. Hierarchical regression analyses revealed that (a) the severity of TF contributed significantly to the explained variance of QOL, while demographics and hand functioning did not; (b) demographics, TF severity and hand function all contributed significantly to the explained variance of A&P. The findings of the study point to the importance of addressing the functional implications and QOL of individuals with TF. Implications for Rehabilitation Although trigger finger is considered to be a mild hand pathology, it has a wide-ranging impact on hand functioning, daily activities and quality of life. Clinicians should include assessments of these outcomes in the treatment of individuals with trigger finger. Treatment efficacy should be evaluated with International Classification of Functioning outcomes, and not limited to symptomatology.

Classification, Seriation, and Counting in Grades 1, 2, and 3 as Two-Year Longitudinal Predictors for Low Achieving in Numerical Facility and Arithmetical Achievement?

ERIC Educational Resources Information Center

Desoete, Annemie; Stock, Pieter; Schepens, Annemie; Baeyens, Dieter; Roeyers, Herbert

2009-01-01

Previous research stresses the importance of seriation, classification, and counting abilities that should be assessed in kindergarten, when looking for crucial predictors of mathematical learning disabilities in Grade 1. This study examines (n = 158) two-year-long predictive relationships between children's seriation, classification, procedural…

Agreement Among Traditional and RTI-based Definitions of Reading-Related Learning Disability with Preschool Children.

PubMed

Milburn, Trelani F; Lonigan, Christopher J; Allan, Darcey M; Phillips, Beth M

2017-04-01

To investigate approaches for identifying young children who may be at risk for later reading-related learning disabilities, this study compared the use of four contemporary methods of indexing learning disability (LD) with older children (i.e., IQ-achievement discrepancy, low achievement, low growth, and dual-discrepancy) to determine risk status with a large sample of 1,011 preschoolers. These children were classified as at risk or not using each method across three early-literacy skills (i.e., language, phonological awareness, print knowledge) and at three levels of severity (i.e., 5th, 10th, 25th percentiles). Chance-corrected affected-status agreement (CCASA) indicated poor agreement among methods with rates of agreement generally decreasing with greater levels of severity for both single- and two-measure classification, and agreement rates were lower for two-measure classification than for single-measure classification. These low rates of agreement between conventional methods of identifying children at risk for LD represent a significant impediment for identification and intervention for young children considered at-risk.

Agreement Among Traditional and RTI-based Definitions of Reading-Related Learning Disability with Preschool Children

PubMed Central

Milburn, Trelani F.; Lonigan, Christopher J.; Allan, Darcey M.; Phillips, Beth M.

2017-01-01

To investigate approaches for identifying young children who may be at risk for later reading-related learning disabilities, this study compared the use of four contemporary methods of indexing learning disability (LD) with older children (i.e., IQ-achievement discrepancy, low achievement, low growth, and dual-discrepancy) to determine risk status with a large sample of 1,011 preschoolers. These children were classified as at risk or not using each method across three early-literacy skills (i.e., language, phonological awareness, print knowledge) and at three levels of severity (i.e., 5th, 10th, 25th percentiles). Chance-corrected affected-status agreement (CCASA) indicated poor agreement among methods with rates of agreement generally decreasing with greater levels of severity for both single- and two-measure classification, and agreement rates were lower for two-measure classification than for single-measure classification. These low rates of agreement between conventional methods of identifying children at risk for LD represent a significant impediment for identification and intervention for young children considered at-risk. PMID:28670102

[Scientific-professional production on the ICF disability model in Spain. A literature review (2001-2010)].

PubMed

Comín Comín, Magdalena; Ruiz Garrós, Cristina; Franco, Esther; Damian, Javier; Ruiz Tovar, Maria; de Pedro-Cuesta, Jesús

2011-12-01

To quantify the use of the International Classification of Functioning, Disability and Health (ICF) in Spain on the basis of published reports, and to compare this use with that in other European countries. We reviewed the scientific literature published by, or with the participation of, authors having Spanish institutional affiliations in Spanish or international journals between May 2001 and June 2010. A total of 47 papers were identified, with a recent annual increase in those published in English. There was a predominance of theoretical journals (53.1%) and those specializing in mental health, rehabilitation and disability, with a medium or low impact factor. The World Health Organization-Disability Assessment Schedule (WHODAS-II) was used in 27.6% of publications. Most studies addressed adult populations with mental illness. Spain ranked midway in the table of European countries (fifth by Medline references). This review suggests that the effective application of the ICF in Spain is limited but is increasing and is internationally co-ordinated. The main fields of application are theoretical and diagnostic, in various clinical, rehabilitation and population-based contexts and, to a much lesser extent, in health services. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Does socioeconomic inequality in health persist among older people living in resource-poor urban slums?

PubMed

Falkingham, Jane C; Chepngeno-Langat, Gloria; Kyobutungi, Catherine; Ezeh, Alex; Evandrou, Maria

2011-06-01

Using self-reported health that assesses functionality or disability status, this paper investigates whether there are any differences in health status among older people living in a deprived area of Nairobi, Kenya. Data from a cross-sectional survey of 2,037 men and women aged 50 years and older are used to examine the association between socioeconomic position and self-reported health status across 6 health domains. Education, occupation, a wealth index, and main source of livelihood are used to assess the presence of a socioeconomic gradient in health. All the indicators showed the expected negative association with health across some, but not all, of the disability domains. Nonetheless, differences based on occupation, the most commonly used indicators to examine health inequalities, were not statistically significant. Primary level of education was a significant factor for women but not for men; conversely, wealth status was associated with lower disability for both men and women. Older people dependent on their own sources of livelihood were also less likely to report a disability. The results suggest the need for further research to identify an appropriate socioeconomic classification that is sensitive in identifying poverty and deprivation among older people living in slums.

Converging, pervasive technologies: chronic and emerging issues and policy adequacy.

PubMed

Seelman, Katherine D

2008-01-01

This article is a thought piece with the expansive goal of identifying policy facilitators and barriers to the development of usable and accessible advanced information and communications technology for people with disabilities across the age span at the research and development and marketing stages. The working hypothesis is as follows: The lack of participation in and representation of the interests of people with disabilities in the technology resource system is a barrier to availability of affordable consumer goods that enable independence and community integration. Converging, pervasive computing technology, especially in housing applications, is used as a case example, drawing especially from research and development conducted by the National Science Foundation Quality of Life Technology Engineering Research Center. A critical theory approach is used to identify problems and seek solutions to the apparent lack of balance between the demand and needs of disabled users and the supply and availability of usable, affordable consumer goods produced by the technology resource system in which allocation decisions are made. The approach uses policy analysis tools such as a technology assessment framework; the participation and environment components of the World Health Organization's International Classification of Functioning, Disability and Health; and participatory action research.

Most common problems across health conditions as described by the International Classification of Functioning, Disability, and Health.

PubMed

Ptyushkin, Pavel; Cieza, Alarcos; Stucki, Gerold

2015-09-01

Health conditions are associated with a variety of functional outcomes. Even though functional outcomes are diverse for different health conditions, they can have important commonalities. The aim of this study was to identify the most common problems in functioning across the wide range of health conditions using the International Classification of Functioning (ICF). Existing databases created for the 21 ICF Core Sets studies were descriptively analyzed. These included data collected in 44 countries on 9978 patients with one of 21 health conditions as the main diagnosis. A frequency cutoff of 50% was used to identify the most common problems in functioning when looking at single health conditions and across them. No category was identified as common to all health conditions included in the study. Fifteen most frequent categories were common in 10 to 13 health conditions out of 21. Eleven categories correspond to the list of activities and participation, and four to the list of body functions. These are related to mobility, daily routine, mental functions, intimate relations, employment, and leisure. Some health conditions have more commonalities between each other. The most common problems across health conditions are therefore related to mental functions, mobility, daily life, intimate relations, employment, and leisure. The results contribute toward the identification of the universal set of ICF categories that can be used in clinical practice for the general assessment of functioning.

Health status transitions in community-living elderly with complex care needs: a latent class approach.

PubMed

Lafortune, Louise; Béland, François; Bergman, Howard; Ankri, Joël

2009-02-03

For older persons with complex care needs, accounting for the variability and interdependency in how health dimensions manifest themselves is necessary to understand the dynamic of health status. Our objective is to test the hypothesis that a latent classification can capture this heterogeneity in a population of frail elderly persons living in the community. Based on a person-centered approach, the classification corresponds to substantively meaningful groups of individuals who present with a comparable constellation of health problems. Using data collected for the SIPA project, a system of integrated care for frail older people (n = 1164), we performed latent class analyses to identify homogenous categories of health status (i.e. health profiles) based on 17 indicators of prevalent health problems (chronic conditions; depression; cognition; functional and sensory limitations; instrumental, mobility and personal care disability) Then, we conducted latent transition analyses to study change in profile membership over 2 consecutive periods of 12 and 10 months, respectively. We modeled competing risks for mortality and lost to follow-up as absorbing states to avoid attrition biases. We identified four health profiles that distinguish the physical and cognitive dimensions of health and capture severity along the disability dimension. The profiles are stable over time and robust to mortality and lost to follow-up attrition. The differentiated and gender-specific patterns of transition probabilities demonstrate the profiles' sensitivity to change in health status and unmasked the differential relationship of physical and cognitive domains with progression in disability. Our approach may prove useful at organization and policy levels where many issues call for classification of individuals into pragmatically meaningful groups. In dealing with attrition biases, our analytical strategy could provide critical information for the planning of longitudinal studies of aging. Combined, these findings address a central challenge in geriatrics by making the multidimensional and dynamic nature of health computationally tractable.

Diagnosis of Specific Learning Disabilities and Prescriptive Teaching.

ERIC Educational Resources Information Center

Alonso, Lou; And Others

The recent trend in special education toward individualized teaching based on the diagnosis of specific learning disabilities is reviewed. The concern of educators for emphasis on psychoeducational diagnosis to determine learning and behavioral problems, and their remediation, rather than primarily on classification and categorization along…

Disability Evaluation in Japan

PubMed Central

2009-01-01

To examine the current state and social ramifications of disability evaluation in Japan, public data from Annual Reports on Health and Welfare 1998-1999 were investigated. All data were analyzed based on the classification of disabilities and the effects of age-appropriate welfare services, which have been developed through a half-century of legislative efforts to support disability evaluation. These data suggest that disability evaluation, while essentially affected by age and impairment factors at a minimum, was impacted more by the assistive environment for disabilities. The assistive environment was found to be closely linked with the welfare support system related to a global assessment in the field of community-based rehabilitation. PMID:19503677

Alignment of classification paradigms for communication abilities in children with cerebral palsy.

PubMed

Hustad, Katherine C; Oakes, Ashley; McFadd, Emily; Allison, Kristen M

2016-06-01

We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed interjudge reliability, whether the VSS and the CFCS captured impairments in speech and language, and whether there were differences in speech intelligibility among levels within each classification paradigm. Eighty children (42 males, 38 females) with a range of types and severity levels of CP participated (mean age 60mo, range 50-72mo [SD 5mo]). Two speech-language pathologists classified each child via parent-child interaction samples and previous experience with the children for the CFCS and VSS, and using quantitative speech and language assessment data for the SLPG. Intelligibility scores were obtained using standard clinical intelligibility measurement. Kappa values were 0.67 (95% confidence interval [CI] 0.55-0.79) for the CFCS, 0.82 (95% CI 0.72-0.92) for the VSS, and 0.95 (95% CI 0.72-0.92) for the SLPG. Descriptively, reliability within levels of each paradigm varied, with the lowest agreement occurring within the CFCS at levels II (42%), III (40%), and IV (61%). Neither the CFCS nor the VSS were sensitive to language impairments captured by the SLPG. Significant differences in speech intelligibility were found among levels for all classification paradigms. Multiple tools are necessary to understand speech, language, and communication profiles in children with CP. Characterization of abilities at all levels of the International Classification of Functioning, Disability and Health will advance our understanding of the ways that speech, language, and communication abilities present in children with CP. © 2015 Mac Keith Press.

Caracterization of adults with cerebral palsy.

PubMed

Margre, Anna L M; Reis, Maria G L; Morais, Rosane L S

2010-01-01

cerebral Palsy (CP) is a group of permanent disorders of the development of movement and posture that cause functional limitation and are attributed to non-progressive disorders which occur in the fetal or infant brain. In recent years, with the increase in life expectancy of individuals with CP, several studies have described the impact of musculoskeletal disabilities and functional limitations over the life cycle. to characterize adults with CP through sociodemographic information, classifications, general health, associated conditions, physical complications and locomotion. twenty-two adults with CP recruited from local rehabilitation centers in an inner town of Brazil participated in this study. A questionnaire was used to collect data on sociodemographic characteristics, comorbities, and physical complications. A brief physical therapy evaluation was carried out, and the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were applied. Data were analyzed through descriptive statistics. the mean age was 28.7 (SD 10.6) years, 86.4% of participants lived with parents, and 4.5% were employed. Most of the sample consisted of spastic quadriplegic subjects, corresponding to levels IV and V of the GMFCS and MACS. Different comorbidities and important physical complications such as scoliosis and muscle contractures were present. More than half of the participants were unable to walk. Most participants demonstrated important restrictions in social participation and lower educational level. Adults with CP can be affected by several physical complications and progressive limitations in gait.

The value of education in special care dentistry as a means of reducing inequalities in oral health.

PubMed

Faulks, D; Freedman, L; Thompson, S; Sagheri, D; Dougall, A

2012-11-01

People with disability are subject to inequality in oral health both in terms of prevalence of disease and unmet healthcare needs. Over 18% of the global population is living with moderate to severe functional problems related to disability, and a large proportion of these persons will require Special Care Dentistry at some point in their lifetime. It is estimated that 90% of people requiring Special Care Dentistry should be able to access treatment in a local, primary care setting. Provision of such primary care is only possible through the education and training of dentists. The literature suggests that it is vital for the dental team to develop the necessary skills and gain experience treating people with special needs in order to ensure access to the provision of oral health care. Education in Special Care Dentistry worldwide might be improved by the development of a recognised academic and clinical discipline and by providing international curricula guidelines based on the International Classification of Functioning, Disability and Health (ICF, WHO). This article aims to discuss the role and value of promoting and harmonising education in Special Care Dentistry as a means of reducing inequalities in oral health. © 2012 John Wiley & Sons A/S.

[Ecological assessment of executive functions in a patient with acquired brain injury].

PubMed

Chevignard, M; Taillefer, C; Picq, C; Pradat-Diehl, P

2008-03-01

Dysexecutive syndrome is one of the most frequent sequel of severe traumatic brain injury. It causes severe disabilities and it is incompletely assessed by the classical "paper and pencil" neuropsychological tests. We developed an ecological assessment conducted in a naturalistic situation, consisting of a cooking task, and we described a classification of errors. This assessment is very sensitive, even to a mild dysexecutive syndrome. To describe the disabilities in activities of daily living of a traumatic brain-injured patient and to demonstrate the sensitivity of an ill-structured ecological assessment. We report a single case study illustrating how the ecological assessment by the cooking task helped better understand and characterize the patient's disabilities. The patient presented severe disabilities in daily life activities, which were well described by his family. His cognitive disorders were mild in the cognitive tests, even those supposed to be more ecological, such as the Six Elements Task or script generation. He exhibited very severe disorders in the cooking task, with a very high number of errors. Moreover, duration of the cooking task was very long; he did not achieve the goal and exhibited dangerous behaviour. The cooking task involves abilities to deal with multitasking, which particularly involve executive functions. The most severe disorders were observed during the patient's interaction with the environment while conducting a complex goal-directed action plan, indicating control disorders. This type of naturalistic assessment provides very useful information to help patients organise their familial, social or professional reintegration.

Using a participatory action strategic approach to enhance accessibility and participation in arts and cultural events: results of four focus groups.

PubMed

Milligan, Nancy Vandewiele; Nieuwenhuijsen, Els R; Grawi, Carolyn L

2014-01-01

Cultural events are abundant in a midwestern college town; however, individuals with disabilities have expressed concerns about their accessibility. Policymakers, business owners, and managers often ignore disability-related issues. Research shows accessibility is the main environmental barrier to participation in arts and cultural events. Individuals with disabilities are disconnected from managers of cultural organizations and city leaders. The lack of awareness about accessibility, including access to the built environment, impedes participation in cultural events in this college town. To encourage the participation of people with disabilities in cultural events in a midwestern college town, a bold strategic project was initiated to conduct a community-based needs assessment as a foundation for an action plan. Participation in arts and culture was selected as a unique focal point for exploring ways to enhance accessibility. Thirty-nine stakeholders participated in four different focus groups: individuals with disabilities, managers of cultural organizations, caregivers and health care providers, and other stakeholders including politicians. Critical problem areas identified were mapped onto the environmental factors in the International Classification of Functioning, Disability, and Health (ICF). Three themes emerged: 1) limited awareness about accessibility among the residents with disabilities and a lack of awareness about disability-related issues and accessibility among the managers of cultural organizations; 2) the need for a "central information clearinghouse" to share, provide, and retrieve information; 3) the need for inclusive city-level policies. Raising awareness about disabilities and accessibility, providing a clearinghouse for information sharing and implementing inclusive policies are crucial to strengthen participation in community life. Copyright © 2014 Elsevier Inc. All rights reserved.

Disability, Disorder, and Identity

ERIC Educational Resources Information Center

Wehmeyer, Michael L.

2013-01-01

The World Health Organization's "International Classification of Diseases" ("ICD") is the most important diagnostic tool, worldwide, to ensure that people with intellectual and developmental disabilities receive the supports they need to live richer, fuller lives. And yet, the "ICD" has naming conventions that create a conundrum for the field,…

Classification and Validation of Behavioral Subtypes of Learning-Disabled Children.

ERIC Educational Resources Information Center

Speece, Deborah L.; And Others

1985-01-01

Using the Classroom Behavior Inventory, teachers rated the behaviors of 63 school-identified, learning-disabled first and second graders. Hierarchical cluster analysis techniques identified seven distinct behavioral subtypes. Internal validation techniques indicated that the subtypes were replicable and had profile patterns different from a sample…

An international qualitative study of functioning in autism spectrum disorder using the World Health Organization international classification of functioning, disability and health framework

PubMed Central

Mahdi, Soheil; Viljoen, Marisa; Yee, Tamara; Selb, Melissa; Singhal, Nidhi; Almodayfer, Omar; Granlund, Mats; de Vries, Petrus J.; Zwaigenbaum, Lonnie

2017-01-01

This is the third in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The present study aimed to describe functioning in ASD (as operationalized by the ICF) derived from the perspectives of diagnosed individuals, family members, and professionals. A qualitative study using focus groups and semi‐structured interviews were conducted with 19 stakeholder groups (N = 90) from Canada, India, Saudi Arabia, South Africa, and Sweden. Meaningful concepts from the focus groups and individual interviews were linked to ICF categories using a deductive qualitative approach with standardized linking procedures. The deductive qualitative content analysis yielded meaningful functioning concepts that were linked to 110 ICF categories across all four ICF components. Broad variation of environmental factors and activities and participation categories were identified in this study, while body functions consisted mainly of mental functions. Body structures were sparsely mentioned by the participants. Positive aspects of ASD included honesty, attention to detail, and memory. The experiences provided by international stakeholders support the need to understand individuals with ASD in a broader perspective, extending beyond diagnostic criteria into many areas of functioning and environmental domains. This study is part of a larger systematic effort that will provide the basis to define ICF Core Sets for ASD, from which assessment tools can be generated for use in clinical practice, research, and health care policy making. Autism Res 2018, 11: 463–475. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary The study findings support the need to understand the living experiences of individuals with Autism Spectrum Disorder (ASD) from a broader perspective, taking into account many areas of an individual's functioning and environment. The ICF can serve as foundation for exploring these living experiences more extensively by offering tools that enable wide variety of individual difficulties and strengths to be captured along with important environmental influences. As such, these tools can facilitate interventions that meet the needs and goals of the individual. PMID:29226604

Relevance of grasp types to assess functionality for personal autonomy.

PubMed

Gracia-Ibáñez, Verónica; Sancho-Bru, Joaquin L; Vergara, Margarita

Cross-sectional research design. Current assessment of hand function is not focused on evaluating the real abilities required for autonomy. To quantify the relevance of grasp types for autonomy to guide hand recovery and its assessment. Representative tasks of the International Classification of Functioning, Disability and Health activities in which the hands are directly involved were recorded. The videos were analyzed to identify the grasps used with each hand, and their relevance for autonomy was determined by weighting time with the frequency of appearance of each activity in disability and dependency scales. Relevance is provided globally and distinguished by hand (right-left) and bimanual function. Significant differences in relevance are also checked. The most relevant grasps are pad-to-pad pinch (31.9%), lumbrical (15.4%), cylindrical (12%), and special pinch (7.3%) together with the nonprehensile (18.6%) use of the hand. Lumbrical grasp has higher relevance for the left hand (19.9% vs 12%) while cylindrical grasp for the right hand (15.3% vs 7.7%). Relevancies are also different depending on bimanual function. Different relative importance was obtained when considering dependency vs disability scales. Pad-to-pad pinch and nonprehensile grasp are the most relevant grasps for both hands, whereas lumbrical grasp is more relevant for the left hand and cylindrical grasp for the right one. The most significant difference in bimanual function refers to pad-to-pad pinch (more relevant for unimanual actions of the left hand and bimanual actions of the right). The relative importance of each grasp type for autonomy and the differences observed between hand and bimanual action should be used in medical and physical decision-making. N/A. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

PREDICT-CP: study protocol of implementation of comprehensive surveillance to predict outcomes for school-aged children with cerebral palsy

PubMed Central

Boyd, Roslyn N; Davies, Peter SW; Ziviani, Jenny; Trost, Stewart; Barber, Lee; Ware, Robert; Rose, Stephen; Whittingham, Koa; Bell, Kristie; Carty, Christopher; Obst, Steven; Benfer, Katherine; Reedman, Sarah; Edwards, Priya; Kentish, Megan; Copeland, Lisa; Weir, Kelly; Davenport, Camilla; Brooks, Denise; Coulthard, Alan; Pelekanos, Rebecca; Guzzetta, Andrea; Fiori, Simona; Wynter, Meredith; Finn, Christine; Burgess, Andrea; Morris, Kym; Walsh, John; Lloyd, Owen; Whitty, Jennifer A; Scuffham, Paul A

2017-01-01

Objectives Cerebral palsy (CP) remains the world’s most common childhood physical disability with total annual costs of care and lost well-being of $A3.87b. The PREDICT-CP (NHMRC 1077257 Partnership Project: Comprehensive surveillance to PREDICT outcomes for school age children with CP) study will investigate the influence of brain structure, body composition, dietary intake, oropharyngeal function, habitual physical activity, musculoskeletal development (hip status, bone health) and muscle performance on motor attainment, cognition, executive function, communication, participation, quality of life and related health resource use costs. The PREDICT-CP cohort provides further follow-up at 8–12 years of two overlapping preschool-age cohorts examined from 1.5 to 5 years (NHMRC 465128 motor and brain development; NHMRC 569605 growth, nutrition and physical activity). Methods and analyses This population-based cohort study undertakes state-wide surveillance of 245 children with CP born in Queensland (birth years 2006–2009). Children will be classified for Gross Motor Function Classification System; Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System. Outcomes include gross motor function, musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function, communication difficulties, oropharyngeal dysphagia, dietary intake and body composition, participation, parent-reported and child-reported quality of life and medical and allied health resource use. These detailed phenotypical data will be compared with brain macrostructure and microstructure using 3 Tesla MRI (3T MRI). Relationships between brain lesion severity and outcomes will be analysed using multilevel mixed-effects models. Ethics and dissemination The PREDICT-CP protocol is a prospectively registered and ethically accepted study protocol. The study combines data at 1.5–5 then 8–12 years of direct clinical assessment to enable prediction of outcomes and healthcare needs essential for tailoring interventions (eg, rehabilitation, orthopaedic surgery and nutritional supplements) and the projected healthcare utilisation. Trial registration number ACTRN: 12616001488493 PMID:28706091

Casting wider nets for anxiety and depression: disability-driven cross-diagnostic subtypes in a large cohort.

PubMed

Wanders, R B K; van Loo, H M; Vermunt, J K; Meijer, R R; Hartman, C A; Schoevers, R A; Wardenaar, K J; de Jonge, P

2016-12-01

In search of empirical classifications of depression and anxiety, most subtyping studies focus solely on symptoms and do so within a single disorder. This study aimed to identify and validate cross-diagnostic subtypes by simultaneously considering symptoms of depression and anxiety, and disability measures. A large cohort of adults (Lifelines, n = 73 403) had a full assessment of 16 symptoms of mood and anxiety disorders, and measurement of physical, social and occupational disability. The best-fitting subtyping model was identified by comparing different hybrid mixture models with and without disability covariates on fit criteria in an independent test sample. The best model's classes were compared across a range of external variables. The best-fitting Mixed Measurement Item Response Theory model with disability covariates identified five classes. Accounting for disability improved differentiation between people reporting isolated non-specific symptoms ['Somatic' (13.0%), and 'Worried' (14.0%)] and psychopathological symptoms ['Subclinical' (8.8%), and 'Clinical' (3.3%)]. Classes showed distinct associations with clinically relevant external variables [e.g. somatization: odds ratio (OR) 8.1-12.3, and chronic stress: OR 3.7-4.4]. The Subclinical class reported symptomatology at subthreshold levels while experiencing disability. No pure depression or anxiety, but only mixed classes were found. An empirical classification model, incorporating both symptoms and disability identified clearly distinct cross-diagnostic subtypes, indicating that diagnostic nets should be cast wider than current phenomenology-based categorical systems.

Investigating rehabilitation needs of visually impaired young adults according to the International Classification of Functioning, Disability and Health.

PubMed

van Leeuwen, Lisette M; Rainey, Linda; Kef, Sabina; van Rens, Ger H M B; van Nispen, Ruth M A

2015-11-01

To gain qualitative insight into the rehabilitation needs of visually impaired young adults (18-25 years) and how these needs relate to the International Classification of Functioning, Disability and Health (ICF) and patient characteristics. Rehabilitation needs and patient characteristics of young adults (N = 392) who applied for multidisciplinary services in 2012 and 2013 were obtained from structured and semi-structured intake records. Linking rules were used to assess how the needs related to Environmental Factors, Body Functions, Body Structures, and Activity and Participation (A&P) ICF components. The relationship between the type of rehabilitation goal and patient characteristics was assessed using multivariate logistic regression analyses. Most rehabilitation needs (67.6%; N = 510) were found on the A&P component of the ICF. Most prevalent needs were related to 'major life areas' (e.g. finding internship or job), followed by the chapters: 'mobility' (e.g. self-reliance in travelling), 'communication' (e.g. using communication devices and techniques), 'general tasks and demands' (e.g. psychological aspects of vision loss) and 'domestic life' (e.g. household tasks). Patients in one of the multidisciplinary rehabilitation centres (odds ratio (OR) = 7.07; 95% confidence interval (CI) [2.97-16.83]) and patients with comorbidity (OR = 3.82; 95% CI [1.62-9.02]) were more likely to report rehabilitation needs related to chapter E3 'support and relationships'. 'Major life areas' prevail in the content of rehabilitation needs, but tend to overshadow topics regarding peer interaction and social, community and civic life. A suitable survey method for young adults with visual impairments is required that contains rehabilitation domains and goals relevant to their lives and development. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Content validity of the Comprehensive ICF Core Set for multiple sclerosis from the perspective of speech and language therapists.

PubMed

Renom, Marta; Conrad, Andrea; Bascuñana, Helena; Cieza, Alarcos; Galán, Ingrid; Kesselring, Jürg; Coenen, Michaela

2014-11-01

The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning, Disability and Health (ICF) and to guide the treatment and rehabilitation process accordingly. It is now undergoing validation from the user perspective for which it has been developed in the first place. To validate the content of the Comprehensive ICF Core Set for MS from the perspective of speech and language therapists (SLTs) involved in the treatment of persons with MS (PwMS). Within a three-round e-mail-based Delphi Study 34 SLTs were asked about PwMS' problems, resources and aspects of the environment treated by SLTs. Responses were linked to ICF categories. Identified ICF categories were compared with those included in the Comprehensive ICF Core Set for MS to examine its content validity. Thirty-four SLTs named 524 problems and resources, as well as aspects of environment. Statements were linked to 129 ICF categories (60 Body-functions categories, two Body-structures categories, 42 Activities-&-participation categories, and 25 Environmental-factors categories). SLTs confirmed 46 categories in the Comprehensive ICF Core Set. Twenty-one ICF categories were identified as not-yet-included categories. This study contributes to the content validity of the Comprehensive ICF Core Set for MS from the perspective of SLTs. Study participants agreed on a few not-yet-included categories that should be further discussed for inclusion in a revised version of the Comprehensive ICF Core Set to strengthen SLTs' perspective in PwMS' neurorehabilitation. © 2014 Royal College of Speech and Language Therapists.

Research-based evidence in stroke rehabilitation: an investigation of its implementation by physiotherapists and occupational therapists.

PubMed

Kristensen, Hanne Kaae; Ytterberg, Charlotte; Jones, Dorrie Lee; Lund, Hans

2016-12-01

Stroke rehabilitation is a multidimensional process that is designed to facilitate restoration of and/or adaptation to loss of functioning. The use of research-based evidence in informed decision-making is insufficient. Occupational therapy and physiotherapy constitute important contributions to rehabilitation. The study aim was to investigate characteristics of the implementation of research-based evidence in stroke rehabilitation by occupational therapists and physiotherapists, using the International Classification of Functioning, Disability and Health as a conceptual framework. A prospective cohort study, including all service levels within stroke rehabilitation. Consecutive patients with stroke admitted to a university hospital between May and December 2012 were enrolled by 13 therapists. Documentation of daily practice was collected from medical records. Analysis compared the therapists' documentation with the national clinical guidelines for physiotherapy and occupational therapy in the rehabilitation of adults with brain injury. The study included 131 patients. The therapists' praxis was seen to be in agreement with the majority of the national clinical guidelines. However, joint goal-setting and evaluation using standardized measures were seldom documented. Although the therapists recognize evidence-based practice as a framework for achieving quality in rehabilitation, findings suggest that they do not employ research-based evidence to the fullest extent. Implications for Rehabilitation In order to individualize the rehabilitation offered, more attention and focus on involving and giving words to patients' expectations, perceptions, experiences, and perspectives is needed. With the intention of enabling meaningful participation the health professionals need to pay more attention to the importance of environmental factors. Both guidelines and clinical practice should consider all components of the International Classification of Functioning, Disability and Health when formulating, and implementing, recommendations in rehabilitation praxis in order to aim for rehabilitation that is based both on evidence and a holistic approach.

Pure word deafness with auditory object agnosia after bilateral lesion of the superior temporal sulcus.

PubMed

Gutschalk, Alexander; Uppenkamp, Stefan; Riedel, Bernhard; Bartsch, Andreas; Brandt, Tobias; Vogt-Schaden, Marlies

2015-12-01

Based on results from functional imaging, cortex along the superior temporal sulcus (STS) has been suggested to subserve phoneme and pre-lexical speech perception. For vowel classification, both superior temporal plane (STP) and STS areas have been suggested relevant. Lesion of bilateral STS may conversely be expected to cause pure word deafness and possibly also impaired vowel classification. Here we studied a patient with bilateral STS lesions caused by ischemic strokes and relatively intact medial STPs to characterize the behavioral consequences of STS loss. The patient showed severe deficits in auditory speech perception, whereas his speech production was fluent and communication by written speech was grossly intact. Auditory-evoked fields in the STP were within normal limits on both sides, suggesting that major parts of the auditory cortex were functionally intact. Further studies showed that the patient had normal hearing thresholds and only mild disability in tests for telencephalic hearing disorder. Prominent deficits were discovered in an auditory-object classification task, where the patient performed four standard deviations below the control group. In marked contrast, performance in a vowel-classification task was intact. Auditory evoked fields showed enhanced responses for vowels compared to matched non-vowels within normal limits. Our results are consistent with the notion that cortex along STS is important for auditory speech perception, although it does not appear to be entirely speech specific. Formant analysis and single vowel classification, however, appear to be already implemented in auditory cortex on the STP. Copyright © 2015 Elsevier Ltd. All rights reserved.

The clinical outcomes of deep gray matter injury in children with cerebral palsy in relation with brain magnetic resonance imaging.

PubMed

Choi, Ja Young; Choi, Yoon Seong; Rha, Dong-Wook; Park, Eun Sook

2016-08-01

In the present study we investigated the nature and extent of clinical outcomes using various classifications and analyzed the relationship between brain magnetic resonance imaging (MRI) findings and the extent of clinical outcomes in children with cerebral palsy (CP) with deep gray matter injury. The deep gray matter injuries of 69 children were classified into hypoxic ischemic encephalopathy (HIE) and kernicterus patterns. HIE patterns were divided into four groups (I-IV) based on severity. Functional classification was investigated using the gross motor function classification system-expanded and revised, manual ability classification system, communication function classification system, and tests of cognitive function, and other associated problems. The severity of HIE pattern on brain MRI was strongly correlated with the severity of clinical outcomes in these various domains. Children with a kernicterus pattern showed a wide range of clinical outcomes in these areas. Children with severe HIE are at high risk of intellectual disability (ID) or epilepsy and children with a kernicterus pattern are at risk of hearing impairment and/or ID. Grading severity of HIE pattern on brain MRI is useful for predicting overall outcomes. The clinical outcomes of children with a kernicterus pattern range widely from mild to severe. Delineation of the clinical outcomes of children with deep gray matter injury, which are a common abnormal brain MRI finding in children with CP, is necessary. The present study provides clinical outcomes for various domains in children with deep gray matter injury on brain MRI. The deep gray matter injuries were divided into two major groups; HIE and kernicterus patterns. Our study showed that severity of HIE pattern on brain MRI was strongly associated with the severity of impairments in gross motor function, manual ability, communication function, and cognition. These findings suggest that severity of HIE pattern can be useful for predicting the severity of impairments. Conversely, children with a kernicterus pattern showed a wide range of clinical outcomes in various domains. Children with severe HIE pattern are at high risk of ID or epilepsy and children with kernicterus pattern are at risk of hearing impairment or ID. The strength of our study was the assessment of clinical outcomes after 3 years of age using standardized classification systems in various domains in children with deep gray matter injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

The severity and associated factors of participation restriction among community-dwelling frail older people: an application of the International Classification of Functioning, Disability and Health (WHO-ICF).

PubMed

Liu, Justina Yat Wa

2017-01-31

The International Classification of Functioning, Disability, and Health (WHO-ICF) describes participation restriction as one aspect of disability. Participation restriction refers to health problems that can hinder people's involvement in different life events. It is rational to believe that the prevalence of participation restriction increases among a frail population. However, information about the level of participation restriction among older people, particularly the pre-frail or frail, remains scant. The aim of this study was to identify the prevalence and underlying risk factors associated with participation restriction among community-dwelling frail and pre-frail older people. A cross-section of 299 community-dwelling frail older people with a mean age of 79.5 participated in this study. They had to have been identified as being either pre-frail or frail based on the five common characteristics of the frailty phenotype. Their level of participation restriction was assessed based on the Chinese Reintegration to Nursing Living Index (C-RNLI). All other independent variables were identified and systematically linked to different components in the WHO-ICF framework. Among all participants, 207 (69.2%) were identified as encountering participation restrictions in at least one aspect of their life, with a mean C-RNLI score of 68.3 (SD 19.43). A multivariate regression analysis showed that the participants' status of frailty, self-perceived social status, level of exhibited depressive mood, sleep quality, mobility, level of fear of falling, and physical activity levels had a significant association with participation restriction. When all of the variables, regardless of significance, were included, the factors together explained 67.1% of the variance in the participants' participation restriction. Participation restriction was prevalent among community-dwelling frail older people and was associated with factors across different components in the WHO-ICF. This finding supports the view that participation restriction is multifactorial in nature.

Adolescents with disabilities participate in the shopping mall: facilitators and barriers framed according to the ICF.

PubMed

Dahan-Oliel, Noémi; Shikako-Thomas, Keiko; Mazer, Barbara; Majnemer, Annette

2016-10-01

Community participation is restricted for youth with disabilities. The mall is an important gathering place where adolescents often socialise and develop community living skills, yet participation may be restricted. The aim of this study was to evaluate the facilitators and barriers to participation in a shopping mall through the perspectives of adolescents with disabilities. Semi-structured individual interviews were conducted with adolescents aged 12-19 years with a physical and/or sensory disability. Audio recordings were transcribed verbatim and coded following a template analysis using the International Classification of Functioning Disability and Health (ICF). Eleven youth (six females, mean age = 17.0 years) participated. Medical conditions included visual impairment, hearing impairment, cerebral palsy, hemiplegia, osteogenesis imperfecta and congenital amputations. Six themes were identified by the adolescents: what the shopping mall means to me, physical environment, transportation, social factors, attitudes and the person. The majority of themes mapped to the ICF's 'environmental factors'. Facilitators and barriers identified were either generic or disability-specific, implying that some modifications to shopping malls may be beneficial across disability types. Changes made to the physical, social and attitudinal environment are required to enable full participation of youth with disabilities within a shopping mall and other built environments of high public access. Implications for Rehabilitation The meaning of the shopping mall according to youth with disabilities includes socialisation, shopping, getting out of the home and employment. The majority of themes mapped to 'environmental factors' indicating that most obstacles to participation are caused by environmental barriers. Facilitators and barriers identified were either generic or disability-specific implying that some modifications to shopping malls may be beneficial across disability types. Changes made to the physical, social and attitudinal environment are required to enable full participation of youth with disabilities within a shopping mall.

Support system for the professional integration of people with disability into the labour market.

PubMed

Filgueiras, Ernesto; Vilar, Elisângela; Rebelo, Francisco

2015-01-01

Successful cases of professional reintegration were achieved when adequate conditions were created for the adaptation of the worker with disability to the working environment and to the professional activity, allowing them to carry out all their functions without any restriction. In this sense, this paper presents a methodology for professional integration of people with disability in service companies and industry. It has as results a matrix of analysis of a set of observables for the reintegration of people with disability into the labour market, as well as an auxiliary tool for those who work in recruitment of personnel. The main objective was to develop a tool (i.e., a software) based on the crossing of data obtained from the analysis of the individual capacities and the requirements of the job to optimise the relationship between worker and the workplace. There was also considered a series of strategies which can be adopted by the individuals and the possible adaptations in the workplace, as a way to reduce the handicap in the accomplishment of different activities. The methodology for the development of this study is divided in two phases: Phase I, destined to the assessment criteria and classification of the indispensable functional characteristics of the individuals; Phase II, related to the assessment criteria of the jobs and the functions that have to be performed. As a result it was developed an evaluation tool to match the individuals' capabilities and the job requirements. A software was created to support the evaluation and to help professionals during the assessment. This methodology together with the support tool demonstrated to be a quite inclusive tool, as it considers, as a matter of priority, the capacities of the individuals and the real necessities of the workplaces.

Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018.

PubMed

Logerstedt, David S; Scalzitti, David A; Bennell, Kim L; Hinman, Rana S; Silvers-Granelli, Holly; Ebert, Jay; Hambly, Karen; Carey, James L; Snyder-Mackler, Lynn; Axe, Michael J; McDonough, Christine M

2018-02-01

The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to meniscus and articular cartilage lesions. J Orthop Sports Phys Ther. 2018;48(2):A1-A50. doi:10.2519/jospt.2018.0301.

Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018.

PubMed

Martin, Robroy L; Chimenti, Ruth; Cuddeford, Tyler; Houck, Jeff; Matheson, J W; McDonough, Christine M; Paulseth, Stephen; Wukich, Dane K; Carcia, Christopher R

2018-05-01

The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to midportion Achilles tendinopathy. J Orthop Sports Phys Ther 2018;48(5):A1-A38. doi:10.2519/jospt.2018.0302.

Dutch Special Education Schools for Children with Learning Disabilities in the Interwar Period

ERIC Educational Resources Information Center

van Drenth, Annemieke; van Essen, Mineke

2011-01-01

In this article Copeland's model of visualising the classification of children with learning disabilities is applied in examining the development of special education schools in the Netherlands during the interwar period. Central are three intertwined social practices: the teacher's professionalism (in pedagogic and practical concerns), the…

The National Learning Disabilities Postsecondary Databank: An Overview.

ERIC Educational Resources Information Center

Vogel, Susan A.; Leonard, Faith; Scales, William; Hayeslip, Peggy; Hermansen, Jane; Donnells, Linda

1998-01-01

A survey of postsecondary institutions (N=147) assessed support services, procedures, policies, and the proportions of students with learning disabilities (LD). Findings indicated .5% to almost 10% of students with LD. Factors affecting this group included size of the student body, type of institution, the institution's Carnegie classification,…

Recategorized WISC-R Scores of Juvenile Delinquents.

ERIC Educational Resources Information Center

Groff, Martin G.; Hubble, Larry M.

1981-01-01

Wechsler Intelligence Scale for Children-Revised scores of a male delinquent sample were grouped by A. Bannatyne's classification of Wechsler's subtests, and these recategorized scores were compared with results of a previous study of learning disabled children. Findings failed to support a theory that learning disabled youth possess a unique…

A Classification Scheme for Therapeutic Recreation Research Grounded in the Rehabilitative Sciences.

ERIC Educational Resources Information Center

Shank, J. W.; And Others

1996-01-01

Presents therapeutic recreation (TR) research according to a model from the National Center for Medical Rehabilitation Research to guide research on disability, rehabilitation, and quality of life for persons with disabilities. Suggests that disseminating TR research can stimulate interdisciplinary collaboration and support inclusion of TR…

Psychological Perspectives in Assessing Mathematics Learning Needs

ERIC Educational Resources Information Center

Augustyniak, Kristine; Murphy, Jacqueline; Phillips, Donna Kester

2005-01-01

While the definition of learning disabilities has been the subject of controversy for decades, the current federal classification system identifies three specific areas of deficit: reading, written language, and mathematics and maintains the presumption that the disabilities are a result of a central nervous system dysfunction. In contrast to the…

Handbook of Learning Disabilities, Second Edition

ERIC Educational Resources Information Center

Swanson, H. Lee, Ed.; Harris, Karen R., Ed.; Graham, Steve, Ed.

2014-01-01

Widely regarded as the standard reference in the field, this comprehensive handbook presents state-of-the-art knowledge about the nature and classification of learning disabilities (LD), their causes, and how individuals with these difficulties can be identified and helped to succeed. Best practices are described for supporting student performance…

Dyslexia: Disability or Difference?

ERIC Educational Resources Information Center

Redford, Kyle

2017-01-01

Redford, a veteran 5th grade teacher, addresses the question of whether, in the case of students with dyslexia, "it's time to ditch the disability classification and replace it with more positive language that embraces and appreciates [the condition] as a 'neurodifference' instead." Her answer is no--at least in the current education…

Assessing the impact of upper limb disability following stroke: a qualitative enquiry using internet-based personal accounts of stroke survivors.

PubMed

Poltawski, Leon; Allison, Rhoda; Briscoe, Simon; Freeman, Jennifer; Kilbride, Cherry; Neal, Debbie; Turton, Ailie J; Dean, Sarah

2016-01-01

Upper limb disability following stroke may have multiple effects on the individual. Existing assessment instruments tend to focus on impairment and function and may miss other changes that are personally important. This study aimed to identify personally significant impacts of upper limb disability following stroke. Accounts by stroke survivors, in the form of web-based diaries (blogs) and stories, were sought using a blog search engine and in stroke-related web-sites. Thematic analysis using the World Health Organisation's International Classification of Functioning Disability and Health (ICF) was used to identify personal impacts of upper limb disability following stroke. Ninety-nine sources from at least four countries were analysed. Many impacts were classifiable using the ICF, but a number of additional themes emerged, including emotional, cognitive and behavioural changes. Blogs and other web-based accounts were easily accessible and rich sources of data, although using them raised several methodological issues, including potential sample bias. A range of impacts was identified, some of which (such as use of information technology and alienation from the upper limb) are not addressed in current assessment instruments. They should be considered in post-stroke assessments. Blogs may help in the development of more comprehensive assessments. A comprehensive assessment of the upper limb following stroke should include the impact of upper limb problems on social participation, as well as associated emotional, cognitive and behavioural changes. Using personalised assessment instruments alongside standardised measures may help ensure that these broader domains are considered in discussions between clinicians and patients. Rehabilitation researchers should investigate whether and how these domains could be addressed and operationalised in standard upper limb assessment instruments.

Official Position of the American Academy of Clinical Neuropsychology Social Security Administration Policy on Validity Testing: Guidance and Recommendations for Change.

PubMed

Chafetz, M D; Williams, M A; Ben-Porath, Y S; Bianchini, K J; Boone, K B; Kirkwood, M W; Larrabee, G J; Ord, J S

2015-01-01

The milestone publication by Slick, Sherman, and Iverson (1999) of criteria for determining malingered neurocognitive dysfunction led to extensive research on validity testing. Position statements by the National Academy of Neuropsychology and the American Academy of Clinical Neuropsychology (AACN) recommended routine validity testing in neuropsychological evaluations. Despite this widespread scientific and professional support, the Social Security Administration (SSA) continued to discourage validity testing, a stance that led to a congressional initiative for SSA to reevaluate their position. In response, SSA commissioned the Institute of Medicine (IOM) to evaluate the science concerning the validation of psychological testing. The IOM concluded that validity assessment was necessary in psychological and neuropsychological examinations (IOM, 2015 ). The AACN sought to provide independent expert guidance and recommendations concerning the use of validity testing in disability determinations. A panel of contributors to the science of validity testing and its application to the disability process was charged with describing why the disability process for SSA needs improvement, and indicating the necessity for validity testing in disability exams. This work showed how the determination of malingering is a probability proposition, described how different types of validity tests are appropriate, provided evidence concerning non-credible findings in children and low-functioning individuals, and discussed the appropriate evaluation of pain disorders typically seen outside of mental consultations. A scientific plan for validity assessment that additionally protects test security is needed in disability determinations and in research on classification accuracy of disability decisions.

How to apply the ICF and ICF core sets for low back pain.

PubMed

Stier-Jarmer, Marita; Cieza, Alarcos; Borchers, Michael; Stucki, Gerold

2009-01-01

To introduce the International Classification of Functioning, Disability and Health (ICF) as conceptual model and classification and the ICF Core Sets as a way to specify functioning for a specific health condition such as Low Back Pain, and to illustrate the application of the ICF and ICF Core Sets in the context of clinical practice, the planning and reporting of studies and the comparison of health status measures. A decision-making and consensus process was performed to develop the ICF Core Sets for Low Back Pain, the linking procedure was applied as basis for the content comparison of health-status measures and the Rehab-Cycle was used to exemplify the application of the ICE and ICF Core Sets in clinical practice. Two different ICF Core Sets, namely, a comprehensive and a brief, are presented, three different health-status measures were linked to the ICF and compared and a case example of a patient with Low back Pain was described based on the Rehab-Cycle. The ICF is a promising new framework and classification to assess the impact of Low Back Pain. The ICF and practical tools, such as the ICF Core Sets for Low Back Pain, are useful for clinical practice, outcome and rehabilitation research, education, health statistics, and regulation.

The global burden of disabling hearing impairment: a call to action

PubMed Central

Neumann, Katrin J; Saunders, James E

2014-01-01

Abstract At any age, disabling hearing impairment has a profound impact on interpersonal communication, psychosocial well-being, quality of life and economic independence. According to the World Health Organization’s estimates, the number of people with such impairment increased from 42 million in 1985 to about 360 million in 2011. This last figure includes 7.5 million children less than 5 years of age. In 1995, a “roadmap” for curtailing the burden posed by disabling hearing impairment was outlined in a resolution of the World Health Assembly. While the underlying principle of this roadmap remains valid and relevant, some updating is required to reflect the prevailing epidemiologic transition. We examine the traditional concept and grades of disabling hearing impairment – within the context of the International Classification of Functioning, Disability and Health – as well as the modifications to grading that have recently been proposed by a panel of international experts. The opportunity offered by the emerging global and high-level interest in promoting disability-inclusive post-2015 development goals and disability-free child survival is also discussed. Since the costs of rehabilitative services are so high as to be prohibitive in low- and middle-income countries, the critical role of primary prevention is emphasized. If the goals outlined in the World Health Assembly’s 1995 resolution on the prevention of hearing impairment are to be reached by Member States, several effective country-level initiatives – including the development of public–private partnerships, strong leadership and measurable time-bound targets – will have to be implemented without further delay. PMID:24839326

Environmental barriers and supports to everyday participation: a qualitative insider perspective from people with disabilities.

PubMed

Hammel, Joy; Magasi, Susan; Heinemann, Allen; Gray, David B; Stark, Susan; Kisala, Pamela; Carlozzi, Noelle E; Tulsky, David; Garcia, Sofia F; Hahn, Elizabeth A

2015-04-01

To describe environmental factors that influence participation of people with disabilities. Constant comparative, qualitative analyses of transcripts from 36 focus groups across 5 research projects. Home, community, work, and social participation settings. Community-dwelling people (N=201) with diverse disabilities (primarily spinal cord injury, traumatic brain injury, and stroke) from 8 states. None. Environmental barriers and supports to participation. We developed a conceptual framework to describe how environmental factors influence the participation of people with disabilities, highlighting 8 domains of environmental facilitators and barriers (built, natural, assistive technology, transportation, information and technology access, social support and attitudes, systems and policies, economics) and a transactional model showing the influence of environmental factors on participation at the micro (individual), mesa (community), and macro (societal) levels. Focus group data validated some International Classification of Functioning, Disability and Health environmental categories while also bringing unique factors (eg, information and technology access, economic quality of life) to the fore. Data were used to construct items to enable people with disabilities to assess the impact of environmental factors on everyday participation from their firsthand experience. Participants with disabilities voiced the need to evaluate the impact of the environment on their participation at the immediate, community, and societal levels. The results have implications for assessing environmental facilitators and barriers to participation within rehabilitation and community settings, evaluating outcomes of environmental interventions, and effecting system and policy changes to target environmental barriers that may result in societal participation disparities versus opportunities. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Creating a Brief Rating Scale for the Assessment of Learning Disabilities Using Reliability and True Score Estimates of the Scale's Items Based on the Rasch Model

ERIC Educational Resources Information Center

Sideridis, Georgios; Padeliadu, Susana

2013-01-01

The purpose of the present studies was to provide the means to create brief versions of instruments that can aid the diagnosis and classification of students with learning disabilities and comorbid disorders (e.g., attention-deficit/hyperactivity disorder). A sample of 1,108 students with and without a diagnosis of learning disabilities took part…

Identifying contextual influences of community reintegration among injured servicemembers.

PubMed

Hawkins, Brent L; McGuire, Francis A; Britt, Thomas W; Linder, Sandra M

2015-01-01

Research suggests that community reintegration (CR) after injury and rehabilitation is difficult for many injured servicemembers. However, little is known about the influence of the contextual factors, both personal and environmental, that influence CR. Framed within the International Classification of Functioning, Disability and Health and Social Cognitive Theory, the quantitative portion of a larger mixed-methods study of 51 injured, community-dwelling servicemembers compared the relative contribution of contextual factors between groups of servicemembers with different levels of CR. Cluster analysis indicated three groups of servicemembers showing low, moderate, and high levels of CR. Statistical analyses identified contextual factors (e.g., personal and environmental factors) that significantly discriminated between CR clusters. Multivariate analysis of variance and discriminant analysis indicated significant contributions of general self-efficacy, services and assistance barriers, physical and structural barriers, attitudes and support barriers, perceived level of disability and/or handicap, work and school barriers, and policy barriers on CR scores. Overall, analyses indicated that injured servicemembers with lower CR scores had lower general self-efficacy scores, reported more difficulty with environmental barriers, and reported their injuries as more disabling.

Movement-to-music computer technology: a developmental play experience for children with severe physical disabilities.

PubMed

Tam, Cynthia; Schwellnus, Heidi; Eaton, Ceilidh; Hamdani, Yani; Lamont, Andrea; Chau, Tom

2007-01-01

Children with severe physical disabilities often lack the physical skills to explore their environment independently, and to play with toys or musical instruments. The movement-to-music (MTM) system is an affordable computer system that allows children with limited movements to play and create music. The present study explored parents' experiences of using the MTM system with their children. A qualitative methodology employing in-depth interview techniques was used with six mothers and their children. The themes extracted from the data were organized under two main concepts of the International Classification of Functioning, Disability, and Health (ICF) (WHO, 2001) framework. The results showed that the MTM expanded horizons for the child along the ICF health dimensions and the MTM had a positive impact on ICF environmental determinants of health. The small sample size should be noted as a limitation of this study. Further research should be carried out with a larger sample of children with restricted mobility to obtain a better understanding of the impact of MTM technology on children's psychosocial development.

Brain magnetic resonance imaging and motor and intellectual functioning in 86 patients born at term with spastic diplegia.

PubMed

Numata, Yurika; Onuma, Akira; Kobayashi, Yasuko; Sato-Shirai, Ikuko; Tanaka, Soichiro; Kobayashi, Satoru; Wakusawa, Keisuke; Inui, Takehiko; Kure, Shigeo; Haginoya, Kazuhiro

2013-02-01

To investigate the association between magnetic resonance imaging (MRI) patterns and motor function, epileptic episodes, and IQ or developmental quotient in patients born at term with spastic diplegia. Eighty-six patients born at term with cerebral palsy (CP) and spastic diplegia (54 males, 32 females; median age 20 y, range 7-42 y) among 829 patients with CP underwent brain MRI between 1990 and 2008. The MRI and clinical findings were analysed retrospectively. Intellectual disability was classified according to the Enjoji developmental test or the Wechsler Intelligence Scale for Children (3rd edition). The median ages at diagnosis of CP, assignment of Gross Motor Function Classification System (GMFCS) level, cognitive assessment, and MRI were 2 years (range 5 mo-8 y), 6 years (2 y 8 mo-19 y), 6 years (1 y 4 mo-19 y), and 7 years (10 mo-30 y) respectively. MRI included normal findings (41.9%), periventricular leukomalacia, hypomyelination, and porencephaly/periventricular venous infarction. The frequency of patients in GMFCS levels III to V and intellectual disability did not differ between those with normal and abnormal MRI findings. Patients with normal MRI findings had significantly fewer epileptic episodes than those with abnormal ones (p=0.001). Varied MRI findings, as well as the presence of severe motor dysfunction and intellectual disability (despite normal MRI), suggest that patients born at term with spastic diplegia had heterogeneous and unidentified pathophysiology. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

State SLD Identification Policies and Practices

ERIC Educational Resources Information Center

Reschly, Daniel J.; Hosp, John L.

2004-01-01

Specific learning disabilities (SLD) conceptual definitions and classification criteria were examined through a survey of state education agency (SEA) SLD contact persons in an effort to update information last published in 1996. Most prior trends continued over the last decade. Results showed that SEA SLD classification criteria continue to be…

Use of Classification Agreement Analyses to Evaluate RTI Implementation

ERIC Educational Resources Information Center

VanDerHeyden, Amanda

2010-01-01

RTI as a framework for decision making has implications for the diagnosis of specific learning disabilities. Any diagnostic tool must meet certain standards to demonstrate that its use leads to predictable decisions with minimal risk. Classification agreement analyses are described as optimal for demonstrating the technical adequacy of RTI…

Diagnosis and Classification in Autism.

ERIC Educational Resources Information Center

Waterhouse, Lynn; And Others

1996-01-01

This study compared four systems for diagnosis of autism (Diagnostic and Statistical Manuals of Mental Disorders III, III-R, and IV, and the International Classification of Disabilities-10) with 2 empirically derived taxa and 3 social subgroups (aloof, passive, and active but odd) in 194 preschool children with social impairment. Findings support…

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination.

PubMed

van Brakel, Wim H; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I; Wilder-Smith, Annelies

2012-01-01

Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability. Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment.

Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

PubMed Central

van Brakel, Wim H.; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I.; Wilder-Smith, Annelies

2012-01-01

Background Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. Methods We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Results Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. Discussion The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability. Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment. PMID:22826694

Addiction and disability: moral and policy issues.

PubMed

Wasserman, David

2004-02-01

This article discusses the conceptual, ethical, and policy issues raised by the legal classification of drug addiction as an impairment, and of some nonusing drug addicts as people with disabilities. It focuses on the questions of (1) what moral judgments, if any, underlie the classification of addiction as an impairment; (2) whether it makes sense to apportion the burdens of drug addiction between chemical, biological, social, political, and other causes; (3) how considerations of distributive justice may compel or constrain measures to ease the burdens of drug addiction; and (4) whether it is justifiable to deny the current users of illegal substances legal protections available to the current users of legal substances.

Classification, disease, and diagnosis.

PubMed

Jutel, Annemarie

2011-01-01

Classification shapes medicine and guides its practice. Understanding classification must be part of the quest to better understand the social context and implications of diagnosis. Classifications are part of the human work that provides a foundation for the recognition and study of illness: deciding how the vast expanse of nature can be partitioned into meaningful chunks, stabilizing and structuring what is otherwise disordered. This article explores the aims of classification, their embodiment in medical diagnosis, and the historical traditions of medical classification. It provides a brief overview of the aims and principles of classification and their relevance to contemporary medicine. It also demonstrates how classifications operate as social framing devices that enable and disable communication, assert and refute authority, and are important items for sociological study.

Systematic review of multidisciplinary rehabilitation in patients with multiple trauma.

PubMed

Khan, F; Amatya, B; Hoffman, K

2012-01-01

Multiple trauma is a cause of significant disability in adults of working age. Despite the implementation of trauma systems for improved coordination and organization of care, rehabilitation services are not yet routinely considered integral to trauma care processes. MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Physiotherapy Evidence Database, Latin American and Caribbean Literature on Health Sciences and Cochrane Library databases were searched up to May 2011 for randomized clinical trials, as well as observational studies, reporting outcomes of injured patients following multidisciplinary rehabilitation that addressed functional restoration and societal reintegration based on the International Classification of Functioning, Disability and Health. No randomized and/or controlled clinical trials were identified. Fifteen observational studies involving 2386 participants with injuries were included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach assessed methodological quality as 'poor' in all studies, with selection and observer bias. Although patients with low functional scores showed improvement after rehabilitation, they were unable to resume their pretrauma level of activity. Their functional ability was significantly associated with motor independence on admission and early acute rehabilitation, which contributed to a shorter hospital stay. Injury location, age, co-morbidity and education predicted long-term functional consequences. Trauma care systems were associated with reduced mortality. The gaps in evidence include: rehabilitation settings, components, intensity, duration and types of therapy, and long-term outcomes for survivors of multiple trauma. Rehabilitation is an expensive resource and the evidence to support its justification is needed urgently. The issues in study design and research methodology in rehabilitation are challenging. Opportunities to prioritize trauma rehabilitation, disability management and social reintegration of multiple injury survivors are discussed. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Self-care and mobility skills in children with cerebral palsy, related to their manual ability and gross motor function classifications.

PubMed

Öhrvall, Ann-Marie; Eliasson, Ann-Christin; Löwing, Kristina; Ödman, Pia; Krumlinde-Sundholm, Lena

2010-11-01

The aim of this study was to investigate the acquisition of self-care and mobility skills in children with cerebral palsy (CP) in relation to their manual ability and gross motor function. Data from the Pediatric Evaluation of Disability Inventory (PEDI) self-care and mobility functional skill scales, the Manual Ability Classification System (MACS), and the Gross Motor Function Classification System (GMFCS) were collected from 195 children with CP (73 females, 122 males; mean age 8 y 1 mo; SD 3 y 11 mo; range 3-15 y); 51% had spastic bilateral CP, 36% spastic unilateral CP, 8% dyskinetic CP, and 3% ataxic CP. The percentage of children classified as MACS levels I to V was 28%, 34%, 17%, 7%, and 14% respectively, and classified as GMFCS levels I to V was 46%, 16%, 15%, 11%, and 12% respectively. Children classified as MACS and GMFCS levels I or II scored higher than children in MACS and GMFCS levels III to V on both the self-care and mobility domains of the PEDI, with significant differences between all classification levels (p<0.001). The stepwise multiple regression analysis verified that MACS was the strongest predictor of self-care skills (66%) and that GMFCS was the strongest predictor of mobility skills (76%). A strong correlation between age and self-care ability was found among children classified as MACS level I or II and between age and mobility among children classified as GMFCS level I. Many of these children achieved independence, but at a later age than typically developing children. Children at other MACS and GMFCS levels demonstrated minimal progress with age. Knowledge of a child's MACS and GMFCS level can be useful when discussing expectations of, and goals for, the development of functional skills. © The Authors. Journal compilation © Mac Keith Press 2010.

Typology of person-environment fit constellations: a platform addressing accessibility problems in the built environment for people with functional limitations.

PubMed

Slaug, Björn; Schilling, Oliver; Iwarsson, Susanne; Carlsson, Gunilla

2015-09-02

Making the built environment accessible for all regardless of functional capacity is an important goal for public health efforts. Considerable impediments to achieving this goal suggest the need for valid measurements of acccessibility and for greater attention to the complexity of person-environment fit issues. To address these needs, this study aimed to provide a methodological platform, useful for further research and instrument development within accessibility research. This was accomplished by the construction of a typology of problematic person-environment fit constellations, utilizing an existing methodology developed to assess and analyze accessibility problems in the built environment. By means of qualitative review and statistical methods we classified the person-environment fit components covered by an existing application which targets housing accessibility: the Housing Enabler (HE) instrument. The International Classification of Functioning, Disability and Health (ICF) was used as a conceptual framework. Qualitative classification principles were based on conceptual similarities and for quantitative analysis of similarities, Principal Component Analysis was carried out. We present a typology of problematic person-environment fit constellations classified along three dimensions: 1) accessibility problem range and severity 2) aspects of functioning 3) environmental context. As a result of the classification of the HE components, 48 typical person-environment fit constellations were recognised. The main contribution of this study is the proposed typology of person-environment fit constellations. The typology provides a methodological platform for the identification and quantification of problematic person-environment fit constellations. Its link to the globally accepted ICF classification system facilitates communication within the scientific and health care practice communities. The typology also highlights how relations between aspects of functioning and physical environmental barriers generate typical accessibility problems, and thereby furnishes a reference point for research oriented to how the built environment may be designed to be supportive for activity, participation and health.

Functional and environmental factors affecting work status in individuals with longstanding poliomyelitis.

PubMed

Zeilig, Gabi; Weingarden, Harold; Shemesh, Yeheskel; Herman, Amir; Heim, Michael; Zeweker, Manual; Dudkiewicz, Israel

2012-01-01

Remunerative employment is a major concern of individuals with chronic disabilities, among them, those with longstanding poliomyelitis (LSP). Although LSP is not rare there are almost no data related to work participation. The aims of the current study were to determine the effects of a number of social and functional variables as barriers or facilitators to work participation in persons with LSP. Charts of 123 LSP patients of working age that were seen in the post-polio outpatient clinic, between the years 2000 and 2005 were reviewed for the study. Data on age, gender, family status, level of function in activities of daily living, basic, and extended (B-ADL and E-ADL), and mobility were then analyzed for correlation to the vocational status. Seventy-two people (58.5%) were employed at the time of the survey. Gender and marital status were not found to significantly differ as regard to employment. Using assistive devices for mobility or being dependent for basic ADL were associated with lower levels of employment. Driving was positively associated with the employment status of the LSP individuals. Persons with LSP encounter important barriers to work participation, particularly on the International Classification of Functioning, Disability, and Health (ICF) components of activity and environment.

Developing comprehensive and Brief ICF core sets for morbid obesity for disability assessment in Taiwan: a preliminary study.

PubMed

Lin, Y-N; Chang, K-H; Lin, C-Y; Hsu, M-I; Chen, H-C; Chen, H-H; Liou, T-H

2014-04-01

The International Classification of Functioning, Disability, and Health (ICF) provides a framework for measuring functioning and disability based on a biopsychosocial model. The aim of this study was to develop comprehensive and brief ICF core sets for morbid obesity for disability assessment in Taiwan. Observational Other Twenty-nine multidisciplinary experts of ICF METHODS: The questionnaire contained 112 obesity-relevant and second-level ICF categories. Using a 5-point Likert scale, the participants rated the significance of the effects of each category on the heath status of people with obesity. Correlation between an individual's score and the average score of the group indicated consensus. The categories were selected for the comprehensive core set for obesity if more than 50% of the experts rated them as "important" in the third round of the Delphi exercise, and for the brief core set if more than 80% of the experts rated them "very important." Twenty-nine experts participated in the study. These included 18 physicians, 4 dieticians, 3 physical therapists, 2 nurses, and 2 ICF experts. The comprehensive core set for morbid obesity contained 61 categories. Of these, 26 categories were from the component body function, 8 were from body structure, 18 were from activities and participation, and 9 were from environmental factors. The brief core set for obesity disability contained 29 categories. Of these, 19 categories were from the component body function, 3 were from body structure, 6 were from activities and participation, and one was from environmental factors. The comprehensive and brief ICF core sets provide comprehensive information on the health effects of morbid obesity and concise information for clinical practice. Comprehensive and brief core sets were created after three rounds of Delphi technique. Further validation study of these core sets by applying to patients with morbid obesity is needed. The comprehensive ICF core set for morbid obesity provides comprehensive information on the health effects of morbid obesity; the brief core set can provide concise information for clinical practice.

Current trends in rehabilitation engineering in Japan.

PubMed

Ohnabe, Hisaichi

2006-01-01

In 2005, the elderly generation comprised 20% of the Japanese population. This percentage will grow to approximately 30% in 2030, meaning that nearly one in three people in Japan will be 65 years of age or older. Japan is the first nation in the world to face this situation. This article uses the context of Japanese society to give an overview of the elderly and people with disabilities; the International Classification of Functioning, Disability, and Health model; rehabilitation engineering-related policy; and education. In addition, we examine how governmental programs and Japanese law regarding technical aids may evolve by 2030. Partner robots, intelligent powered wheelchairs, nursing robots, and other technologies are introduced as examples of rehabilitation engineering and assistive technology. We also discuss the volunteer activities of the Rehabilitation Engineering Society of Japan (RESJA) in response to the Asian tsunami disaster and the achievements of a group of students from a Japanese senior high school of industry.

Disability related to COPD tool (DIRECT): towards an assessment of COPD-related disability in routine practice

PubMed Central

Aguilaniu, B; Gonzalez-Bermejo, J; Regnault, A; Barbosa, C Dias; Arnould, B; Mueser, M; Granet, G; Bonnefoy, M; Similowski, T

2011-01-01

Background Chronic Obstructive Pulmonary Disease (COPD) is a worldwide public health concern. It is also a major source of disability that is often overlooked, depriving patients of effective treatments. This study describes the development and validation of a questionnaire specifically assessing COPD-related disability. Methods The DIsability RElated to COPD Tool (DIRECT) was developed according to reference methods, including literature review, patient and clinician interviews and test in a pilot study. A 12-item questionnaire was included for finalization and validation in an observational cross-sectional study conducted by 60 French pulmonologists, who recruited 275 COPD patients of stage II, III and IV according to the GOLD classification. Rasch modeling was conducted and psychometric properties were assessed (internal consistency reliability; concurrent and clinical validity). Results The DIRECT score was built from the 10 items retained in the Rasch model. Their internal consistency reliability was excellent (Cronbach’s alpha = 0.95). The score was highly correlated with the Saint George’s Respiratory Questionnaire Activity score (r = 0.83) and the London Handicap Scale (r = −0.70), a generic disability measure. It was highly statistically significantly associated to four clinical parameters (P < 0.001): GOLD classification, BODE index, FEV1 and 6-minute walk distance. Conclusion DIRECT is a promising tool that could help enhance the management of COPD patients by integrating an evaluation of the COPD-related disability into daily practice. PMID:21760726

To ID or Not to ID? Changes in Classification Rates of Intellectual Disability Using "DSM-5"

ERIC Educational Resources Information Center

Papazoglou, Aimilia; Jacobson, Lisa A.; McCabe, Marie; Kaufmann, Walter; Zabel, T. Andrew

2014-01-01

The "Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition" ("DSM-5") diagnostic criteria for intellectual disability (ID) include a change to the definition of adaptive impairment. New criteria require impairment in one adaptive domain rather than two or more skill areas. The authors examined the diagnostic…

45 CFR 86.71 - Interim procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

...]; 86.51 Job Classification and Structure, 86.55 Marital and Parental Status, 86.57 Pregnancy, [85, 93]; 86.57(b) Pregnancy as Temporary Disability, [85, 93]; 86.57(c) Pregnancy Leave, [85, 93, 94]; 86.57(d... Employment General, [85, 93, 94]; 86.57 Pregnancy, [85, 93, 94]; 86.57(b) Pregnancy as a temporary disability...

45 CFR 86.71 - Interim procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

...]; 86.51 Job Classification and Structure, 86.55 Marital and Parental Status, 86.57 Pregnancy, [85, 93]; 86.57(b) Pregnancy as Temporary Disability, [85, 93]; 86.57(c) Pregnancy Leave, [85, 93, 94]; 86.57(d... Employment General, [85, 93, 94]; 86.57 Pregnancy, [85, 93, 94]; 86.57(b) Pregnancy as a temporary disability...

45 CFR 86.71 - Interim procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

...]; 86.51 Job Classification and Structure, 86.55 Marital and Parental Status, 86.57 Pregnancy, [85, 93]; 86.57(b) Pregnancy as Temporary Disability, [85, 93]; 86.57(c) Pregnancy Leave, [85, 93, 94]; 86.57(d... Employment General, [85, 93, 94]; 86.57 Pregnancy, [85, 93, 94]; 86.57(b) Pregnancy as a temporary disability...

Predictive Efficiency of Direct, Repeated Measurement: An Analysis of Cost and Accuracy in Classification.

ERIC Educational Resources Information Center

Marston, Doug; And Others

Two studies were conducted to examine the efficacy of direct measurement, standardized achievement tests, and aptitude-achievement discrepancy scores in distinguishing learning disabled (LD) and nonlearning disabled (NLD) students in grades 3 to 6. For both reading (Study I) and written expression (Study II), students' scores on direct and…

Perspectives on Teaching the International Classification of Functioning, Disability, and Health Model to Physical Therapy Students.

PubMed

Peters-Brinkerhoff, Cheryl

2016-01-01

During a reaccreditation visit, deficiencies were discovered in the clinical education curriculum regarding patient-centered care in a Doctorate of Physical Therapy program. To understand the problem and address those deficiencies, the clinical internship experience was examined using the International Classification of Functioning, Disability, and Health (ICF) model as a conceptual framework for clinical reasoning. This qualitative case study aimed to study (1) perceptions of physical therapy (PT) students regarding their knowledge and learning experiences during clinical affiliations and what knowledge they acquired of the ICF as applied to patient-centered care during their internship, and (2) the perceptions of clinical instructors (CIs) of their knowledge of the ICF model, its integration into their practice, barriers to its use, and the learning experiences the CIs provided to students regarding the ICF model. Data were collected using questionnaires sent to 42 CIs and at focus groups of 22 PT students conducted at the study site. Data were also collected from student evaluations on the Clinical Performance Instrument. Data were analyzed using coding techniques and themes based on the use of the ICF model in the clinical setting by students and CIs. Most CIs reported a poor understanding of the ICF model or how it relates to patient-centered care; both CIs and students reported none to minimal learning experience related to the ICF model. Document analysis of the student evaluations revealed no assessment of the ICF model was mentioned. Learning experiences of all domains of the ICF model are generally not being presented to PT students during their clinical affiliations.

Investigating the International Classification of Functioning, Disability, and Health (ICF) Framework to Capture User Needs in the Concept Stage of Rehabilitation Technology Development.

PubMed

Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andy; Levesley, Martin; Bhakta, Bipin

2014-01-01

This study evaluates whether the International Classification of Functioning, Disability, and Health (ICF) framework provides a useful basis to ensure that key user needs are identified in the development of a home-based arm rehabilitation system for stroke patients. Using a qualitative approach, nine people with residual arm weakness after stroke and six healthcare professionals with expertise in stroke rehabilitation were enrolled in the user-centered design process. They were asked, through semi-structured interviews, to define the needs and specification for a potential home-based rehabilitation device to facilitate self-managed arm exercise. The topic list for the interviews was derived by brainstorming ideas within the clinical and engineering multidisciplinary research team based on previous experience and existing literature in user-centered design. Meaningful concepts were extracted from questions and responses of these interviews. These concepts obtained were matched to the categories within the ICF comprehensive core set for stroke using ICF linking rules. Most of the concepts extracted from the interviews matched to the existing ICF Core Set categories. Person factors like gender, age, interest, compliance, motivation, choice, and convenience that might determine device usability are yet to be categorized within the ICF comprehensive core set. The results suggest that the categories of the comprehensive ICF Core Set for stroke provide a useful basis for structuring interviews to identify most users needs. However some personal factors (related to end users and healthcare professionals) need to be considered in addition to the ICF categories.

"Staying safe" - a narrative review of falls prevention in people with Parkinson's - "PDSAFE".

PubMed

Hulbert, Sophia; Rochester, Lynn; Nieuwboer, Alice; Goodwin, Vicki; Fitton, Carolyn; Chivers-Seymour, Kim; Ashburn, Ann

2018-05-18

Parkinson's disease demonstrates a spectrum of motor and non-motor symptoms. Falling is common and disabling. Current medical management shows minimal impact to reduce falls or fall-related risk factors, such as deficits in gait, strength, and postural instability. Despite evidence supporting rehabilitation in reducing fall risk factors, the most appropriate intervention to reduce overall fall rate remains inconclusive. This article aims to 1) synthesise current evidence and conceptual models of falls rehabilitation in Parkinson's in a narrative review; and based on this evidence, 2) introduce the treatment protocol used in the falls prevention and multi-centre clinical trial "PDSAFE". Search of four bibliographic databases using the terms "Parkinson*" and "Fall*" combined with each of the following; "Rehab*, Balanc*, Strength*, Strateg*and Exercis*" and a framework for narrative review was followed. A total of 3557 papers were identified, 416 were selected for review. The majority report the impact of rehabilitation on isolated fall risk factors. Twelve directly measure the impact on overall fall rate. Results were used to construct a narrative review with conceptual discussion based on the "International Classification of Functioning", leading to presentation of the "PDSAFE" intervention protocol. Evidence suggests training single, fall risk factors may not affect overall fall rate. Combining with behavioural and strategy training in a functional, personalised multi-dimensional model, addressing all components of the "International Classification of Functioning" is likely to provide a greater influence on falls reduction. "PDSAFE" is a multi-dimensional, physiotherapist delivered, individually tailored, progressive, home-based programme. It is designed with a strong evidence-based approach and illustrates a model for the clinical delivery of the conceptual theory discussed. Implications for Rehabilitation Parkinson's disease demonstrates a spectrum of motor and non-motor symptoms, where falling is common and disabling. Current medical and surgical management have minimal impact on falls, rehabilitation of falls risk factors has strong evidence but the most appropriate intervention to reduce overall fall rate remains inconclusive. Addressing all components of the International Classification of Function in a multifactorial model when designing falls rehabilitation interventions may be more effective at reducing fall rates in people with Parkinson's than treating isolated risk factors. The clinical model for falls rehabilitation in people with Parkinson's should be multi-dimensional.

Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury(TBI)

DTIC Science & Technology

2016-10-01

particularly likely to involve TBI, peripheral trauma or both. Disability due to pain and other causes is very high amongst such patients. We have no...Chemokine, Disability , Analgesia, Spinal Cord 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18. NUMBER OF PAGES 15 19a. NAME OF...are particularly likely to involve TBI, peripheral trauma or both. Disability due to pain and other causes is very high amongst such patients. We have

Social determinants of sex differences in disability among older adults: a multi-country decomposition analysis using the World Health Survey.

PubMed

Hosseinpoor, Ahmad Reza; Williams, Jennifer Stewart; Jann, Ben; Kowal, Paul; Officer, Alana; Posarac, Aleksandra; Chatterji, Somnath

2012-09-08

Women represent a growing proportion of older people and experience increasing disability in their longer lives. Using a universally agreed definition of disability based on the International Classification of Functioning, Disability and Health, this paper examines how, apart from age, social and economic factors contribute to disability differences between older men and women. World Health Survey data were analyzed from 57 countries drawn from all income groups defined by the World Bank. The final sample comprises 63638 respondents aged 50 and older (28568 males and 35070 females). Item Response Theory was applied to derive a measure of disability which ensured cross country comparability. Individuals with scores at or above a threshold score were those who experienced significant difficulty in their everyday lives, irrespective of the underlying etiology. The population was then divided into "disabled" vs. "not disabled". We firstly computed disability prevalence for males and females by socio-demographic factors, secondly used multiple logistic regression to estimate the adjusted effects of each social determinant on disability for males and females, and thirdly used a variant of the Blinder-Oaxaca decomposition technique to partition the measured inequality in disability between males and females into the "explained" part that arises because of differences between males and females in terms of age and social and economic characteristics, and an "unexplained" part attributed to the differential effects of these characteristics. Prevalence of disability among women compared with men aged 50+ years was 40.1% vs. 23.8%. Lower levels of education and economic status are associated with disability in women and men. Approximately 45% of the sex inequality in disability can be attributed to differences in the distribution of socio-demographic factors. Approximately 55% of the inequality results from differences in the effects of the determinants. There is an urgent need for data and methodologies that can identify how social, biological and other factors separately contribute to the health decrements facing men and women as they age. This study highlights the need for action to address social structures and institutional practices that impact unfairly on the health of older men and women.

A Global Oral Health Survey of professional opinion using the International Classification of Functioning, Disability and Health.

PubMed

Dougall, Alison; Molina, Gustavo F; Eschevins, Caroline; Faulks, Denise

2015-06-01

The concept of oral health is frequently reduced to the absence of disease, despite existing conceptual models exploring the wider determinants of oral health and quality of life. The International Classification of Functioning, Disability and Health (ICF) (WHO) is designed to qualify functional, social and environmental aspects of health. This survey aimed to reach a consensual description of adult oral health, derived from the ICF using international professional opinion. The Global Oral Health Survey involved a two-round, online survey concerning factors related to oral health including functioning, participation and social environment. Four hundred eighty-six oral health professionals from 74 countries registered online. Professionals were pooled into 18 groups of six WHO world regions and three professional groups. In a randomised stratification process, eight professionals from each pool (n=144) completed the survey. The first round consisted of eight open-ended questions. Open expression replies were analysed for meaningful concepts and linked using established rules to the ICF. In Round 2, items were rated for their relevance to oral health (88% response rate). Eighty-nine ICF items and 30 other factors were considered relevant by at least 80% of participants. International professionals reached consensus on a holistic description of oral health, which could be qualified and quantified using the ICF. These results represent the first step towards developing an ICF Core Set in Oral Health, which would provide a practical tool for reporting outcome measures in clinical practice, for research and epidemiology, and for the improvement of interdisciplinary communication regarding oral health. Professional consensus reached in this survey is the foundation stone for developing an ICF Core Set in Oral Health, allowing the holistic aspects of oral health to be qualified and quantified. This tool is necessary to widen our approach to clinical decision making, measurement of clinical outcomes, research and epidemiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Review Article: Mapping of children's health and development data on population level using the classification system ICF-CY.

PubMed

Ståhl, Ylva; Granlund, Mats; Gäre-Andersson, Boel; Enskär, Karin

2011-02-01

The aim of this study was to investigate if essential health and development data of all children in Sweden in the Child Health Service (CHS) and School Health Service (SHS) can be linked to the classification system International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY). Lists of essential health terms, compiled by professionals from CHS and SHS, expected to be used in the national standardised records form the basis for the analysis in this study. The essential health terms have been linked to the codes of ICF-CY by using linking rules and a verification procedure. After exclusion of terms not directly describing children's health, a majority of the health terms could be linked into the ICF-CY with a high proportion of terms in body functions and a lower proportion in activity/participation and environment respectively. Some health terms had broad description and were linked to several ICF-CY codes. The precision of the health terms was at a medium level of detail. ICF-CY can be useful as a tool for documenting child health. It provides not only a code useful for statistical purposes but also a language useful for the CHS and SHS in their work on individual as well as population levels. It was noted that the health terms used by services mainly focused on health related to body function. This indicates that more focus is needed on health data related to child's functioning in everyday life situations.

Intervention for an Adolescent With Cerebral Palsy During Period of Accelerated Growth.

PubMed

Reubens, Rebecca; Silkwood-Sherer, Debbie J

2016-01-01

The purpose of this case report was to describe changes in body functions and structures, activities, and participation after a biweekly 10-week program of home physical therapy and hippotherapy using a weighted compressor belt. A 13-year-old boy with spastic diplegic cerebral palsy, Gross Motor Function Classification System level II, was referred because of accelerated growth and functional impairments that limited daily activities. The Modified Ashworth Scale, passive range of motion, 1-Minute Walk Test, Timed Up and Down Stairs, Pediatric Balance Scale, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and Dimensions of Mastery Questionnaire 17 were examined at baseline, 5, and 10 weeks. Data at 5 and 10 weeks demonstrated positive changes in passive range of motion, balance, strength, functional activities, and motivation, with additional improvements in endurance and speed after 10 weeks. This report reveals enhanced body functions and structures and activities and improved participation and motivation.

[Early diagnosis and treatment of compartment syndrome caused by landslides:a report of 20 cases].

PubMed

Xie, Hong-Bo; Peng, Zi-Lai; Liu, Xu-Bang; Chen, Lian

2012-01-01

To summarize early diagnosis and treatment methods of 20 patients with compartment syndrome caused by landslides during coal mine accidents in order to improve the level of diagnosis and treatment of compartment syndrome and reduce disability. From September 2006 to April 2010,20 patients with compartment syndrome were treated with the methods of early decompression, systemic support. All the patients were male with an average age of 42 years (ranged, 23 to 54). All the patients with high tension limb swelling, pain, referred pain passive positive; 5 extremities feeling diminish or disappear and the distal blood vessel beat were normal or weakened or disappeared; myoglobinuria, hyperkalemia, serum urea nitrogen and creatinine increased in 5 cases and oliguria in occurred 1 case. The function of affected limbs was observed according to disability ratings. Three cases complicated with infection of affected limb and 6 cases occurred with renal function insufficiency. Total recovery was in 16 cases, basically recovery in 3, amputation in 1 case. All patients were followed up for 6-15 months with an average of 12 months. The ability to work according to national standard identification--Employee work-related injuries and occupational disability rating classification (GB/T16180-2006) to assess, grade 5 was in 1 case, grade 8 in 2 cases, grade 10 in 1 case, no grade in 16 cases. Arteriopalmus of dorsalis pedis weaken and vanished can not be regard as an evidence in early diagnosis of compartment syndrome. Early diagnosis and decompression, systemic support and treatment is the key in reducing disability.

Diagnostic Classification of Children within the Educational System: Should It Be Eliminated?

ERIC Educational Resources Information Center

Kuther, Tara L.

This paper reviews the literature on positive and negative aspects of diagnostic classification of children, or labeling. It reviews the Education for All Handicapped Children Act, which mandated that special education must be available to all children with disabilities. Definitional issues in diagnostic labeling of students with learning…

Brain-computer interface design using alpha wave

NASA Astrophysics Data System (ADS)

Zhao, Hai-bin; Wang, Hong; Liu, Chong; Li, Chun-sheng

2010-01-01

A brain-computer interface (BCI) is a novel communication system that translates brain activity into commands for a computer or other electronic devices. BCI system based on non-invasive scalp electroencephalogram (EEG) has become a hot research area in recent years. BCI technology can help improve the quality of life and restore function for people with severe motor disabilities. In this study, we design a real-time asynchronous BCI system using Alpha wave. The basic theory of this BCI system is alpha wave-block phenomenon. Alpha wave is the most prominent wave in the whole realm of brain activity. This system includes data acquisition, feature selection and classification. The subject can use this system easily and freely choose anyone of four commands with only short-time training. The results of the experiment show that this BCI system has high classification accuracy, and has potential application for clinical engineering and is valuable for further research.

Spelling in adolescents with dyslexia: errors and modes of assessment.

PubMed

Tops, Wim; Callens, Maaike; Bijn, Evi; Brysbaert, Marc

2014-01-01

In this study we focused on the spelling of high-functioning students with dyslexia. We made a detailed classification of the errors in a word and sentence dictation task made by 100 students with dyslexia and 100 matched control students. All participants were in the first year of their bachelor's studies and had Dutch as mother tongue. Three main error categories were distinguished: phonological, orthographic, and grammatical errors (on the basis of morphology and language-specific spelling rules). The results indicated that higher-education students with dyslexia made on average twice as many spelling errors as the controls, with effect sizes of d ≥ 2. When the errors were classified as phonological, orthographic, or grammatical, we found a slight dominance of phonological errors in students with dyslexia. Sentence dictation did not provide more information than word dictation in the correct classification of students with and without dyslexia. © Hammill Institute on Disabilities 2012.

Structuring Word Problems for Diagnostic Teaching: Helping Teachers Meet the Needs of Children with Mild Disabilities.

ERIC Educational Resources Information Center

Parmar, Rene S.; Cawley, John F.

1994-01-01

Matrix organization can be used to construct math word problems for children with mild disabilities. Matrix organization specifies the characteristics of problems, such as problem theme or setting, operations, level of computation complexity, reading vocabulary level, and need for classification. A sample scope and sequence and 16 sample word…

The Effect of Achievement Test Selection on Identification of Learning Disabilities within a Patterns of Strengths and Weaknesses Framework

ERIC Educational Resources Information Center

Miciak, Jeremy; Taylor, W. Pat; Denton, Carolyn A.; Fletcher, Jack M.

2015-01-01

Few empirical investigations have evaluated learning disabilities (LD) identification methods based on a pattern of cognitive strengths and weaknesses (PSW). This study investigated the reliability of LD classification decisions of the concordance/discordance method (C/DM) across different psychoeducational assessment batteries. C/DM criteria were…

Treatment of Moderately Intellectually Disabled Delinquent Youth in a Dutch Juvenile Justice Facility with Closed and Open Units

ERIC Educational Resources Information Center

Lodewijks, Henny P. B.

2011-01-01

This article will focus on a juvenile justice facility in the Netherlands, targeted at moderately intellectually disabled juveniles, who are sentenced because of serious crimes. All of the juveniles have a disruptive disorder (conduct disorder or oppositional defiant disorder) and 70% have comorbid psychiatric classifications. Treatment amounts to…

What Is Intellectual Disability? How Is It Assessed and Classified?

ERIC Educational Resources Information Center

Parmenter, Trevor R.

2011-01-01

People with an intellectual disability have existed across human history, making up a part of all cultures. They represent a small part of the extremely wide variety of people in the human population at any one time. This review essay examines the 11th and latest Definition and Classification Manual published by the American Association on…

A Longitudinal Analysis of Torque and its Relationship to Achievement and Educational Classification among Normal, Disturbed, and Learning-Disabled Children.

ERIC Educational Resources Information Center

Alberts, Fred L.; Edwards, Ron P.

1983-01-01

Examined the effect of the presence of torque (clockwise circlings with either hand on a visual-motor task) on academic achievement variables among normal, disturbed, and learning-disabled children (N=948). Results indicated no clear relationship between torque and the various academic variables. (LLL)

A Pilot Study to Test the Efficacy of Psychologically Based Physical Therapy Training for Treating Deployed U.S. Sailors and Marines with Musculoskeletal Injuries

DTIC Science & Technology

2016-10-01

purpose of this study is to demonstrate the effectiveness of a PBPT intervention for the prevention of disability in ADSM who sustain an MSI during...intervention, pain coping skills, outcome, randomized controlled trial, risk factor, disability , attrition. 16. SECURITY CLASSIFICATION OF: Unclassified 17...help all service members who sustain MSI by improving care, reducing the need for ongoing medical utilization and reducing disability . 2. Keywords

Apgar scores at 10 min and outcomes at 6-7 years following hypoxic-ischaemic encephalopathy.

PubMed

Natarajan, Girija; Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; Bann, Carla M; McDonald, Scott A; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R; Vohr, Betty R

2013-11-01

To determine the association between 10 min Apgar scores and 6-7-year outcomes in children with perinatal hypoxic-ischaemic encephalopathy (HIE) enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) whole body cooling randomised controlled trial (RCT). Evaluations at 6-7 years included the Wechsler Preschool and Primary Scale of Intelligence III or Wechsler Intelligence Scale for Children IV and Gross Motor Functional Classification Scale. Primary outcome was death/moderate or severe disability. Logistic regression was used to examine the association between 10 min Apgar scores and outcomes after adjusting for birth weight, gestational age, gender, outborn status, hypothermia treatment and centre. In the study cohort (n=174), 64/85 (75%) of those with 10 min Apgar score of 0-3 had death/disability compared with 40/89 (45%) of those with scores >3. Each point increase in 10 min Apgar scores was associated with a significantly lower adjusted risk of death/disability, death, death/IQ <70, death/cerebral palsy (CP) and disability, IQ<70 and CP among survivors (all p<0.05). Among the 24 children with a 10 min Apgar score of 0, five (20.8%) survived without disability. The risk-adjusted probabilities of death/disability were significantly lower in cooled infants with Apgar scores of 0-3; there was no significant interaction between cooling and Apgar scores (p=0.26). Among children with perinatal HIE enrolled in the NICHD cooling RCT, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of infants with 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration.

[Impairment - disability - participation for all : New federal reporting in light of the UN Convention on the Rights of Persons with Disabilities].

PubMed

Wacker, Elisabeth

2016-09-01

The new Federal Government's Report on Participation explores the contexts in which impairments become disabilities for those individuals who experience them. In parallel, it outlines the factors that foster inclusion and opportunities to act for everyone in society - despite existing impairments.From a sociopolitical and health policy perspective, disability refers to unequal opportunities based on impairment. Hence, the focus here is on the equalisation of these participation opportunities to match those of the entire population - but always from differentiated perspectives on the various social arenas. The human rights approach stresses protection against discrimination as well as dignity and self-determination for all. From a human resources angle, the emphasis is on the performance of individuals in favourable conditions and the attainment of personal goals within their actual everyday circumstances.The new reporting concept is indebted to these perspectives and thus focuses on individual life circumstances, while referring to the WHO's International Classification of Functioning, Disability and Health (ICF) - an approach now validated on a global scale. Therefore, it does not only report on measures provided by services for persons with disabilities but, more crucially, investigates determinants on the personal and environmental levels, unequal opportunities and the interdependency between context and competence for particular sections of the population. Two groups are singled out in the process: elderly persons and individuals with mental health impairments.The participation report is part of the National Action Plan to implement the UN Convention on the Rights of Persons with Disabilities (UNCRPD). An independent scientific committee conceptualises the design of the report while accompanying and commenting upon its realisation. Currently, a second federal report on participation is emerging from the new concept.

Apgar scores at 10 min and outcomes at 6–7 years following hypoxic-ischaemic encephalopathy

PubMed Central

Natarajan, Girija; Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; Bann, Carla M; McDonald, Scott A; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R; Vohr, Betty R

2014-01-01

Aim To determine the association between 10 min Apgar scores and 6–7-year outcomes in children with perinatal hypoxic-ischaemic encephalopathy (HIE) enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) whole body cooling randomised controlled trial (RCT). Methods Evaluations at 6–7 years included the Wechsler Preschool and Primary Scale of Intelligence III or Wechsler Intelligence Scale for Children IV and Gross Motor Functional Classification Scale. Primary outcome was death/moderate or severe disability. Logistic regression was used to examine the association between 10 min Apgar scores and outcomes after adjusting for birth weight, gestational age, gender, outborn status, hypothermia treatment and centre. Results In the study cohort (n=174), 64/85 (75%) of those with 10 min Apgar score of 0–3 had death/disability compared with 40/89 (45%) of those with scores >3. Each point increase in 10 min Apgar scores was associated with a significantly lower adjusted risk of death/disability, death, death/IQ <70, death/cerebral palsy (CP) and disability, IQ<70 and CP among survivors (all p<0.05). Among the 24 children with a 10 min Apgar score of 0, five (20.8%) survived without disability. The risk-adjusted probabilities of death/disability were significantly lower in cooled infants with Apgar scores of 0–3; there was no significant interaction between cooling and Apgar scores (p=0.26). Conclusions Among children with perinatal HIE enrolled in the NICHD cooling RCT, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of infants with 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration. PMID:23896791

Understanding factors that influence participation in physical activity among people with a neuromusculoskeletal condition: a review of qualitative studies.

PubMed

Newitt, Rosemarie; Barnett, Fiona; Crowe, Melissa

2016-01-01

This review aims to describe the factors that influence participation in physical activity (PA) in people with neuromusculoskeletal (NMS) conditions. A systematic search of six databases was conducted. Articles were included if the study qualitatively explored factors that influence participation in PA by individuals with a NMS condition. Fifteen peer-reviewed articles published between 2003 and 2013 were analysed for common themes and critically appraised. Results were categorised using the International Classification of Functioning, Disability and Health framework. The most common demotivators reported for the three areas of functioning, body function and structures, activities and participation were lack of walking balance, muscle weakness, pain, stiffness, bladder and blower problems, depression, thermoregulation and fear of injury. Fluctuating symptoms and fatigue were mentioned as demotivators in all of the progressive conditions. Maintaining independence, function and weight, and the prevention of secondary conditions were the leading motivators reported in this domain. Most common environmental barriers include accessibility, costs, transport and insufficient information and knowledge from health professionals. Social support is a consistent determinate of PA and is reported as a facilitator in every study. The most common personal demotivators include lack of motivation, feelings of self-consciousness and embarrassment in public, anxiety, frustration and anger. Personal motivators include goal setting and achieving, enjoyment, feeling good, feeling "normal", motivation and optimism, redefining self and escapism from everyday boundaries. Individuals with NMS conditions report complex common barriers, facilitators, demotivators and motivators to participation in PA. The way these factors influence participation in PA is unique to the individual; therefore, it is necessary to adopt an individually tailored approach when designing interventions. Individuals with neuromusculoskeletal conditions report common factors that influence participation in physical activity. It is the characteristics, attitude and beliefs of an individual that determine the way in which these factors influence participation in physical activity. Health professionals should be guided by the International Classification of Functioning, Disability and Health framework when assessing individuals, as the model will ensure all major factors of interest with regard to disability and physical activity behaviour are considered. Interventions to promote participation in physical activity in people with neuromusculoskeletal conditions require an individual approach that facilitates the assessment and management of an individual's barriers to physical activity. A multi-disciplinary approach may be required to address factors that influence participation in physical activity. Health professionals must be informed about other areas of expertise and draw on this when necessary.

Who gets the disability grant in South Africa? An analysis of the characteristics of recipients in urban and rural areas.

PubMed

Jelsma, Jennifer; Maart, Soraya; Eide, Arne; Toni, Mzolisi; Loeb, Mitch

2008-01-01

This study was to establish whether there was a difference in the characteristics of people who received a disability grant and those who did not in rural and urban samples of isiXhosa-speaking people with disability in South Africa. The sample was a convenience sample and was identified through a 'snowballing' process. A demographic survey and isiXhosa versions of the International Classification of Functioning, Disability and Health (ICF) and EQ-5D, a health-related quality of life measure were utilized. The sample consisted of 244 rural and 61 urban respondents, demonstrating a preponderance of physical disabilities. The groups who received or did not receive grants were equivalent in terms of age, gender, marital status and employment status. A significantly higher proportion of rural dwellers accessed the grant. The grant holders displayed significantly more problems related to mobility and to technology and policies and services relating to mobility and transport. Those who did not receive grants reported more barriers with regard to the attitudes of health workers but not with regard to any other aspect of social support. The majority of men and women with disability identified in this study received the grant, whether or not they lived in remote rural or in urban areas. As there were few differences between the groups, it is likely that several non-grant holders might qualify if they were informed of the grant and applied. The role of medical doctors as 'gatekeepers' to the grant might need to be examined.

17-Year Outcome of Preterm Infants with Diverse Neonatal Morbidities: Part 1, Impact on Physical, Neurological, and Psychological Health Status

PubMed Central

Sullivan, Mary C.; Msall, Michael E.; Miller, Robin J.

2012-01-01

Purpose The purpose of this study was to comprehensively examine physical, neurological, and psychological health in a U.S. sample of 180 infants at age 17. Design & Methods The World Health Organization International Classification of Functioning, Disability and Health model framed the health-related domains and contextual factors. Assessments included growth, chronic conditions, neurological status, and psychological health. Results Physical health, growth, and neurological outcomes were poorer in the preterm groups. Minor neurological impairment was related to integrative function. Preterm survivors reported higher rates of depression, anxiety, and inattention/hyperactivity. Practice Implications Complex health challenges confront preterm survivors at late adolescence suggesting the necessity of continued health surveillance. PMID:22734876

Eligibility, the ICF and the UN Convention: Australian perspectives

PubMed Central

2011-01-01

The UN Convention on the Rights of Persons with Disabilities, in Australia, acts as a philosophical and moral statement and framework guiding integrated and strategic policy across the nation. Broad policy agreement has been reached by governments, and both the government and non-government sectors are developing strategies for implementation or evaluation. There is however a need for a more integrated approach to disability policy and information, reflecting all three components of the Italian project: • legislation and a high level philosophical framework and policy guide; • a technical framework that can underpin specific policies and programs aiming to achieve the major goals; and , • a language and set of tools, relating to both the above, that provide infrastructure for assessment methods and information systems. The International Classification of Functioning, Disability and Health (ICF) is the ideal tool to support the latter two components, consistent with the UN Convention. While the ICF has been used as the basis for national data standards, in population surveys and in the national data collection on disability support services, there is considerable scope for greater use of it, including using all domains of the Activities and Participation and the Environmental Factors component for policy, information and service provision, to advance a disability-inclusive society. Information available from the income support system and from generic services could be enhanced by reference to the ICF components. It would be of significant national value in Australia, especially as a ‘continuum of care’ is desired, if consistency of concepts and information were expanded across health and social welfare sectors. It would then be possible to obtain consistent data from health, aged care, disability and community services systems about key aspects of health and functioning, building a consolidated picture of access and experience across these sectors. Without attention to all three components of the Italian project and continuing effort to meet the challenges identified in this paper, it will not be possible to determine whether the goals of Australia’s National Disability Agreement or the ambitions of the Convention are achieved. PMID:21624192

Measuring everyday functional competence using the Rasch assessment of everyday activity limitations (REAL) item bank.

PubMed

Oude Voshaar, Martijn A H; Ten Klooster, Peter M; Vonkeman, Harald E; van de Laar, Mart A F J

2017-11-01

Traditional patient-reported physical function instruments often poorly differentiate patients with mild-to-moderate disability. We describe the development and psychometric evaluation of a generic item bank for measuring everyday activity limitations in outpatient populations. Seventy-two items generated from patient interviews and mapped to the International Classification of Functioning, Disability and Health (ICF) domestic life chapter were administered to 1128 adults representative of the Dutch population. The partial credit model was fitted to the item responses and evaluated with respect to its assumptions, model fit, and differential item functioning (DIF). Measurement performance of a computerized adaptive testing (CAT) algorithm was compared with the SF-36 physical functioning scale (PF-10). A final bank of 41 items was developed. All items demonstrated acceptable fit to the partial credit model and measurement invariance across age, sex, and educational level. Five- and ten-item CAT simulations were shown to have high measurement precision, which exceeded that of SF-36 physical functioning scale across the physical function continuum. Floor effects were absent for a 10-item empirical CAT simulation, and ceiling effects were low (13.5%) compared with SF-36 physical functioning (38.1%). CAT also discriminated better than SF-36 physical functioning between age groups, number of chronic conditions, and respondents with or without rheumatic conditions. The Rasch assessment of everyday activity limitations (REAL) item bank will hopefully prove a useful instrument for assessing everyday activity limitations. T-scores obtained using derived measures can be used to benchmark physical function outcomes against the general Dutch adult population.

Early postoperative repair status after rotator cuff repair cannot be accurately classified using questionnaires of patient function and isokinetic strength evaluation.

PubMed

Colliver, Jessica; Wang, Allan; Joss, Brendan; Ebert, Jay; Koh, Eamon; Breidahl, William; Ackland, Timothy

2016-04-01

This study investigated if patients with an intact tendon repair or partial-thickness retear early after rotator cuff repair display differences in clinical evaluations and whether early tendon healing can be predicted using these assessments. We prospectively evaluated 60 patients at 16 weeks after arthroscopic supraspinatus repair. Evaluation included the Oxford Shoulder Score, 11-item version of the Disabilities of the Arm, Shoulder and Hand, visual analog scale for pain, 12-item Short Form Health Survey, isokinetic strength, and magnetic resonance imaging (MRI). Independent t tests investigated clinical differences in patients based on the Sugaya MRI rotator cuff classification system (grades 1, 2, or 3). Discriminant analysis determined whether intact repairs (Sugaya grade 1) and partial-thickness retears (Sugaya grades 2 and 3) could be predicted. No differences (P < .05) existed in the clinical or strength measures. Although discriminant analysis revealed the 11-item version of the Disabilities of the Arm, Shoulder and Hand produced a 97% true-positive rate for predicting partial thickness retears, it also produced a 90% false-positive rate whereby it incorrectly predicted a retear in 90% of patients whose repair was intact. The ability to discriminate between groups was enhanced with up to 5 variables entered; however, only 87% of the partial-retear group and 36% of the intact-repair group were correctly classified. No differences in clinical scores existed between patients stratified by the Sugaya MRI classification system at 16 weeks. An intact repair or partial-thickness retear could not be accurately predicted. Our results suggest that correct classification of healing in the early postoperative stages should involve imaging. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey

PubMed Central

2011-01-01

Background Since 1986, the study of disability in Spain has been mainly addressed by National Disability Surveys (NDSs). While international attempts to frame NDS designs within the International Classification of Functioning, Disability and Health (ICF) have progressed, in general, the ICF has hardly been used in either the NDS or epidemiological studies. This study sought to identify ICF Activity- and Participation-related content in the most recent Spanish NDS, the 2008 Survey on Disabilities, Independence and Dependency Situations (Encuesta sobre discapacidades, autonomía personal y situaciones de Dependencia - EDAD 2008), and estimate the prevalence of such ICF-framed disability. Methods EDAD 2008 methods and questions were perused. Of the 51 EDAD items analysed, 29 were backcoded to specific d2-d7 domains of the ICF Checklist and, by rating the recorded difficulty to perform specific tasks with or without help, these were then taken as performance and capacity respectively. A global ICF score was also derived, albeit lacking data for d1, "Learning and applying knowledge", d8, "Major Life Areas" and d9, "Community, Social and Civic Life". Data were grouped by sex, age, residence and initial positive screening, and prevalence figures were calculated by disability level both for the general population, using the originally designed weights, and for the population that had screened positive to disability. Data for institutionalised persons were processed separately. Results Crude prevalence of ICF severe/complete and moderate disability among the community-dwelling population aged ≥6 years was 0.9%-2.2% respectively, and that of severe/complete disability among persons living in sheltered accommodation was 0.3%. Prevalence of severe/complete disability was: higher in women than in men, 0.8% vs. 0.4%; increased with age; and was particularly high in domains such as "Domestic Life", 3.4%, "Mobility", 1.8%, and "Self-care", 1.9%, in which prevalence decreased when measured by reference to performance. Moreover, global scores indicated that severe/complete disability in these same domains was frequent among the moderately disabled group. Conclusions The EDAD 2008 affords an insufficient data set to be ICF-framed when it comes to the Activity and Participation domains. Notwithstanding their unknown validity, ratings for available ICF domains may, however, be suitable for consideration under the ADL model of functional dependency, suggesting that there are approximately 500,000 persons suffering from severe/complete disability and 1,000,000 suffering from moderate disability, with half the latter being severely disabled in domains capable of benefiting from technical or personal aid. Application of EDAD data to the planning of services for regions and other subpopulations means that need for personal help must be assessed, unmet needs ascertained, and knowledge of social participation and support, particularly for the mentally ill, improved. International, WHO-supported co-operation in ICF planning and use of NDSs in Spain and other countries is needed. PMID:22122806

Selecting and Validating Tasks from a Kindergarten Screening Battery that Best Predict Third Grade Educational Placement

ERIC Educational Resources Information Center

Scott, Marcia Strong; Delgado, Christine F.; Tu, Shihfen; Fletcher, Kathryn L.

2005-01-01

In this study, predictive classification accuracy was used to select those tasks from a kindergarten screening battery that best identified children who, three years later, were classified as educable mentally handicapped or as having a specific learning disability. A subset of measures enabled correct classification of 91% of the children in…

The DMON2: A Commercially Available Broadband Acoustic Monitoring Instrument

DTIC Science & Technology

2014-09-30

Assignment of Export Control Classification Number ( ECCN ) of 6A991 by the Department of Commerce for the DMON2 (July 30, 2014), allowing the DMON2 to be...The ECCN 6A991 classification requires that an external pressure transducer be mounted in the head so that the hydrophone output can be disabled

Long-term prediction of changes in health status, frailty, nursing care and mortality in community-dwelling senior citizens—results from the Longitudinal Urban Cohort Ageing Study (LUCAS).

PubMed

Dapp, Ulrike; Minder, Christoph E; Anders, Jennifer; Golgert, Stefan; von Renteln-Kruse, Wolfgang

2014-12-19

The detection of incipient functional decline in elderly persons is not an easy task. Here, we propose the self-reporting Functional Ability Index (FA index) suitable to screen functional competence in senior citizens in the community setting. Its prognostic validity was investigated in the Longitudinal Urban Cohort Ageing Study (LUCAS). This index is based equally on both, resources and risks/functional restrictions which precede ADL limitations. Since 2001, the FA index was tested in the LUCAS cohort without any ADL restrictions at baseline (n = 1,679), and followed up by repeated questionnaires in Hamburg, Germany. Applying the index, 1,022 LUCAS participants were initially classified as Robust (60.9%), 220 as postRobust (13.1%), 172 as preFrail (10.2%) and 265 as Frail (15.8%). This classification correlated with self-reported health, chronic pain and depressive mood (rank correlations 0.42, 0.26, 0.21; all p < .0001). Survival analyses showed significant differences between these classes as determined by the FA index: the initially Robust survived longest, the Frail shortest (p < .0001). Analyses of the time to need of nursing care revealed similar results. Significant differences persisted after adjustment for age, sex and self-reported health. Disability free lifetime and its development over time are important topics in public health. In this context, the FA index presented here provides answers to two questions. First, how to screen the heterogeneous population of community-dwelling senior citizens, i.e. for their functional ability/competence, and second, how far away they are from disability/dependency. Furthermore, the index provides a tool to address the urgent question whether incipient functional decline/incipient frailty can be recognized early to be influenced positively. The FA index predicted change in functional status, future need of nursing care, and mortality in an unselected population of community-dwelling seniors. It implies an operational specification of the classification into Robust, postRobust, preFrail and Frail. Based on a self-administered questionnaire, the FA index allows easy screening of elderly persons for declining functional competence. Thereby, incipient functional decline is recognized, e.g. in GPs' practices and senior community health centers, to initiate early appropriate preventive action.

Comparison of patients with and without intellectual disability under general anesthesia: A retrospective study.

PubMed

Sitilci, T; Demirgan, S; Akcay, C; Kahraman, N; Koseoglu, B G; Erdem, M A; Cankaya, A B

2017-04-01

We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia. A total of 348 patients were selected from the Department of Maxillofacial Surgery and the Department of Pedodontics who underwent surgery with general anesthesia. Medical histories of all patients were taken, and their electrocardiography, chest X-rays, complete blood count, and blood clotting tests were checked during a preoperative assessment. Mallampati evaluations were also performed. Patients were grouped into ASA I, II, or III according to the ASA classification and were treated under general anesthesia. There was no significant difference between normal and intellectually disabled patients in terms of gender, Mallampati scores, intubation difficulties, mean anesthetic period, time to discharge, or postoperative nausea and vomiting. Epilepsy and genetic diseases in intellectually disabled patients were significantly more common than in non-ID (NID) patients. However, the frequency of diabetes and chronic obstructive pulmonary disease in NID patients was significantly higher than in the intellectually disabled patients. Dental treatment of intellectually disabled patients under general anesthesia can be performed just as safely as that with NID patients.

PREDICT-CP: study protocol of implementation of comprehensive surveillance to predict outcomes for school-aged children with cerebral palsy.

PubMed

Boyd, Roslyn N; Davies, Peter Sw; Ziviani, Jenny; Trost, Stewart; Barber, Lee; Ware, Robert; Rose, Stephen; Whittingham, Koa; Sakzewski, Leanne; Bell, Kristie; Carty, Christopher; Obst, Steven; Benfer, Katherine; Reedman, Sarah; Edwards, Priya; Kentish, Megan; Copeland, Lisa; Weir, Kelly; Davenport, Camilla; Brooks, Denise; Coulthard, Alan; Pelekanos, Rebecca; Guzzetta, Andrea; Fiori, Simona; Wynter, Meredith; Finn, Christine; Burgess, Andrea; Morris, Kym; Walsh, John; Lloyd, Owen; Whitty, Jennifer A; Scuffham, Paul A

2017-07-12

Cerebral palsy (CP) remains the world's most common childhood physical disability with total annual costs of care and lost well-being of $A3.87b. The PREDICT-CP (NHMRC 1077257 Partnership Project: Comprehensive surveillance to PREDICT outcomes for school age children with CP) study will investigate the influence of brain structure, body composition, dietary intake, oropharyngeal function, habitual physical activity, musculoskeletal development (hip status, bone health) and muscle performance on motor attainment, cognition, executive function, communication, participation, quality of life and related health resource use costs. The PREDICT-CP cohort provides further follow-up at 8-12 years of two overlapping preschool-age cohorts examined from 1.5 to 5 years (NHMRC 465128 motor and brain development; NHMRC 569605 growth, nutrition and physical activity). This population-based cohort study undertakes state-wide surveillance of 245 children with CP born in Queensland (birth years 2006-2009). Children will be classified for Gross Motor Function Classification System; Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System. Outcomes include gross motor function, musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function, communication difficulties, oropharyngeal dysphagia, dietary intake and body composition, participation, parent-reported and child-reported quality of life and medical and allied health resource use. These detailed phenotypical data will be compared with brain macrostructure and microstructure using 3 Tesla MRI (3T MRI). Relationships between brain lesion severity and outcomes will be analysed using multilevel mixed-effects models. The PREDICT-CP protocol is a prospectively registered and ethically accepted study protocol. The study combines data at 1.5-5 then 8-12 years of direct clinical assessment to enable prediction of outcomes and healthcare needs essential for tailoring interventions (eg, rehabilitation, orthopaedic surgery and nutritional supplements) and the projected healthcare utilisation. ACTRN: 12616001488493. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Longitudinal Changes in Functioning and Disability in Patients with Disorders of Consciousness: The Importance of Environmental Factors

PubMed Central

Willems, Michelle; Sattin, Davide; Vingerhoets, Ad J.J.M.; Leonardi, Matilde

2015-01-01

Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in “Activities & Participation” were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in “Activities & Participation” decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor “support and relationships” reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in “Environmental Factors” were significant predictors of relative variability in “Activities & Participation”. It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness. PMID:25837348

“Intellectual developmental disorders”: reflections on the international consensus document for redefining “mental retardation-intellectual disability” in ICD-11

PubMed Central

Bertelli, Marco O.; Munir, Kerim; Harris, James; Salvador-Carulla, Luis

2016-01-01

Purpose The debate as to whether intellectual disability (ID) should be conceptualized as a health condition or as a disability has intensified as the revision of World Health Organization’s (WHO’s) International Classification of Diseases (ICD) is being finalized. Defining ID as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. The purpose of this paper is to include some reflections on the consensus document produced by the first WHO Working Group on the Classification of MR (WHO WG-MR) and on the process that was followed to realize it. The consensus report was the basis for the development of official recommendations sent to the WHO Advisory Group for ICD-11. Design/methodology/approach A mixed qualitative approach was followed in a series of meetings leading to the final consensus report submitted to the WHO Advisory group. These recommendations combined prior expert knowledge with available evidence; a nominal approach was followed throughout with face-to-face conferences. Findings The WG recommended a synonym set (“synset”) ontological approach to the conceptualisation of this health condition underlying a clinical rationale for its diagnosis. It proposed replacing MR with Intellectual Developmental Disorders (IDD) in ICD-11, defined as “a group of developmental conditions characterized by a significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills”. The WG further advised that IDD be included under the parent category of neurodevelopmental disorders, that current distinctions (mild, moderate, severe and profound) be continued as severity qualifiers, and that problem behaviours removed from its core classification structure and instead described as associated features. Originality/value Within the ID/IDD synset two different names combine distinct aspects under a single construct that describes its clinical as well as social, educational and policy utilities. The single construct incorporates IDD as a clinical meta-syndrome, and ID as its functioning and disability counterpart. IDD and ID are not synonymous or mirror concepts as they have different scientific, social and policy applications. New diagnostic criteria for IDD should be based on a developmental approach, which accounts for the complex causal factors known to impact the acquisition of specific cognitive abilities and adaptive behaviours. The paper focuses on a new clinical framework for the diagnosis of IDD that also includes and complements the existing social, educational and policy components inherent in ID. PMID:27066217

Utilizing Health Records to Characterize Obesity, Comorbidities, and Health-Care Services in One Human Service Agency in the United States

ERIC Educational Resources Information Center

Fisher, Kathleen; Hardie, Thomas L.; Ranjan, Sobhana; Peterson, Justin

2017-01-01

US surveys report higher prevalence of obesity in adults with intellectual disability. Health records of 40 adults with intellectual disability were retrospectively reviewed for data on health status, problem lists with International Classification of Diseases, Ninth Revision codes, medication lists, and health encounters over 18 months. Mean age…

An Evaluation of Risk Factors Related to Employment Outcomes for Youth with Disabilities

ERIC Educational Resources Information Center

Sima, Adam P.; Wehman, Paul H.; Chan, Fong; West, Michael D.; Leucking, Richard G.

2015-01-01

This study explores non-modifiable risk factors associated with poor post-school competitive employment outcomes for students with disabilities. A classification tree analysis was used with a sample of 2,900 students who were in the second National Longitudinal Transition Study-2 (NLTS2) up to 6 years following school exit to identify groups of…

Brief Report: Independent Validation of Autism Spectrum Disorder Case Status in the Utah Autism and Developmental Disabilities Monitoring (ADDM) Network Site

ERIC Educational Resources Information Center

Bakian, Amanda V.; Bilder, Deborah A.; Carbone, Paul S.; Hunt, Tyler D.; Petersen, Brent; Rice, Catherine E.

2015-01-01

An independent validation was conducted of the Utah Autism and Developmental Disabilities Monitoring Network's (UT-ADDM) classification of children with autism spectrum disorder (ASD). UT-ADDM final case status (n = 90) was compared with final case status as determined by independent external expert reviewers (EERs). Inter-rater reliability…

The Support Needs of Children with Intellectual Disability and Autism: Implications for Supports Planning and Subgroup Classification

ERIC Educational Resources Information Center

Shogren, Karrie A.; Shaw, Leslie A.; Wehmeyer, Michael L.; Thompson, James R.; Lang, Kyle M.; Tassé, Marc J.; Schalock, Robert L.

2017-01-01

The Supports Intensity Scale-Children's version (SIS-C) was developed to provide a standardized measure of support needs of children with intellectual disability. Over half of the norming sample had a secondary diagnosis of autism. Using this subset of the sample, we engaged in exploratory analysis to examine the degree to which latent clusters…

Changes in Social Impairment for People with Intellectual Disabilities: A Follow-up of the Camberwell Cohort.

ERIC Educational Resources Information Center

Beadle-Brown, Julie; Murphy, Glynis; Wing, Lorna; Gould, Judy; Shah, Amitta; Holmes, Nan

2002-01-01

The skills and social impairments of 146 adolescents and young adults in London who had been found to have severe intellectual disabilities and/or autism as children in the 1970s were assessed. Classification as socially impaired or not remained relatively stable over time. Within the socially impaired group, there was a significant increase in…

Prospective pilots of routine data capture by paediatricians in clinics and validation of the Disabilities Complexity Scale.

PubMed

Horridge, Karen A; Mcgarry, Kenneth; Williams, Jane; Whitlingum, Gabriel

2016-06-01

To pilot prospective data collection by paediatricians at the point of care across England using a defined terminology set; demonstrate feasibility of data collection and utility of data outputs; and confirm that counting the number of needs per child is valid for quantifying complexity. Paediatricians in 16 hospital and community settings collected and anonymized data. Participants completed a survey regarding the process. Data were analysed using R version 3.1.2. Overall, 8117 needs captured from 1224 consultations were recorded. Sixteen clinicians responded positively about the process and utility of data collection. The sum of needs varied significantly (p<0.01) by level of gross motor function ascertained using the Gross Motor Function Classification System for children with cerebral palsy; epilepsy severity as defined by level of expertise required to manage it; and by severity of intellectual disability. Prospective data collection at the point of clinical care proved possible without disrupting clinics, even for those with the most complex needs, and took the least time when done electronically. Counting the number of needs was easy to do, and quantified complexity in a way that informed clinical care for individuals and related directly to validated scales of functioning. Data outputs could inform more appropriate design and commissioning of quality services. © 2016 Mac Keith Press.

Revision of the ICIDH: mental health aspects. WHO/MNH Disability Working Group.

PubMed

Ustün, T B; Cooper, J E; van Duuren-Kristen, S; Kennedy, C; Hendershot, G; Sartorius, N

1995-01-01

This article reviews the key issues arising in the revision of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) from a mental health perspective, and describes the work of the Disability Working Group of the WHO's Division of Mental Health. The ICIDH, which describes the consequences of disorders at three levels as impairments, disabilities, and handicaps, is generally applicable and useful for mental health purposes. While some impairments are mainly a consequence of 'mental' disorders (e.g. cognitive impairment), there should be no differences between mental and physical disorders in the classification scheme, to avoid a dichotomy between mind and body. There is also a need to improve the ways in which interference with the performance of social roles is described, since this is often the most obvious consequence of mental disorders. This article presents the potentials of the ICIDH in the field of mental health, and gives recommendations for the development of the revision process of the ICIDH. To stimulate the process of producing a 'common language' in the ICIDH related to mental health issues, former and potential users of the ICIDH are invited to give comments and suggestions.

Afrikaans-speaking parents' perceptions of the rights of their children with mild to moderate intellectual disabilities: A descriptive investigation.

PubMed

Erasmus, Alta; Bornman, Juan; Dada, Shakila

2016-06-01

This study aimed to describe the perceptions of Afrikaans-speaking parents regarding the human rights, as defined by the United Nation's Convention on the Rights of the Child (CRC), of their children, aged between 8.0 and 14.11 (years/months), with mild to moderate intellectual disabilities. The underlying premise is that the CRC defines the rights of children, whereas the International Classification of Functioning, Disability and Health, Child and Youth version (ICF-CY) can provide the framework for documenting a deprivation of rights and the conditions under which those rights can be realized. Forty-seven Afrikaans-speaking parents completed a custom-designed survey. The results of the closed-ended questions indicated that most parents felt that their children had rights and that these rights were met. A theme analysis performed on the open-ended questions revealed that parents were mostly concerned about their children's rights pertaining to school education and safety. These rights were discussed in terms of the CRC articles and linked to environmental codes of the ICF-CY. Finally, the limitations and implications of the study are discussed and recommendations are made. © The Author(s) 2015.

Effects of physiotherapy interventions on balance in multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Paltamaa, Jaana; Sjögren, Tuulikki; Peurala, Sinikka H; Heinonen, Ari

2012-10-01

To determine the effects of physiotherapy interventions on balance in people with multiple sclerosis. A systematic literature search was conducted in Medline, Cinahl, Embase, PEDro, both electronically and by manual search up to March 2011. Randomized controlled trials of physiotherapy interventions in people with multiple sclerosis, with an outcome measure linked to the International Classification of Functioning, Disability and Health (ICF) category of "Changing and maintaining body position", were included. The quality of studies was determined by the van Tulder criteria. Meta-analyses were performed in subgroups according to the intervention. After screening 233 full-text papers, 11 studies were included in a qualitative analysis and 7 in a meta-analysis. The methodological quality of the studies ranged from poor to moderate. Low evidence was found for the efficacy of specific balance exercises, physical therapy based on an individualized problem-solving approach, and resistance and aerobic exercises on improving balance among ambulatory people with multiple sclerosis. These findings indicate small, but significant, effects of physiotherapy on balance in people with multiple sclerosis who have a mild to moderate level of disability. However, evidence for severely disabled people is lacking, and further research is needed.

Preliminary Results for the PAR-PRO: A Measure of Home and Community Participation

PubMed Central

Ostir, Glenn V.; Granger, Carl V.; Black, Terrie; Roberts, Pamela; Burgos, Laura; Martinkewiz, Paula; Ottenbacher, Kenneth J.

2007-01-01

Objective To develop a measure of home and community participation related to the World Health Organization’s International Classification of Functioning, Disability and Health. Design Cross-sectional analysis of survey data. Setting Nine medical inpatient rehabilitation facilities from 6 states. Participants A total of 594 patients of mixed impairment type admitted for inpatient rehabilitation in 2002. Mean age was 74.0 years and 61.4% were women. Interventions Not applicable. Main Outcome Measures Reliability and validity of the participation instrument. Results A 20-item instrument of home and community participation was developed (PAR-PRO). The instrument showed good internal consistency and good Rasch person and item fit statistics. Four subfactors were identified beyond the unidimensional construct of participation including domestic management, socialization, physical vigor, and generative activities. The PAR-PRO total participation score correlated inversely with age (r=−.31, P<.001) but did not differ by sex. Conclusions The 20-item PAR-PRO instrument of home and community participation displayed good psychometric characteristics. The instrument shows promise as a broad measure of home and community involvement for persons with disabilities. Further work is needed to support its application for people without disability. PMID:16876548

Social protection and public policy for vulnerable populations: an assessment of the Continuous Cash Benefit Program of Welfare in Brazil.

PubMed

Duarte, Cristina Maria Rabelais; Marcelino, Miguel Abud; Boccolini, Cristiano Siqueira; Boccolini, Patrícia de Moraes Mello

2017-11-01

This paper describes the historical development and profile of Continuous Cash Benefit (BPC) applicants, intended for poor elderly and people with disabilities, which, since 2009, uses eligibility criteria based on the International Classification of Functioning, Disability and Health (ICF) of the WHO and is aligned with the UN Convention on the Rights of Persons with Disabilities. The behavior of benefits was determined from the analysis the coefficients of the general and non-judicial grants between 1998 and 2014. The profile was established for the years 2010 and 2014 according to situation of acceptance, age, gender and ICF components. The average annual growth of the coefficient was higher from 2000 to 2010, prior to the adoption of the biopsychosocial eligibility model, and the coefficient of non-judicial grants increased until 2010, falling thereafter. The deferrals acceptance /rejections ratio was higher among children and among those facing severe or total environmental barriers, limitations, constraints and bodily changes. The implementation of the biopsychosocial evaluation model did not cause an increased rate of grants and results evidence the need for flexibility in the eligibility criteria.

Exploring the relationships between International Classification of Functioning, Disability and Health (ICF) constructs of Impairment, Activity Limitation and Participation Restriction in people with osteoarthritis prior to joint replacement.

PubMed

Pollard, Beth; Johnston, Marie; Dieppe, Paul

2011-05-16

The International Classification of Functioning, Disability and Health (ICF) proposes three main constructs, impairment (I), activity limitation (A) and participation restriction (P). The ICF model allows for all paths between the constructs to be explored, with significant paths likely to vary for different conditions. The relationships between I, A and P have been explored in some conditions but not previously in people with osteoarthritis prior to joint replacement. The aim of this paper is to examine these relationships using separate measures of each construct and structural equation modelling. A geographical cohort of 413 patients with osteoarthritis about to undergo hip and knee joint replacement completed the Aberdeen measures of Impairment, Activity Limitation and Participation Restriction (Ab-IAP). Confirmatory factor analysis was used to test the three factor (I, A, P) measurement model. Structural equation modelling was used to explore the I, A and P pathways in the ICF model. There was support from confirmatory factor analysis for the three factor I, A, P measurement model. The structural equation model had good fit [S-B Chi-square = 439.45, df = 149, CFI robust = 0.91, RMSEA robust = 0.07] and indicated significant pathways between I and A (standardised coefficient = 0.76 p < 0.0001) and between A and P (standardised coefficient = 0.75 p < 0.0001). However, the path between I and P was not significant (standardised coefficient = 0.01). The significant pathways suggest that treatments and interventions aimed at reducing impairment, such as joint replacement, may only affect P indirectly, through A, however, longitudinal data would be needed to establish this.

Neurodevelopmental, health, and growth status at age 6 years of children with birth weights less than 1001 grams.

PubMed

Teplin, S W; Burchinal, M; Johnson-Martin, N; Humphry, R A; Kraybill, E N

1991-05-01

The neurodevelopmental, health, and growth outcomes for 28 six-year-old extremely low birth weight (ELBW) (birth weight less than 1001 gm) children were compared with those of 26 control children born at term. The two groups did not differ in mean weight or height, but the ELBW group had smaller head circumferences (p = 0.015). Kaufman mental processing scores correlated with head circumference (p = 0.0003). Significantly more of the ELBW children (61%) had mild or moderate to severe neurologic problems compared with control children (23%) (p = 0.003). Three ELBW children had mild spastic diplegia; one was blind. Eighteen (64%) of the ELBW children had required rehospitalization versus five (20%) of the comparison group. The mean Kaufman Mental Processing Composite was lower for the ELBW group, but when the data were analyzed by maternal education, only those children whose mothers had a twelfth-grade education had significantly lower scores (p = 0.0001). A similar pattern of group differences was seen for scores on visual-motor function (p = 0.0045), visual-perceptual abilities (p = 0.003), and attention span (p = 0.0001). No group differences were seen regarding hyperactivity or parental stress. Overall functional disability among the ELBW children was considered absent in 46%, mild in 36%, and moderate to severe in 18%. There was a significant association (p = 0.029) between classification of handicap at 12 to 34 months and classification at 6 years. No neonatal factors correlated with 6-year outcome. A significant proportion of ELBW children had no severe disabilities, but many had dysfunctions likely to affect learning and behavior in school.

The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome.

PubMed

Engelbert, Raoul H H; Juul-Kristensen, Birgit; Pacey, Verity; de Wandele, Inge; Smeenk, Sandy; Woinarosky, Nicoleta; Sabo, Stephanie; Scheper, Mark C; Russek, Leslie; Simmonds, Jane V

2017-03-01

New insights into the phenotype of Joint Hypermobility Syndrome (JHS) and Ehlers-Danlos Syndrome-hypermobile type (hEDS) have raised many issues in relation to classification, diagnosis, assessment, and treatment. Within the multidisciplinary team, physical therapy plays a central role in management of individuals with hypermobility related disorders. However, many physical therapists are not familiar with the diagnostic criteria, prevalence, common clinical presentation, and management. This guideline aims to provide practitioners with the state of the art regarding the assessment and management of children, adolescents, and adults with JHS/hEDS. Due to the complexity of the symptoms in the profile of JHS/hEDS, the International Classification of Functioning, Disability and Health (ICF) is adopted as a central framework whereby the umbrella term of disability is used to encompass functions, activities and participation, as well as environmental and personal factors. The current evidence-based literature regarding the management of JHS/hEDS is limited in size and quality and there is insufficient research exploring the clinical outcomes of a number of interventions. Multicenter randomized controlled trials are warranted to assess the clinical and cost-effectiveness of interventions for children and adults. Until further multicenter trials are conducted, clinical decision-making should be based on theoretical and the current limited research evidence. For all individuals diagnosed with JHS/hEDS, international consensus and combined efforts to identify risk profiles would create a better understanding of the pathological mechanisms and the potential for optimizing health care for affected individuals. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project).

PubMed

Sverker, Annette; Östlund, Gunnel; Thyberg, Mikael; Thyberg, Ingrid; Valtersson, Eva; Björk, Mathilda

2015-01-01

To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records. A Systematic Literature Review.

PubMed

Maritz, Roxanne; Aronsky, Dominik; Prodinger, Birgit

2017-09-20

The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization's standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet. To provide a systematic review of peer-reviewed literature about the ICF's use in EHRs, including related challenges and benefits. Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline ® , CINAHL ® , Scopus ® , and ProQuest ® Social Sciences using search terms related to ICF and EHR concepts. Publications were categorized according to three groups: Requirement specification, development and implementation. Information extraction was conducted according to a qualitative content analysis method, deductively informed by the evaluation framework for Health Information Systems: Human, Organization and Technology-fit (HOT-fit). Of 325 retrieved articles, 17 publications were included; 4 were categorized as requirement specification, 7 as development, and 6 as implementation publications. Information regarding the HOT-fit evaluation framework was summarized. Main benefits of using the ICF in EHRs were its unique comprehensive perspective on health and its interdisciplinary focus. Main challenges included the fact that the ICF is not structured as a formal terminology as well as the need for a reduced number of ICF codes for more feasible and practical use. Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing. Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.

Assessment of Aphasia Across the International Classification of Functioning, Disability and Health Using an iPad-Based Application.

PubMed

Guo, Yiting Emily; Togher, Leanne; Power, Emma; Hutomo, Edwin; Yang, Yi-Fei; Tay, Arthur; Yen, Shih-Cheng; Koh, Gerald Choon-Huat

2017-04-01

Access2Aphasia™ is an iPad™-based aphasia assessment application that enables real-time audiovisual communication between people with aphasia (PWA) and speech-language pathologists (SLPs), and the use of supported conversation techniques. This study aimed to establish the reliability of aphasia assessment across the International Classification of Functioning, Disability and Health (ICF) using Access2Aphasia, and compare it with face-to-face (FTF) assessment. Consumer perspectives of Access2Aphasia were also examined. Thirty PWA were randomized into two conditions: online-led and FTF assessment. Participants in the online-led group were assessed remotely using Access2Aphasia™ in their own homes, while an FTF SLP scored silently simultaneously. Participants in the FTF group were assessed FTF using standard administration materials. Assessment included two subtests of the Psycholinguistic Assessment of Language Processing Activities (PALPA) and the Assessment of Living with Aphasia (ALA) to allow for outcomes to be captured across the ICF domains. Consumer perspectives on Access2Aphasia were obtained from both PWA and research SLPs in the online-led group. Kappa statistics indicated moderate to almost perfect agreement between online and FTF SLPs (k = 0.71-1.00). Intrarater and interrater reliability was excellent (ICC = 0.99-1.00) and equivalent for the online-led and FTF conditions. Both PWA and research SLPs in the online-led group reported being satisfied with the experience overall, with suggestions provided by research SLPs to improve Access2Aphasia. This study supports the provision of iPad-based aphasia assessments across the ICF in the online environment, with comparable reliability to FTF assessments. Future research is warranted to support the development of iPad-based aphasia assessment and treatment as an alternative mode of service delivery to PWA.

Development of the International Classification of Functioning, Disability and Health core sets for bipolar disorders: results of an international consensus process.

PubMed

Ayuso-Mateos, José L; Avila, Carolina C; Anaya, Celia; Cieza, Alarcos; Vieta, Eduard

2013-01-01

The International Classification of Functioning, Disability and Health (ICF) is a tool of the World Health Organization (WHO) designed to be a guide to identify and classify relevant domains of human experience affected by health conditions. The purpose of this article is to describe the process for the development of two Core Sets for bipolar disorder (BD) in the framework of the ICF. The Comprehensive ICF Core Set for BD intends to be a guide for multidisciplinary assessment of patients diagnosed with this condition, while the Brief ICF Core Set for BD will be useful when rating aspects of patient's experience for clinical practice or epidemiological studies. An international consensus conference involving a sample of experts with different professional backgrounds was performed using the nominal group technique. Various preparatory studies identified a set of 743 potential ICF categories to be included in the Core Sets. A total of 38 ICF categories were selected to be included in the Comprehensive Core Set for BD. A total of 19 ICF categories from the Comprehensive Core Set were chosen as the most significant to constitute the Brief Core Set for BD. The formal consensus process integrating evidence and expert opinion on the ICF led to the formal adoption of the ICF Core Sets for BD. The most important categories included are representative of the characteristics usually associated with BD. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings. Implications for Rehabilitation Bipolar disorder (BD) is a prevalent condition that has a great impact on people who suffer it, not only in health but also in daily functioning and quality of life. No standard has been defined so far regarding the problems in functioning of persons with BDs. The process described in this article defines the set of areas of functioning to be addressed in clinical assessments of persons with BD and establish the starting point for the development of condition-specific outcome measures.

Data-driven heterogeneity in mathematical learning disabilities based on the triple code model.

PubMed

Peake, Christian; Jiménez, Juan E; Rodríguez, Cristina

2017-12-01

Many classifications of heterogeneity in mathematical learning disabilities (MLD) have been proposed over the past four decades, however no empirical research has been conducted until recently, and none of the classifications are derived from Triple Code Model (TCM) postulates. The TCM proposes MLD as a heterogeneous disorder, with two distinguishable profiles: a representational subtype and a verbal subtype. A sample of elementary school 3rd to 6th graders was divided into two age cohorts (3rd - 4th grades, and 5th - 6th grades). Using data-driven strategies, based on the cognitive classification variables predicted by the TCM, our sample of children with MLD clustered as expected: a group with representational deficits and a group with number-fact retrieval deficits. In the younger group, a spatial subtype also emerged, while in both cohorts a non-specific cluster was produced whose profile could not be explained by this theoretical approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Spatial-temporal analysis and clinical findings of gait: comparison of two modalities of treatment in children with cerebral palsy-spastic hemiplegia. Preliminary report].

PubMed

Arellano-Martínez, Irma Tamara; Rodríguez-Reyes, Gerardo; Quiñones-Uriostegui, Ivet; Arellano-Saldaña, María Elena

2013-01-01

Cerebral palsy is the most common cause of disability among children. Parent's main concerns are the acquisition and improvement of gait. The aim of this study was to compare long term results of the effect of two modalities of gait training. Quantitative measurement of gait and clinical assessment of the gross motor function classification system and Modified Ashworth Scale were perfomed in 14 patients with Cerebral palsy -spastic hemiplegia and randomizedly assigned into two groups of treatment: the first one using a driven gait orthosis (Lokomat(®)) and the second a gait training a long a rail inside a hydrotherapy tank. Measurements and assessments, above described, were performed immediately and one year after the treatment concluded. Significant change was observed in the gross motor function classification system from II to I among children (p=0.042) and a positive correlation between the shape functional of the march and the gross motor function classification system (r = 0.54, p = 0.042). Patients on the Lokomat(®) training improved on gait symmetry over patients on the conventional therapy (p = 0.05). A year after, this intervention showed tendency to kept the gait patterns only on patients treated with the Lokomat(®) Benefit obtained with either modality was evident for both groups. However, residual effects observed on the Lokomat group, either in clinical assessment or gait parameters, were more promising than in the conventional therapy. Due to the size of the sample used in this study the results are not conclusive and more research must be done on this subject in long term time horizon.

[Scores and stages in pneumology].

PubMed

Kuhn, Max

2013-10-01

Useful scales and classifications for patients with pulmonary diseases are discussed. The modified Medical Research Council breathlessness scale (mMRC) is a measure of disability in lung patients. The GOLD classifications, the COPD-Assessment Test (CAT) and the BODE Index are important to classify the severity of COPD and to measure the disability of these patients. The Geneva score is a clinical prediction rule used in determining the pre-test probability of pulmonary embolism. The Pulmonary Embolism Severity Index (PESI) is a scoring system used to predict 30 day mortality in patients with pulmonary embolism. The Epworth Sleepiness Scale is intended to measure daytime sleepiness in patients with sleep apnea syndrome. The Asthma Controll Test (ACT) determines if asthma symptoms are well controlled.

Suicide Attempts Among Adolescents with Self-Reported Disabilities.

PubMed

Moses, Tally

2018-06-01

This study examines the relative risk for suicide attempts (SA) among high-school students self-identifying with one or more disability classifications (nine); assesses the extent to which youth with disabilities are disproportionately vulnerable to risk factors that predict suicidal behavior among all adolescents; and explores whether disability status adds to risk for SA after accounting for a comprehensive set of known risk and protective factors for SA. Analyses using Wisconsin's 2012 Dane County Youth Assessment Survey data found that youth in each disability category were 3-9 times more likely to report suicide attempt(s) relative to peers, and the endorsement of multiple disabilities tripled the risk SA relative to youth reporting a single disability. Some disability sub-groups, including youth reporting autism spectrum disorder, hearing, and vision impairments reported surprisingly high rates of SA. While youth with disabilities reported disproportionate exposure to adversity in every life domain examined, similar to youth reporting SA, disability status added unique risk for suicidal behavior. This suggests that disability may be a 'fundamental cause' of suicidal behavior, a question that requires further investigation.

Musculoskeletal disabilities among police force personnel of the Islamic Republic of Iran.

PubMed

Jahani, Mohammad Reza; Motevalian, Seyed Abbas; Asgari, Ali Reza

2002-10-01

Musculoskeletal disorders are among the most common causes of disability in the military population. The objectives of this study were to assess the frequency of musculoskeletal disabilities in police force personnel and to determine the association between disabilities and age, rank, and different job types. The population studied were 2600 Islamic Republic of Iran police force disability cases from March 1997 to March 1998. Ninth revision of International Classification of Diseases was used to indicate diagnoses. The frequency of disabilities related to musculoskeletal disorders was 25.7%. Back disabilities were the most common musculoskeletal problems. Patients with back disabilities were older on average than patients with other musculoskeletal disorders (p < 0.001). Back disabilities were more common in commissioned officers (third lieutenant to colonel) than other police force personnel (p < 0.0001). On the contrary, fractures and dislocations were more common in noncommissioned officers (sergeant to warrant officer) (p < 0.001). There were associations between specific jobs and musculoskeletal disabilities. According to present data, musculoskeletal disorders account for one-quarter of disability cases in police force personnel. Prevention programs, especially in high-risk groups, should be considered.

Factors Associated With Exercise Behavior in People With Parkinson Disease

PubMed Central

Cavanaugh, James T.; Earhart, Gammon M.; Ford, Matthew P.; Foreman, K. Bo; Fredman, Lisa; Boudreau, Jennifer K.; Dibble, Leland E.

2011-01-01

Background The benefits of exercise for reducing disability in people with Parkinson disease (PD) are becoming more evident. Optimal benefit, however, requires regular and sustained participation. Factors associated with engaging in regular exercise have received little scientific scrutiny in people with PD. Objective The purpose of this study was to explore factors associated with exercise behavior in patients with PD using the International Classification of Functioning, Disability and Health (ICF) as a guiding framework. Design This was a cross-sectional study. Methods The participants in this study were 260 patients with PD from 4 institutions. Participants were designated as “exercisers” or “nonexercisers” based on responses to the Stages of Readiness to Exercise Questionnaire. Exercise status was validated using the Physical Activity Scale for the Elderly and an activity monitor. Factors potentially associated with exercise behavior included measures of body structure and function, activity, participation, environmental factors, and personal factors. Their relative contributions were analyzed using logistic regression and quantified with odds ratios. Results One hundred sixty-four participants (63%) were designated as exercisers. Participants with high self-efficacy were more than twice as likely to engage in regular exercise than those with low self-efficacy (adjusted odds ratio=2.34, 95% confidence interval=1.30–4.23). College educated and older participants also were more likely to exercise. Disabling influences of impairments, activity limitations, and participation restrictions were not associated with exercise behavior. Limitations The cross-sectional nature of the study limited the ability to make causal inferences. Conclusions Self-efficacy, rather than disability, appears to be strongly associated with whether ambulatory, community-dwelling people with PD exercise regularly. The results of this study suggest that physical therapists should include strategies to increase exercise self-efficacy when designing patient intervention programs for patients with PD. PMID:22003171

Relationship between work-related attitudes, performance and capacities according to the ICF in patients with mental disorders.

PubMed

Linden, Michael; Baron, Stefanie; Muschalla, Beate

2010-01-01

The International Classification of Functioning Disability and Health (ICF) differentiates between functions, activities/capacities, contextual factors and participation. Dysfunctions can result in impaired capacities, which in turn can lead to problems with participation depending on the context. Motivational and volitional deficits are intervening factors. The question is to what degree work performance (i.e. participation), motivational factors, and the inability to perform activities (i.e. dysfunctions) interact. Incapacities were measured in 213 patients (70% women) admitted to the Department of Behavioral Medicine using the Mini-ICF-Rating for Mental Disorders (Mini-ICF-APP), work performance was measured with the Endicott Work Productivity Scale (EWPS), and volitional and motivational problems in regard to work were assessed with the Arbeitsbezogenes Verhaltens- und Erlebensmuster (AVEM). Sick leave prior to admission and work-related problems were assessed in a special clinical interview. The mean global score of the Mini-ICF-APP across all patients was 0.84 +/- 0.56 (SD), corresponding to 'mild disability'. The highest disabilities in this patient population were found for 'flexibility' (item 3, 1.64 +/- 0.94); the lowest disabilities were found for 'self maintenance' (item 11, 0.19 +/- 0.44) and 'mobility' (item 12, 0.43 +/- 0.85). Partial correlations between the Mini-ICF-APP, AVEM and EWPS showed highly significant correlations between the Mini-ICF-APP and EWPS and no or weak correlations between the AVEM and the Mini-ICF-APP or EWPS. Work performance is primarily related to the inability to perform activities and incapacities, and only due to attitudes or volitional/motivational factors to a much lesser degree. Therefore, capacity and motivation can and must be separated. Copyright (c) 2010 S. Karger AG, Basel.

Conjuring a New Category of Disability from Prenatal Cocaine Exposure: Are the Infants Unique Biological or Caretaking Casualties?

ERIC Educational Resources Information Center

Schutter, Linda S.; Brinker, Richard P.

1992-01-01

A review of the literature on biological and environmental effects of cocaine use suggests that the classification of infants and young children as prenatally cocaine exposed is neither descriptive nor predictive of behavior. The classification of behavior rather than labeling of the child is encouraged, as are partnerships with families of…

Outcomes for Students Receiving School-Based Physical Therapy as Measured by the School Function Assessment.

PubMed

Effgen, Susan K; McCoy, Sarah Westcott; Chiarello, Lisa A; Jeffries, Lynn M; Starnes, Catherine; Bush, Heather M

2016-01-01

To describe School Function Assessment (SFA) outcomes after 6 months of school-based physical therapy and the effects of age and gross motor function on outcomes. Within 28 states, 109 physical therapists and 296 of their students with disabilities, ages 5 to 12 years, participated. After training, therapists completed 10 SFA scales on students near the beginning and end of the school year. Criterion scores for many students remained stable (46%-59%) or improved (37%-51%) with the most students improving in Participation and Maintaining/Changing Positions. Students aged 5 to 7 years showed greater change than 8- to 12-year-olds on 5 scales. Students with higher gross motor function (Gross Motor Function Classification System levels I vs IV/V and II/III vs IV/V) showed greater change on 9 scales. Positive SFA change was recorded in students receiving school-based physical therapy; however, the SFA is less sensitive for older students and those with lower functional movement.

Prevalence and clinical presentation of constipation in children with severe generalized cerebral palsy.

PubMed

Veugelers, Rebekka; Benninga, Marc A; Calis, Elsbeth A C; Willemsen, Sten P; Evenhuis, Heleen; Tibboel, Dick; Penning, Corine

2010-09-01

Our aim was to study the prevalence and characteristics of constipation in children with profound multiple disabilities, as data in this area are scarce. A cross-sectional observational study was performed in specialized day-care centres and schools in the Netherlands. The study included 152 children (81 males, 71 females; mean age 9 y 6 mo, SD 4 y 6 mo). Intellectual disability ranged from moderate (7%) to profound (52%) in all participants who also had severe motor disabilities (83% classified at Gross Motor Function Classification System level V). We collected data on defaecation characteristics, food and fluid intake, and laxative consumption using standardized bowel diaries and interviews. Constipation was defined as (1) scybalous, pebble-like, hard stools in over a quarter of defaecations in combination with a defaecation frequency of less than three times per week during a 2-week study period; (2) large stools palpable on abdominal examination; or (3) laxative use or manual disimpaction of faeces. Of the studied population, 57% were constipated and 55% used laxatives, 27% of whom showed symptoms of constipation. Daily intakes of water and fibre were below the required standards in 87% and 53% of participants respectively, without a proven relation to constipation. Constipation is a common problem in children with severe disabilities. Laxative use is high but dosing is frequently inadequate to prevent symptoms.

The role of clothing in participation of persons with a physical disability: a scoping review protocol

PubMed Central

Poncet, Frédérique; Rochette, Annie; Auger, Claudine; Billebaud, Christophe; de Guise, Élaine; Ducharme, Isabelle; Kehayia, Eva; Labbé, Delphine; Dahan-Oliel, Noémi; Lessard, Isabelle; Vermeersch, Olivier; Swaine, Bonnie

2018-01-01

Introduction Clothing is an important aspect of nearly all human societies from performing social and cultural functions to indicating social status, a form of protection and a way for self-expression. It can help or hinder the ability to fulfil everyday activities and social roles and with the rising industry of wearable technologies, smart textiles are adding health-monitoring functions to clothing. The influence that clothing can have on the life of someone with a physical disability is significant, and further research is needed to understand it better. To achieve this, a scoping review will be performed with the aim of understanding the role of clothing in participation (ie, at home, in the community, etc) of individuals with a physical disability. This article presents the protocol and procedure to be adopted. Methods and analysis An in-depth iterative analysis of the scientific literature from six databases (MEDLINE, Embase, CINAHL, Scopus, PsycINFO and ERIC) as well as a hand search of grey literature and reference lists will be performed. After an abstract and full-text review of references by three reviewers independently, data from the selected articles will be tabulated and synthesised with a qualitative and quantitative approach using the International Classification of Functioning, Disability and Health as a unifying conceptual framework. A multidisciplinary consultation group of experts from various stakeholder groups will be involved in multiple steps to ensure validation and relevance of the data. Ethics and dissemination As this is a review involving analysis of data available in the public domain and does not involve human participants, ethical approval was not required. Results will be presented in a co-constructed format with the expert consultation group to ensure validity and maximise its practicality moving forward. Our dissemination plan includes peer-reviewed publications, presentations and stakeholder meetings. PMID:29523570

The role of clothing in participation of persons with a physical disability: a scoping review protocol.

PubMed

Esmail, Alida; Poncet, Frédérique; Rochette, Annie; Auger, Claudine; Billebaud, Christophe; de Guise, Élaine; Ducharme, Isabelle; Kehayia, Eva; Labbé, Delphine; Dahan-Oliel, Noémi; Lessard, Isabelle; Vermeersch, Olivier; Swaine, Bonnie

2018-03-08

Clothing is an important aspect of nearly all human societies from performing social and cultural functions to indicating social status, a form of protection and a way for self-expression. It can help or hinder the ability to fulfil everyday activities and social roles and with the rising industry of wearable technologies, smart textiles are adding health-monitoring functions to clothing. The influence that clothing can have on the life of someone with a physical disability is significant, and further research is needed to understand it better. To achieve this, a scoping review will be performed with the aim of understanding the role of clothing in participation (ie, at home, in the community, etc) of individuals with a physical disability. This article presents the protocol and procedure to be adopted. An in-depth iterative analysis of the scientific literature from six databases (MEDLINE, Embase, CINAHL, Scopus, PsycINFO and ERIC) as well as a hand search of grey literature and reference lists will be performed. After an abstract and full-text review of references by three reviewers independently, data from the selected articles will be tabulated and synthesised with a qualitative and quantitative approach using the International Classification of Functioning, Disability and Health as a unifying conceptual framework. A multidisciplinary consultation group of experts from various stakeholder groups will be involved in multiple steps to ensure validation and relevance of the data. As this is a review involving analysis of data available in the public domain and does not involve human participants, ethical approval was not required. Results will be presented in a co-constructed format with the expert consultation group to ensure validity and maximise its practicality moving forward. Our dissemination plan includes peer-reviewed publications, presentations and stakeholder meetings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Outcomes of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease: a systematic review.

PubMed

Morris, Meg E; Perry, Alison; Bilney, Belinda; Curran, Andrea; Dodd, Karen; Wittwer, Joanne E; Dalton, Gregory W

2006-09-01

This article describes a systematic review and critical evaluation of the international literature on the effects of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease (PwMND). The results were interpreted using the framework of the International Classification of Functioning, Disability and Health. This enabled us to summarize therapy outcomes at the level of body structure and function, activity limitations, participation restrictions, and quality of life. Databases searched included MEDLINE, PUBMED, CINAHL, PSYCInfo, Data base of Abstracts of Reviews of Effectiveness (DARE), The Physiotherapy Evidence data base (PEDro), Evidence Based Medicine Reviews (EMBASE), the Cochrane database of systematic reviews, and the Cochrane Controlled Trials Register. Evidence was graded according to the Harbour and Miller classification. Most of the evidence was found to be at the level of "clinical opinion" rather than of controlled clinical trials. Several nonrandomized small group and "observational studies" provided low-level evidence to support physical therapy for improving muscle strength and pulmonary function. There was also some evidence to support the effectiveness of speech pathology interventions for dysarthria. The search identified a small number of studies on occupational therapy for PwMND, which were small, noncontrolled pre-post-designs or clinical reports.

Australian Cerebral Palsy Child Study: protocol of a prospective population based study of motor and brain development of preschool aged children with cerebral palsy.

PubMed

Boyd, Roslyn N; Jordan, Rachel; Pareezer, Laura; Moodie, Anne; Finn, Christine; Luther, Belinda; Arnfield, Evyn; Pym, Aaron; Craven, Alex; Beall, Paula; Weir, Kelly; Kentish, Megan; Wynter, Meredith; Ware, Robert; Fahey, Michael; Rawicki, Barry; McKinlay, Lynne; Guzzetta, Andrea

2013-06-11

Cerebral palsy (CP) results from a static brain lesion during pregnancy or early life and remains the most common cause of physical disability in children (1 in 500). While the brain lesion is static, the physical manifestations and medical issues may progress resulting in altered motor patterns. To date, there are no prospective longitudinal studies of CP that follow a birth cohort to track early gross and fine motor development and use Magnetic Resonance Imaging (MRI) to determine the anatomical pattern and likely timing of the brain lesion. Existing studies do not consider treatment costs and outcomes. This study aims to determine the pathway(s) to motor outcome from diagnosis at 18 months corrected age (c.a.) to outcome at 5 years in relation to the nature of the brain lesion (using structural MRI). This prospective cohort study aims to recruit a total of 240 children diagnosed with CP born in Victoria (birth years 2004 and 2005) and Queensland (birth years 2006-2009). Children can enter the study at any time between 18 months to 5 years of age and will be assessed at 18, 24, 30, 36, 48 and 60 months c.a. Outcomes include gross motor function (GMFM-66 & GMFM-88), Gross Motor Function Classification System (GMFCS); musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function (Manual Ability Classification System), communication difficulties using Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP), participation using the Paediatric Evaluation of Disability Inventory (PEDI), parent reported quality of life and classification of medical and allied health resource use and determination of the aetiology of CP using clinical evaluation combined with MRI. The relationship between the pathways to motor outcome and the nature of the brain lesion will be analysed using multiple methods including non-linear modelling, multilevel mixed-effects models and generalised estimating equations. This protocol describes a large population-based study of early motor development and brain structure in a representative sample of preschool aged children with CP, using direct clinical assessment. The results of this study will be published in peer reviewed journals and presented at relevant international conferences. Australia and New Zealand Clinical Trials Register (ACTRN1261200169820).

Australian Cerebral Palsy Child Study: protocol of a prospective population based study of motor and brain development of preschool aged children with cerebral palsy

PubMed Central

2013-01-01

Background Cerebral palsy (CP) results from a static brain lesion during pregnancy or early life and remains the most common cause of physical disability in children (1 in 500). While the brain lesion is static, the physical manifestations and medical issues may progress resulting in altered motor patterns. To date, there are no prospective longitudinal studies of CP that follow a birth cohort to track early gross and fine motor development and use Magnetic Resonance Imaging (MRI) to determine the anatomical pattern and likely timing of the brain lesion. Existing studies do not consider treatment costs and outcomes. This study aims to determine the pathway(s) to motor outcome from diagnosis at 18 months corrected age (c.a.) to outcome at 5 years in relation to the nature of the brain lesion (using structural MRI). Methods This prospective cohort study aims to recruit a total of 240 children diagnosed with CP born in Victoria (birth years 2004 and 2005) and Queensland (birth years 2006–2009). Children can enter the study at any time between 18 months to 5 years of age and will be assessed at 18, 24, 30, 36, 48 and 60 months c.a. Outcomes include gross motor function (GMFM-66 & GMFM-88), Gross Motor Function Classification System (GMFCS); musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function (Manual Ability Classification System), communication difficulties using Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP), participation using the Paediatric Evaluation of Disability Inventory (PEDI), parent reported quality of life and classification of medical and allied health resource use and determination of the aetiology of CP using clinical evaluation combined with MRI. The relationship between the pathways to motor outcome and the nature of the brain lesion will be analysed using multiple methods including non-linear modelling, multilevel mixed-effects models and generalised estimating equations. Discussion This protocol describes a large population-based study of early motor development and brain structure in a representative sample of preschool aged children with CP, using direct clinical assessment. The results of this study will be published in peer reviewed journals and presented at relevant international conferences. Trial registration Australia and New Zealand Clinical Trials Register (ACTRN1261200169820) PMID:23758951

Content comparison of haemophilia specific patient-rated outcome measures with the international classification of functioning, disability and health (ICF, ICF-CY)

PubMed Central

2010-01-01

Background Patient-Reported Outcomes (PROs) are considered important outcomes because they reflect the patient's experience in clinical trials. PROs have been included in the field of haemophilia only recently. Purpose Comparing the contents of PROs measures used in haemophilia, based on the ICF/ICF-CY as frame of reference. Methods Haemophilia-specific PROs for adults and children were selected on the grounds of international accessibility. The content of the selected instruments were examined by linking the concepts within the items of these instruments to the ICF/ICF-CY. Results Within the 5 selected instruments 365 concepts were identified, of which 283 concepts were linked to the ICF/ICF CY and mapped into 70 different categories. The most frequently used categories were "b152: Emotional functions" and "e1101: Drugs". Conclusions The present paper provides an overview on current PROs in haemophilia and facilitates the selection of appropriate instruments for specific purposes in clinical and research settings. This work was made possible by the grant of the European Murinet Project (Multidisciplinary Research Network on Health and Disability in Europe). PMID:21108796

Health related quality of life assessment in metastatic disease of the spine: a systematic review.

PubMed

Street, John; Berven, Sigurd; Fisher, Charles; Ryken, Timothy

2009-10-15

Systematic literature review. To examine the available literature on health related quality of life (HRQOL) assessment in metastatic disease of the spine and identify the optimal functional outcome scales to be used in developing a disease-specific tool. There is a lack of consensus in the use of HRQOL measures in patients with metastatic spine disease. A systematic review was conducted using MEDLINE, EMBASE, the Science Citation Index (ISI), the Cumulative Index to Nursing and Allied Health Literature, the PsycINFO, the Allied and Complementary Medicine (AMED), Cochrane Reviews and Global Health databases for clinical studies addressing metastatic spine disease from 1966 through 2008. The validity of outcome tools was established by linkage analysis with the International Classification of Functioning Disability and Health (ICF). One hundred forty-one clinical studies met inclusion criteria including 10,347 patients. Only 5 moderate grade and 1 high grade study were identified. Thirty- four studies used a patient self-assessment instrument to assess health status. None of the instruments were validated for metastatic spine patients. The most commonly used Pi-by-no tools were SF-36, SIP 5, and the ADL. None of the studies defined health related quality of life (HRQOL) or justified the choice of instrument. The most commonly used cancer-specific tools were ECOG, EORTC QCQ-C30, and EUROQOL 5D. Based on frequency of citation and on correlation with the International Classification of Functioning Disability and Health, the ECOG and SF36 were judged as most valid and reliable. A systematic review of the available evidence suggests that valid and reliable health related quality of life measures exist for the assessment of oncology patients; however, a disease-specific tool for metastatic spine disease awaits development. Until such time as a disease-specific tool is available, we recommend that the ECOG and SF-36 be considered for use in studies addressing the outcome assessment of patients with metastatic spine disease.

Classification of binary intentions for individuals with impaired oculomotor function: ‘eyes-closed’ SSVEP-based brain-computer interface (BCI)

NASA Astrophysics Data System (ADS)

Lim, Jeong-Hwan; Hwang, Han-Jeong; Han, Chang-Hee; Jung, Ki-Young; Im, Chang-Hwan

2013-04-01

Objective. Some patients suffering from severe neuromuscular diseases have difficulty controlling not only their bodies but also their eyes. Since these patients have difficulty gazing at specific visual stimuli or keeping their eyes open for a long time, they are unable to use the typical steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI) systems. In this study, we introduce a new paradigm for SSVEP-based BCI, which can be potentially suitable for disabled individuals with impaired oculomotor function. Approach. The proposed electroencephalography (EEG)-based BCI system allows users to express their binary intentions without needing to open their eyes. A pair of glasses with two light emitting diodes flickering at different frequencies was used to present visual stimuli to participants with their eyes closed, and we classified the recorded EEG patterns in the online experiments conducted with five healthy participants and one patient with severe amyotrophic lateral sclerosis (ALS). Main results. Through offline experiments performed with 11 participants, we confirmed that human SSVEP could be modulated by visual selective attention to a specific light stimulus penetrating through the eyelids. Furthermore, the recorded EEG patterns could be classified with accuracy high enough for use in a practical BCI system. After customizing the parameters of the proposed SSVEP-based BCI paradigm based on the offline analysis results, binary intentions of five healthy participants were classified in real time. The average information transfer rate of our online experiments reached 10.83 bits min-1. A preliminary online experiment conducted with an ALS patient showed a classification accuracy of 80%. Significance. The results of our offline and online experiments demonstrated the feasibility of our proposed SSVEP-based BCI paradigm. It is expected that our ‘eyes-closed’ SSVEP-based BCI system can be potentially used for communication of disabled individuals with impaired oculomotor function.

Classification of binary intentions for individuals with impaired oculomotor function: 'eyes-closed' SSVEP-based brain-computer interface (BCI).

PubMed

Lim, Jeong-Hwan; Hwang, Han-Jeong; Han, Chang-Hee; Jung, Ki-Young; Im, Chang-Hwan

2013-04-01

Some patients suffering from severe neuromuscular diseases have difficulty controlling not only their bodies but also their eyes. Since these patients have difficulty gazing at specific visual stimuli or keeping their eyes open for a long time, they are unable to use the typical steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI) systems. In this study, we introduce a new paradigm for SSVEP-based BCI, which can be potentially suitable for disabled individuals with impaired oculomotor function. The proposed electroencephalography (EEG)-based BCI system allows users to express their binary intentions without needing to open their eyes. A pair of glasses with two light emitting diodes flickering at different frequencies was used to present visual stimuli to participants with their eyes closed, and we classified the recorded EEG patterns in the online experiments conducted with five healthy participants and one patient with severe amyotrophic lateral sclerosis (ALS). Through offline experiments performed with 11 participants, we confirmed that human SSVEP could be modulated by visual selective attention to a specific light stimulus penetrating through the eyelids. Furthermore, the recorded EEG patterns could be classified with accuracy high enough for use in a practical BCI system. After customizing the parameters of the proposed SSVEP-based BCI paradigm based on the offline analysis results, binary intentions of five healthy participants were classified in real time. The average information transfer rate of our online experiments reached 10.83 bits min(-1). A preliminary online experiment conducted with an ALS patient showed a classification accuracy of 80%. The results of our offline and online experiments demonstrated the feasibility of our proposed SSVEP-based BCI paradigm. It is expected that our 'eyes-closed' SSVEP-based BCI system can be potentially used for communication of disabled individuals with impaired oculomotor function.

Using Simultaneous Prompting to Teach Restaurant Words and Classifications as Non-Target Information to Secondary Students with Moderate to Severe Disabilities

ERIC Educational Resources Information Center

Smith, Bethany R.; Schuster, John W.; Collins, Belva; Kleinert, Harold

2011-01-01

This paper reviews selected literature pertaining to simultaneous prompting and the acquisition of non-target information for individuals with moderate to severe disabilities. The purpose of this review was to discuss the definition of non-target information (NTI) and the various places it can be embedded within an instructional trial. The…

Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF).

PubMed

Sigmundsdottir, Linda; Longley, Wendy A; Tate, Robyn L

2016-10-01

Computerised cognitive training (CCT) is an increasingly popular intervention for people experiencing cognitive symptoms. This systematic review evaluated the evidence for CCT in adults with acquired brain injury (ABI), focusing on how outcome measures used reflect efficacy across components of the International Classification of Functioning, Disability and Health. Database searches were conducted of studies investigating CCT to treat cognitive symptoms in adult ABI. Scientific quality was rated using the PEDro-P and RoBiNT Scales. Ninety-six studies met the criteria. Most studies examined outcomes using measures of mental functions (93/96, 97%); fewer studies included measures of activities/participation (41/96, 43%) or body structures (8/96, 8%). Only 14 studies (15%) provided Level 1 evidence (randomised controlled trials with a PEDro-P score ≥ 6/10), with these studies suggesting strong evidence for CCT improving processing speed in multiple sclerosis (MS) and moderate evidence for improving memory in MS and brain tumour populations. There is a large body of research examining the efficacy of CCT, but relatively few Level 1 studies and evidence is largely limited to body function outcomes. The routine use of outcome measures of activities/participation would provide more meaningful evidence for the efficacy of CCT. The use of body structure outcome measures (e.g., neuroimaging) is a newly emerging area, with potential to increase understanding of mechanisms of action for CCT.

Prospective validation study of the International Classification of Functioning, Disability and Health score in Crohn's disease and ulcerative colitis.

PubMed

Leong, Rupert W L; Huang, Tony; Ko, Yanna; Jeon, Ari; Chang, Jeff; Kohler, Friedbert; Kariyawasam, Viraj

2014-10-01

Inflammatory bowel diseases (IBD) may result in disability. We aim to validate a novel scoring system for the IBD disability index (IBD-DI), and identify predictors of disability and its correlation with work absenteeism. This prospective IBD ambulatory clinic cohort study measured IBD-DI, Crohn's Disease Activity Index (CDAI) for Crohn's disease (CD) or partial Mayo score (pMayo) for ulcerative colitis (UC), IBDQ quality-of-life, and Work Productivity and Activity Impairment. Negative IBD-DI represented greater disability. Validation tests were performed and predictors and extent of work absenteeism were determined. 166 consecutive subjects were recruited (75 CD, 41 UC, 50 controls). IBD-DI correlated with CDAI (r=-0.77, P<0.001), pMayo (r=-0.82, P<0.001) and IBDQ (r=0.86, P<0.001). IBD-DI differentiated CD, and UC from controls (medians -7, -4, +10; P<0.001) with a score of >3.5 identifying controls with 94% sensitivity and 83% specificity (area-under-curve 0.92). Stable patients had unchanged IBD-DI (P=ns) but not in those who relapsed (P<0.001). Intraclass correlation was 0.89 and Cronbach's alpha of internal consistency was 0.94. Diagnosis age, sex, phenotype, perianal disease, prior surgery, steroid-use and disease duration did not influence the IBD-DI but active use of biological agents significantly reduced disability (P=0.03). 21.6% of IBD patients had moderate-severe disability equating to missing >25% of work hours in the previous week. Multivariate analysis identified that only IBD-DI to be predictive of unemployment status (OR: 0.94; 95% CI: 0.89-0.99). The IBD-DI is a valid tool measuring disability in both CD and UC and correlates with workforce participation. It is a potential useful tool in the assessment of participation restriction and activity limitation. ACTRN12613000903785. Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Rehabilitation needs approached by health professionals at a rheumatism hospital.

PubMed

Mengshoel, Anne Marit; Skarbø, Åse

2017-09-01

The aim of the present study was to examine the characteristics of patients referred to occupational therapists (OTs), physiotherapists (PTs) and social workers (SWs) at a rehabilitation unit in a hospital specializing in rheumatology, and the rehabilitation needs that clinicians and patients agreed should be addressed in the encounters with the particular health professional groups. Consecutive hospitalized patients at a rheumatism hospital were recruited by the health professionals. Questions about patient characteristics and rehabilitation needs were posed. Free-text responses to questions about rehabilitation needs were coded by the International Classification of Functioning, Disability, and Health (ICF). The patients varied considerably in age distribution, disease duration, disability level and diagnoses, and several patients had comorbidities. The rehabilitation needs classified under the component Body Function fell into the chapters: Sensory Functions and Pain (PTs), Functions of Cardiovascular System (PTs), Neuromusculoskeletal and Movement-Related Functions (OTs, PTs); under the Activity and Participation component, these were: General Tasks and Demands (OTs), Mobility (OTs), Self-Care (PTs), Interpersonal Interactions and Relationships (SWs) and Major Life Stress (SWs); and under the Environmental Factors component these were: Products and Technology (OTs) and Services, Systems and Politics (SWs). The patients were fairly heterogeneous. The needs identified in the encounters with the different professional groups fell into all three components of the ICF, and there was only a minor overlap between the health professionals at the chapter level of the ICF. Copyright © 2016 John Wiley & Sons, Ltd.

McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Sensitivity to Change in Low Back Pain: Influence of Shifts in Priorities

PubMed Central

Sanchez, Katherine; Papelard, Agathe; Nguyen, Christelle; Bendeddouche, Imad; Jousse, Marylène; Rannou, François; Revel, Michel; Poiraudeau, Serge

2011-01-01

Objective To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) in chronic low back pain (CLBP) and shifts in patients' priorities of disabling activities over time. Methods A prospective longitudinal survey of 100 patients (38 males) with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC), Hospital Anxiety and Depression scale (HAD), Fear-Avoidance Beliefs Questionnaire (FABQ), Coping Strategies Questionnaire (CSQ), and pain and handicap visual analogue scales (VASs). Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES) and Standardized response mean (SRM) and effect size (ES) were used to evaluate sensitivity to change of the MACTAR. Results The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37) were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF), most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients); community, social and civic life (22.7%); and domestic life (22.4%). At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated. Conclusions Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change. PMID:21629777

Looking at hospitalized persons throughout the prism of the handicap.

PubMed

Giral, M; Boussat, B; Lombard, F; Stempfle, S; François, P; Pérennou, D

2018-01-01

To describe the disability status of non-selected hospitalized persons. We conducted a cross-sectional survey to assess activity limitations of every person older than 18 years hospitalized in a regional university hospital covering all medical fields. Evaluators rated, on a scale from 0 to 4, 22 selected items of the International Classification of Functioning (ICF), covering the 6 following domains: learning and applying knowledge, general tasks and demands, communication, mobility, self-care, and interpersonal interactions and relationships. Univariate and multivariate analyses were performed to analyze the prevalence, severity and profile of the handicap in terms of sociodemographic characteristics and care pathways. Among 1572 eligible persons, 1267 (81%) were surveyed (mean age 62.7±20.4years; 655 males [51.7%]). Overall, 82% showed at least one activity limitation. For 52%, disability was severe or total for at least one ICF item. Prevalence of disabilities was higher for mobility (75%) and self-care domains (63%). Disability was strongly related to age: age older than 80years versus 18 to 44years (OR=12.8 95% CI 6.4-27.9]; P<0.01). Disability was associated with hospitalization in rehabilitation units (96%; OR=4.3 [95% CI 2.2-5.3]; P<0.01). Severe disability was associated with hospitalization in critical care units (OR=6.7 [CI 3.2-15.1]; P<0.001) and psychiatry units (OR=5.3 [CI 2.7-11.4]; P<0.001). Handicap was common in hospitalized persons, involving all 6 tested ICF activity domains, particularly mobility and self-care. This study alerts care givers, hospital administrators, and in general, people influencing health policies about the need to plan actions to reduce activity limitations of hospitalized persons, whatever the cause of the hospitalization. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A descriptive study on the functioning profile of patients with spinal cord injury in a rehabilitation center in Russia.

PubMed

Vasilchenko, E; Escorpizo, R; Filatov, E; Kislova, A; Surodeyeva, Y; Lyachovetskaya, V; Zoloyev, G

2017-05-01

This is a cross-sectional study. (1) To use the International Classification of Functioning, Disability and Health (ICF) profile to assess the functioning of patients with spinal cord injury (SCI) admitted to a rehabilitation center; (2) To determine the role of the ICF in the operation of a rehabilitation center in Russia. This study was conducted in the Federal center for disability rehabilitation in Novokuznetsk, Russia. Eighty-one patients with SCI (59 men and 22 women; 31 with cervical, 41 with thoracic and 9 with lumbar level of injury) were included in the study. We determined the odds ratios of more pronounced impairments in ICF categories according to the duration of SCI and degree of neurological deficit. Mean age of patients was 34.9±11.1 years, men/women ratio was 2.7:1 and the median of time from injury was 2.5 (1.5-6) years. On the basis of American Spinal Injury Association Impairment Scale (AIS), most patients had AIS A (N=31, 38.3%). Patients with tetraplegia and AIS A or AIS B were at risk for more significant impairments in b620 'urination functions' and b640 'sexual functions'. Patients with paraplegia and AIS A or AIS B were at risk for more significant impairments in b735 'muscle tone functions'. Using the ICF, we were able to describe the range and extent of functioning problems experienced by patients with SCI who were admitted in our rehabilitation center. Moreover, the use of the ICF improved the interaction between specialists.

Sociodemographic features and diagnoses as predictors of severe disability in a sample of adults applying for disability certification.

PubMed

Raggi, Alberto; Covelli, Venusia; Pagani, Marco; Meucci, Paolo; Martinuzzi, Andrea; Buffoni, Mara; Russo, Emanuela; Leonardi, Matilde

2014-06-01

To assess the association between sociodemographic factors and factors related to number and type of comorbidities, and presence of severe disability in a population of adults applying for disability certification. Data have been collected using a protocol based on the ICF Classification. Hierarchical logistic regression was performed to assess the association between severe disability and sex, age, marital status, education, living situation, number, and type of diagnosis. In total, 552 individuals were enrolled (46.2% men, mean age 62.3 years), with an average of three diagnoses, mostly mental, neurological, and cardiovascular. Being married/cohabitating and higher education levels were associated with reduced odds of severe disability; living with other individuals, such as in an institution, was associated with increased odds. Our results show that age and education level were associated with severe disability, and that no association with number of diseases was found: in our opinion, this is specific to the population of individuals with disability.

[Review of assessment methods used to evaluate feeding for children with pervasive developmental disorder].

PubMed

Nadon, G; Ehrmann Feldman, D; Gisel, E

2008-08-01

Current evaluations used by occupational therapists to assess and treat feeding problems derive mainly from the domain of dysphagia. The purpose of this article is to familiarize the reader with tools used, in research, for children with pervasive developmental disorders (PDD) and to determine if any of these meet the needs of occupational therapists. The following data bases were searched: Medline, CINAHL, HAPI and PsyINFO, using the terms pervasive developmental disorder, autism, Asperger syndrome, pervasive developmental disorder not otherwise specified, eating behavior, eating disorder, food preference, food selectivity, feeding disorders, picky eater and child. All articles published between 1980 and 2006 (n=27) were reviewed. A total of 20 studies met our selection criteria. Assessment methods are compared using the Disability Creation Model (DCP). The DCP is the Quebec alternative to the International Classification of Functioning, Disability and Health (ICF). None of the evaluation tools reviewed met all factors that may influence eating in children with PDD. Implications for research and practice in occupational therapy are discussed.

Vegetative state, minimally conscious state, akinetic mutism and Parkinsonism as a continuum of recovery from disorders of consciousness: an exploratory and preliminary study

PubMed Central

Formisano, Rita; D’Ippolito, Mariagrazia; Risetti, Monica; Riccio, Angela; Caravasso, Chiara Falletta; Catani, Sheila; Rizza, Federica; Forcina, Antonio; Buzzi, Maria Gabriella

Summary The aim of this study was to review the usefulness of clinical and instrumental evaluation in individuals with disorders of consciousness (DOC). Thirteen subjects with severe acquired brain injury (ABI) and a diagnosis of DOC were evaluated using the Coma Recovery Scale in its revised version (CRS-R) and a new global disability index, the Post-Coma Scale (PCS). These instruments were administered both by a neutral examiner (professional) and by a professional in the presence of a caregiver. All patients were also scored using the International Classification of Functioning, Disability and Health (ICF). A statistically significant correlation between CRS-R and PCS was demonstrated. However, there also emerged significant differences in responsiveness between professional versus caregiver+professional assessment using the two scales. The emotional stimulation provided by significant others (caregivers) during administration of DOC evaluation scales may improve the assessment of responsiveness. PMID:21693084

Using the WHO-ICF with talking mats to enable adults with long-term communication difficulties to participate in goal setting.

PubMed

Murphy, Joan; Boa, Sally

2012-03-01

The World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) provides a framework that helps rehabilitation staff to take a holistic view of the patient. However, it is used predominantly by professionals rather than by active participation on behalf of the person with the disability. In addition, the language used within the framework can be difficult for patients to understand. In order to address these issues the Activities and Participation section of the ICF has been adapted by using graphic symbols. It has been used in conjunction with Talking Mats(™ 1 ), a low-tech communication framework, to help adults with long-term conditions participate in goal setting. This paper describes how this was done and provides examples from clinical practice. The paper discusses how this combined framework can empower people with communication difficulties and long-term conditions to become active participants in the rehabilitation process by identifying their own goals, indicating changing priorities and tracking their progress.

Built Environment and Elderly Population Health: A Comprehensive Literature Review

PubMed Central

Garin, Noe; Olaya, Beatriz; Miret, Marta; Ayuso-Mateos, Jose Luis; Power, Michael; Bucciarelli, Paola; Haro, Josep Maria

2014-01-01

Global population aging over recent years has been linked to poorer health outcomes and higher healthcare expenditure. Policies focusing on healthy aging are currently being developed but a complete understanding of health determinants is needed to guide these efforts. The built environment and other external factors have been added to the International Classification of Functioning as important determinants of health and disability. Although the relationship between the built environment and health has been widely examined in working age adults, research focusing on elderly people is relatively recent. In this review, we provide a comprehensive synthesis of the evidence on the built environment and health in the elderly. PMID:25356084

[Medical and psychological rehabilitation of patients and disabled persons].

PubMed

Zaĭtsev, V P

2013-01-01

The paper unveils the concept of medical rehabilitation and defines its place in clinical medicine. It underlines the inextricable link and interaction of different components of a rehabilitation system. The value of the psychological aspect of rehabilitation is considered. Categories of patients and disabled persons who need psychological rehabilitation are identified; a classification of personal reactions to disease and the changes in the psychological state of patients in different periods after disease onset are given. The factors influencing the process of psychological readjustment in patients and the disabled are analyzed. The psychological rehabilitation system for patients and disabled persons is considered in detail. Data on its medical and socioeconomic efficiency are presented.

Exploring competitive orientation in a group of athletes participating in the 1996 paralympic trials.

PubMed

Page, S J

2000-10-01

The purposes of this study were to test (1) whether athletes with congenital disabilities exhibited different competitive orientations than athletes with disabilities acquired during their lifespans and (2) whether male athletes with disabilities exhibited different competitive orientations than their female peers. 54 paraplegic, quadriplegic and amputee athletes competing in the 1996 Paralympic Track and Field Trials completed the Sport Orientation Questionnaire. No mean differences were found between men and women, athletes with different onsets of their disabilities across the lifespan, between adolescents and adults, and between athletes with different severity classifications on the Goal orientation, Competitiveness, and Desire to win scales. Larger studies are encouraged to examine competitive orientation, as well as scores on tests specifically constructed to be administered to athletes with disabilities.

Poverty and disability in low- and middle-income countries: A systematic review.

PubMed

Banks, Lena Morgon; Kuper, Hannah; Polack, Sarah

2017-01-01

Disability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs). Ten electronic databases were searched to retrieve studies of any epidemiological design, published between 1990-March 2016 with data comparing the level of poverty between people with and without disabilities in LMICs (World Bank classifications). Poverty was defined using economic measures (e.g. assets, income), while disability included both broad assessments (e.g. self-reported functional or activity limitations) and specific impairments/disorders. Data extracted included: measures of association between disability and poverty, population characteristics and study characteristics. Proportions of studies finding positive, negative, null or mixed associations between poverty and disability were then disaggregated by population and study characteristics. From the 15,500 records retrieved and screened, 150 studies were included in the final sample. Almost half of included studies were conducted in China, India or Brazil (n = 70, 47%). Most studies were cross-sectional in design (n = 124, 83%), focussed on specific impairment types (n = 115, 77%) and used income as the measure for economic poverty (n = 82, 55%). 122 studies (81%) found evidence of a positive association between disability and a poverty marker. This relationship persisted when results were disaggregated by gender, measure of poverty used and impairment types. By country income group at the time of data collection, the proportion of country-level analyses with a positive association increased with the rising income level, with 59% of low-income, 67% of lower-middle and 72% of upper-middle income countries finding a positive relationship. By age group, the proportion of studies reporting a positive association between disability and poverty was lowest for older adults and highest for working-age adults (69% vs. 86%). There is strong evidence for a link between disability and poverty in LMICs and an urgent need for further research and programmatic/policy action to break the cycle.

Physiotherapeutic interventions and physical activity for children in Northern Sweden with cerebral palsy: a register study from equity and gender perspectives.

PubMed

Degerstedt, Frida; Wiklund, Maria; Enberg, Birgit

Young people with disabilities, especially physical disabilities, report worse health than others. This may be because of the disability, lower levels of physical activity, and discrimination. For children with cerebral palsy, access to physiotherapy and physical activity is a crucial prerequisite for good health and function. To date, there is limited knowledge regarding potential gender bias and inequity in habilitation services. To map how physiotherapeutic interventions (PTI), physical leisure activity, and physical education are allocated for children with cerebral palsy regarding sex, age, level of gross motor function, and county council affiliation. This was done from a gender and equity perspective. A register study using data from the Cerebral Palsy follow-Up Program (CPUP). Data included 313 children ≤18 years with cerebral palsy from the five northern counties in Sweden during 2013. Motor impairment of the children was classified according to the expanded and revised Gross Motor Function Classification System (GMFCS). In three county councils, boys received more physiotherapy interventions and received them more frequently than girls did. Differences between county councils were seen for frequency and reasons for physiotherapy interventions (p < 0.001). The physiotherapist was involved more often with children who had lower motor function and with children who had low physical leisure activity. Children with lower motor function level participated in physical leisure activity less often than children with less motor impairment (p < 0.001). Boys participated more frequently in physical education than did girls (p = 0.028). Gender and county council affiliation affect the distribution of physiotherapy interventions for children with cerebral palsy, and there are associations between gender and physical activity. Thus, the intervention is not always determined by the needs of the child or the degree of impairment. A gender-bias is indicated. Further studies are needed to ensure fair interventions.

Physiotherapeutic interventions and physical activity for children in Northern Sweden with cerebral palsy: a register study from equity and gender perspectives

PubMed Central

Degerstedt, Frida; Wiklund, Maria; Enberg, Birgit

2017-01-01

ABSTRACT Background: Young people with disabilities, especially physical disabilities, report worse health than others. This may be because of the disability, lower levels of physical activity, and discrimination. For children with cerebral palsy, access to physiotherapy and physical activity is a crucial prerequisite for good health and function. To date, there is limited knowledge regarding potential gender bias and inequity in habilitation services. Objectives: To map how physiotherapeutic interventions (PTI), physical leisure activity, and physical education are allocated for children with cerebral palsy regarding sex, age, level of gross motor function, and county council affiliation. This was done from a gender and equity perspective. Methods: A register study using data from the Cerebral Palsy follow-Up Program (CPUP). Data included 313 children ≤18 years with cerebral palsy from the five northern counties in Sweden during 2013. Motor impairment of the children was classified according to the expanded and revised Gross Motor Function Classification System (GMFCS). Results: In three county councils, boys received more physiotherapy interventions and received them more frequently than girls did. Differences between county councils were seen for frequency and reasons for physiotherapy interventions (p < 0.001). The physiotherapist was involved more often with children who had lower motor function and with children who had low physical leisure activity. Children with lower motor function level participated in physical leisure activity less often than children with less motor impairment (p < 0.001). Boys participated more frequently in physical education than did girls (p = 0.028). Conclusion: Gender and county council affiliation affect the distribution of physiotherapy interventions for children with cerebral palsy, and there are associations between gender and physical activity. Thus, the intervention is not always determined by the needs of the child or the degree of impairment. A gender-bias is indicated. Further studies are needed to ensure fair interventions. PMID:28219314

Does classification of persons with fibromyalgia into Multidimensional Pain Inventory subgroups detect differences in outcome after a standard chronic pain management program?

PubMed Central

Verra, Martin L; Angst, Felix; Brioschi, Roberto; Lehmann, Susanne; Keefe, Francis J; Staal, J Bart; de Bie, Rob A; Aeschlimann, André

2009-01-01

INTRODUCTION: The present study aimed to replicate and validate the empirically derived subgroup classification based on the Multidimensional Pain Inventory (MPI) in a sample of highly disabled fibromyalgia (FM) patients. Second, it examined how the identified subgroups differed in their response to an intensive, interdisciplinary inpatient pain management program. METHODS: Participants were 118 persons with FM who experienced persistent pain and were disabled. Subgroup classification was conducted by cluster analysis using MPI subscale scores at entry to the program. At program entry and discharge, participants completed the MPI, Medical Outcomes Study Short Form-36, Hospital Anxiety and Depression Scale and Coping Strategies Questionnaire. RESULTS: Cluster analysis identified three subgroups in the highly disabled sample that were similar to those described by other studies using less disabled samples of FM. The dysfunctional subgroup (DYS; 36% of the sample) showed the highest level of depression, the interpersonally distressed subgroup (ID; 24%) showed a modest level of depression and the adaptive copers subgroup (AC; 38%) showed the lowest depression scores in the MPI (negative mood), Medical Outcomes Study Short Form-36 (mental health), Hospital Anxiety and Depression Scale (depression) and Coping Strategies Questionnaire (catastrophizing). Significant differences in treatment outcome were observed among the three subgroups in terms of reduction of pain severity (as assessed using the MPI). The effect sizes were 1.42 for DYS, 1.32 for AC and 0.62 for ID (P=0.004 for pairwise comparison of ID-AC and P=0.018 for ID-DYS). DISCUSSION: These findings underscore the importance of assessing individuals’ differences in how they adjust to FM. PMID:20011715

What areas of functioning are influenced by aquatic physiotherapy? Experiences of parents of children with cerebral palsy.

PubMed

Güeita-Rodríguez, Javier; García-Muro, Francisco; Rodríguez-Fernández, Ángel L; Lambeck, Johan; Fernández-de-Las-Peñas, Cesar; Palacios-Ceña, Domingo

2017-09-21

To explore the experiences regarding aquatic physiotherapy among parents of children with cerebral palsy and to identify a list of relevant intervention categories for aquatic physiotherapy treatments. We conducted semi-structured interviews and focus groups using the components of the International Classification of Functioning, Disability and Health (ICF) as a frame of reference to explore and code experiences regarding aquatic physiotherapy. A non-probabilistic purposive sampling strategy was used. Content analysis methods and ICF linking processes were used to analyze data. From the parents' perspective (n = 34), both the Body Functions and Activities and Participation components were mainly influenced by aquatic physiotherapy. Also, parents described Environmental Factors acting as barriers affecting progress during therapy. Parents identified a wide range of categories influenced by aquatic physiotherapy. Social and contextual aspects were highlighted, as well as a series of changes related to the illness as a result of treatment.

Do the physiotherapy results make us happy in a case with ‘happy puppet’ (Angelman) syndrome?

PubMed Central

Kara, Ozgun Kaya; Mutlu, Akmer; Gunel, Mintaze Kerem; Haliloglu, Goknur

2010-01-01

This study aimed to investigate the benefits of physiotherapy programme in a patient with Angelman syndrome (AS) during a follow-up of 3 years. Assessments included: disability level with gross motor function classification systems, gross motor function with gross motor function measurement (GMFM), balance with Berg Balance Scale, motor performance with gross motor performance measurement (GMPM) and tonus assessment with Modified Ashworth Scale. Physiotherapy programme was performed during 36 months, 3 days per week by physical therapist according to Neurodevelopmental Treatment approach. During the 36 months, GMFM increased from 11.46% to 70.82% and GMPM increased from 1.25% to 70.25%. This case report is the first study about the effectiveness of physiotherapy with medium-term follow-up in a child with AS. Physiotherapy results make us happy in this particular patient with ‘happy puppet’ syndrome. PMID:22802472

Description of the person-environment interaction: methodological issues and empirical results of an Italian large-scale disability assessment study using an ICF-based protocol.

PubMed

Francescutti, Carlo; Gongolo, Francesco; Simoncello, Andrea; Frattura, Lucilla

2011-05-31

There is a connection between the definition of disability in a person-environment framework, the development of appropriate assessment strategies and instruments, and the logic underpinning the organization of benefits and services to confront disability. The Italian Ministry of Health and Ministry of Labor and Social Policies supported a three-year project for the definition of a common framework and a standardised protocol for disability evaluation based on ICF. The research agenda of the project identified 6 phases: 1) adoption of a definition of disability; 2) analytical breakdown of the contents of disability definition, so as to indicate as clearly as possible the core information essential to guide the evaluation process; 3) definition of a data collection protocol; 4) national implementation of the protocol and collection of approximately 1,000 profiles; 5) proposal of a profile analysis and definition of groups of cases with similar functioning profiles; 6) trial of the proposal with the collected data. The data was analyzed in different ways: descriptive analysis, application of the person-environment interactions classification tree, and cluster analysis. A sample of 1,051 persons from 8 Italian regions was collected that represented different functioning conditions in all the phases of the life cycle. The aggregate result of the person-environment interactions was summarized. The majority of activities resulted with no problems in all of the A&P chapters. Nearly 50.000 facilitators codes were opened. The main frequent facilitators were family members, health and social professionals, assistive devices and both health and social systems, services and politics. The focus of the person-environment interaction evaluation was on the A&P domains, differentiating those in which performance presented limitations and restrictions from those in which performance had no or light limitations and restrictions. Communication(d3) and Learning and Applying Knowledge(d1) appeared as the more problematic A&P areas. Self Care(d5) was the domain in which facilitators were more effective in supporting functioning, suggesting that the Italian welfare system is mainly focused on providing care services for activities of daily living, jointly with the family. The cluster analysis was limited to those categories that were common to all age classes (38 categories out of 55). For a final representation, a solution with 6 clusters was chosen. An example is provided of how it is possible to plan empirical studies in which theoretical advances and operative goals on disability in a person-environment framework can support the definition of a research design, measurement strategies, and data analysis. The description of functioning and disability at population level is no more based on individual deficits or limitations. Personal profiles may be elaborated and groups created based on the characteristics of the person-environment interactions. Personal profiles may also be used as a "rationale" for defining personalized intervention programs.

What Do Clinicians Consider when Assessing Chronic Low Back Pain? A Content Analysis of Multidisciplinary Pain Centre Team Assessments of Functioning, Disability, and Health.

PubMed

Bagraith, Karl S; Strong, Jenny; Meredith, Pamela J; McPhail, Steven M

2018-05-22

Beyond expert suggestions as to the appropriate subject matter for chronic pain assessments, little is known about the actual content of multidisciplinary pain centre (MPC) clinical assessments. The International Classification of Functioning, Disability and Health Low Back Pain Core Set (ICF LBP-CS) provides a universal language to support the consistent description of LBP-related assessments across disciplines within multidisciplinary teams (MDT). This study sought to map the content of MPC clinical assessments to the ICF to: 1) identify and compare the content of clinical MDT assessments using a cross-disciplinary framework and, 2) examine the content validity of the LBP-CS. A qualitative examination of MPC team clinical assessments of CLBP was undertaken. MDT (pain medicine, psychiatry, nursing, physiotherapy, occupational therapy, and psychology) assessments were audio-recorded and transcribed. Concepts were extracted from transcripts using a meaning condensation procedure and then linked to the ICF. Across seven MDT assessments, comprised of 42 discipline-specific assessments and 241,209 transcribed words, 8596 concepts were extracted. Contextual factors (i.e., the person and environment), except for physiotherapy, accounted for almost half of each discipline's assessments (range: 49% - 58%) Concepts spanned 113 second-level ICF categories, including 73/78 LBP-CS categories. Overall, the findings revealed novel insights into the content of MPC clinical assessments that can be used to improve healthcare delivery. ICF-based assessment profiles demonstrated unique contributions from each discipline to CLBP assessment. Finally, users of the LBP-CS can be confident that the tool exhibits sound content validity from the perceptive of MDT assessments of functioning, disability, and health.

Stable Sparse Classifiers Identify qEEG Signatures that Predict Learning Disabilities (NOS) Severity

PubMed Central

Bosch-Bayard, Jorge; Galán-García, Lídice; Fernandez, Thalia; Lirio, Rolando B.; Bringas-Vega, Maria L.; Roca-Stappung, Milene; Ricardo-Garcell, Josefina; Harmony, Thalía; Valdes-Sosa, Pedro A.

2018-01-01

In this paper, we present a novel methodology to solve the classification problem, based on sparse (data-driven) regressions, combined with techniques for ensuring stability, especially useful for high-dimensional datasets and small samples number. The sensitivity and specificity of the classifiers are assessed by a stable ROC procedure, which uses a non-parametric algorithm for estimating the area under the ROC curve. This method allows assessing the performance of the classification by the ROC technique, when more than two groups are involved in the classification problem, i.e., when the gold standard is not binary. We apply this methodology to the EEG spectral signatures to find biomarkers that allow discriminating between (and predicting pertinence to) different subgroups of children diagnosed as Not Otherwise Specified Learning Disabilities (LD-NOS) disorder. Children with LD-NOS have notable learning difficulties, which affect education but are not able to be put into some specific category as reading (Dyslexia), Mathematics (Dyscalculia), or Writing (Dysgraphia). By using the EEG spectra, we aim to identify EEG patterns that may be related to specific learning disabilities in an individual case. This could be useful to develop subject-based methods of therapy, based on information provided by the EEG. Here we study 85 LD-NOS children, divided in three subgroups previously selected by a clustering technique over the scores of cognitive tests. The classification equation produced stable marginal areas under the ROC of 0.71 for discrimination between Group 1 vs. Group 2; 0.91 for Group 1 vs. Group 3; and 0.75 for Group 2 vs. Group1. A discussion of the EEG characteristics of each group related to the cognitive scores is also presented. PMID:29379411

Stable Sparse Classifiers Identify qEEG Signatures that Predict Learning Disabilities (NOS) Severity.

PubMed

Bosch-Bayard, Jorge; Galán-García, Lídice; Fernandez, Thalia; Lirio, Rolando B; Bringas-Vega, Maria L; Roca-Stappung, Milene; Ricardo-Garcell, Josefina; Harmony, Thalía; Valdes-Sosa, Pedro A

2017-01-01

In this paper, we present a novel methodology to solve the classification problem, based on sparse (data-driven) regressions, combined with techniques for ensuring stability, especially useful for high-dimensional datasets and small samples number. The sensitivity and specificity of the classifiers are assessed by a stable ROC procedure, which uses a non-parametric algorithm for estimating the area under the ROC curve. This method allows assessing the performance of the classification by the ROC technique, when more than two groups are involved in the classification problem, i.e., when the gold standard is not binary. We apply this methodology to the EEG spectral signatures to find biomarkers that allow discriminating between (and predicting pertinence to) different subgroups of children diagnosed as Not Otherwise Specified Learning Disabilities (LD-NOS) disorder. Children with LD-NOS have notable learning difficulties, which affect education but are not able to be put into some specific category as reading (Dyslexia), Mathematics (Dyscalculia), or Writing (Dysgraphia). By using the EEG spectra, we aim to identify EEG patterns that may be related to specific learning disabilities in an individual case. This could be useful to develop subject-based methods of therapy, based on information provided by the EEG. Here we study 85 LD-NOS children, divided in three subgroups previously selected by a clustering technique over the scores of cognitive tests. The classification equation produced stable marginal areas under the ROC of 0.71 for discrimination between Group 1 vs. Group 2; 0.91 for Group 1 vs. Group 3; and 0.75 for Group 2 vs. Group1. A discussion of the EEG characteristics of each group related to the cognitive scores is also presented.

Facilitators and Barriers to Performing Activities and Participation in Children With Cerebral Palsy: Caregivers' Perspective.

PubMed

Earde, Pinailug Tantilipikorn; Praipruk, Aina; Rodpradit, Phanlerd; Seanjumla, Parichad

2018-01-01

To investigate contextual factors that were facilitators and barriers to performing activity and participation for children with cerebral palsy from the caregivers' perspective. Qualitative in-depth interview with primary caregivers of children with cerebral palsy aged 4 to 12 years was conducted in the metropolitan area of Thailand. Semistructured questions related to environmental and personal factors were recorded. Interviews were transcribed verbatim and analyzed for main themes on the basis of the International Classification of Functioning, Disability, and Health-Children and Youth Version (ICF-CY) classification. Twenty-seven caregivers participated. Facilitators were appropriateness of assistive devices, support and acceptance from family, friends, and society, health services, willingness, and self-acceptance. Barriers were inappropriate design and facilities, overprotection of family, nonacceptance from family, friends, and society, inconvenient transportation, financial problems, limited health services, limited access to education, frustration, and being an introvert. Contextual factors that can be facilitators and barriers to perform activities and participation should be considered for improving lives of children with cerebral palsy.

Autism according to diagnostic and statistical manual of mental disorders 5(th) edition: The need for further improvements.

PubMed

Posar, Annio; Resca, Federica; Visconti, Paola

2015-01-01

The fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) introduced significant changes in the classification of autism spectrum disorders (ASD), including the abolition of the diagnostic subcategories proposed by DSM-IV-Text Revision. DSM-5 describes three levels of increasing severity of ASD. The authors report two explanatory cases with ASD (verbal boys, aged about 7 and a half years, without intellectual disability). According to DSM-5, both cases fall into the lowest severity level of ASD. However, their neuropsychological and neurobehavioral profile varies significantly. While the first boy showed a prevalent impairment of visuoconstructional and visuoperceptual abilities, the second one presented a predominant involvement of verbal functions, with qualitative impairments in communication. A further step forward in the definition and classification of ASD, taking into account both intensity and quality of symptoms, is recommended in order to formulate a reliable prognosis, plan an individualized treatment and monitor the clinical course over time.

Development and Validation of the 34-Item Disability Screening Questionnaire (DSQ-34) for Use in Low and Middle Income Countries Epidemiological and Development Surveys.

PubMed

Trani, Jean-François; Babulal, Ganesh Muneshwar; Bakhshi, Parul

2015-01-01

Although 80% of persons with disabilities live in low and middle-income countries, there is still a lack of comprehensive, cross-culturally validated tools to identify persons facing activity limitations and functioning difficulties in these settings. In absence of such a tool, disability estimates vary considerably according to the methodology used, and policies are based on unreliable estimates. The Disability Screening Questionnaire composed of 27 items (DSQ-27) was initially designed by a group of international experts in survey development and disability in Afghanistan for a national survey. Items were selected based on major domains of activity limitations and functioning difficulties linked to an impairment as defined by the International Classification of Functioning, Disability and Health. Face, content and construct validity, as well as sensitivity and specificity were examined. Based on the results obtained, the tool was subsequently refined and expanded to 34 items, tested and validated in Darfur, Sudan. Internal consistency for the total DSQ-34 using a raw and standardized Cronbach's Alpha and within each domain using a standardized Cronbach's Alpha was examined in the Asian context (India and Nepal). Exploratory factor analysis (EFA) using principal axis factoring (PAF) evaluated the lowest number of factors to account for the common variance among the questions in the screen. Test-retest reliability was determined by calculating intraclass correlation (ICC) and inter-rater reliability by calculating the kappa statistic; results were checked using Bland-Altman plots. The DSQ-34 was further tested for standard error of measurement (SEM) and for the minimum detectable change (MDC). Good internal consistency was indicated by Cronbach's Alpha of 0.83/0.82 for India and 0.76/0.78 for Nepal. We confirmed our assumption for EFA using the Kaiser-Meyer-Olkin measure of sampling well above the accepted cutoff of 0.40 for India (0.82) and Nepal (0.82). The criteria for Bartlett's test of sphericity were also met for both India (< .001) and Nepal (< .001). Estimates of reliability from the two countries reached acceptable levels of ICC of 0.75 (p<0.001) for India of 0.77 for Nepal (p<0.001) and good strength of agreement for weighted kappa (respectively 0.77 and 0.79). The SEM/MDC was 0.80/2.22 for India and 0.96/2.66 for Nepal indicating a smaller amount of measurement error in the screen. In Nepal and India, the DSQ-34 shows strong psychometric properties that indicate that it effectively discriminates between persons with and without disabilities. This instrument can be used in association with other instruments for the purpose of comparing health outcomes of persons with and without disabilities in LMICs.

Usefulness of new wetness tester for diagnosis of dry mouth in disabled patients.

PubMed

Kakinoki, Yasuaki; Nishihara, Tatsuji; Arita, Masahiro; Shibuya, Koji; Ishikawa, Masao

2004-12-01

The condition of dry mouth is an influential factor in the incidence of caries, periodontal disease, fungal infections, masticatory dysfunctions and denture function. Bedridden elderly and disabled persons often suffer from oral dryness and the aim of this study was to evaluate the usefulness of measuring the amount of moisture in the oral mucosa for clinical diagnosis of dry mouth in this group. The subjects were 20 elderly bedridden individuals, age range 65-89 years old, living in a nursing home and six healthy laboratory researchers, aged 20-46 years old, used as controls. Tongue dorsum moisture measurements were performed using a newly developed wetness tester (L-SALIVO), in which the wet portion was measured after 10 s. Further, clinical diagnosis of dry mouth was carried out using a clinical classification scale of the tongue mucosa (grade range, 0-3). It was possible to measure tongue dorsum moisture in all subjects with the wetness tester. The average moisture value was 0.1+/-0.2 mm in elderly subjects with a dry mouth grade of 2 (n = 8) or 3 (n = 12), while the average moisture value in the control subjects was 3.67+/-1.75 mm with a dry mouth grade of 0 (n = 4) or 1 (n = 2). Tester values and cliniical classification showed a positive co-relationship (r = 0.31, p < 0.05). Our results show that this new tester could be useful for evaluating oral dryness and diagnosing dry mouth.