Towards an international framework for communication disorders: Use of the ICF
ABSTRACT There has been an interest in the World Health Organization's framework of functioning and disability by those in communication disorders since the original 1980 International Classification of Impairments, Disabilities, and Handicaps (ICIDH). In 2001, WHO published the substantially revised International Classification of Functioning, Disability, and Health (ICF). This framework is gaining in acceptance as a system that would be beneficial for the field and for our clients. This article describes the basics of the ICF and how it differs from the ICIDH; the possible applications of the ICF to communication disorders; some of the work done with the ICF in communication disorders internationally; and the benefits to the field from increased interdisciplinary and international collaboration using the ICF as a common framework. LEARNING OUTCOMES: As a result of this activity the reader will be able to: (1) describe the basics of the ICF, (2) describe the applications of the ICF to communication disorders, and (3) describe the possible impact upon the field internationally.
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- "In ICF, the elements inherent in AT assessment and selection including body structure and function, activity and participation, and environmental and personal factors. The ICF provides a common reference framework for better communication between the clinicians, patients, and their families , . However, the classifications set up by the ICF cannot lead to better patient care without an improved problem-solving technique . "
ABSTRACT: Many disabled individuals lack extensive knowledge about assistive technology, which could help them use computers. In 1997, Denis Anson developed a decision tree of 49 evaluative questions designed to evaluate the functional capabilities of the disabled user and choose an appropriate combination of assistive devices, from a selection of 26, that enable the individual to use a computer. In general, occupational therapists guide the disabled users through this process. They often have to go over repetitive questions in order to find an appropriate device. A disabled user may require an alphanumeric entry device, a pointing device, an output device, a performance enhancement device, or some combination of these. Therefore, the current research eliminates redundant questions and divides Anson's decision tree into multiple independent subtrees to meet the actual demand of computer users with disabilities. The modified decision tree was tested by six disabled users to prove it can determine a complete set of assistive devices with a smaller number of evaluative questions. The means to insert new categories of computer-related assistive devices was included to ensure the decision tree can be expanded and updated. The current decision tree can help the disabled users and assistive technology practitioners to find appropriate computer-related assistive devices that meet with clients' individual needs in an efficient manner.IEEE transactions on neural systems and rehabilitation engineering: a publication of the IEEE Engineering in Medicine and Biology Society 04/2012; 20(4):564-73. DOI:10.1109/TNSRE.2012.2193419 · 2.82 Impact Factor
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- "With this approach, the first consideration in a clinical feeding evaluation is the child's level of participation in mealtime environments. Other dimensions to consider include functioning and disability (body functions, body structures, and activities and participation), contextual factors (environmental—external to an individual's control), and personal factors (unique to each person, such as past experience or background) [WHO, 2001; Threats, 2006]. Details on the ICF can be found at http://www.who.int/classifications/icf/en/ . "
ABSTRACT: Assessment of infants and children with dysphagia (swallowing problems) and feeding disorders involves significantly more considerations than a clinical observation of a feeding. In addition to the status of feeding in the child, considerations include health status, broad environment, parent-child interactions, and parental concerns. Interdisciplinary team approaches allow for coordinated global assessment and management decisions. Underlying etiologies or diagnoses must be delineated to every extent possible because treatment will vary according to history and current status in light of all factors that are often interrelated in complex ways. A holistic approach to evaluation is stressed with a primary goal for every child to receive adequate nutrition and hydration without health complications and with no stress to child or to caregiver. Instrumental swallow examinations that aid in defining physiological swallowing status are needed for some children. Successful oral feeding must be measured in quality of meal time experiences with best possible oral sensorimotor skills and safe swallowing while not jeopardizing a child's functional health status or the parent-child relationship.Developmental Disabilities Research Reviews 01/2008; 14(2):118-27. DOI:10.1002/ddrr.17 · 0.29 Impact Factor
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- "In clinical research, an instrument would help to identify differences in the severity and pattern of restrictions in participation across and within various populations (e.g., dysarthria vs. cognitive-communication disorders, traumatic brain injury vs. multiple sclerosis, and mild vs. moderate severity of impairment). Finally, if communicative participation was adequately measured, we could study its relationship with other important variables such as QOL (Threats, 2006). "
ABSTRACT: To assess the adequacy of self-report instruments in speech-language pathology for measuring a construct called communicative participation. Six instruments were evaluated relative to (a) the construct measured, (b) the relevance of individual items to communicative participation, and (c) their psychometric properties. No instrument exclusively measured communicative participation. Twenty-six percent (n = 34) of all items (N = 132) across the reviewed instruments were consistent with communicative participation. The majority (76%) of the 34 items were associated with general communication, while the remaining 24% of the items were associated with communication at work, during leisure, or for establishing relationships. Instruments varied relative to psychometric properties. No existing self-report instruments in speech-language pathology were found to be solely dedicated to measuring communicative participation. Developing an instrument for measuring communicative participation is essential for meeting the requirements of our scope of practice.American Journal of Speech-Language Pathology 12/2006; 15(4):307-20. DOI:10.1044/1058-0360(2006/030) · 1.64 Impact Factor