Functional Profile Based on ICF-CY for Infants with Developmental Delay/Disabilities: Implementation in Assessment with Interdisciplinary Approach

Autor: Yi-Ling Pan, 潘懿玲
Rok vydání: 2012
Druh dokumentu: 學位論文 ; thesis
Popis: 100
Background and purpose: Early assessment is important in providing early intervention services for infants with developmental delay/disabilities (DD). According to the By-laws of Children and Youth Welfare Act and the People with Disabilities Rights Protection Act, the eligibility determination for children with DD to receive early intervention services should be decided after assessment. Current Evaluation Reports, used for eligibility determination and inter-professional communication, are based on the developmental-specific viewpoint, and the impact of the environment is usually ignored. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY) published by WHO emphasized the importance of activities/participation and environmental factors, with functioning resulting from the interactions between components, could be used as a reference in exploration of current Evaluation Reports. For infants under three years of age and with DD, there are two purposes of this study: (1) To identify/derive an ICF-CY code set for infants with early delay and disabilities (EDD code set) for team initial evaluation and eligibility determination; (2) To explore the content of current Evaluation Reports in terms of ICF-CY, with linkage to the EDD code set. Methods: the EDD code set was developed through an international Delphi survey by a group of professionals who had experiences in conducting studies or implementing ICF-CY, and the professionals in the early intervention service system in Taiwan, based on current ICF-CY code sets for infants under three years of age. Then 20 Evaluation Reports for infants with DD from National Taiwan University Children’s Hospital (NTUCH) during July- December, 2010 were linked to the EDD code set table by two linking professionals with basic concept of child development and experience in evaluating and treating infants with DD, and were familiar with the framework and classification/coding structure. The meaningful concepts were identified in the Evaluation Reports, and then were linked to the EDD code set table and assigned generic qualifiers or denoted. The mean category linking percentage and code (category + qualifier) linking percentage of the EDD code set were calculated separately for the compulsory part and the whole report for content exploration. Results: (1) 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 in Activities and Participation, 29 categories in Body Functions, 10 categories in Body Structures, and 15 categories in Environmental Factors. (2) There were 4378 meaningful concepts identified in the 20 Evaluation Reports, with 1179 concepts in the compulsory part, and 3199 concepts in the additional part. The mean category/code linking percentage for all categories of the compulsory part was 22%/19%. The mean category/code linking percentage of the EDD code set for all categories of the whole report was 57%/54%, both 35% higher than the compulsory parts. The mean category/code linking percentage of each component in the whole report were 88%/84% in the Activity and Participation (d) component, 51%/50% in the Body Function (b) component, 15%/15% in the Body Structure (s) component, and 31%/21% in the Environmental Factors (e) component. There were some meaningful concepts in the Evaluation Reports linked to Personal Factors component and other ICF-CY categories; many of them were family-related environmental factors. Conclusions: The EDD code set with 82 essential ICF-CY categories should be taken into consideration in the initial team evaluation for infants under three years of age with DD. The linkage of the 20 Evaluation Reports of one medical center to the EDD code set revealed that current reports contained sufficient activity and participation information, but less information was included in the compulsory part. Lower category linking percentages in Environmental Factors and Body Structures were noted and need further examination. Future design of the Evaluation Reports may add ICF-CY categories in the EDD code set to describe functioning for infants with DD, in a more holistic viewpoint.
Databáze: Networked Digital Library of Theses & Dissertations
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