Relevance of the International Classification of Functioning, Health and Disability: Children & Youth Version in Early Hearing Detection and Intervention Programs

Clinical application of the International Classification of Functioning, Disability and Health (ICF) in children and adolescents from a public hearing rehabilitation service

ABSTRACT Purpose: to develop an International Classification of Functioning, Disability and Health (ICF) Checklist for clinical application in the rehabilitation of children and adolescents presented with hearing loss, to describe the biopsychosocial profile of participants and present the results of the use of ICF by speech therapists. Methods: a descriptive cross-sectional observational research, with quantitative and qualitative analyses. The study was conducted with five speech therapists, eight children aged 7 to 10 years and eight adolescents between 11 and 18 years old, diagnosed with moderate to profound bilateral hearing loss. Data collection included interviews, analysis of medical records and a questionnaire for the speech therapists. Exploratory data analysis was performed using summary measures and descriptive analysis of the profile of participants. Results: an ICF Checklist for clinical use in Hearing Rehabilitation was created. With its application, deficiencies related to hearing, speech and language functions were observed, with considerable difficulties in expressive and receptive language skills, learning and communication and access barriers related to communication and health services. Conclusion: the use of the Checklist expands the aspects observed by professionals, allows identification of the subjects' needs, and enables the recording and monitoring of worsening, stabilization or progress of the biopsychosocial aspects in the rehabilitation process.

Aplicação clínica da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) em crianças e adolescentes de um serviço público de reabilitação auditiva

RESUMO Objetivo: elaborar uma Checklist da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) para aplicação clínica na reabilitação de crianças e adolescentes com deficiência auditiva, descrever o perfil biopsicossocial dos participantes e apresentar os resultados do uso da CIF por fonoaudiólogos. Métodos: pesquisa transversal observacional descritiva, com análises quantitativa e qualitativa. Participaram cinco fonoaudiólogos, oito crianças com idade entre 7 e 10 anos e oito adolescentes entre 11 e 18 anos, com diagnóstico de perdas auditivas bilaterais de grau moderado a profundo. A coleta de dados incluiu entrevistas com os responsáveis pelos participantes, questionário com os fonoaudiólogos e análise de prontuários. Foi realizada análise exploratória dos dados e análise descritiva da caracterização e do perfil biopsicossocial dos participantes. Resultados: foi elaborada uma Checklist da CIF para uso clínico na Reabilitação Auditiva. Com sua aplicação observou-se deficiência relacionada às funções de audição, fala e linguagem com dificuldades consideráveis nas habilidades de linguagem expressiva e receptiva, aprendizagem e comunicação e barreiras de acesso relacionadas à comunicação e aos serviços de saúde. Conclusão: o uso da Checklist amplia os aspectos observados pelos profissionais, permite identificar as necessidades dos sujeitos e possibilita o registro e monitoramento de agravamento, estabilização ou progresso dos aspectos biopsicossociais no processo de reabilitação.

Applying the ICF-CY to Specialist Speech-Language Pathologists’ Practice With Toddlers With Cleft Palate Speech

Objective:

To evaluate how the practice of specialist speech-language pathologists (SLPs) working with young children with cleft palate ± cleft lip (CP±L) maps onto the International Classification of Functioning, Disability, and Health – Children and Youth version (ICF-CY) and consider the functionality of the categories of the ICF-CY for this specialist area of practice.

Design:

Cross-sectional, qualitative study.

Setting:

Semistructured face-to-face interviews were conducted with SLPs working in tertiary-level hospitals, universities, and public clinics.

Participants:

Six specialist SLPs with 17 to 39 years of experience working with young children with CP±L as researchers and clinicians in Australia, Brazil, Denmark, Ireland, New Zealand, and the United States.

Main Outcome Measure(s):

Specialists’ practices were captured using in-depth, semistructured interviews. Data collected were analyzed by directed content analysis applying the ICF-CY as a coding schema.

Results:

In total, 4077 data points were coded. Most mapped onto Body Structures (684, 16.8%), Body Functions (906, 22.2%), and Environmental Factors (1626, 39.9%) with less emphasis on Activities and Participation (560, 13.7%). A “best fit” approach was taken to topics that did not map exactly onto categories of the ICF-CY (eg, velopharyngeal insufficiency [VPI]); however, there was not always an ideally suitable category available.

Conclusions:

The current study revealed strengths and challenges in categorizing practice within the ICF-CY for children with CP±L, including collaboration with parents and significant others, specificity around speech, language, and articulation, and the different types of VPI. Therefore, future discussion around how best to use the framework with children with CP±L is needed.