Assessing Children With Disabilities Using WHO International Classification of Functioning, Disability and Health Child and Youth Version Activities and Participation D Codes

Efficacy of Occupational Performance Coaching with and without Four Quadrant Model of Facilitated Learning for mothers of children with specific learning disorder: Study protocol for a randomized controlled trial

Background

In addition to academic problems, children with a specific learning disability (SLD) encounter problems with participation in activities outside school.

Purpose

To investigate the efficacy of Occupational Performance Coaching (OPC) with and without Four Quadrant Model of Facilitated Learning (4QM) in the mothers of children with SLD.

Method

A single-blinded, parallel-group randomized clinical trial will be carried out. Mothers of children with SLD will constitute the participants and be allocated to experimental (OPC+4QM) and control (OPC alone) groups.

Key issues

Children's occupational performance and satisfaction, participation in activities outside school, goals attainment, executive function, and academic achievement along with self-efficacy of mothers will be measured in baseline, post-intervention, and one-month follow-up stages.

Implications

An OPC intervention protocol may improve children's participation in activities outside school and may help clarify whether 4QM promotes maternal empowerment and better results for children with SLD.

Trial registration

Clinical Trials, IRCT20140416017301N9. (https://en.irct.ir/trial/55842)

Establishing childhood disability clinics may help reduce the prevalence of disability among children in Africa: A viewpoint

Globally, there are about a billion people comprising of about 95 million children who experience disability. The number of people in Africa living with disability is about 80 million people; out of which 10%-15% are children of school age. The causes of disability among these children include epilepsy, vision loss, or hearing loss, cerebral palsy, poliomyelitis, tetanus, cerebrospinal meningitis and malaria. However, these causes of disability are preventable and can be managed with proper care. The aim of this article is to propose the establishment of childhood disability clinics in Africa in order to help prevent or reduce the incidence/ prevalence of disability among children. Some of the mandates of the clinics will be to carry out routine assessment of children for disability, to provide education on disability and strategies for disability prevention to parents and caregivers, to promptly prevent and manage disability or its causes. However, establishing these clinics requires shared commitment of all the stakeholders.

Effect of Occupation Performance Coaching with Four-Quadrant Model of Facilitated Learning on Children with Specific Learning Disorder

Background

Children with a specific learning disability (SLD) have deficits in everyday occupations along with executive function in addition to academic issues.

Objective

The present study is aimed at investigating the effectiveness of Occupational Performance Coaching (OPC) and the Four-Quadrant Model of Facilitated Learning (4QM) interventions on the participation in occupational performance and executive function skills in children with SLD.

Method

This study was a single-case experimental design (multiple baselines) in which six children with SLD were randomly assigned to three groups. In the baseline phase, three groups of children underwent repeated executive function assessments using the Stroop Color and Word Test (SCWT) and the Wisconsin Card Sorting Test (WCST) in the multiple baselines. In the intervention phase, all six mothers of children with SLD individually received OPC and 4QM interventions once a week for 14 sessions of 60 minutes and during this period, children were evaluated six more times for executive function skills according to SCWT and WCST. In addition, The Canadian Occupational Performance Measure (COPM) and Behavior Rating Inventory of Executive Function (BRIEF) at the beginning and the end of the baseline phase and the end of the intervention phase were completed by mothers of children with SLD.

Results

More than 50% PND of the SCWT and WCST in the visual analysis graph's information along with significant changes in COPM scores and large effect size of BRIEF subscales (Cohen's d ≥ 0.8) in pre- and postintervention showed the effectiveness of OPC and 4QM on the participation in occupational performance and executive function skills in children with SLD.

Conclusion

The results of the study support the effectiveness of OPC and 4QM interventions on children with SLD. However, research with more participants and experimental methods can provide further evidence.

Parents' Assessment of Disability in Their Children With Down Syndrome

Aim:

To describe a population of children with Down syndrome and evaluate their parents’ assessment of disability.

Methods:

Medical records of a population of 80 children with Down syndrome aged 5 to 17 years were analyzed for genetic background and associated diagnoses. And 27 parents to their children agreed to assess disability by employing a set of 26 International Classification of Functioning, Disability and Health body function (b) codes and activity and participation (d) codes. Clinical data were gathered and analysis of parents’ assessment of disability using psychometric and Rasch analysis was performed.

Results:

Clinical data on 27 children assessed by their parents and 53 children not assessed had identical associated diagnoses. The 26 International Classification of Functioning, Disability and Health codes and qualifiers had a mean score of 2.67 (range 1.26-4.11) and corrected code-total correlations mean of 0.55 (range −1.17 to 0.82). Rasch analysis showed proper code MNSQ infit and outfit values with mean 1.03 and 1.06.

Conclusion:

Clinical data on 27 children assessed were similar to 53 children that were not evaluated. Parents’ assessment of the 27 children showed good psychometric and Rasch analysis properties. Similar results might be expected in the total population of 80 children.

Parents' Expressions of Concerns and Hopes for the Future and Their Concomitant Assessments of Disability in Their Children

Aim

To assess parents' ability to express their concerns and hopes for the future in their children with disability and assess their children's disability as well as to analyse these data for consistency.

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 were asked to freely express their concerns and hopes for the future and to assess disability in their own children by employing a set of 26 International Classification of Functioning, Disability and Health, Children and Youth Version (ICF-CY) body function (b) codes and activity and participation (d) codes. A grounded theory approach was employed to systematize parents' expressions of concerns and hopes; then, parents scored qualifiers on a 5-step qualitative Likert scale. Parents assessed their children's disability in the same way using the ICF-CY 5-step qualifier scale.

Results

Altogether, 119 parents freely expressed their concerns and hopes, and 101 of them also assessed their children's disability using the 26 ICF-CY codes. A total of 475 expressions of concern and hopes (issues) were expressed and categorized into 34 areas of concern and hopes (subsections). The most frequently mentioned issues were education; understanding, goodwill, and communication between parents; and community support. Qualitative data on both 5-step qualifier scales showed good reliability. Rasch analysis maps on concerns and hopes for children as well as on the ICF-CY assessment demonstrated good alignment and a clinically relevant progression from the least to the most disabled children.

Conclusion

Parents can express valid and reliable data on their concerns and hopes for the future and can reliably assess disability in their own children.

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

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.