Abstract
This is the fourth and final study 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 investigate aspects of functioning and environment of individuals with ADHD as documented by the ICF-CY in clinical practice settings. An international cross-sectional multi-centre study was applied, involving nine units from eight countries: Denmark, Germany, India, Italy, Portugal, Saudi Arabia, Sweden and Taiwan. Clinicians and clinical researchers rated the functioning level of 112 children, adolescents and adults with ADHD using the extended ICF-CY checklist version 2.1a. The ratings were based on a variety of information sources, such as medical records, medical history, clinical observations, clinical questionnaires, psychometric tests and structured interviews with participants and family members. In total, 113 ICF-CY categories were identified, of which 50 were related to the activities and participation, 33 to environmental factors and 30 to body functions. The clinical study also yielded strengths related to ADHD, which included temperament and personality functions and recreation and leisure. The study findings endorse the complex nature of ADHD, as evidenced by the many functional and contextual domains impacted in ADHD. ICF-CY based tools can serve as foundation for capturing various functional profiles and environmental facilitators and barriers. The international nature of the ICF-CY makes it possible to develop user-friendly tools that can be applied globally and in multiple settings, ranging from clinical services and policy-making to education and research.
Highlights
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition behaviourally defined by patterns of persistent age inappropriate inattention, hyperactivity and impulsivity [1], affecting 3–7% of children and adults worldwide [2,3,4,5]
The present study is part of a larger systematic effort that will subsequently lead to the development of standardized ICF Core Sets for ADHD. As part of this project, ICF Core Sets are being developed for Autism Spectrum Disorder (ASD), with the results reported in separate publications [30,31,32,33]
Corroborating our own research [15, 16, 41], this study identified relevant environmental factors across different chapters of the ICF-CY, highlighting the importance of taking into account all types of facilitators and barriers in the environment when conducting functional assessments related to ADHD
Summary
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition behaviourally defined by patterns of persistent age inappropriate inattention, hyperactivity and impulsivity [1], affecting 3–7% of children and adults worldwide [2,3,4,5]. ADHD is associated with an increased risk for other neurodevelopmental and psychiatric conditions [11, 12], poorer quality of life [13], and premature mortality [14]. Despite these negative outcomes in individual functioning, reports suggest that there may be specific strengths related to ADHD, such as creativity and hyperfocusing [15, 16], these have not been documented consistently by research [17, 18].
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