Abstract
Aims: To create a single disability variable in 332 children with different disability severities, ICD-10 diagnoses, and ages by employing the WHO ICF-CY body functions coding system. Study Design: Open field pilot research study. Place and Duration of Study: H. C. Andersen Children’s Hospital and Centre for Clinical Epidemiology, Odense University Hospital, Odense Denmark, between October 2010 and November 2011. Methodology: We included 332 children (144 boys and 188 girls; age range 1.0–15.9 years) with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, and disabilities following treatment for a brain tumour. A set of 47 body function codes (b codes) representing a broad spectrum of functions in daily living and with five qualifiers each was scored during interviews with parents. Psychometric and Rasch data analyses were performed. Original Research Article Illum and Gradel; BJAST, 11(1): 1-19, 2015; Article no.BJAST.19635 2 Results: Mean code score for each child was 32.17 (range 0–159). The corrected code-total correlation was high (0.70). Inter-code correlation was mean 0.50 (range 0.01–0.97), and Cronbach s alpha 0.98. Following Rasch analysis and due to disordering of Andrich thresholds (τs) and infit and outfit mean square values >1.5, the number of codes was reduced from 47 to 33. Retained codes all had ordered τs and mean square and corresponding Z-standardised values within the recommended range of 0.5–1.5. The t-statistic for differential item functioning across codes and diagnosis group, age, and gender was between 2.0 and 3.0. Graphical data for disability variable, the child-code map, paralleled clinical expectations across the total population of children. Conclusion: WHO ICF-CY b codes can provide a coherent measure of the severity of disability in children across various diagnoses, age, and gender and add important information to WHO ICD-10 diagnosis codes when employed in daily clinical practice.
Highlights
Assessing disabilities in children in sufficient detail is essential in daily clinical practice, and for habilitation, rehabilitation, the development of new intervention strategies, and research [1]
World Health Organization (WHO) ICF-CY b codes can provide a coherent measure of the severity of disability in children across various diagnoses, age, and gender and add important information to WHO ICD-10 diagnosis codes when employed in daily clinical practice
There was missing data for 47 b codes in 796 out of a total of 15,604 responses (5.1%). This was due to the fact that some children were not old enough to be evaluated with respect to certain b codes
Summary
Assessing disabilities in children in sufficient detail is essential in daily clinical practice, and for habilitation, rehabilitation, the development of new intervention strategies, and research [1]. In 2001 the World Health Organization (WHO) released the International Classification of Functioning, Disability and Health (ICF) to provide a common framework for the assessment of disability for clinical and research use; a Child and Youth version (ICF-CY) was released in 2007 [2,3]. The classification is based on a conceptual model encompassing the health condition of the individual with a disability, together with factors related to body function and structure, activities of daily living, and participation in social activities and other relationships. These factors should be evaluated in relation to environmental factors and personal factors that may have a positive or negative influence on the impact of the disability. Parallel analysis of ICF-CY data has not yet been published
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