ICF-Based functional profile in education and rehabilitation: a multidisciplinary pilot experience

Abstract

Following the changes introduced by Legislative Decree no. 66/2017, the Multidisciplinary Evaluation Unitsestablished at the local health districts are mandated to draft a Functioning Profile (FP) based on the ICF Classification, for the purposes of establishing an Individual Project (Law No. 328 / 2000, art.14), as well as thepreparationof the Individualized Educational Plan (PEI) (Legislative Decree no. 66/2017, art. 5). The innovation introduced bythe legislation is far-reaching, not only for the impact it has on the organization of the Services and on the procedures relating to school support and accompaniment towards the Life Project. Particularly relevant is the change ofperspective brought by the adoption of the anthropological model of the International Classification of Functioning,Disability and Health (ICF). If, so far, the condition of disability hasbeen assessed on the basis of clinical parameters, the Functioning Profile now requires a biopsychosocial assessment of the person which will consider not onlydeficits and impairments, as well as its effect on the development process of personal experiences (personal factors)and the setting of daily life (environmental factors). Indeed, this threefold focal lens is the only means to comprehendthe overall condition of a person with disability – encompassing their needs and wishes – which is intertwined to thequality and the complexity of the social networkto which they belong. Accordingly, the regulation foresees that drafting of the FP be jointly carried forth by physicians, rehabilitationprofessionals, evolutional age psychologists, evolutionary psychologists, social workers, paedagogists, specializedteachers, parents, and not least the very individualas by the principal of autodetermination. Following the modifications introduced with such Decree, the University ofVerona began a trial aimed at developing n ICF-based FP model that is both sustainable an organizational level andfunctional to planning the Individual Projects and the PEI. Such trial has involved the Scaligera local health district‘ULSS Company no. 9 a delegation of family Pediatricians of the province and the Local School Office in Verona.The FP model produced in the pilot experience which is still active, contains some particular features that allow isformal as well as dynamic use in both the design and the monitoring and evaluation of educational, rehabilitationand care interventions. For this purpose, we created an online platform that processes the data collected and makes itavailable to the user in real time providing a series of qualitative and quantitative graphs and indicators, describingthe biopsychosocial functioning of the subject and his/her needs for social inclusion. The present article describes themain elements of this pilot experience and the results obtained.