World Health OrganizationWorld Health OrganizationAssessment Classification & Epidemiology Assessment Classification & Epidemiology

GroupGroup

International Classification International Classification of of

Functioning and DisabilityFunctioning and Disability

ICIDH-2ICIDH-2

WHO Family of International Classifications

SPECIALITY-BASEDADAPTATIONS

ICIDHInternational Classification

of Functioning

and Disability

Procedures

Reasons for encounter

ICDInternational

Classification of

Diseases

PRIMARY CARE

. Lay reporting

. Community-based information schemes

IND

Nomenclature of Diseases

SPECIALITY-BASEDADAPTATIONS

Need for the ICIDHNeed for the ICIDH

Change in the Health Care Scene: from Change in the Health Care Scene: from acuteacute to to chronicchronic disease disease

Change from Change from diseasedisease focus to focus to consequencesconsequences focus focus

Need for an international ‘Need for an international ‘common common language’language’ of consequences of consequences

To serve the To serve the needsneeds of people with disability of people with disability

Foundations of ICIDH-2Foundations of ICIDH-2

Human FunctioningHuman Functioning - - notnot merely disablement merely disablement

Universal ModelUniversal Model - - notnot a minority model a minority model

Integrative ModelIntegrative Model - - notnot merely medical or social merely medical or social

Interactive ModelInteractive Model - - notnot linear progressive linear progressive

Parity Parity - - notnot etiological causality etiological causality

InclusiveInclusive - contextual:environment & person- contextual:environment & person

Cultural applicabilityCultural applicability - not western concepts- not western concepts

TheThe “Bridged” “Bridged” Model of DisablementModel of Disablement Medical Medical AND AND Social ModelsSocial Models

PERSONAL problem PERSONAL problem ANDAND SOCIAL problemSOCIAL problem medical care medical care ANDAND biopsychosocial biopsychosocial

integration integration individual treatment individual treatment ANDAND social actionsocial action professional help professional help ANDAND individual & individual &

collective collective responsibilityresponsibility personal personal ANDAND environmental environmental

adjustment adjustment manipulation manipulation behavior behavior ANDAND attitude attitude care care ANDAND human rightshuman rights health care policy health care policy AND AND politicspolitics individual adaptation individual adaptation ANDAND social changesocial change

UNIVERSAL vs MINORITYUNIVERSAL vs MINORITY

Cultural ApplicabilityCultural Applicability

• Conceptual equivalence of Classification • Translatability• Usability• International Comparisons

Functioning & ContextFunctioning & Context

PersonPerson

Environment

ICIDH levels:ICIDH levels:forest - tree - stem - branch - leafsforest - tree - stem - branch - leafs

Item 1

Item ..

Item N

Facet 1

Item 1

Item ..

Item N

Facet N

D o m a in 1 D o m a in 2 D o m a in N

Im pairm entb o d y s truc tu re - fu nc tion

Item 1

Item ..

Item N

Facet 1

Item 1

Item ..

Item N

Facet N

D o m a in 1 D o m a in 2 D o m a in N

ActivityP e rso n - a c tiv ity

Item 1

Item ..

Item N

Facet 1

Item 1

Item ..

Item N

Facet N

D o m a in 1 D o m a in 2 D o m a in 3

ParticipationS o c ie ta l fac ilita t io n /h in dra n ce

D IS A B L E M E NTO ve ra ll T erm : Co n d it io n s re la te d to H ea lth S ta tus

InternationalClassificationof Impairments,Activities, andParticipation

WORLD HEALTHORGANIZATIONGENEVA2000

A manual ofDimensions of

Functioningand Disablement

ICIDH- 2ICIDH- 2

1. Main volume with1. Main volume with glossaryglossary

2. Clinical Descriptions2. Clinical Descriptions& Assessment & Assessment GuidelinesGuidelines

3. Assessment Criteria3. Assessment Criteriafor Researchfor Research

4. Dedicated 4. Dedicated Assessment ToolsAssessment Tools

Principles of RevisionPrinciples of Revision

Multi-center network support for development and later training

WHO being the client server Multiple versions for different users at different sectors and

levels of health care Field trials: applicability is the key Empirical work serves the conceptual position and comes

before ideological position

WHO ACE

Level 3

ArgentinaBrazil

Chile

China

Denmark

Egypt

Islamic Republic of Iran

Malaysia

Pakistan

Philippines

South AfricaChildren’s T FMH TF

NACC

Nordic CC

Japan CC

French CC

Dutch CC

Australian CCLevel 2

UK CC

Revision StructureRevision Structure

ALL WHO

Member States

Environment T F

OHSCEQ

EBD

Ageing

Substance Abuse

Mental Health

DPR

Health Promotion

Other Clusters

Level 1

Collaborating CentersCollaborating Centers

French - I focus - Mind is not Body - Quebec ModelFrench - I focus - Mind is not Body - Quebec Model

Netherlands -Taxonomy - Moment vs Process Netherlands -Taxonomy - Moment vs Process

USA - Handicap, Environment, USA - Handicap, Environment,

Canada - A/P distinction: Person vs EnvironmentCanada - A/P distinction: Person vs Environment

Australia: PWD - DDRAGAustralia: PWD - DDRAG

Japan: Subjective dimensionsJapan: Subjective dimensions

UK: Morbidity coding, DPI UK: Morbidity coding, DPI

Spanish Network: Cultural sensitivitySpanish Network: Cultural sensitivity

Finnish: terms, words, ...Finnish: terms, words, ...

Overall Objective of Overall Objective of ICIDH-2 RevisionICIDH-2 Revision

To develop an operational classification system on

human functioning and disability

that is applicable to every human being: universality addresses multiple dimensions regarding the ‘person’ and

‘environment’ (at body, person and society levels) international practices that are culture sensitive based on user needs empirical field trials on applicability, reliability and utility

Significant Changes: Significant Changes: OverallOverall

Focus: Disabilities Focus: Disabilities Functioning & DisabilityFunctioning & Disability

Impairments Impairments Body Functions & StructuresBody Functions & Structures

Disabilities Disabilities Activities Activities

HandicapsHandicaps ParticipationParticipation

No environmentNo environment Environmental FactorsEnvironmental Factors

Causal - linearCausal - linear Interactive-integrativeInteractive-integrative

No Definitions No Definitions Operational DefinitionsOperational Definitions

No Assessment No Assessment Linked InstrumentsLinked Instruments

ICIDH-1 ICIDH-2ICIDH-1 ICIDH-2

Conceptual transformationConceptual transformation User needsUser needs Advocacy --> scienceAdvocacy --> science

– Summary health measures: evidence to inform policySummary health measures: evidence to inform policy– Causality: multi-linear webCausality: multi-linear web

Polarization: Polarization: – medical vs socialmedical vs social– global vs localglobal vs local– universal vs minority modelsuniversal vs minority models

ModelsModels

Sequence of Concepts Sequence of Concepts ICIDH 1980 ICIDH 1980

Impairments Disabilities HandicapsDisease ordisorder

Interaction of ConceptsInteraction of Concepts19991999

Body FunctionBody Function Activities Activities Participation Participation(Impairments)(Impairments) (Activity Limitation) (Participation Restriction) (Activity Limitation) (Participation Restriction)

Health ConditionHealth Condition(disorder/disease)(disorder/disease)

Environmental PersonalFactors Factors

Functioning & DisabilityFunctioning & Disabilityas a Spectrumas a Spectrum

Functioning & DisabilityFunctioning & Disabilityas a multidimensional constructas a multidimensional construct

Body

F+S

Person level (activity)

Societal

(Part

icipati

on)

Environment

Hidden Logic of ClassificationHidden Logic of Classification Common Sense - Science LinkCommon Sense - Science Link

UniverseUniverse Interconnectedness with other Interconnectedness with other

classificationsclassifications Dimension (s)Dimension (s)

– uni-dimensionaluni-dimensional– multi-dimensional multi-dimensional

ExtendibilityExtendibility– downwards / upwardsdownwards / upwards– hierarchical relationshierarchical relations

Categories-mutually exclusiveCategories-mutually exclusive Categories- jointly exhaustiveCategories- jointly exhaustive Taxonomic UnitTaxonomic Unit Systematic approachSystematic approach Boundaries vs CoreBoundaries vs Core

Natural classifications Natural classifications - primary (symbolic)- primary (symbolic)

Scientific Scientific Classifications- Classifications- secondary (logical)secondary (logical)

Equity / ParityEquity / Parity

Loss of limb Loss of limb landmines landmines == diabetes diabetes == thalidomide thalidomide

Missed days at usual activitiesMissed days at usual activitiesflu flu = = depression depression == back pain back pain == angina angina

StigmaStigmaleprosy leprosy == schizophrenia schizophrenia == epilepsy epilepsy = = HIVHIV

Images of Disability: Images of Disability: Forrest GumpForrest Gump

Activity Activity Li Limitationmitation

(Disability) (Disability)

Impairment Impairment Activity Activity LiLimitationmitation

(Disability)(Disability)

Impairment Activity Impairment Activity ParticipationParticipation

LiLimitationmitation Restriction Restriction (Disability) (Disability) (Handicap)(Handicap)

ICIDH in simple termsICIDH in simple terms

Your Your bodybody doesn’t doesn’t functionfunction properlyproperly

You are limited in yourYou are limited in your activitiesactivities

You face You face barriersbarriers in society in society

Components of ICIDH-IIComponents of ICIDH-II

Body FunctionsBody Functions

Body StructureBody Structure

ActivityActivity

ParticipationParticipation

Environmental FactorsEnvironmental Factors

ICIDH-IIICIDH-II

Body FunctionsBody Functions are the physiological or are the physiological or

psychological functions of body systems. psychological functions of body systems.

Body StructuresBody Structures are anatomic parts of the body are anatomic parts of the body

such as organs, limbs and their components. such as organs, limbs and their components.

Impairments are problems in body function or

structure such as a significant deviation or loss.

ICIDH-IIICIDH-II

ActivityActivity is the performance of a task or action by an is the performance of a task or action by an

individual.individual.

Activity Limitations are difficulties an individual

may have in the performance of activities.

ICIDH-IIICIDH-II

ParticipationParticipation is an individual's involvement in life is an individual's involvement in life

situations in relation to Health Conditions, Body situations in relation to Health Conditions, Body

Functions and Structure, Activities, and Contextual Functions and Structure, Activities, and Contextual

factors. factors.

Participation Restrictions are problems an

individual may have in the manner or extent of

involvement in life situation

ICIDH-IIICIDH-II

Environmental Factors make up the physical, social

and attitudinal environment in which people live and

conduct their lives

Dimensions of Dimensions of Functioning & DisabilityFunctioning & Disability

BODYBODY PERSON PERSON SOCIETY SOCIETY

Function/Function/ Activities Activities Participation Participation

StructureStructure

(impairment) (limitation)(impairment) (limitation) (restriction) (restriction)

Body Body ACTIVITIES PARTICIPATION ACTIVITIES PARTICIPATION

SchizophreniaSchizophrenia

Information Information Deficit in Deficit in Occupational Occupational

processing processing parental functions hindrance, parental functions hindrance,

Work dysfunctionWork dysfunction Stigmatization Stigmatization

Body Body ACTIVITIES ACTIVITIES ParticipationParticipation

Epilepsy Epilepsy

Transient loss ofTransient loss of none none denial of a denial of a

Consciousness Consciousness driving licencedriving licence

IMPAIRMENTSIMPAIRMENTS ACTIVITY ACTIVITY PARTICIPATION PARTICIPATION LIMITATIONS RESTRICTIONLIMITATIONS RESTRICTION

Multiple Sclerosis Multiple Sclerosis

Fatigue Fatigue self-care self-care Community part. Community part.

Speech Speech doing housework Employment doing housework Employment

Weakness in Weakness in handling objects lack of special handling objects lack of special

musclesmuscles devicesdevices

IMPAIRMENTSIMPAIRMENTS ACTIVITY ACTIVITY PARTICIPATION PARTICIPATION LIMITATIONS RESTRICTIONLIMITATIONS RESTRICTION

ICIDH-IIICIDH-IIClassification of Each ComponentClassification of Each Component

ChapterChapter e.g., Activities of moving around e.g., Activities of moving around

BlockBlock e.g., Walking and related activities e.g., Walking and related activities

Two-Level categoryTwo-Level category e.g., Walking activity e.g., Walking activity

Three-Level categoryThree-Level category e.g., Walking short e.g., Walking short

distancesdistances

Four-Level categoryFour-Level category, if needed, if needed

ICIDH-IIICIDH-IIUniform QualifierUniform Qualifier

0 NO problem 0-4 %

1 MILD problem 5-24 %

2 MODERATE problem 25-49 %

3 SEVERE problem 50-95 %

4 COMPLETE problem 96-100 %

8 not specified

9 not applicable

ICIDH 2 CodesICIDH 2 Codes

a 4 a 4 10 10 0 X . 2 00 X . 2 0

DimensionChapter

Two level

Three level

Four level

First qualifier

Second qualifier

ICIDH-IIICIDH-IIQualifiers for EFQualifiers for EF

-0 NO barriers (none, absent, negligible… ) 0-4 %

-1 MILD barriers (slight, low…) 5-24 %

-2 MODERATE barriers (medium, fair...) 25-49 %

-3 SEVERE barriers (high, extreme, …) 50-95 %

-4 COMPLETE barriers (total…) 96-100 %

+0 NO facilitators (none, absent, negligible… ) 0-4 %

+1 MILD facilitators (slight, low…) 5-24 %

+2 MODERATE facilitators (medium, fair...) 25-49 %

+3 SEVERE facilitators (high, extreme, …) 50-95 %

+4 COMPLETE facilitators (total…) 96-100 %

www.who.ch/icidhwww.who.ch/icidh

Multi-level ICIDH DatabaseMulti-level ICIDH Database

User CommentsUser Comments

ICIDH Code p4 101

Name Leslie

Surname Loe

Organization University of North Carolina Occupational Therapy Student

Address 110 WIndsor Circle

City Chapel Hill, NC

Country USA

email lkloe@intrex.net

comment I think there is an error in the description of this item. I think"fulfill parental roles" should be "fulfill child roles".

Date 09/25/1999 6:16:39 AM

Interaction of E with B, A, PInteraction of E with B, A, P

B A P

Micro LightAirgravity

HouseSchoolChairtools

Social envCommunity

Meso ClimateAltitude

Assistive Tech. Services

Macro Policies

ISO Standards ApplicationISO Standards Application

Terminology– Harmonization of terms and clarification of semantic principles

– Translation

– Operationalization

– Computerization

Standardization for a multi-view and multi version approach

– Compatibility

– Standard classification procedures: Parent-child categories

Use of ICIDHUse of ICIDH

Scientific :Scientific : Impact of illnessImpact of illness

Services :Services : Interventions and outcomes Interventions and outcomes

Individual :Individual : Specify needsSpecify needs

Economic :Economic : Planning Planning

Social: Social: Rights of the individual-duties Rights of the individual-duties

of the societyof the society

Future Directions with Future Directions with ICIDH-2ICIDH-2

Use of the ICIDH-2 at country level Use of the ICIDH-2 at country level

Establishing an international data set and Establishing an international data set and

comparisonscomparisons

Algorithms for eligibility benefits, etc.Algorithms for eligibility benefits, etc.

Assessment instruments Assessment instruments

Computerization & case-recording formsComputerization & case-recording forms

Links of ICIDH and DALYsLinks of ICIDH and DALYs

II

CC

II

D A L YD A L Y

HH

AAccttiivviittiieess

+ -

+PP

aa rr tt

ii ccii pp

aa tt ii

oonn

-

Activity/ParticipationActivity/Participation

GOODGOOD

Remove BarriersRemove Barriers

Good exampleGood exampleLearn from itLearn from itIdentify facilitatorsIdentify facilitators

AwarenessAwarenessR & DR & D

Links between Links between Disability & Quality of LifeDisability & Quality of Life

DisablementsNone Present

Good

Bad

Quality of Life

ICIDH 2 ICIDH 2 Beta 2 Beta 2

Field Trial StudiesField Trial Studies

World Health OrganizationWorld Health Organization

Assessment, Classification & Epidemiology GroupAssessment, Classification & Epidemiology Group

ICIDH 2 Beta 2 Field Trial StudiesICIDH 2 Beta 2 Field Trial Studies Goals

to test the feasibility of the use of the classification in different settings

to test the reliability of the classification in different settings, formats and versions

to address some basic questions related to constructs and validity

ICIDH-2 ChecklistICIDH-2 Checklist

Easy to fill short list of ICIDH-2 categoriesEasy to fill short list of ICIDH-2 categories Available in several versionsAvailable in several versions

– ClinicianClinician

– Self-administeredSelf-administered

– InformantInformant

Can be used for Activity limitations aloneCan be used for Activity limitations alone

ICIDH-2 Beta 2ICIDH-2 Beta 2Field TrialsField Trials

Core StudiesCore Studies– Translation and Linguistic EvaluationTranslation and Linguistic Evaluation

– Basic QuestionsBasic Questions

– Feasibility and Reliability for CasesFeasibility and Reliability for Cases

Additional StudiesAdditional Studies– Feasibility and Reliability for Health RecordsFeasibility and Reliability for Health Records

– Feasibility and Reliability for SurveysFeasibility and Reliability for Surveys

– Face validity and predictive validityFace validity and predictive validity

– Utility for Intervention planning and evaluationUtility for Intervention planning and evaluation

– Individual Centre & Task Force studies Individual Centre & Task Force studies

Translation & Translation & Linguistic EvaluationLinguistic Evaluation

Translation - Translation - must for non-english speaking countriesmust for non-english speaking countries Linguistic Evaluation - Linguistic Evaluation - for all countriesfor all countries

ProcessProcess

Translation of the short version (two-level) Back-translation and linguistic evaluation of key terms Evaluation by a bi-lingual expert panel Modifications made based on its recommendations The translation, back-translation and linguistic evaluation The translation, back-translation and linguistic evaluation

of key terms and a of key terms and a reportreport on this exercise on this exercise

Linguistic Evaluation Linguistic Evaluation for English Speakersfor English Speakers

English term has different or modified meaningEnglish term has different or modified meaning Term has specific meaning in a specialty Term has specific meaning in a specialty Definitions and inclusion/exclusion terms do not meet the Definitions and inclusion/exclusion terms do not meet the

operational requirementsoperational requirements improvements suggested in:improvements suggested in:

– terminologyterminology

– definitionsdefinitions

– operationalizationsoperationalizations

– links with assessment and evaluation toolslinks with assessment and evaluation tools

better translatable terms for other languagesbetter translatable terms for other languages

Basic QuestionsBasic Questions

New Basic Questions for Beta 2 Response Possibilities:

– Individuals

–Consensus Conferences

–Feedback form

Qualitative and Quantitative analysis

Examples of Examples of Basic QuestionsBasic Questions

Title of of ICIDH-2Title of of ICIDH-2 Changes in the Definitions & terminologyChanges in the Definitions & terminology Conceptualizations of B,A,P and EConceptualizations of B,A,P and E Structure of the ClassificationStructure of the Classification OperationalizationsOperationalizations Qualifiers Qualifiers Guidelines and application notesGuidelines and application notes PhilosophyPhilosophy

– Have changes been effective, if not identify problems, recommend changes?Have changes been effective, if not identify problems, recommend changes?

– Are the current structures acceptable, accurate ? Any better approach?Are the current structures acceptable, accurate ? Any better approach?

Feasibility in Live EvaluationsFeasibility in Live Evaluations

Familiarisation of usersFamiliarisation of users Test coding with actual clientsTest coding with actual clients systematic feedback on systematic feedback on

– use of codesuse of codes

– ease of useease of use

– confidence in codingconfidence in coding

– meaningfulnessmeaningfulness

– time to do codingtime to do coding

– missing areasmissing areas

Reliability in Live EvaluationsReliability in Live Evaluations

Rater-observer in one evaluationRater-observer in one evaluation

Repeat assessment after one weekRepeat assessment after one week

Reliability calculated for Reliability calculated for

–2 level categories2 level categories

–3 and 4 level categories3 and 4 level categories

–qualifiersqualifiers

Reliability on Case Summaries Reliability on Case Summaries (Vignettes)(Vignettes)

Vignettes collected from centresVignettes collected from centres

Standard vignettes developedStandard vignettes developed

Accepted coding developedAccepted coding developed

Rated across centresRated across centres

Comparisons madeComparisons made

CASE 1CASE 1

Ms.Ms. A, with a diagnosis of ICD 10 mild mental retardation, can understand can understand the basic need to maintain her health. the basic need to maintain her health. Yet, because no physician in her area Yet, because no physician in her area provides care for people with mental provides care for people with mental retardation, she does not receive the retardation, she does not receive the preventive and basic care she preventive and basic care she requires to maintain good health.requires to maintain good health.

CASE 1 -- codingCASE 1 -- coding

Ms. Ms. A: mild mental retardation; can understand the need can understand the need to maintain her health; no physician provides care; she to maintain her health; no physician provides care; she does not receive health caredoes not receive health care

B: Intellectual functions (b120) – impaired

A: Activities of looking after one’s health (a580) – not limited

P: Participation in health (p140) – restricted

EF: Health service providers (e345) – barrier

CASE 2CASE 2

Mr. B has a paraplegic condition, as a result of a severe neck injury, and cannot perform the basic movements required to drive a standard car; however, with a suitably modified vehicle, he can drive safely. Unfortunately, there is a law in his province that prohibits him from driving.

CASE 2-- codingCASE 2-- coding

Mr. B: paraplegic condition; cannot drive standard car, but can drive modified vehicle; law prohibits driving.

B:B: Muscles power functions (b730) – Muscles power functions (b730) – impairedimpaired

A:A: Activities of using transportation as a driver (a450) –Activities of using transportation as a driver (a450) –not impairednot impaired

P:P: Participation in mobility with transportation Participation in mobility with transportation (p240) – (p240) – restrictedrestricted

EF:EF: Products for personal mobility and transportation Products for personal mobility and transportation (e140) – (e140) – facilitator facilitator

Transportation systems and policies (e635) – Transportation systems and policies (e635) – barrierbarrier

CASE 3CASE 3

Mr. C has cerebral palsy can not speak clearly, but has improved with the help of a speech therapist. Around friends or close colleagues at work he has no difficulty with conversations. However, most strangers do not take the time to listen carefully to understand him. So, Mr. C does not always get what he wants in stores and restaurants.

CASE 3 -- codingCASE 3 -- coding

Mr. C: has cerebral palsy; with speech therapy can speak clearly around friends or close colleagues at work; not strangers; doesn’t get service in stores.

B:B: Articulation functions (b320) – Articulation functions (b320) – impaired impaired

A:A: Activities of producing spoken messages (a230) – Activities of producing spoken messages (a230) – limitedlimited

Activities of maintaining interaction (a740) – Activities of maintaining interaction (a740) – not limitednot limited

P:P: Participation in spoken exchange of information (p310) – Participation in spoken exchange of information (p310) – restricted restricted

Participation in necessities for oneself (p130) – Participation in necessities for oneself (p130) – restricted restricted

Participation in informal social relationships (p430) –Participation in informal social relationships (p430) –not restrictednot restricted

EF:EF: Health services (e575) – Health services (e575) – facilitator facilitator

Friends (e320) – Friends (e320) – facilitatorfacilitator Strangers (e355) – Strangers (e355) – barrierbarrier

CASE 4CASE 4

A mentally retarded couple have been married for several years and have always wanted to have children. There are no medical reasons why they cannot, and they believe that they will not have any problems in the day-to-day care of a child. Yet, they have decided not to have a child because they believe that people will think they are bad parents and their child will be shunned by other children and made fun of.

CASE 4-- codingCASE 4-- coding

Mentally retarded couple: want and can care for children; fear attitudes of others, so have decided not to have children.

B:B: Intellectual functions (b120) – impaired Intellectual functions (b120) – impaired Procreation functions (b660) – not impaired Procreation functions (b660) – not impaired

A:A: Activities of assisting others (a660) – not limitedActivities of assisting others (a660) – not limitedP:P: Participation in family relationships (p410) – Participation in family relationships (p410) –

restrictedrestrictedParticipation in caring for others (p530) – Participation in caring for others (p530) –

restrictedrestrictedEF:EF: Societal attitudes and beliefs (e420) – barrierSocietal attitudes and beliefs (e420) – barrier

CASE 5CASE 5

A child born deaf and blind but with normal intelligence, is covered by strict educational mainstreaming laws and is a student in a regular public school. Her teacher has access to support staff trained to teach children with multiple sensory impairments, the child uses a computer with a Braille adaptation, and is fully accepted by other children in the class. Unfortunately, despite the assistance, she is having considerable difficulty learning basic reading skills.

CASE 5 -- codingCASE 5 -- coding

Child: deaf , blind, normal intelligence; mainstreamed with good support in public school; difficulty learning reading.

B:B: Seeing functions (b210) – Seeing functions (b210) – impairedimpaired; Hearing functions (b230) – ; Hearing functions (b230) – impairedimpaired; ; Intellectual functions (b120) – Intellectual functions (b120) – not impairednot impaired

A:A: Purposeful sensory activities (a110) – Purposeful sensory activities (a110) – limitedlimited; Activities of learning to ; Activities of learning to read (a115) – read (a115) – limitedlimited; Activities of understanding spoken messages ; Activities of understanding spoken messages

(a210) (a210) – – limitedlimited; Activities of understanding written messages (a225) – ; Activities of understanding written messages (a225) – limitedlimited; ; Basic interpersonal activities (a710) – Basic interpersonal activities (a710) – not limitednot limited; Complex ; Complex interpersonal interpersonal activities (a720) – activities (a720) – not limitednot limited

P:P: Participation in education in school (p630) – Participation in education in school (p630) – restrictedrestricted

EF:EF: Products for communication (e135) – Products for communication (e135) – facilitatorfacilitator; Products for education ; Products for education e145) – e145) – facilitatorfacilitator; Friends (e320) – ; Friends (e320) – facilitatorfacilitator; People in positions of ; People in positions of authority (e330) – authority (e330) – facilitatorfacilitator

Applicability on RecordsApplicability on Records

Use of routine health or other recordsUse of routine health or other records

Information extracted using checklistInformation extracted using checklist

Feasibility and Reliability of Feasibility and Reliability of

classification testedclassification tested

Applicability in SurveysApplicability in Surveys

Back-coding of existing survey recordsBack-coding of existing survey records

Application in new surveysApplication in new surveys

– FeasibilityFeasibility

– ReliabilityReliability

– Meaningfulness of informationMeaningfulness of information

Face and Predictive ValidityFace and Predictive Validity

Information on functioning and disabilityInformation on functioning and disability– ICIDH-2ICIDH-2

– ICIDH-2 checklistICIDH-2 checklist

– Other assessment instrumentsOther assessment instruments

Other information collected onOther information collected on– diagnosis, severitydiagnosis, severity

– health care utilisationhealth care utilisation

– loss of work days, etc...loss of work days, etc...

Correlation for cross-sectional measuresCorrelation for cross-sectional measures Predictive power for longitudinal measuresPredictive power for longitudinal measures

Utility for InterventionsUtility for Interventions

Intervention matching Intervention matching – indications, outcomesindications, outcomes

Intervention planning based on ICIDH-2 Intervention planning based on ICIDH-2

Evaluation by intervention personnelEvaluation by intervention personnel– Review of advantages and disadvantagesReview of advantages and disadvantages

– Multiple informant feedbackMultiple informant feedback

Centre and Task Force Centre and Task Force Recommended StudiesRecommended Studies

For A and P overlapFor A and P overlap Formal Reference Model of the Formal Reference Model of the

ICIDH-2ICIDH-2 Any othersAny others

ICIDH-2 MaterialICIDH-2 Material

Available from the WHO WebsiteAvailable from the WHO Website

http://www.who.int/icidhhttp://www.who.int/icidh