PEDIATRIC PT

ASSESSMENT
WITH ICF-CY MODEL

By: Johannes.P
Reviewed By: Johannes Purwanto 1
Reviewed By: Johannes Purwanto 2
FOUNDATIONS OF THE ICF
Human Functioning - not merely disability
Universal Model - not a minority model
Integrative Model - not merely medical or
social
Interactive Model - not linear progressive
Parity - not etiological causality
Context - inclusive - not person alone
Cultural applicability - not western concepts
Operational - not theory driven alone
Life span coverage - not adult driven

• Diseases vs Health
• Medical model vs Social Model
• Biological model vs Bio-Psycho-Social Models
Reviewed By: Johannes Purwanto 3
 ICF MODEL
Health Condition
(disorder/disease)

Body function
Activities Participation
and structure
(Limitation) (Restriction)
(Impairment)

Environmental Personal Factors

Factors
Reviewed By: Johannes Purwanto 4
 DEFINITION
Impairment Loss or abnormality in body structure or
function (including mental function)

Activity Limitations Difficulties individual may have in

executing activities in terms of quantity or
quality

Participation Problems an individual may experience

Restrictions in involvement in life situations

Facilitators & Barriers Environmental factors may be a facilitator

for one person & barrier
for another

Reviewed By: Johannes Purwanto 5

 ICF COMPONENTS
Body functions Physiological functions of body systems
Body Structures Structural or anatomical parts of the body
Activities Execution of a task or action by an individual (individual
perspective)
Participation Persons involvement in a life situation (societal
perspective)
Environmental Factors All aspects of the external world that impact
on the person’s functioning

Reviewed By: Johannes Purwanto 6

 ICF COMPONENTS
Body Functions Activities & Environmental Factors
& Structures Participation

Functions Capacity Barriers

Structures Performance Facilitators

Reviewed By: Johannes Purwanto 7
 STRUCTURE OF THE ICF
ICF Classification

Part 1: Part 2:
Functioning and Contextual Parts
Disability Factors

Body Functions Activities and Environmental Personal Components

and Structures Participation Factors Factors

Change in Change in Constructs/

Body Body Capacity Performance Facilitator/
Functions Structures Barrier qualifiers

Item Item Item Item Item Domains and

levels: levels: levels: levels: levels:
1st 1st 1st 1st 1st categories
2nd 2nd 2nd 2nd 2nd at different levels
3rd 3rd 3rd 3 rd
3rd
4th 4th 4th 4thReviewed By: Johannes
4th Purwanto 8
 AIMS OF ICF
• To provide a scientific basis for consequences of
health conditions
• To establish a common language to improve
communications
• To permit comparison of data across:
– countries
– health care disciplines
– services
– time
• To provide a systematic coding scheme for health
information systems

Reviewed By: Johannes Purwanto 9

 APPLICATIONS OF ICF
• As a statistical tool
• As a research tool
• As a clinical tool
• As a social policy tool
• As an educational tool
• Social action

Reviewed By: Johannes Purwanto 10

 NEED FOR ICF-CY
Functioning, Activities, Participation &
Environments different from those of adults

Reviewed By: Johannes Purwanto 11

WHY IS THERE A NEED FOR AN ICF FOR
CHILDREN & YOUTH?
• Nature and form of functioning in children different
from that of adults
• Main volume of ICF lacking precursors of adult
characteristics
• Child as a “moving target” in
• Indicators of functional risk factors crucial for
prevention and early intervention
• ICF version for children and youth provides continuity
of documentation in transitions from child to adult
services
• classification of function
Reviewed By: Johannes Purwanto 12
 ICF-CY TEAM MEMBERS

• Mats Granlund • Travis Threats

• Professor in Psychology at • Saint Louis University,
Jönköping University, School of International, World Health
Health Science, Organization (2006)
Swedish Institute for Disability • Classifications adopted by
Research ASHA, physical and
• Researcher Reviewed By: Johannes Purwanto occupational therapists 13
Reviewed By: Johannes Purwanto 14
BODY FUNCTION, code (b)

Reviewed By: Johannes Purwanto 15

BODY STRUCTURE, code (s)

Reviewed By: Johannes Purwanto 16

ACTIVITIES and PARTICIPATION, code (d)

Reviewed By: Johannes Purwanto 17

ENVIRONMENTAL FACTORS, code (e)

Reviewed By: Johannes Purwanto 18

Reviewed By: Johannes Purwanto 19
BODY FUNCTION, code (b)

Reviewed By: Johannes Purwanto 20

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BODY STRUCTURE, code (s)

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ACTIVITY AND PARTICIPATION, code: (d)

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ENVIRONMENTAL FACTOR, code (e)

Reviewed By: Johannes Purwanto 50

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 CODE STRUCTURE
1st level b2 Sensory functions
and pain

2nd level b210 Seeing function

3rd level b2102 quality of vision

4th level b21022 Contrast

sensitivity

Reviewed By: Johannes Purwanto 56

 BODY FUNCTION CODING (b)
• Body functions are coded with one qualifier
that indicates the extent or magnitude of the
impairment.
• The presence of an impairment can be
identified as a loss or lack, reduction, addition
or excess, or deviation.

Reviewed By: Johannes Purwanto 57

BODY FUNCTION CODING (b)

Reviewed By: Johannes Purwanto 58

 QUALIFIERS FOR BODY FUNCTION (b)

xxx.0 NO problem (none, absent, negligible…) 0–4 %

xxx.1 MILD problem (slight, low….) 5–24%
xxx.2 MODERATE problem (medium, fair…) 25–49%
xxx.3 SEVERE problem (high, extreme…) 50–95%
xxx.4 COMPLETE problem (total…) 96–100%
xxx.8 not specified
xxx.9 not applicable

Reviewed By: Johannes Purwanto 59

 BODY STRUCTURE CODING (s)
• Body structures are coded with three
qualifiers.
• The first qualifier describes the extent or
magnitude of the impairment,
• The second qualifier is used to indicate the
nature of the change,
• The third qualifier denotes the location of the
impairment.

Reviewed By: Johannes Purwanto 60

BODY STRUCTURE CODING (s)

Reviewed By: Johannes Purwanto 61

QUALIFIERS FOR BODY STRUCTURE (s)

Reviewed By: Johannes Purwanto 62

ACTIVITY AND PARTICIPATION CODING
(d)
• Activities and Participation is coded with two
qualifiers: the performance qualifier, which
occupies the first digit position after the point,
and the capacity qualifier, which occupies the
second digit position after the point.
• The code that identifies the category from the
Activities and Participation list and the two
qualifiers form the default information matrix.

Reviewed By: Johannes Purwanto 63

ACTIVITY AND PARTICIPATION CODING
(d)

Reviewed By: Johannes Purwanto 64

 QUALIFIERS FOR
ACTIVITY AND PARTICIPATION (d)

Reviewed By: Johannes Purwanto 65

 ENVIRONMENT CODING (e)
• Environmental factors are to be coded from the
perspective of the person whose situation is
being described
• The qualifier indicates the extent to which a
factor is a facilitator or a barrier
• The following is the negative and positive scale
that denotes the extent to which an
environmental factor acts as a barrier or a
facilitator

Reviewed By: Johannes Purwanto 66

 ENVIRONMENT CODING (e)

environmental factor as a barrier or a facilitator

e130

Reviewed By: Johannes Purwanto 67

QUALIFIER FOR ENVIRONMENT (e)

Reviewed By: Johannes Purwanto 68

 PRACTICE
http://apps.who.int/classifications/icfbrowser/

Reviewed By: Johannes Purwanto 69