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Putting ICF-CY into Practice - Helsinki Version


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The ICF concept of health provides perspectives on people’s lives through the lens of functioning. This view of health promotes an integration of a patient’s body functions
and structures, activities performed in daily life, and the personal and social roles that constitute their participation in life situations.
Service providers (health, education, welfare) engaged in the habilitation process have varied disciplinary language, training and culture that all emphasize certain
domains of patient’s functioning over others. However, adoption of the ICF allows that all members of a clinical team are motivated to improve their patient’s functioning
within a common conceptual approach. This can be used to describe the different goals of intervention, negotiate priorities and communicate among different disciplines
and with patients and parents.

Published in: Health & Medicine
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Putting ICF-CY into Practice - Helsinki Version

  1. 1. Research Making a Difference Putting the ICF into Practice First ICF Education Symposium, Helsinki, Finland June 5th 2015 Liane Simon Olaf Kraus de Camargo @Devpeds
  2. 2. Outline • Overview of the ICF and its use as a framework in disability (Olaf) • Brief history and experience with the use of ICF codes in Early Intervention Services (Liane) • Video example • Summary
  3. 3. 3
  4. 4. Components of the ICF
  5. 5. We can give you a diagnosis!
  6. 6. Change of the Definition of Disability ➡ "He-Who-Must-Not-Be-Named" ➡ In the ICF-language “The” disability is an experience ➡ All people can find themselves in disabling life situations (“Disability” as a relative term) ➡ Disability can be prevented (in relative terms) ➡ The relations between Disability and Functioning are complex
  7. 7. Disability: Why does it matter? • People with disabilities and chronic health conditions are the largest minority on earth (1 billion people) (WHO and The World Bank (2011). World Report on Disability) • Chronic health conditions affect around 25% of the paediatric patients ( • Care for children with disabilities is complex and demanding (Burke, R. T. and B. Alverson (2010). Pediatrics 126(4): 789-790). • Psychosocial factors are of major importance for the wellbeing of children and families (Lach, L. et al. (2009). Disability and rehabilitation 31(9): 741-752. • “too much care that is important is often not delivered, and too much care that is delivered is often not important” (Institute of Medicine, 2011)
  8. 8. A person is functioning well, if – with regard to the context in which she is living (Concept of Environmental Factors) – • Her Body Functions (including the mental functions) and her Body Structures correspond to general accepted norms (Concept of Body Functions and Body Structures), • She is able to perform the type of activities in the same way as a person without a health problem (Concept of Activities), • She is able to develop her existence in all domains that are important to her in the same way and the same extent as it would be expected to be by a person without impairments of body functions or structures or restrictions in activities. (Concept of participation) Functioning Bio Psycho Social
  9. 9. Contextual factors (Environmental factors, personal factors) influence functioning: Positively (Facilitators) Therefore, it is always necessary to take into consideration the contextual factors when evaluating functioning! Negatively (Barriers) Functioning and Contextual Factors
  10. 10. Common Language • Professionals can communicate across disciplines • Patients can identify common needs across diagnoses - speak with one voice! • Service providers can identify populations for programs and services across diagnoses • Public Health services can identify priorities based on needs
  11. 11. Laulima Many hands working together in cooperation and harmony
  12. 12. Acute Care The ICF and Cultures of Care Developmental Care/Early Intervention
  13. 13. The ICF and Cultures of Care Acute Care Strategy curative, cause oriented optimizing, bio-psycho-social Developmental Care/Early Intervention
  14. 14. The ICF and Cultures of Care Acute Care Strategy curative, cause oriented optimizing, bio-psycho-social Developmental Care/Early Intervention Patients/Parents passive, enduring, „patient“ active, responsible
  15. 15. The ICF and Cultures of Care Acute Care Strategy curative, cause oriented optimizing, bio-psycho-social Developmental Care/Early Intervention Patients/Parents passive, enduring, „patient“ active, responsible Physician giving orders, „in charge“ counselling accompanying member of a team
  16. 16. Putting the ICF into Practice
  17. 17. First contact ? ? ?
  18. 18. Who are you? Who are you? What do/would you like to do?
  19. 19. Where and how do you live?
  20. 20. Now, let’s focus on what you want!
  21. 21. What do people want? Function Family Fitness Fun Friends Future
  22. 22. 11 years with ICF
  23. 23. Vortragstitel - Headline e Referent: Name Frühförderung Norderstedt
  24. 24. • 2004 Developing an ICF-Checklist  Marijke Kaffka-Backmann  Olaf Kraus de Camargo  Jürgen Kühl  Liane Simon • 2005 Impelmentation of ICF in daily praxis of early childhood intervention ICF in early intervention 2004-2015
  25. 25. Searching for a „common language“ Integration of different professional knowledge Focused on ressources Capturing them systematically Why?
  26. 26. „Development is a dynamic process by which the child moves progressively from dependency on others for all activities in infancy towards physical, social and psychological maturity and independence in adolescence. In this dynamic process, the child´s functioning is dependent on continuous interactions with the family or other caregivers in a close, social environment. Therefore the functioning of a child cannot be seen in isolation but rather in terms of the child in the context of the family system“ (WHO,2007, XV). Thinking in interdependencies
  27. 27. Connecting the dots. interprofessional goal setting. Talk and listen to each other Requirements to the team
  28. 28. „The continuos reflection with caregivers and within the team is crucial for the success of early intervention“ (VIFF 1999).
  29. 29. Implementation by decision of the leadership Slowly because it takes time to learn a language Including the informations of external professionals to the reports. Joint reports. The implementation
  30. 30. Every child Every 6-12 month Multiprofessional diagnostic at the beginning Video-consultation in teams The person, who works with the child and it´s family presents the facts Questions Video Hypothesis and “talking prosa” Using the ICF-CY Code set for goal setting for the next 6 month (max. 6) How do we use it?
  31. 31. Confusion about the most apropriate component. Aiming too high (b2, d3…), i.e. wanting to solve everything We used the common language but sometimes didn´t want to talk or listen to each other The coding is not enough to be understandable We also needed a short comment. Learning from our mistakes
  32. 32. : 1.asking Caregivers describe the childs and familiys needs PEM-CY Participation and Environment Measure für Children and Youth (PEM-CY) von Coster and Khetani Khetani, M.A., Graham, J., & Alvord, C. (in press). Community participation patterns among preschool-aged children who have received Part C early intervention services. Child: Care, Health and Development (Special Issue). Volume 39, Issue 4, July 2013, Pages: 490–499, ICF-PEI IC-CYF based schedule for Individualized Education Plan Alberto Raggi, Paolo Meucci, Matilde Leonardi, Tiziana Barbera, Annamaria Villano, Maria R Caputo, and Alessandra Grassi (2014) The development of a structuredschedule for collecting ICF-CY based information on disability for school and preschool children: an action research from Italy. Int J Rehab Res, 37, 86-96. ICF-CY- based approach
  33. 33. 2. Interprofessional discussion  Not only professions but professionals discuss and cooperate  They need the disposition to do this  Interprofessional discussion is subject to the terms of communication theories ICF-CY- based approach
  34. 34. 3. coding Is not enough, you need a additional comment. ICF-CY- based approach
  35. 35. VIDEO
  36. 36. When putting the ICF into practice – importance of taking different perspectives and views Use of a Code-set makes it easier for paper-based approach Using the ICF to classifiy goals allows to match resources and needs Using the ICF facilitates the communication within the team and professionals and services outside of the team. Summary