Using the International Classification of Functioning, Disability and Health (ICF) to Describe Children Referred to Special Care or Paediatric Dental Services

Abstract

Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child’s capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child’s real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ±3.6yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were ‘Intellectual functions’, ‘High-level cognitive functions’, and ‘Attention functions’. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including ‘Handling stress’, ‘Caring for body parts’, ‘Looking after one’s health’ and ‘Speaking’. In the Environment domain, facilitating items included ‘Support of friends’, ‘Attitude of friends’ and ‘Support of immediate family’. One item was reported as an environmental barrier – ‘Societal attitudes’. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might be used to develop an ICF-CY Core Set for Oral Health - a holistic but practical tool for clinical and epidemiological use.

ICF-CY code set for infants with early delay and disabilities (EDD Code Set) for interdisciplinary assessment: a global experts survey

“…Compared to the ICF-CY questionnaires [16], the EDD Code Set had a smaller number of categories overall and fewer Environmental Factors focusing on the home-related environment. However, the proportion of e categories was more than that of b categories in ICF-CY questionnaires [16] and in the ICF-CY checklist for Oral Health [24].…”

“…The proportion of codes for the body functions and body structures (b/s), activities and participation (d) and environmental factors (e) were 77%, 10% and 5%, respectively. For another example, an ICF-CY-based checklist for Oral Health to identify the medical, functional, social and environmental context of children and adolescents referred to special care or pediatric dental services revealed that more than 50% of children presented problems across 25 d, 10 b and 20 e categories [24]. A study in Taiwan showed that very few Environmental Factors information could be found in the Evaluation Report of children with DD [23].…”

“…In the cleft lip and/or palate Core Set for children younger than 17 years of age, the selected d categories were in all nine chapters except d4 [34]. For older children (mean age eight years), the most frequent d categories in restriction in dental health were ''Handling stress'' (d2), ''Speaking'' (d3), ''Caring for body parts'' (d5) and ''Looking after one's health'' (d6) [24]. The studies demonstrate that the content of code sets will be different according to the target population characteristics and specific age groups.…”

“…Other studies have also reported e categories from the same four chapters [21,24,34]. All studies have addressed the importance of the home environment and services for infants with DD.…”

Améliorer les cadres de référence pour le suivi de l’application de la Convention des Nations Unies relative aux droits des personnes handicapées : une illustration à travers le processus de mise à jour de l’International Classification of Functioning, Disability and Health (ICF)

“…Les domaines d'application sont également très divers, par exemple : l'éthique (Ajovalasit et al, 2012), l'éducation (Hollenweger & Moretti, 2012), les assurances (Brage, Donceel, & Falez), le domaine clinique (Bickenbach, Cieza, Rauch, & Stucki, 2012), la santé orale (Faulks et al, 2013), les enquêtes en population (Madans, Loeb, & Altman, 2011), et plus récemment le suivi de l'application de la Convention des Nations Unies relative aux droits des personnes handicapées (Bickenbach, 2011).…”