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Reliability in assigning ICF codes to children with special health care needs using a developmentally structured

Rebecca A Kronk1, Julie A Ogonowski, Carryn N Rice

  • 1Department of Paediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA15213, USA.

Disability and Rehabilitation
|August 13, 2005
PubMed

Insights

A structured interview effectively assigned International Classification of Functioning, Disability, and Health (ICF) codes for children with special health care needs. This method showed high rater agreement, proving more reliable than standardized assessments.

Area of Science:

  • Pediatric Health Services Research
  • Rehabilitation Medicine
  • Disability Studies

Background:

  • Children with special health care needs (CSHCN) require comprehensive functional assessments.
  • The International Classification of Functioning, Disability, and Health (ICF) provides a standardized framework for describing health and functioning.
  • Accurate ICF coding is crucial for service planning and research in CSHCN.

Purpose of the Study:

  • To evaluate the reliability of assigning ICF codes and performance qualifiers by two rater teams.
  • To assess the effectiveness of a developmentally structured interview for coding CSHCN.
  • To compare the interview's reliability against standardized functional assessments.

Main Methods:

  • Forty children (11 months to 12 years 10 months) with diverse health conditions participated.
  • A structured interview with open-ended questions was administered and scored using developmental guidelines.
  • Two independent raters assigned ICF codes and performance qualifiers, with inter-rater reliability measured by Cohen's kappa statistic.

Main Results:

  • High inter-rater agreement was achieved for most ICF codes (39/39 by Team I, 38/39 by Team II).
  • Good to excellent agreement was observed for performance qualifiers (5/5 by Team I, 10/14 by Team II).
  • The structured interview demonstrated strong reliability in coding CSHCN.

Conclusions:

  • A developmentally structured interview is a viable clinical tool for assigning ICF codes to CSHCN.
  • This interview method yielded higher agreement rates compared to traditional standardized functional assessments.
  • Modifications to ICF performance qualifier guidelines are recommended for pediatric application.
Abstract

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