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Usefulness of ICF-CY to define functioning and disability in very low birth weight children: a retrospective study
A M Giovannetti1, A Raggi, M Leonardi
1Neurological Institute Carlo Besta IRCCS Foundation, Via Celoria 11, 20133 Milan, Italy. ambra.giovannetti@istituto-besta.it
Insights
Very low birth weight (VLBW) infants need comprehensive assessments beyond traditional tools. The International Classification of Functioning, Disability and Health-Children and Youth version (ICF-CY) questionnaire offers a better evaluation of VLBW infant functioning.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Preterm birth can lead to brain injury and developmental issues in infants.
- Very low birth weight (VLBW) infants face ongoing health and developmental challenges.
Purpose of the Study:
- To describe the functional characteristics of VLBW infants using the ICF-CY classification.
- To explore associations between infant factors (gender, birth weight, gestational age) and functioning.
- To evaluate the utility of the ICF-CY model in assessing VLBW infant development.
Main Methods:
- Observational, retrospective, cross-sectional study of 56 VLBW infants (12-24 months corrected age).
- Utilized neuro-functional assessment (NFA), Griffiths Mental Development Scales-Revised (Griffiths 0-2), and ICF-CY questionnaire.
- Employed two-step cluster analysis to categorize infant functioning into four groups.
Main Results:
- Four distinct functioning groups (very low, low, intermediate, high) were identified.
- Traditional tools inadequately assess the interaction between infant functioning and environmental factors (EF).
- Environmental facilitators significantly influenced the functioning differences in VLBW infants.
Conclusions:
- A comprehensive biopsychosocial evaluation of VLBW children's functioning is essential.
- The ICF-CY questionnaire provides a valuable tool for routine follow-up assessments.
- Integrating ICF-CY enhances the understanding of VLBW infant development and needs.
Background:
Preterm birth is associated with variable degrees of brain injury, adverse neurodevelopmental outcomes and continuing special health care needs.
Study And Aims:
This observational, retrospective and cross-sectional study aims to describe the functional features of VLBW infants using the ICF-CY classification and to identify the association between gender, twinship, birth weight, gestational age, adjusted age and functioning as defined by the ICF biopsychosocial model.
Sample:
56 VLBW infants (corrected age of 12-24 months) were consecutively enrolled.
Instruments:
Three assessment tools were used: a neuro-functional assessment (NFA); the Griffiths Mental Development Scales-Revised: Birth to 2 years (Griffiths 0-2) to evaluate psychomotor development and the ICF-CY questionnaire for ages 0-3.
Results:
A two-step cluster component analysis with the Bayesian information criterion was conducted based on NFA and Griffiths 0-2 scores and four groups of infant's functioning (very low, low, intermediate, high) emerged. Study findings demonstrate that the traditional assessment tools tend to poorly evaluate the interaction between the person's functioning and environment factors (EF), even thought EF results to be relevant for VLBW infants. The higher number of symptoms, more difficulties in activities and participations and the higher number of environmental facilitators maximize the difference between infants with very low and those with intermediate or higher functioning. The distribution of gender or the presence of siblings is not significantly associated to any group.
Conclusion:
This study shows that a more complete evaluation of functioning of VLBW children, based on the biopsychosocial approach, is needed and can be successfully implemented in the follow-up routine through ICF-CY questionnaire.
