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Published on: February 11, 2014
Evaluating rehabilitation goals of visually impaired children in multidisciplinary care according to ICF-CY
Linda Rainey1, Ruth van Nispen, Ger van Rens
1Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands.
Insights
Rehabilitation goals for visually impaired children change with age, focusing more on activity and participation for older children. Current assessments may miss key goals like communication and leisure. A standardized approach is needed to track progress effectively.
Area of Science:
- Pediatric Rehabilitation
- Ophthalmology
- Disability Studies
Background:
- Visual impairment in children presents unique rehabilitation challenges.
- Understanding rehabilitation goals is crucial for effective intervention.
- The International Classification of Functioning, Disability and Health (ICF) provides a framework for classifying health and disability.
Purpose of the Study:
- To explore rehabilitation goals for visually impaired children.
- To examine the relationship between goals and ICF structure.
- To analyze how patient characteristics influence rehabilitation objectives.
Main Methods:
- A patient record study analyzed data from 289 children (<18 years) with suspected visual impairment in the Netherlands.
- Chi-square analyses identified trends in rehabilitation goals across age groups.
- Regression analysis determined the impact of age and visual acuity on goal setting.
Main Results:
- Common diagnoses included nystagmus, cerebral visual impairment, and albinism.
- Younger children (<7 years) focused on physical functioning and environmental factors.
- Older children (≥7 years) had more goals in activity and participation (A&P) domains, particularly 'Learning and applying knowledge,' 'Mobility,' and 'Major life areas.'
- Age and visual acuity significantly predicted the number of A&P goals.
Conclusions:
- Rehabilitation goals for visually impaired children significantly vary with age.
- Key A&P goals (communication, peer interaction, leisure) appear underrepresented in current intake procedures.
- A systematic, standardized procedure is necessary for comprehensive goal cataloging and progress evaluation.
Purpose:
To gain qualitative insight into the rehabilitation goals of visually impaired children and how these goals relate to the structure of the International Classification of Functioning, Disability and Health (ICF) and patient characteristics.
Methods:
A patient record study was conducted, analysing rehabilitation goals and characteristics of children with a suspected visual impairment in the Netherlands (<18 years) who applied for multidisciplinary services in 2012 (N = 289). Chi-square analyses for trend in rehabilitation content across age bands and additional analyses were performed.
Results:
The three most common diagnoses were nystagmus (21.2%), cerebral visual impairment (16.2%) and albinism (6.1%). Rehabilitation goals for children aged <7 years were mostly aimed at 'physical (visual) functioning' (36.7%) and 'environmental factors' (36.7%). For children ≥7 years, significantly more goals were identified on activity and participation (A&P) domains (52.2%). Three A and P domains presented a significant linear trend on the number of rehabilitation goals across age bands: (1) 'Learning and applying knowledge' (13.042, p < 0.001), (4) 'Mobility' (31.340, p < 0.001) and (8) 'Major life areas' (5.925, p = 0.015). Regression analysis showed that both age and visual acuity significantly contributed to the number of A and P goals.
Conclusion:
Although analyses were based on a selection of patient records, the number and nature of rehabilitation goals differ significantly with age. Many A and P goals seem underrepresented at the intake procedure, for example: communication, peer interaction and participating in leisure activities. A systematic, standardized procedure is required to catalogue all existing goals and to be able to evaluate progress and potential new or other important goals.
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