Validating the ICF core set for cerebral palsy using a national disability sample in Taiwan

Area of Science:

• Rehabilitation Medicine
• Pediatric Neurology
• Disability Studies

Background:

• Cerebral palsy (CP) is a leading cause of childhood physical disability.
• The International Classification of Functioning, Disability, and Health (ICF) core sets aid in comprehensive CP assessment and service delivery.
• Validating ICF core sets ensures their relevance and applicability in specific populations and healthcare systems.

Purpose of the Study:

• To validate the activities and participation (d) codes within two age-specific, brief ICF core sets for school-aged children with CP.
• To assess the coverage and predictive value of these ICF core sets using a national dataset from Taiwan.
• To identify potential additions to the ICF core sets for improved assessment in the Taiwanese context.

Main Methods:

• Analysis of a national dataset of 546 students with CP aged 6-17.9 years in Taiwan.
• Linking items from the child version of the Functioning Scale of the Disability Evaluation System (FUNDES) to ICF d-codes.
• Calculating restriction rates of linked d-codes and using Random Forest regression to identify important predictors of school participation frequency.

Main Results:

• The two brief ICF core sets demonstrated substantial content validity, covering the majority of the Taiwanese dataset.
• Matched d-codes showed high restriction rates (80%) and were largely significant predictors of school participation.
• One important ICF code, d740 (formal relationships), was identified as relevant but not included in the existing core sets.

Conclusions:

• The validated ICF core sets effectively capture essential functional information for children with CP as measured by the child FUNDES.
• The study recommends considering additional ICF codes, such as d740, for inclusion in revised Taiwanese versions of the core sets.
• The findings support the clinical application of specific ICF codes for assessing school participation in children with CP.