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Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
A Narrative Review of Function-Focused Measures for Children With Neurodevelopmental Disorders
Kajaani Shanmugarajah1,2, Peter Rosenbaum2,3,4, Mohammad Zubairi3,4
1School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
Insights
This review identified 14 clinical measures for children with neurodevelopmental disorders (NDD) that incorporate the International Classification of Functioning, Disability, and Health (ICF) framework. These measures effectively capture functioning domains, aiding clinical practice and research.
Area of Science:
- Rehabilitation Medicine
- Developmental Pediatrics
- Health Services Research
Background:
- Clinical measures assess child functioning to support children with neurodevelopmental disorders (NDD) and their families.
- The World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework guides health assessment beyond biomedical deficits.
- Understanding how NDD measures incorporate the ICF is crucial for effective clinical practice and research.
Purpose of the Study:
- To identify and describe function-focused clinical measures based on the ICF for children with NDD.
- To analyze how these measures incorporate ICF domains within healthcare contexts.
- To enhance the operationalization of function-focused concepts in pediatric NDD research and practice.
Main Methods:
- A narrative review utilizing a systematic search strategy across multiple health databases (Medline, PsycInfo, EMBASE, EMCARE).
- Inclusion criteria focused on clinical measures supporting children (0-21 years) with NDD in pediatric settings.
- Identified 14 relevant clinical measures for analysis.
Main Results:
- The 14 identified measures primarily target cerebral palsy, autism spectrum disorder, and communication disorders.
- Measures varied in contextual use (clinical-only or multiple settings) and underwent psychometric testing.
- Participation (79%) and Activities (71%) were the most frequently captured ICF domains; 71% utilized multiple ICF domains.
Conclusions:
- Clinical measures can effectively apply the ICF's functioning concepts for children with NDD.
- The identified measures demonstrate the dynamic nature of ICF domain interactions, differentiating from common linking rules.
- Findings support the use of ICF-aligned measures to improve the assessment and support of functioning in pediatric NDD populations.
Abstract:
Clinical measures in health and rehabilitation settings are often used to examine child functioning to better support the diverse needs of children with neurodevelopmental disorders (NDD) and their families. The WHO's International Classification of Functioning, Disability, and Health (ICF) framework reflects a focus of health beyond biomedical deficits, using the concept of functioning to create opportunities for measurement development involving this construct. In the measures developed in the field of childhood NDD, it is unclear whether and how these tools measure and incorporate the ICF framework and its domains within health care contexts. Understanding how these measures utilize the ICF will enable researchers and clinicians to operationalize function-focused concepts in studies and clinical practice more effectively. This narrative review aims to identify and describe function-focused measures that are based on the ICF for children with NDD, as described in the peer-reviewed literature. This review used a systematic search strategy with multiple health-focused databases (Medline, PsycInfo, EMBASE, EMCARE), and identified 14 clinical measures that provide direct support for children (aged 0-21) with NDD in pediatric health (and other) settings. Results described the measures that were primarily developed for three main diagnostic populations [cerebral palsy, autism spectrum disorder, and communication disorders]; had varying contextual use (clinical-only or multiple settings); and for which authors had conducted psychometric tests in the measure's initial development studies, with the most common being content validity, interrater reliability, test-retest reliability. Participation (79%, n = 11) & Activities (71%, n = 10) were the most common ICF domains captured by the set of measurement tools. Overall (71%, n = 10) of the identified measures utilized multiple ICF domains, indicating that the "dynamic nature" of the interactions of the ICF domains was generally evident, and that this result differentiated from "linking rules," commonly used in research and clinical practice. The implications of these findings suggest that clinical measures can be an effective application of the ICF's defined concepts of functioning for children with NDD.
