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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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CLASSIFYING FUNCTIONING OF CHILDREN AND ADOLESCENTS WITH INTELLECTUAL DISABILITY: THE UTILITY OF THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH FOR CHILDREN AND YOUTH

Vale MC1, Pereira-da-Silva L2, Pimentel MJ1, Marques TN3, Rodrigues H4, Cunha G5, Machado MC6, Sanches-Ferreira M7, Simeonsson RS8,9

Afiliações:
1 - Pediatric Neurodevelopment Unit, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
2 - Woman,Children and Adolescent’s Medicine Teaching and Research Area, NOVA Medical School of Lisbon, Universidade Nova de Lisboa, Lisbon, Portugal
3 - Early Intervention Program Regional Lisbon Area, Ministry of Social Security and Solidarity, Portugal. Infancy and Youth Unit, Institute of Social Security, Ministry of Labor and Social Solidarity, Portugal
4 - Department of Special Education, Ministry of Education and Science, Portugal
5 - Department of Exact Science, Lisbon School of Health Technology, Lisbon, Portugal
6 - Department of Pediatrics, Faculty of Medicine, Universidade de Lisboa, Lisbon, Portugal
7 - Special Education Department, School of Education, Porto Polytechnic, Porto, Portugal
8 - School of Education, University of North Carolina, Chapel Hill, NC, USA
9 - C.H.I.L.D., Jonkoping University, Jonkoping, Sweden

Journal of Policy and Practice in Intellectual Disabilities 2017;14:285-92.-

Resumo:
Observational cross-sectional study carried out in a pediatric neurodevelopment unit of a tertiary-care hospital. A sample of 355 children with median ((min.–max.) 1.0–17.3) years with intellectual disability (30.4% borderline, 43.1% mild, 19.7% moderate, 5.1% severe, and 1.7% profound disability) was seen over a period of 3 years. Based on clinical observation and psychological evaluation, a neurodevelopmental pediatrician selected ICF-CY body functions codes, and respective qualifiers, to effectively describe functioning of children. Based on evaluation reports, a psychologist and a special educator assigned the previously chosen ICF-CY body functions codes to 139 and 67 children, respectively. Inter-rater agreement was estimated using simple and weighted Cohen’s kappa coefficients and Gwet’s AC1 statistic and Gwet’s weighted kappa coefficient statistic. A set of eight ICF-CY codes was identified as efficiently describing impairments of body functions of children with intellectual disability: global mental functions b117 and b122; specific mental functions b147, b163, b164, and b167; and voice and speech functions b320 and b330. Results indicate a correspondence between the level of severity of qualifiers assigned to ICF-CY codes and the level of intellectual disability. Inter-rater agreement was variable among raters, with the best agreements found for qualifying intellectual functions (b117) and psychomotor functions (b122). A profile of eight ICF-CY codes effectively describes functioning of children with intellectual disability, providing an alternative to medically based classification, based on diagnoses with functionally based classification of children’s characteristics. The findings contribute to define a comprehensive set of codes to reliably record individual differences of functioning in this population.

Palavras Chave: Disability and Health for Children and Youth (ICF-CY); International Classification of Functioning, intellectual disabilities; interobserver agreement