1. Mapping Tools For Assessing Rehabilitation and Health Needs to the ICF
Elias Mpofu, PhD, DEd, CRC
University of Sydney
070512
ICF Workshop

2. Presentation Overview
World Health Organization
International Classification of Functioning Model
Mapping rehabilitation and health assessment tools to the ICF
Rehabilitation and health: Applying ICF guidelines (Springer Publications)
Assessment in rehabilitation and health (Pearson Publishers)
Best and least represented assessments tools
In the books

3. ICF Model
Framework for describing human functions that may be affected by health conditions
Biopsychosocial model (not a medical/pathology model)
Describe behaviors that may lead to intervention, not to diagnose a disorder
If fully implemented, acquiring and integrating information on three health conditions and two contextual conditions.

4. ICF’s Two Broad Parts Health Conditions Contextual Conditions
Body Functions Activity Participation
& Structure
Contextual Factors
Environmental Factors
Personal Factors

5. Health Conditions Include
Body Functions and Structures
Activities
Participation
Let’s consider each more closely

6. Body Functions and Structures
Body functions: physiological and psychological functions
Body structures: anatomy

7. Body Functions and Structures
8 physiological body system functions:
mental; sensory and pain; skin;
voice and speech; reproductive;
cardiovascular, hematological, immunological;
digestive, metabolic, & endocrine;
neuromusculoskeletal and movement

8. Body Functions and Structures
8 anatomical body structures:
nervous; voice and speech; eyes and ears;
cardiovascular, immunological, respiratory;
digestive, metabolic, endocrine;
reproductive; movement; skin

9. Activities and Participation
Activity: execution of a task or action
Can the person perform the activity?
Participation: one’s involvement in life:
Does the person perform the activity, when needed
Two examples:
bathing
riding a bicycle

10. 8 Activities and Participation Areas
learning and applying knowledge; communication; mobility; self-care;
domestic life; interpersonal interactions
and relationships; community, social, and civic life; general tasks and demands (e.g., carrying out daily routines); major life areas (i.e., education, employment, economic life)

11. Contextual Conditions Include
Environmental Qualities
At three levels: Individual, Service and Cultural-legal Levels
Personal Qualities
These are still to be operationalized .
Race, SES, gender, fitness, upbringing, etc.

12. 5 Environmental Qualities
2. Natural environment and human-made changes (e.g.)
physical geography,
climate,
air quality,
population,
light and sounds

13. 5 Environmental Qualities
Physical, social, and attitudinal environments in which people live and conduct their lives
Products and technology for (e.g.)
personal communication,
education,
recreation,
religion

14. 5 Environmental Qualities
3. Support and relationships (e.g)
immediate and extended family,
friends, acquaintances,
persons in authoritative or subordinate positions,
health and health-related professionals,
domestic animals,

15. 5 Environmental Qualities
4. Attitudes (e.g.)
immediate and extended family,
friends and acquaintances,
strangers,
societal,
social norms,
persons in authoritative and subordinate positions,
health and health-related practitioners

16. 6 Personal factors
6. “May include gender, age, coping styles, social background, education, profession, past and current experience, overall behaviour pattern, character and other factors that influence how disability is experienced by the individual” and
“Their assessment is left to the user, if needed” (WHO, 2001, p. 19)

17. 6 Personal factors
6. Important for rehabilitation goal setting, intervention design, implementation and evaluation (Geyh, 2011, Mpofu and Oakland, 2010).

18. 6 Personal factors cont.
6. “The particular background of an individual’s life and living, including features of the individual that are not part of a health condition or health states, and which can impact functioning positively or negatively” (Grotkamp et al, in press)

19. 6. Personal Factors cont.
6.Grotkamp et al. (in press) personal factors classified personal factors into 72 categories arranged in six chapters as follows:
General factors normally unchangeable (chapter 1), a person's inherent physical and mental constitution (chapters 2 and 3), more modifiable factors as attitudes, basic skills and behaviour patterns (chapter 4), life situation and socioeconomic/sociocultural factors (Chapter 5), and other health factors, e.g., prior interventions (chapter 6)

20. 6. Personal Factors cont. Other qualities of personal
Changeable, potentially modifiable, and unchangeable (Badley,2006, Howe, 2008).
Subjective, psychological assets (Huber, Sillick, and Skarakis-Doyle, 2010; Ueda & Okawa, 2003)

21. 6. Personal Factors cont. Ethical aspects Privacy issues
Respect of person’s autonomy and choices
Use in person-oriented, nonstigmatizing ways

22. The ICF in Health Education and Training
The ICF is not an assessment tool
It is a framework for describing human functions that may be affected by health conditions
It doesn’t evaluate a patient for CHD, but describes functional capacities of those with CHD
ICF guides health professionals in identifying functional domains & communicating results

23. The ICF in Health Education and Training
The ICF is not an assessment tool
It is a framework for describing human functions that may be affected by health conditions
It doesn’t evaluate a patient for CHD, but describes functional capacities of those with CHD
ICF guides health professionals in identifying functional domains & communicating results

25. TABLE OF CONTENTS Foreword - Norman L. Berven
Preface - Elias Mpofu, and Thomas Oakland
Part 1: Professional Issues in the ICF Context
1. Concepts and Models in Disability, Functioning, and Health
2. Development and Health Assessment in Rehabilitation with the International Classification of Functioning, Disability, and Health for Children and Youth
3. Ethical Considerations in Applying the ICF
4. Measures of Culture and Diversity in Rehabilitation and Health Assessment
Part 2: Measures and Procedures
5. Item Response Theory and Computer Adaptive Testing
6. Real and Virtual World Tools for Objectively Measuring Function During Everyday Activities
7. Healthcare Quality Assessments
8. Economic Evaluations with Pre-Scored Health Status Instruments
9. fMRI: functional Magnetic Resonance Imaging
10. Measuring the Physical Environment
11. Measures of Assistive Technology Predisposition and Use
12. Assessing Universal Design in the Physical Environment
13. Assessment of Capacity
14. Life Care Planning Evaluation
15. Rehabilitation Outcome Assessment in Program Evaluation
Part 3. Measures of Adaptation and Adjustment
16. Assessment of Adaptive Behavior Development in Young Children
17. Acculturation Measures
18. Assessment of Values
19. Measures of Subjective Wellbeing
20. Pain Assessment
21. Application and Assessment of Interpersonal Forgiveness
22. Self-Efficacy and Resilience Measures
23. Assessment in Rehabilitation and Health: Spirituality and Religiosity
24. Measures of Perfectionism
Part 4. Measures of Participation
25. Measures of Functional Performance
26. Assessment of Community Integration
27. Social Safety Net Assessments
28. Sexual Functioning Assessments
29. Assessing Recreation and Leisure Participation
30. Health Literacy Assessment
Part 5: Looking ahead
31. Trends in Rehabilitation and Health Assessment

26. Assessment in Rehabilitation and Health, 1/e 0205501745
Mpofu/Oakland
Assessment in Rehabilitation and Health, 1/e
First and only text tailored specifically for students seeking a structured foundation of tests and related assessment practices used by health professionals
Chapters are structured using World Health Organization’s Internal Classification of Disability, Functioning, and Health (ICF)
Case studies and vignettes provide real-life examples and help students apply information

27. Assessment and Rehabilitation in Health, 1/e
Table of Contents
Assessment and Rehabilitation in Health, 1/e
Part One: Foundations of Assessment            
1. The Context of Assessment in Rehabilitation and Health
2. Legal and ethical considerations
3. Diversity, Utility, fairness and social issues
Part Two: Types of Assessments, Norms and the Interpretation of Scores  
4. Planning the assessment process 
5. Types of tests and assessments
6. Statistical concepts
7. Reliability and validity
8. Standards for selecting tests and other assessment methods
9. Administering, scoring tests, and reporting results
10. Clinical interview 
11. Forensic assessment
12. Social security administration determination evaluations
13. Assessment for work place accommodations                      

28. Assessment and Rehabilitation in Health, 1/e
Table of Contents
Assessment and Rehabilitation in Health, 1/e
Part Three: Measures of Development and Adjustment  
14. Intelligence
15. Adaptive behavior 
16. Neuropsychological assessment
17. Achievement
18. Personality
19. Vocational interests and aptitudes
20. Assessment of vocational and work adjustment
21. Transition outcomes
22. Attitudes 
Part Four: Measures of Participation  
23. Measures of physical and functional performance
24.  Measures of Independent Living
25. Measures of Speech and Communication     
26. Orientation and mobility
27. Health-related quality of Life
28. Occupational functioning
29. Family functioning 
30. Customer Satisfaction
Part Five: Looking ahead
31. The futures of assessment in rehabilitation and health

29. Assessment in Rehabilitation and Health, 1/e 0205501745
Mpofu/Oakland
Assessment in Rehabilitation and Health, 1/e
Resources
Online Instructor’s Manual
Packages
MyHelpingLab
Pearson Custom Library

30. Best and Least Represented
Best represented
Measures of personal factors, environment, and participation
Least represented
measures of body functions and structures and activity

31. ICF’s Two Broad Parts Health Conditions Contextual Factors
Measures of physical and functional performance
Communication
Vision
fMRI
Neuropsych/Intelligence
ICF’s Two Broad Parts
Occupational assessment
Real & virtual assessments
Adaptive behaviour
Independent living
Health care quality
Recreation & leisure
Health literacy
Community integration
Health Conditions
Body Function and Structure
Activity
Pain assessment
Social security determination
Capacity evaluations
Vocational and work adjustment
Forensic assessment
Participation
Spirituality and Religiosity
Achievement
Personality
Voc. Interest & aptitude
Self-efficacy& resilience
Values
Perfectionism
Sexual Functioning
Personal
Environmental Factors
Contextual Factors
Physical environment
Universal design
Family functioning
Social safety nets
Economic evaluation
Acculturation
Work place accommodations
Assistive technology predisposition and use
Life care planning

32. Online References and Resources
ICF Home Page
Centers for Disease Control and Prevention
Australian Institute of Health and Welfare
National Health Service in England
Canadian Institute for Health Information
World Health Organization (online international databases – See Research Tools)

33. Select References
Bruyère, S. M., Van Looy, S. A., & Peterson, D. B. (2005). The International Classification of Functioning, Disability, and Health: Contemporary Literature Overview. Rehabilitation Psychology, 50(2),
Geyh, S., Peter, C., Müller, R., Bickenbach, J. E., Kostanjsek, N., Üstün, B. T., Stucki, G., & Cieza, A. (2011). The Personal Factors of the International Classification of Functioning, Disability and Health in the literature – a systematic review and content analysis. Disability and Rehabilitation, 33,
Grill, E., Stucki, G., Scheuringer, M., & Melvin, J. (2006). Validation of International Classification of Functioning, Disability, and Health (ICF) Core Sets for early postacute rehabilitation facilities: Comparisons with three other functional measures. American Journal of Physical Medicine & Rehabilitation, 85,
Grotkamp, S. et al. (in press). Personal factors in the International Classification of Functioning, Disability and Health: Prospective Evidence. Australian Journal of Rehabilitation Counselling

34. Select References
Heerkens, Y., Engels, J, Kniper, C., van der Gulden, J., & Oostendorp, R. (2004). The use of the ICF to describe work related factors influencing the health of employees. Disability and Rehabilitation, 26,
Howe, T. J. (2008). The ICF Contextual Factors related to speech language pathology. International Journal of Speech-Language Pathology, 10,
Huber, J. G., Sillick, J., & Skarakis-Doyle, E. (2010): Personal perception and personal factors: Incorporating health-related quality of life into the International Classification of Functioning, Disability and Health. Disability and Rehabilitation, 32,

35. References
Mpofu, E., & Oakland, T. (2009) (Eds). Rehabilitation and health assessment: Applying ICF guidelines. NY,NY: Springer.
Peterson, D. B. (2010). Psychological aspects of functioning, disability, and health. Springer: New York.
Reed, G. M., Lux, J. B., Bufka, L. F., Trask, C., Peterson, D. B., Stark, S., Threats, T. T., Jacobson, J. W., & Hawley, J. A. (2005). Operationalizing the International Classification of Functioning, Disability, and Health in clinical settings. Rehabilitation Psychology, 50(2),
Scherer, M. J., & Glueckauf, R. (2005). Assessing the benefits of assistive technologies for activities and participation. Rehabilitation Psychology, 50(2),
Ueda, S., Okawa, Y. (2003). The subjective dimension of functioning and disability: What is it and what is it for? Disability and Rehabilitation, 25,
World Health Organization. (2001). International classification of functioning, disability, and health. Geneva: World Health Organization.