Presentation at the 8th ICF Education International Symposium and 5th Neuro Socio Psycho Rehab Conference - 2022 in India
An overview of current best practice and guidelines in treatment approaches for developmental disabilities and tools to implement a patient centred approach.
2. Developmental Paediatrics
§Principles
§ Developmental Perspective:
§ “signs and symptoms” are extremely variable and have different significance at
different ages
§ “learning” is a major component of development
§ development occurs always in a context
§ Transdisciplinary Competencies
§ Early Childhood Education, Occupational Therapy, Physical Therapy, Psychology,
Social Work, Speech and Language Therapy, etc.
§ Nursing, Nutrition
ØWorking together and learning from each other is central to
developmental paediatrics
3. Children,Youth and Families
§ United Nations' Convention on the Rights of Persons with
Disabilities (2006): “Children with disabilities have the right to express
their views freely on all matters affecting them.” (Art. 7)
§ Strategy for Patient Oriented Research:“Patients need to be involved in all
aspects of research to ensure questions and results are relevant” (CIHR)
§ World Health Organization:“ICF respects the rights of every person and
actively avoids labelling, stigmatisation and discrimination.”
10. Functional Approach
§ Focus on relevant activities for the daily participation
§ Empower children and families to choose an individualized approach to set
goals
§ Do NOT focus only on body functions and structures!
11. F-Words
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12. How the ICF relates to the life of children?
§ Body Functions and Structures: refers to everything that makes up their body and
makes it function. One way to relate to this is thinking about fitness.
§ Activities: refers to the things children do. All they do is a way of functioning
(playing, walking, communicating etc.)
§ Participation: refers to how children are involved in different life situations while
doing something. Children usually are involved with other kids, so a good term to
refer to participation is friendships
§ Environment: refers to what is around the child.The most important aspects
surrounding any child is their family
§ Personal Factors: refer to things that are unique and important to a child.They
can be summarized by everything that is fun.
13. The ICF Framework1 and the F-Words2
1
2
E
Body Structure and Function
veryone needs to stay fit and healthy both physically
and mentally. Help me find ways to keep fit.
Fitness
Activity
I might do things differently but I CAN do them.
How I do it is not important. Please let me try!
Functioning
Participation
Having friends is important. Please give me
opportunities to make friends.
Friends
Environmental Factors
My family knows me best and I trust them.
Listen to them. Talk to them. Hear them.
Respect them.
Family
Personal Factors
Life is about having fun. Please help me do
the activities that I find the most fun.
Fun
Future
I am growing up every day, so please find ways for me to participate and be included in my community.
For more information visit the F-words Knowledge Hub:
www.canchild.ca/f-words
) World Health Organization. (2001) International
Classification of Functioning, Disability and Health (ICF)
) Rosenbaum P & Gorter JW. (2012). The ‘F‐words’ in
childhood disability: I swear this is how we should
think! Child Care Health Dev; 38.
15. Setting Functional Goals
§ Chosen by the child/family: improve activities that are important for
the child
§ Functional: goals that reflect real-life tasks – not strength, sensory
processing or range of motion
§ Specific: (SMART) – choose a short and realistic time-frame
§ Set as a Team: when more people are involved, all should be on-board
with the chosen goals (child & family are part of the team)
16. My F-words Goal Sheet
Today’s Date:
Name:
Instructions:
FUN:
Goal:
Why?!
FRIENDS:
Goal:
Why?!
FUTURE:
Goal:
Why?!
FUNCTIONING:
Goal:
Why?!
FAMILY:
Goal:
Why?!
FITNESS:
Goal:
Why?!
(Adapted from Fuller & Susini Goal Sheet, 2015)
Please use this form to write down one goal for each of the F-words – Functioning, Family,
Fitness, Fun, Friends & Future and explain why this goal is important to you. These can be goals you
would like to work on at home, in therapy, in school, and/or in the community. Together let’s work on
the goals that are meaningful to you!
The ICF Framework1 and the F-Words2
1
2
E
Body Structure and Function
veryone needs to stay fit and healthy both physically
and mentally. Help me find ways to keep fit.
Fitness
Activity
I might do things differently but I CAN do them.
How I do it is not important. Please let me try!
Functioning
Participation
Having friends is important. Please give me
opportunities to make friends.
Friends
Environmental Factors
My family knows me best and I trust them.
Listen to them. Talk to them. Hear them.
Respect them.
Family
Personal Factors
Life is about having fun. Please help me do
the activities that I find the most fun.
Fun
Future
I am growing up every day, so please find ways for me to participate and be included in my community.
For more information visit the F-words Knowledge Hub:
www.canchild.ca/f-words
) World Health Organization. (2001) International
Classification of Functioning, Disability and Health (ICF)
) Rosenbaum P & Gorter JW. (2012). The ‘F‐words’ in
childhood disability: I swear this is how we should
think! Child Care Health Dev; 38.
17. • Brain (Cognition, motor control)
• Articulation
• Hand use
• Expressing needs verbally
• Lack of knowledge of family how to introduce assistive devices
• Curious
• Fear of health professionals
Diagnosis: Kernicterus
Goal Setting
18. F-words into Policy
*MCCSS Ministry of Children, Community and Social Services (2022). Retrieved from
https://files.ontario.ca/mccss-smart-start-hubs-policy-and-practice-guidelines-en-2022-05-02.pdf
20. What are the Advantages of Tiered Models?
In a tiered model, the therapist:
§ can be the point of first contact which can negate the need for
lengthy and resource-intensive referral mechanisms before the child
is able to receive support.
§ works with educators and whole classrooms of children in schools, providing
support that increases all children’s participation and achievement.
§ provides service without the need for diagnosis of health care
conditions before supports are able to be put in place.
21. Summary
§ Rehabilitation in the 21st century is rights-based
§ Current guidelines recommend a focus on meaningful activities
§ Patients and families are partners in decision-making
§ Systems and Services need to be designed to increase participation
for all children
24. References
§ Cahill, P. T., Ng, S., Dix, L., Ferro, M. A., Turkstra, L., & Campbell, W. N. (2022). Outcomes management practices in tiered school-based speech-
language therapy: A Canadian example. Int J Lang Commun Disord. https://doi.org/10.1111/1460-6984.12822
§ Cheng, W. M., Smith, T. B., Butler, M., Taylor, T. M., & Clayton, D. (2022). Effects of Parent-Implemented Interventions on Outcomes of Children
with Autism: A Meta-Analysis. J Autism Dev Disord. https://doi.org/10.1007/s10803-022-05688-8
§ Demont, A., Gedda, M., Lager, C., de Lattre, C., Gary, Y., Keroulle, E., Feuillerat, B., Caudan, H., Sancelme, Z., Isapof, A., Viehweger, E., Chatelin, M.,
Hochard, M., Boivin, J., Vurpillat, P., Genes, N., de Boissezon, X., Fontaine, A., & Brochard, S. (2022). Evidence-based, Implementable Motor
Rehabilitation Guidelines for Individuals With Cerebral Palsy. Neurology. https://doi.org/10.1212/WNL.0000000000200936
§ Jackman, M., Sakzewski, L., Morgan, C., Boyd, R. N., Brennan, S. E., Langdon, K., Toovey, R. A. M., Greaves, S., Thorley, M., & Novak, I. (2022).
Interventions to improve physical function for children and young people with cerebral palsy: international clinical practice guideline. Dev Med
Child Neurol, 64(5), 536-549. https://doi.org/10.1111/dmcn.15055
§ Kraus de Camargo, O., Simon, L., Ronen, G. M., & Rosenbaum, P. L. (2019). ICF - A Hands-on Approach for Clinicians and Families. MacKeith Press.
§ Novak, I., McIntyre, S., Morgan, C., Campbell, L., Dark, L., Morton, N., Stumbles, E., Wilson, S. A., & Goldsmith, S. (2013). A systematic review of
interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol, 55(10), 885-910. https://doi.org/10.1111/dmcn.12246
§ Ritzema, A. M., Lach, L. M., Rosenbaum, P., & Nicholas, D. (2016). About my Child: measuring 'Complexity' in neurodisability. Evidence of reliability
and validity. Child Care Health Dev, 42(3), 402-409. https://doi.org/10.1111/cch.12326
§ Rosenbaum, P. (2009). Cerebral palsy in the 21st century: is there anything left to say? [Historical Article]. Neuropediatrics, 40(2), 56-60.
https://doi.org/10.1055/s-0029-1234104
§ Rosenbaum, P., & Gorter, J. W. (2012). The 'F-words' in childhood disability: I swear this is how we should think! Child Care Health Dev, 38(4), 457-
463. https://doi.org/10.1111/j.1365-2214.2011.01338.x
§ VanderKaay, S., Dix, L., Rivard, L., Missiuna, C., Ng, S., Pollock, N., Whalen, S. S., Eisen, I., Kyte, C., Phoenix, M., Bennett, S., Specht, J., Kennedy, J.,
McCauley, D., & Campbell, W. (2021). Tiered Approaches to Rehabilitation Services in Education Settings: Towards Developing an Explanatory
Programme Theory. International Journal of Disability, Development and Education, 1-22. https://doi.org/10.1080/1034912x.2021.1895975
§ Wickstrom, J., Dell'Armo, K., Salzman, E., Hooker, J. L., Delehanty, A., Bishop, S., Tasse, M. J., Wetherby, A. M., Piergies, A. M. H., Damiano, D.,
Rauch, A., & Thurm, A. (2021). Systematic Review: Recommendations for Rehabilitation in ASD and ID From Clinical Practice Guidelines. Arch
Rehabil Res Clin Transl, 3(3), 100140. https://doi.org/10.1016/j.arrct.2021.100140