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<div class="editorbox"> '''Original Editor '''- [[User:Robin Tacchetti|Robin Tacchetti]] based on the course by
[https://members.physio-pedia.com/course_tutor/krista-eskay/ Krista Eskay]<br>
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
== Introduction ==
== Introduction ==
ICF which stands for the International Classification of Functioning, Disability and Health is a World Health Organization classification of health and health-related arenas.   This framework measures health and disability at both the individual and population levels while also looking at environmental factors.<ref>Barlett CP, Madison CS, Heath JB, DeWitt CC. Please browse responsibly: [https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health A correlational examination of technology access and time spent online in the Barlett Gentile Cyberbullying Model]. Computers in Human Behavior. 2019 Mar 1;92:250-5.</ref> This framework emphasises function, impact and health rather than disability and cause. <ref>World Health Organization. [https://cdn.who.int/media/docs/default-source/classification/icf/icfbeginnersguide.pdf?sfvrsn=eead63d3_4&download=true Towards a common language for functioning, disability, and health]: ICF. The international classification of functioning, disability and health. 2002.</ref> Understanding the functional deficits afflicted by the health condition promotes better patient management. ICF incorporates a more holistic model of health utilising goal setting, evaluation of outcomes and communication among colleagues. <ref name=":0">Jiandani MP, Mhatre BS. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954814/ Physical therapy diagnosis: How is it different?]. Journal of postgraduate medicine. 2018 Apr;64(2):69.</ref>
The [[Overview of the ICF and Clinical Practice|International Classification of Functioning, Disability and Health (ICF)]] is a World Health Organization classification of health and health-related domains. This framework measures health and disability at both the individual and population levels while also looking at environmental factors.<ref>Barlett CP, Madison CS, Heath JB, DeWitt CC. Please browse responsibly: [https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health A correlational examination of technology access and time spent online in the Barlett Gentile Cyberbullying Model]. Computers in Human Behavior. 2019 Mar 1;92:250-5.</ref> This framework emphasises function, impact and health rather than disability and cause.<ref>World Health Organization. [https://cdn.who.int/media/docs/default-source/classification/icf/icfbeginnersguide.pdf?sfvrsn=eead63d3_4&download=true Towards a common language for functioning, disability, and health]: ICF. The international classification of functioning, disability and health. 2002.</ref> Understanding the functional deficits associated with a health condition promotes better patient management. The [[Overview of the ICF and Clinical Practice|ICF]] offers a more holistic model of health, which utilises goal setting, and requires the evaluation of outcomes and communication among colleagues.<ref name=":0">Jiandani MP, Mhatre BS. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954814/ Physical therapy diagnosis: How is it different?]. Journal of postgraduate medicine. 2018 Apr;64(2):69.</ref>


== Physical Therapy Diagnosis ==
== ICF Model ==
A medical diagnosis and a physical therapy diagnosis are two distinct entities.  A medical diagnosis provides cause and prognosis, whereby a physical therapy diagnosis identifies functional limitations and quality of life. The objective of the physical therapy diagnosis is establish movement system impairments. According to Jiandani, et al., 2018, the key diagnostic questions are:
[[File:ICF Model Generic (correct version).png|thumb|450x450px|Figure 1. ICF Model.]]
The ICF framework is a biopsychosocial model, which intertwines medical and social models of disability. The ICF framework recognises that one's health is shaped by environmental and personal factors. The ICF can be separated into three components of health:


# what are the impairments, their nature and source?
# Body functions and structures
# What impairments are related to patients functional limitation?
# Activities
# Which amongst these can be remedied by interventions?
# Participation
# What is the influence of the contextual (environment and personal) factor of a person in his function?
Then, there are contextual factors that influence an individual's life:
# Can the contextual factors be changed or remedied to maximize performance?
# Environmental factors
# What is the diagnostic label?<ref name=":0" />
# Personal factors


Physical therapy evaluations focus on treatment of dysfunction versus the physician model which focuses on differential diagnosis and treatment of disease.<ref name=":0" />
Body functions refers to the physiological functions of body systems. Body structures refers to the anatomical parts of the body (e.g. organs, limbs etc). Activities and participation refer to involvement in life events and the implementation of various tasks. Environmental factors are the attitudinal, social and physical environments where people conduct and live their lives. Personal factors might relate to the individual and their family.<ref name=":3" /><ref>Eskay K. ICF Model and Goal Writing Course. Plus. 2022.</ref><blockquote>
==== Special Topic: the ICF and Paediatric Rehabilitation ====
"The ICF describes the relationship between health conditions diagnosed and coded in the ICD [International Classification of Diseases] and the personal and environmental factors that act as facilitators or barriers to functioning. There are 3 identified levels of functioning: the body part or organ system, the person, and the person in social situations. These levels correspond to body functions, activities, and participation, respectively. Disability is the umbrella term for impairments at the body part or organ system level, activity restrictions at the person level, and participation restrictions at the person-in-society level. The WHO defines impairments as “problems in body function or structure such as a significant deviation or loss,” activity limitations as “difficulties an individual may have in executing a task,” and participation restrictions as “problems an individual may experience in involvement in life situations.”


=== Functional Limitations ===
The ICF also includes the concepts of capacity and performance. Capacity is the individual’s intrinsic ability to perform a task or an action in a standardized environment, whereas performance is how well the individual is able to actually perform the task in his or her own real-life environment. These concepts are important in understanding the role of habilitative and rehabilitative therapies for children with disabilities, because achievement of skill requires extensive practice and must be integrated into the child’s routine for the successful enhancement of participation in life events. In addition, the ICF framework highlights the importance of a child’s environment on his or her functional outcomes. The environment includes not just the physical world, such as the town where the child lives or the topography of the community, but also includes the attitudes and values of the family, community, and society at large and the technologies, services, supports, laws, and policies where the child lives. Access to health and therapeutic services, the physical environment, and social supports all affect how well a child with disabilities functions in his or her daily life."<ref name=":4" />
When physical therapists assess functional limitation in individuals, they are looking for:


# activity: able to execute a task or action
-Houtrow et al 2019</blockquote>
# participation: able to fulfill the socially defined role


Participation can relate to family, work, peer groups within a physical and sociocultural environment.  ICF framework considers factors whether immediate or distant that might facilitate or hinder overall functioning. <ref name=":0" />
== Functional Limitations ==
It is important during rehabilitation evaluation to determine what functional limitations the individual has. For example, physiotherapists are interested in learning how the individual's functional limitations are inhibiting or restricting their activity and participation; occupational therapists are interested in how their ability to complete activities of daily living are effected. Activity refers to the ability of the individual to execute a task or action, whereas participation is the ability to fulfill a socially defined role. Participation can relate to activities with family, at work and/or with peer groups. The [[ICF and Application in Clinical Practice|ICF]] framework considers immediate or distant factors that might facilitate or hinder overall functioning, including:  


=== Interventions ===
* Environmental factors
The plan of care is created once the impairments, functional limitations and activity limitations have been identified.  Interventions are targeted at minimizing disability and using function as an outcome.<ref name=":0" />Within the peadiatric population, the ICF emphasises the importance of a child's environment on their functional outcomes.  The environment encompasses not just the physical world, but the values and attitudes of the family and community.  Accessibility to services and support will affect overall daily function for a child with functional impairments.<ref>Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. [https://publications.aap.org/pediatrics/article/143/4/e20190285/37233/Prescribing-Physical-Occupational-and-Speech Prescribing physical, occupational, and speech therapy services for children with disabilities]. Pediatrics. 2019 Apr 1;143(4).</ref>
** Setting at home
** Setting at school
** Motivation of the individual
** Amount of family support
** Accessibility to assistive devices<ref name=":0" />
* Personal factors
** Age
** Gender
** Lifestyle
** Fitness
** Coping styles
** Cultural beliefs
** Pain experience<ref name=":0" />


=== Goal-Setting ===
== Interventions ==
The ICF framework can be helpful for goal-setting.  Goals are created to increase activity and participation caused by the functional impairments.<ref name=":1" /> (speaker)  Functional goals can not only be motivational but lead to improved outcomes.  Within the paediatric population, goal-setting is done with a family-centred approach.<ref name=":1">Rast FM, Labruyère R. I[https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.14471 CF mobility and self‐care goals of children in inpatient rehabilitation]. Developmental Medicine & Child Neurology. 2020 Apr;62(4):483-8</ref>Collaboration with the family for goal-setting ensures the goals are focused on what is important to the family and what activities they would like the child to participate in.    Goal creation favors the strengths of the child and how to build on those strengths to accomplish new tasks. (SPEAKER) 
The plan of care is created once the impairments, functional limitations and activity limitations have been identified.  Interventions are targeted at minimising disability and using function as an outcome.<ref name=":0" /> Within the paediatric population, the [[ICF and Application in Clinical Practice|ICF]] emphasises the importance of a child's environment on their functional outcomes. The environment encompasses not just the physical world, but the values and attitudes of the family and community. Accessibility to services and support will affect overall daily function for a child with functional impairments.<ref name=":4">Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. [https://publications.aap.org/pediatrics/article/143/4/e20190285/37233/Prescribing-Physical-Occupational-and-Speech Prescribing physical, occupational, and speech therapy services for children with disabilities]. Pediatrics. 2019 Apr 1;143(4).</ref>


== SMARTt ==
== Goal-Setting ==
Meaningful new goals are created using the SMART method:
The [[ICF and Application in Clinical Practice|ICF]] framework can be helpful for goal-setting. Goals are created to increase activity and participation, which are impacted by functional impairments.<ref name=":1" /> <ref name=":2">Eskay, K.  ICF Model and Goal-Writing Course.  Physioplus. 2022</ref> Goal creation favours the strengths of the child and focuses on how to build on these strengths to accomplish new tasks.<ref name=":2" /> Within the paediatric population, a family-centred approach is adopted when setting goals.<ref name=":1">Rast FM, Labruyère R. I[https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.14471 CF mobility and self‐care goals of children in inpatient rehabilitation]. Developmental Medicine & Child Neurology. 2020 Apr;62(4):483-8</ref> This sort of collaboration enables the patient and family to highlight their interests and provide assistance in intervention planning.<ref name=":3" />  Research has shown that a family-/patient-centred approach can increase patient motivation and improve therapy outcomes.<ref name=":3" /> 
 
== SMART Goals ==
When creating meaningful functional goals, the SMART method is recommended.  The acronym SMART stands for:


* S: specific
* S: specific
* M: measureable
* M: measurable
* A: attainable
* A: attainable
* R: realistic
* R: realistic
* T: time-limited<ref>Angeli JM, Schwab SM, Huijs L, Sheehan A, Harpster K. [https://pubmed.ncbi.nlm.nih.gov/31766925/ ICF-inspired goal-setting in developmental rehabilitation: an innovative framework for pediatric therapists]. Physiotherapy theory and practice. 2021 Nov 2;37(11):1167-76.</ref>  
* T: time-limited<ref name=":3">Angeli JM, Schwab SM, Huijs L, Sheehan A, Harpster K. [https://pubmed.ncbi.nlm.nih.gov/31766925/ ICF-inspired goal-setting in developmental rehabilitation: an innovative framework for pediatric therapists]. Physiotherapy theory and practice. 2021 Nov 2;37(11):1167-76.</ref>
 
Using the SMART acronym, rehabilitation professionals can ensure they have set realistic goals for the child that are attainable. Goals are typically geared for the short term or long term depending on the particular task.<ref name=":2" />
o you want to make sure that you're setting realistic goals that are attainable and achievable for that particular patient.
 
You also want to think about how long it's going to take to achieve that goal. So we're thinking about our goal setting.
 
We're going to look at how long we think that particular plan of care for that patient
 
is going to be and identify goals that can be completed within that timeline.
 
Often when we make goals, we're talking about developing some short term goals and some long term goals, depending on the patient.
 
The length of those goals can be different. So a lot of times, you know, I'm setting some short term goals that are four and six weeks and time,


and then we're going to do a check in to see how they're doing and then some longer term goals that might be more in the 12 16 weeks time period.
== Resources ==


And that's going to change depending on why you're seeing a patient.
* [[Introduction to the International Classification of Functioning, Disability and Health (ICF)]]


So keep these factors in mind whenever you're thinking about how long it's going to take to achieve a particular kind of goal.
* [[ICF Educational and Clinical Resources]]


So when we talk about smart goals, really what we mean is, you know,
* [[ICF and RPS within Cerebral Palsy]]


making a goal that has a lot of different features to it that are going to allow you to reassess it in a very specific kind of way.
* [[International Classification of Functioning, Disability and Health (ICF)]]


We want these goals to be objective as much as possible so that we know whether or not we achieved that goal.
* [[Overview of the ICF and Clinical Practice|Overview of the ICF in Clinical Practice]]
 
So the smart goal is really an acronym.
 
So the smart goal is really an acronym.
 
And what it stands for is the essence in the smart is we're specific, so we want to make sure our goal is specific.
 
So we want to make sure that when we're thinking about something that it has,
 
like all of the components, tell us to say yes, this is the thing we are doing.
 
The next thing that we're going to look for in our goal is that it's measurable. So we have to have some way to give some context to the goal.
 
And we think that's a reasonable amount of time. Family thinks that's reasonable. So, OK, now it's measurable.
 
And the next part of the goal is you want to make sure it's attainable. Can Thomas actually do this?
 
So you want to make sure that you're thinking about, all right, like, is this something that we're actually going to be able to get him to?
 
Because if it's not attainable, if it's not achievable, you're not setting a good goal for him.
 
So I want to make sure this is something that he can do. And, you know, like, it has to be realistic.
 
So, you know, is this something that your goal is both achievable and you think you can do it in a timeframe that's realistic?
 
So you know you're going to set a plan of care for maybe 16 weeks? Is he going to be able to get there in 16 weeks?
 
Or maybe it's going to take him being four years older and that, you know,
 
he's not going to have that detour anymore before it's actually a realistic goal for him to do this.
 
nd then lastly, you want to make sure you have that time frame. So how long is it going to take for you to achieve this goal?
 
 
you know, with a certain type of gait or, you know, with one person there to assist by providing close supervision only.
 
So you can add in lots of other specific components to that or measurable components to that.
 
Make sure it's attainable. This is something that, yeah, we totally think he can do this and we think he can do it within like a single plan of care.
 
At the age he's in with the potential barriers that are in his way, and we think that he can do this in that 12 week period of time.
 
So when you have all of that together, there is no question as to whether or not he did or did not achieve his goal because you have all of the
 
components of this goal that are set up really beautifully for you to be able to then objectively say yes or no.
 
And what do we need to modify as we move forward to make it a little more realistic,
 
attainable or achievable if we're not seeing the progress that we anticipated to?
 
So just going through a different patient and this is something that you're going to use for another knowledge check here next,
 
so you can use this information as a reference.
 
 
often after participating in a full day of school. He is beat.
 
He is really tired. It takes a lot out of him. And when he goes home, he likes to take his AFO off, sometimes just because he needs a break from it.
 
And when he's at home, [INAUDIBLE] kind of furniture start from one thing to the next, and he does have a history of falls.
 
You know, sometimes from that fatigue,
 
sometimes from its toe catching whenever he's at home and not wearing his AFL family lives in a two storey home.
 
And there are six steps to get into the house. Mom and dad both work full time jobs.
 
They're not at home whenever he gets home, and he has three younger siblings.
 
One of Jonathan's goals is that he really wants to be able to take his three and four siblings to the park across the street.
 
That's also up a hill from their home.
 
So this is information you've gathered so far in your examination and evaluation of Jonathan whenever he came into the clinic with mom and dad.
 
So what we're going to do is a little knowledge track to come up with two smart goals for Jonathan based on the previously provided information.
 
So I'm just going to pop that back up for you so that you can kind of jot down some notes if you need to before we go into our knowledge check.
 
And then that'll be it for us talking about the ICF model and goal setting for today.


== References ==
== References ==
<references />
<references />
 
[[Category:Rehabilitation]]
 
[[Category:ReLAB-HS Course Page]]
== SPECIFICS OF GOALS ==
[[Category:Course Pages]]
So you want to make sure that you're setting realistic goals that are attainable and achievable for that particular patient.
[[Category:Paediatrics]]
 
You also want to think about how long it's going to take to achieve that goal. So we're thinking about our goal setting.
 
We're going to look at how long we think that particular plan of care for that patient
 
is going to be and identify goals that can be completed within that timeline.
 
Often when we make goals, we're talking about developing some short term goals and some long term goals, depending on the patient.
 
The length of those goals can be different. So a lot of times, you know, I'm setting some short term goals that are four and six weeks and time,
 
and then we're going to do a check in to see how they're doing and then some longer term goals that might be more in the 12 16 weeks time period.
 
And that's going to change depending on why you're seeing a patient.
 
So keep these factors in mind whenever you're thinking about how long it's going to take to achieve a particular kind of goal.
 
So when we talk about smart goals, really what we mean is, you know,
 
making a goal that has a lot of different features to it that are going to allow you to reassess it in a very specific kind of way.
 
We want these goals to be objective as much as possible so that we know whether or not we achieved that goal.
 
So the smart goal is really an acronym.
 
So the smart goal is really an acronym.
 
And what it stands for is the essence in the smart is we're specific, so we want to make sure our goal is specific.
 
So we want to make sure that when we're thinking about something that it has,
 
like all of the components, tell us to say yes, this is the thing we are doing.
 
The next thing that we're going to look for in our goal is that it's measurable. So we have to have some way to give some context to the goal.
 
And we think that's a reasonable amount of time. Family thinks that's reasonable. So, OK, now it's measurable.
 
And the next part of the goal is you want to make sure it's attainable. Can Thomas actually do this?
 
So you want to make sure that you're thinking about, all right, like, is this something that we're actually going to be able to get him to?
 
Because if it's not attainable, if it's not achievable, you're not setting a good goal for him.
 
So I want to make sure this is something that he can do. And, you know, like, it has to be realistic.
 
So, you know, is this something that your goal is both achievable and you think you can do it in a timeframe that's realistic?
 
So you know you're going to set a plan of care for maybe 16 weeks? Is he going to be able to get there in 16 weeks?
 
Or maybe it's going to take him being four years older and that, you know,
 
he's not going to have that detour anymore before it's actually a realistic goal for him to do this.
 
nd then lastly, you want to make sure you have that time frame. So how long is it going to take for you to achieve this goal?
 
 
you know, with a certain type of gait or, you know, with one person there to assist by providing close supervision only.
 
So you can add in lots of other specific components to that or measurable components to that.
 
Make sure it's attainable. This is something that, yeah, we totally think he can do this and we think he can do it within like a single plan of care.
 
At the age he's in with the potential barriers that are in his way, and we think that he can do this in that 12 week period of time.
 
So when you have all of that together, there is no question as to whether or not he did or did not achieve his goal because you have all of the
 
components of this goal that are set up really beautifully for you to be able to then objectively say yes or no.
 
And what do we need to modify as we move forward to make it a little more realistic,
 
attainable or achievable if we're not seeing the progress that we anticipated to?
 
So just going through a different patient and this is something that you're going to use for another knowledge check here next,
 
so you can use this information as a reference.
 
 
often after participating in a full day of school. He is beat.
 
He is really tired. It takes a lot out of him. And when he goes home, he likes to take his AFO off, sometimes just because he needs a break from it.
 
And when he's at home, [INAUDIBLE] kind of furniture start from one thing to the next, and he does have a history of falls.
 
You know, sometimes from that fatigue,
 
sometimes from its toe catching whenever he's at home and not wearing his AFL family lives in a two storey home.
 
And there are six steps to get into the house. Mom and dad both work full time jobs.
 
They're not at home whenever he gets home, and he has three younger siblings.
 
One of Jonathan's goals is that he really wants to be able to take his three and four siblings to the park across the street.
 
That's also up a hill from their home.
 
So this is information you've gathered so far in your examination and evaluation of Jonathan whenever he came into the clinic with mom and dad.
 
So what we're going to do is a little knowledge track to come up with two smart goals for Jonathan based on the previously provided information.
 
So I'm just going to pop that back up for you so that you can kind of jot down some notes if you need to before we go into our knowledge check.
 
And then that'll be it for us talking about the ICF model and goal setting for today.

Latest revision as of 07:40, 19 May 2024

Original Editor - Robin Tacchetti based on the course by

Krista Eskay

Top Contributors - Robin Tacchetti, Jess Bell and Stacy Schiurring


Introduction[edit | edit source]

The International Classification of Functioning, Disability and Health (ICF) is a World Health Organization classification of health and health-related domains. This framework measures health and disability at both the individual and population levels while also looking at environmental factors.[1] This framework emphasises function, impact and health rather than disability and cause.[2] Understanding the functional deficits associated with a health condition promotes better patient management. The ICF offers a more holistic model of health, which utilises goal setting, and requires the evaluation of outcomes and communication among colleagues.[3]

ICF Model[edit | edit source]

Figure 1. ICF Model.

The ICF framework is a biopsychosocial model, which intertwines medical and social models of disability. The ICF framework recognises that one's health is shaped by environmental and personal factors. The ICF can be separated into three components of health:

  1. Body functions and structures
  2. Activities
  3. Participation

Then, there are contextual factors that influence an individual's life:

  1. Environmental factors
  2. Personal factors

Body functions refers to the physiological functions of body systems. Body structures refers to the anatomical parts of the body (e.g. organs, limbs etc). Activities and participation refer to involvement in life events and the implementation of various tasks. Environmental factors are the attitudinal, social and physical environments where people conduct and live their lives. Personal factors might relate to the individual and their family.[4][5]

Special Topic: the ICF and Paediatric Rehabilitation[edit | edit source]

"The ICF describes the relationship between health conditions diagnosed and coded in the ICD [International Classification of Diseases] and the personal and environmental factors that act as facilitators or barriers to functioning. There are 3 identified levels of functioning: the body part or organ system, the person, and the person in social situations. These levels correspond to body functions, activities, and participation, respectively. Disability is the umbrella term for impairments at the body part or organ system level, activity restrictions at the person level, and participation restrictions at the person-in-society level. The WHO defines impairments as “problems in body function or structure such as a significant deviation or loss,” activity limitations as “difficulties an individual may have in executing a task,” and participation restrictions as “problems an individual may experience in involvement in life situations.”

The ICF also includes the concepts of capacity and performance. Capacity is the individual’s intrinsic ability to perform a task or an action in a standardized environment, whereas performance is how well the individual is able to actually perform the task in his or her own real-life environment. These concepts are important in understanding the role of habilitative and rehabilitative therapies for children with disabilities, because achievement of skill requires extensive practice and must be integrated into the child’s routine for the successful enhancement of participation in life events. In addition, the ICF framework highlights the importance of a child’s environment on his or her functional outcomes. The environment includes not just the physical world, such as the town where the child lives or the topography of the community, but also includes the attitudes and values of the family, community, and society at large and the technologies, services, supports, laws, and policies where the child lives. Access to health and therapeutic services, the physical environment, and social supports all affect how well a child with disabilities functions in his or her daily life."[6]

-Houtrow et al 2019

Functional Limitations[edit | edit source]

It is important during rehabilitation evaluation to determine what functional limitations the individual has. For example, physiotherapists are interested in learning how the individual's functional limitations are inhibiting or restricting their activity and participation; occupational therapists are interested in how their ability to complete activities of daily living are effected. Activity refers to the ability of the individual to execute a task or action, whereas participation is the ability to fulfill a socially defined role. Participation can relate to activities with family, at work and/or with peer groups. The ICF framework considers immediate or distant factors that might facilitate or hinder overall functioning, including:

  • Environmental factors
    • Setting at home
    • Setting at school
    • Motivation of the individual
    • Amount of family support
    • Accessibility to assistive devices[3]
  • Personal factors
    • Age
    • Gender
    • Lifestyle
    • Fitness
    • Coping styles
    • Cultural beliefs
    • Pain experience[3]

Interventions[edit | edit source]

The plan of care is created once the impairments, functional limitations and activity limitations have been identified. Interventions are targeted at minimising disability and using function as an outcome.[3] Within the paediatric population, the ICF emphasises the importance of a child's environment on their functional outcomes. The environment encompasses not just the physical world, but the values and attitudes of the family and community. Accessibility to services and support will affect overall daily function for a child with functional impairments.[6]

Goal-Setting[edit | edit source]

The ICF framework can be helpful for goal-setting. Goals are created to increase activity and participation, which are impacted by functional impairments.[7] [8] Goal creation favours the strengths of the child and focuses on how to build on these strengths to accomplish new tasks.[8] Within the paediatric population, a family-centred approach is adopted when setting goals.[7] This sort of collaboration enables the patient and family to highlight their interests and provide assistance in intervention planning.[4] Research has shown that a family-/patient-centred approach can increase patient motivation and improve therapy outcomes.[4]

SMART Goals[edit | edit source]

When creating meaningful functional goals, the SMART method is recommended. The acronym SMART stands for:

  • S: specific
  • M: measurable
  • A: attainable
  • R: realistic
  • T: time-limited[4]

Using the SMART acronym, rehabilitation professionals can ensure they have set realistic goals for the child that are attainable. Goals are typically geared for the short term or long term depending on the particular task.[8]

Resources[edit | edit source]

References[edit | edit source]

  1. ↑ Barlett CP, Madison CS, Heath JB, DeWitt CC. Please browse responsibly: A correlational examination of technology access and time spent online in the Barlett Gentile Cyberbullying Model. Computers in Human Behavior. 2019 Mar 1;92:250-5.
  2. ↑ World Health Organization. Towards a common language for functioning, disability, and health: ICF. The international classification of functioning, disability and health. 2002.
  3. ↑ 3.0 3.1 3.2 3.3 Jiandani MP, Mhatre BS. Physical therapy diagnosis: How is it different?. Journal of postgraduate medicine. 2018 Apr;64(2):69.
  4. ↑ 4.0 4.1 4.2 4.3 Angeli JM, Schwab SM, Huijs L, Sheehan A, Harpster K. ICF-inspired goal-setting in developmental rehabilitation: an innovative framework for pediatric therapists. Physiotherapy theory and practice. 2021 Nov 2;37(11):1167-76.
  5. ↑ Eskay K. ICF Model and Goal Writing Course. Plus. 2022.
  6. ↑ 6.0 6.1 Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. Prescribing physical, occupational, and speech therapy services for children with disabilities. Pediatrics. 2019 Apr 1;143(4).
  7. ↑ 7.0 7.1 Rast FM, Labruyère R. ICF mobility and self‐care goals of children in inpatient rehabilitation. Developmental Medicine & Child Neurology. 2020 Apr;62(4):483-8
  8. ↑ 8.0 8.1 8.2 Eskay, K. ICF Model and Goal-Writing Course. Physioplus. 2022
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