Application of ICF-CY in the Screening of Iranian Children with Primary Language Impairment

Application of ICF-CY in the screening of Iranian children with primary language impairment (PLI)

Yalda Kazemi1, Tahmineh Maleki 2

1Assistant Professor, Department of Speech Therapy, Research Cluster of Developmental Language Disorders, Isfahan University of Medical Sciences, Iran, 2MSc student of Speech Therapy, Student Research committee, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Iran, Email: ,

Background:

The main goal of the International Classification of Functioning, Disability and Health- Children and Youth (ICF-CY) version, is to provide a unified terminology among the health professionals in the field of children’s health up to 18 years of age. This framework describes children’s health status within several domains including body structure, functions, participation, activities, environmental,and individual factors (World Health Organization, 2007).

Due to the lack of standardised language assessments in speech therapy clinics in Iran for children who are suspected as being primary language impaired (PLI, specified with unknown etiology for language impairment, Paul & Norbury, 2012), this study sought to determine the extent of compatibility of the clinician-made assessments with the ICF-CY framework and with evidence-based diagnostic fundamentals. The second goal was to suggest an evidence-based screening protocol for children suspected as being PLI within the framework of ICF-CY.

Methods:

This study was a mixed qualitative-quantitative one. The assessment profiles of children with PLI who had been visited by speech therapists (STs), were screened retrospectively to be further analysed and extract those major themes that Iranian STs examine during a routine assessment. Also the other way of extracting the themes was through a questionnaire interview with 30 STs asking their way of the assessment of PLI. The themes were compared to ICF-CY codes and evaluated against the criteria of an evidence-based diagnosis by seven qualified STs in a focus group, prospectively (Marshall, Catherine, Rossman, Gretchen, 1998; Bogdan Ksander, 1980). In the last phase of the study this evidence-based ICF-CY-compatible screening was piloted on three children who were suspected as being PLI.

Results:

Content analysis (Marshall, Catherine, Rossman, Gretchen, 1998; Bogdan & Ksander, 1980) was used as the main procedure of data analysis. Of all themes of ICF-CY, 178 themes were identified as eligible themes to be considered in the screening protocol of PLI. The focus group confirmed 16 out of 22 themes as essential to be allocated in this protocol. The compatibility of these themes with EB diagnostic tools will be discussed.

Conclusion:

The majority of assessment domains applied by Iranian STs to screen children with PLI conform to ICF-CY themes and codes. The results of pilot also showed that in the process of diagnosing PLI, “child’s medical history”, “parents’s report of their children’s communication interaction”, and “child’s clinician’s informal assessment” take the main roles. If the concern arises, a 20-minute language sample analysis is essential to confirm the child’s language condition (Kazemi, Klee, & Stringer, 2015). By all means, the need of reference standards for reliable screening of the Iranian children suspected of being PLI is essential. So, our protocol is ready to be empirically assayed to find its feasibility in identifying children with PLI and to investigate whether using this protocol would assist to intervene more efficiently compared to when we have no consensus relating to the identifying children with PLI.

Key words: ICF-CY, EBP, assessment, PLI, children

References

World Health Organization. (2007). International classification of functioning, disability and health : children & youth version : ICF-CY

Paul, R., Norbury, C. (2012). Language disorders from Infancy through adolescence. St. Louis, Missouri: Elsevier,Mosby.

Marshall. Catherine. Rossman. Gretchen, B. (1998). Designing Qualitative Research. Thousand Oaks, CA: Sage. ISBN 0-7619-1340-8

Bogdan, R. Ksander, M. (1980). Policy data as a social process: A qualitative approach to quantitative data. Human Organization 39 (4): 302–309. Doi:10.17730/humo.39.4.x42432981487k54q

Kazemi, Y. Klee, T. Stringer, H. (2015). Diahnostic accuracy of language sample measures with Persian-speaking preschool children. Clinical linguistics & phonetics: 1-15. Doi: 10.3109/02699206.2014.1003097