Clinical application of the International Classification of Functioning, Disability and Health (ICF) in children and adolescents from a public hearing rehabilitation service

Ferreira, Josiane Batista; Vianna, Nubia Garcia; Lima, Maria Cecília Marconi Pinheiro

doi:10.1590/1982-0216/20222425621

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ORIGINAL ARTICLES • Rev. CEFAC 24 (2) • 2022 • https://doi.org/10.1590/1982-0216/20222425621 copy

Clinical application of the International Classification of Functioning, Disability and Health (ICF) in children and adolescents from a public hearing rehabilitation service

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose:

to develop an International Classification of Functioning, Disability and Health (ICF) Checklist for clinical application in the rehabilitation of children and adolescents presented with hearing loss, to describe the biopsychosocial profile of participants and present the results of the use of ICF by speech therapists.

Methods:

a descriptive cross-sectional observational research, with quantitative and qualitative analyses. The study was conducted with five speech therapists, eight children aged 7 to 10 years and eight adolescents between 11 and 18 years old, diagnosed with moderate to profound bilateral hearing loss. Data collection included interviews, analysis of medical records and a questionnaire for the speech therapists. Exploratory data analysis was performed using summary measures and descriptive analysis of the profile of participants.

Results:

an ICF Checklist for clinical use in Hearing Rehabilitation was created. With its application, deficiencies related to hearing, speech and language functions were observed, with considerable difficulties in expressive and receptive language skills, learning and communication and access barriers related to communication and health services.

Conclusion:

the use of the Checklist expands the aspects observed by professionals, allows identification of the subjects' needs, and enables the recording and monitoring of worsening, stabilization or progress of the biopsychosocial aspects in the rehabilitation process.

Keywords:
International Classification of Functioning, Disability and Health; Hearing Loss; Needs Assessment; Health Status Indicators; Speech, Language and Hearing Sciences

Variable	(N)	Mean	Standard deviation	Minimum	Median	Maximum
Participants	16
Age (years)		11.40	04.73	04.00	11.50	18.00
Age at diagnosis (years)		02.26	02.37	00.25	01.95	10.00
Time of use of the electronic device (years)		07.53	05.00	00.50	06.75	17.00
Hearing assessment:			(N)		%
Bilateral profound SNHL			6		37.50
Bilateral severe SNHL			3		18.75
Bilateral moderate SNHL			3		18.75
Bilateral moderately severe mixed HL			1		06.25
Bilateral moderate mixed HL			1		06.25
Moderately severe right ear and moderate left year SNHL			1		06.25
Severe right ear and profound left ear SNHL			1		06.25
Electronic device:			(N)		%
Bilateral PSAD			8		50.00
CI and PSAD			3		18.75
CI			3		18.75
Unilateral PSAD			1		06.25
Does not use			1		06.25

Body structures	Mild impairment	Moderate impairment	Severe impairment	Complete impairment	With impairment (N)%
s240 outer ear structure		2			13%
s250 middle ear structure		2			13%
s2500 tympanic membrane		2			13%
s260 inner ear structure	1	4	6		69%
s2600 cóclea	3	5	3	4	94%

Body functions	Mild impairment	Moderate impairment	Severe impairment	Complete impairment	With impairment G1 (N)%
b230 hearing functions	4	3		1	100%
b2301 sound discrimination	3	3		1	87%
b2302 sound source location	5			1	75%
b2303 sound lateralization	4	1		1	75%
b16711 written language expression	3		2		62%
b3300 speech fluency	4	1			62%
b16700 oral language reception	1	1	2		50%
b16710 oral language expression	1		3		50%
b1672 language integrating functions	2	1	1		50%
b2304 speech discrimination	3			1	50%
b320 articulation functions	4				50%
b3301 speech rhythm, b3302 speech rate and b3303 speech melody	3	1			50%

Body functions	Mild impairment	Moderate impairment	Severe impairment	Complete impairment	With impairment G2 (N)%
b16701 written language reception	2	2	2		75%
b16710 oral language expression	3	1	2		75%
b16711 written language expression	1	2	2	1	75%
b230 hearing functions	2	2		2	75%
b2301 sound discrimination	2	1	2	1	75%
b320 articulation functions	1	5			75%
b3301 speech rhythm	2	3	1		75%
b3302 speech rate b3303 speech melody	4	1	1		75%
b16700 oral language reception	3	1	1		62%
b1672 language integrating functions	2	2	1		62%
b2302 sound source location	1	2	1	1	62%
b2300 sound detection b2303 sound lateralization	2	1	1	1	62%
b2304 speech discrimination	2		2	1	62 %
b3300 speech fluency	2	2	1		62%
b1440 short-term memory b1441 long-term memory	2	1	1		50%
b1640 abstraction b1646 problems resolution b1641 organization and planning	3	1			50%

Activities and participation	Mild difficulty	Moderate difficulty	Severe difficulty	Complete difficulty	With difficulty G1 (N)%
d310 oral message reception	4	2		1	87%
d330 speech	4	1		2	87 %
d360 utilization of communication techniques	2	2	1	2	87 %
d145 learning how to write	3	1	1	1	75%
d3102 understanding complex spoken messages	3	1		2	75%
d325 written messages reception	3	1	1	1	75 %
d332 singing	4			2	75%
d3600 utilization of telecommunication devices	2	2	1	1	75%
d140 learning how to read	2	1	1	1	62 %
d150 learning how to calculate	3	1	1		62 %
d163 thinking	4		1		62 %
d166 reading	3	1	1		62%
d170 writing	2	2	1		62 %
d1701 using grammar rules	1	3	1		62%
d2305 managing his/her own time	4	1			62%
d3100 responding to human voice	3	1		1	62%
d345 writing messages	3		1	1	62%
d115 listening	2	1		1	50%
d315 reception of non-verbal messages	3	1			50%
d3503 talking with someone	3		1		50%
d355 discussion	2	1		1	50%

Activities and participation	Mild difficulty	Moderate difficulty	Severe difficulty	Complete difficulty	With difficulty G2 (N)%
d330 speech d3600 utilization of telecommunication devices	4	3			87%
d360 utilization of communication techniques	4	2	1		87%
d166 reading	1	3	2		75%
d170 writing	2	2	2		75%
d310 oral message reception	1	2	2	1	75%
d3102 understanding complex spoken messages	2	2		2	75%
d325 written messages reception	1	3	2		75%
d345 writing messages		2	4		75%
d137 acquisition of concepts	4	1			62%
d140 learning how to read	2	1	2		62%
d145 learning how to write	1	2	2		62%
d1701 using grammar rules		3		2	62%
d2305 managing his/her own time d2400 dealing with responsibility	3	2			62%
d3100 responding to human voice	2	1	1	1	62%
d3503 talking with someone	4	1			62%
d355 discussion	1	1	3		62%
d710 basic interpersonal interactions	5				62%
d115 listening		1	2	1	50%
d130 imitating d133 language acquisition	3	1			50%
d315 reception of non-verbal messages	1	2	1		50%
d3151 reception of signs and symbols	1	3			50%
d332 singing	2	2			50%
d810 informal education d2301 managing the daily routine d9201 sports practice	3	1			50%
d820 school education d8202 progression in educational program	2	2			50%
d9205 socialization	3		1		50%

Group	Environmental factors categories	Facilitator	Barrier	None
G1	e1250 communication products and technologies	88%	-	12%
	e355 health professionals	75%	-	25%
	e5800 health services	50%	38%	12%
	e5801 health systems	38%	38%	24%
	e5802 health policies	63%	-	37%
G2	e1250 communication products and technologies	88%	-	12%
	e1300 education products and technologies	63%	-	37%
	e310 immediate family	63%	-	37%
	e355 health professionals	63%	-	37%
	e460 social attitudes	-	63%	37%
	e5600 communication means services	75%	13%	12%
	e5800 health services	88%	12%	-
	e5801 health systems	63%	13%	24%
	e5802 health policies	63%	13%	24%

Speech therapists	Number of categories without variation in the selection of qualifier	Number of categories without significant difference in the selection of qualifier (p < 0.05)	Agreement level
Professional 1	49	79	96%
Professional 2	41	75	87%
Professional 3	32	89	91%
Professional 4	39	78	88%

Qualifiers	Nominal definition		Quantitative definition
Qualifiers	Body functions and structures, activities and participations	Environmental factors	Quantitative definition
0	No impairment or difficulty	No facilitator or barrier	0-4%
+1	-	Mild facilitator	5-24%
+2	-	Moderate facilitator	25-49%
+3	-	Considerable facilitator	50-95%
+4	-	Complete facilitator	96-100%
1	Mild impairment or difficulty	Mild barrier	5-24%
2	Moderate impairment or difficulty	Moderate barrier	25-49%
3	Severe impairment or difficulty severe	Severe barrier	50-95%
4	Complete impairment or difficulty	Complete barrier	96-100%
8	Non-specified	Non-specified	-
9	Not applicable	Not applicable	-

ABRAMO Associação Brasileira de Motricidade Orofacial Rua Uruguaiana, 516, Cep 13026-001 Campinas SP Brasil, Tel.: +55 19 3254-0342 - São Paulo - SP - Brazil
E-mail: revistacefac@cefac.br

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[1] Corresponding address: Josiane Batista Ferreira, Faculdade de Ciências Médicas da UNICAMP, Rua Tessália Vieira de Camargo 126, cidade universitária, CEP: 13084-971 - Campinas, São Paulo, Brasil, E-mail: josianebferreira@gmail.com

Date: ___/___/_____
Patient name:	Birth date:	Age:
Patient record n:
Hearing loss:	Age at diagnosis:
Electronic device:
How long has been using the electronic device:	Time of daily use:
Communication:	( ) Oral ( ) Libras ( ) Bilingual
Caretaker name:
Examiner:
Protocols or evaluations employed:

CHECKLIST OF ICF IN HEARING REHABILITATION
Body functions
1. Global mental functions: addressed the brain functions, including functions as consciousness, energy and impulse.
b1140 Orientation in relation to time - Mental functions that produce consciousness of today, yesterday, date, month, year. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1141 Orientation in relation to place - Mental functions that produce consciousness of the person’s location in relation to the immediate environment, city or country. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1142 Orientation in relation to the person - Brain functions that produce consciousness of the own identity and of individuals in the immediate environment. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b117 Intellectual functions - understanding and integrating the different mental functions, including cognitive functions and their development. Intellectual development, intellectual and mental impairment. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
2. Specific mental functions - attention, memory language and calculation.
b1400 Maintenance of attention - concentration for the required time period. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1401 Change of attention - changing concentration from a stimulus to another. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1402 Division of attention - concentrating in two or more stimuli at the same time. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1440 Short-term memory - temporary and fragile storage of information in the memory, around 30 seconds of duration, after which the information is lost if not consolidated in the long-term memory. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1441 Long-term memory - memory system that allows storage of information for a long time, from the short-term memory and autobiographic memory of past events and semantic memory for language and facts. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1442 Recovery and memory processing - reminding information stored in the long-term memory and bringing them to consciousness. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1560 Hearing perception - discrimination of sounds, tunes, intensities and other acoustic stimuli. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1561 Visual perception - discrimination of shape, size, color and other ocular stimuli. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1640 Abstraction - creating general ideas, qualities or characteristics outside, or different from, concrete realities, specific objects or real situations. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1641 Organization and planing - coordinating parts of a whole, systematizing; mental function involved in the development of a procedure or action method. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1644 Self-knowledge (insight) - consciousness and understanding of oneself and own behavior. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1646 Problems resolution - identification, analysis and integration of inconsistent or conflicting information in a solution. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
3. Mental functions of language - receptive, expressive, integrating.
b1670 Language reception - decoding of messages in oral, written or other language, such as sign language, to achieve its meaning. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16700 Oral language reception - decoding of oral messages to achieve its meaning. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16701 Written language reception - decoding of written messages to achieve its meaning. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16702 Sign language reception - decoding of messages in languages that use signs made by the hands and other movements to achieve its meaning. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16703 Gestural message reception - decoding of messages of non-formalized gestures, made by the hands and other movements, to achieve their meaning. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1671 Language expression. - producing significant messages expressed in oral, written form, by signs or other language forms. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16710 Oral language expression. - producing significant oral messages. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16711 Written language expression. - producing significant written messages. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16712 Sign language expression. - producing significant messages in languages that use signs made by the hands and other movements. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b16713 Gestural language expression - producing messages from non-formalized gestures made by the hands or other movements. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b1672 Language integrating functions - organize the semantic and symbolic meaning, grammar structure and ideas for the production of messages in oral, written or other types of language. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
4. Sensory functions
b210 Visual functions - perception of light and shape, size, shape and color of a visual stimulus. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b230 Hearing functions - noticing sounds and discriminating their location, intensity, noise and quality. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2300 Sound detection - noticing the presence of sounds. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2301 Sound discrimination - noticing the presence of sound and differentiation background sound and biauricular synthesis, in the separation and combination. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2302 Sound source location - determination of sound source location. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2303 Sound lateralization - detecting if the sound is coming from the right or left side. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2304 Discrimination of speech - detecting oral language and differentiating it from other sounds. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b240 Feelings associated with hearing and vestibular function - feelings of dizziness, fall, vibration and vertigo. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2400 Ear tinnitus - sensation of low tone thumping, hissing or ringing in the ear. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2404 Ear irritation - itching or other similar feelings in the ear. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b2405 Ear pressure - feeling of pressure in the ear. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
5 .Voice and speech functions
b3100 Voice production - production of sounds by coordination of the larynx and adjacent muscles with the respiratory system. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b3101 Voice quality - production of voice characteristics including tone, resonance and other aspects. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b320 Articulation functions - production of speech sounds. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b330 Functions of speech fluency and rhythm - production of speech flow and rhythm. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b3300 Fluency of speech - production of uniform and uninterrupted speech flow. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b3301 Speech rhythm - patterns of speech modulation, rhythm and tone. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b3302 Speech rate - rate of speech production. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b3303 Speech melody - modulation of patterns of speech tone. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b340 Alternative functions of vocalization - production of other types of vocalization. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
b3401 Production of a variety of sounds - production of a broad range of vocalizations, including functions of screaming, cooing and babbling. [ ] 0 - No impairment [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
Body structures
	0 - absent impairment	1 - mild impairment	2 - moderate impairment	3 - severe impairment	4 - complete impairment	8 - non specified	9 - not applicable
s240 Outer ear structure	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]
s250 Middle ear structure	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]
s2500 Tympanic membrane	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]
s2501 Auditory tube	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]
s2502 Auditory ossicles	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]
s260 Inner ear structure	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]
s2600 Cochlea	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]	[ ]
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
Activities and Participation
1. Intentional sensory experiences
d110 Observing - experiencing visual stimuli, such as visually following an object, observing people, watching a sports event, observing people or children playing. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d115 Listening - Experiencing auditory stimuli, such as listening radio, human voice, music, a lecture or a history being told. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
2. Basic learning
d130 Imitation - imitation or mimicry as a basic component of learning, such as copying, repeating a facial expression, a gesture, a sound or the letters of the alphabet. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d131 Learning by interaction with objects - learning by simple actions with one or more objects, symbolic games or “make-believe”. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d132 Acquiring information - achieving facts about people, things or happenings, such as asking “why”, “what”, “where” and “how”, or asking “names”. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d133 Acquiring language - developing competence to represent people, objects, happenings, feelings, by words, symbols, expressions and sentences. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d137 Acquiring concepts - developing competence to understand and use basic and complex concepts related to the characteristics of objects, people or happenings. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d140 Learning how to read - reading printed material (including braille and other symbols) with fluency and precision, such as recognizing characters and alphabets, vocalizing written words with correct speech and understanding words and sentences. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d145 Learning how to write - producing symbols that represent sounds, words or sentences, so as they have a meaning (including braille and other symbols) such as efficient writing and using correct grammar. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d150 Learning how to calculate - handling numbers and performing simple and complex mathematical calculations. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
3. Application of knowledge
d160 Concentrating the attention - intentionally focusing on a specific stimulus. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d1600 Concentrating the attention on human touch, face and voice. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d163 Thinking - making and handling ideas, concepts and images, directed to an objective, in isolation or with others, with types of activities of thinking, playing with words, creating fiction, discussing ideas, weighing, reflecting. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d166 Reading - performing activities involved in understanding and interpreting written language. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d170 Writing - using or producing symbols or language to transmit information, such as producing a written registry of events or ideas or writing a letter. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d1701 Using grammatical and automated conventions in written compositions - applying rules of writing, punctuation, proper verbal tenses, etc. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
4. General tasks and demands
d2100 Performing a simple task - with a single main component as building a cube tower, putting on a shoe, reading a book, writing a letter or making the bed. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d2101 Performing a complex task - with more than one component, such as finding a place to play, using several toys in “make-believe” games, arranging furniture in the living room, or completing the school homework. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d2300 Following routines - responding to the direction or leadership of others to engage in basic daily life procedures or duties. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d2301 Manage the daily routine - planning and managing the requirements of daily procedures or duties. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d2305 Managing the own time - managing the time needed to complete usual or specific activities. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d2400 Handling responsibility - performing and coordinating simple or complex actions to manage task performance duties and assess the need for such duties. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
5. Communication
d310 Oral message reception - understanding the literal and implied meanings of messages in oral language, how to distinguish if a sentence has literal meaning, responding and understanding spoken messages. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d3100 Responding to human voice that is expressed by changes in breathing patterns or by fine or broad body movements. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d3101 Understanding simple spoken messages and responding appropriately by actions or words to simple spoken messages (2-3 words), such as requests (“give it to me”) or orders (“no”, “come here”) [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d3102 Understanding complex spoken messages and responding appropriately by actions or words to complex spoken messages (complete sentences), such as questions or instructions. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d315 Reception of non-verbal messages - understanding literal and implied meanings of messages transmitted by gestures, symbols and drawings. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d3151 Reception of general signs and symbols - understanding the meaning of public signs and symbols, such as road signs, warning symbols, musical or scientific notations, and icons. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d325 Written messages reception - understanding the literal and implied meanings of messages transmitted by written language (including Braille). [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d330 Speech - producing words, sentences and longer passages in spoken messages with literal and implicit meaning such as expressing a fact or telling a story in oral language. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d332 Singing - producing sounds in a sequence, resulting in a melody or singing songs alone or in a group. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d345 Writing messages - producing the literal and implicit meanings of messages that are transmitted by written language, such as writing a letter. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d3503 Talking with someone - initiating, maintaining, shaping, and ending an exchange of ideas or dialogue with a person. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d3504 Talking to many people exchanging ideas or talking to more than one individual. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d355 Discussion - analysis of a subject, with arguments for or against or a debate with one or several people. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d360 Use of devices, techniques and other means to communicate. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d3600 Utilization of telecommunication devices - telephones or machines (fax, telex, email) [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d710 Basic interpersonal interactions - interacting with people in contextually and socially appropriate manners, such as showing consideration and esteem when appropriate or reacting to the feelings of others. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
6. Education
d810 Informal education - learning at home or in another non-institutional environment, acquiring skills in a family or community environment. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d815 Preschool education - learning at an early level of organized instruction at home or in the community to introduce the child to a school environment and prepare for compulsory education, such as acquiring skills in a daycare center. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d8152 Progressing in preschool education program - performing activities to fulfill a certain program or any other assessment process relevant to obtaining preschool education. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d820 School education - achieving access to school, education; participating in all school-related responsibilities and privileges and learning course material and other curriculum requirements in a primary and secondary education program. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d8202 Progressing in educational program - performing activities to fulfill the assigned tasks and projects, exams or other assessment processes relevant to achieving education. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
7. Professional training
d8250 Being admitted to a professional training program or progressing in level - performing activities that allow access to professional training and transition from one level of professional training to the next. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d8253 Completing a vocational training program - adequately completing this program to enter the next level of education, work, or other adult life domain. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
8. Work and job
d840 Internship (training for work) - participating in programs related to job training. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d850 Paid work - participating in all aspects of work, in exchange for payment. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
9. Community, social and civic life
d9200 Playing - games with rules or non-structured or non-organized games and spontaneous recreation. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d9201 Practicing sports - participating in competitive athletic games or events, organized informally or formally, alone or in a group. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
d9205 Socializing - participating in informal or casual meetings with others. [ ] 0 - No difficulty [ ] 1 - mild [ ] 2 - moderate [ ] 3 - severe [ ] 4 - complete [ ] 8 - non-specified [ ] 9 - not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
Environmental Factors
1. Products and technology
e1250 General products and technologies for communication - optical and auditory devices, audio recorders and receivers, television and video equipment, telephone, sound transmission system and non-adapted communication devices. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e1251 Communication assistant products and technologies - writing devices, hardware and software signaling systems, cochlear implants, hearing aids, FM hearing trainers, voice prostheses, whiteboards, etc. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e1300 General education products and technology - books, manuals, educational toys, hardware or software, not adapted or specially designed. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e1301 Educational assistant technology and products - adapted and specially designed methods and technology used for acquiring knowledge, experience, or skill, such as a specialized computing technology. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
2. Support and relationships
e310 Immediate family - individuals related by birth, marriage or other culturally recognized relationships such as immediate family, spouses, parents, siblings, children, foster and adoptive parents, grandparents. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e315 Extended family - individuals related by family or marriage, relatives, uncles, aunts, nephews and nieces. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e320 Friends - individuals who are close and ongoing in a relationship characterized by trust and mutual support. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e325 Acquaintances, companions, colleagues, neighbors and community members - individuals who maintain a relationship of familiarity with each other, such as acquaintances, companions, colleagues, neighbor and community members, at work, school, recreation, etc. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e330 People in positions of authority - individuals who have decision-making responsibility for others and socially defined influence or power based on their social, economic, cultural or religious role; teachers, employers, etc. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e340 Caregivers and personal assistants - individuals who provide services required to support other individuals in their daily activities and in maintaining performance in work, education or other life situations Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e345 Strangers - individuals who are not family members or relatives or those who have not yet established a relationship or association, such as substitute teachers, collaborators. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e355 Health professionals - all service providers working in the health system, such as doctors, nurses, physiotherapists, speech therapists, audiologists, medical social workers. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e360 Other professionals - all service providers who work outside the health system yet provide health-related services such as social workers, teachers, architects, designers. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
3. Attitudes
e410 Individual attitudes of immediate family members - opinions and beliefs of immediate family members about the person or other issues (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e415 Individual attitudes of extended family members - opinions and beliefs of other family members about the person or about other aspects (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e420 Individual attitudes of friends - opinions and beliefs of friends about the person or about other aspects (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e425 Individual attitudes of acquaintances, peers, colleagues, neighbors and community members - opinions and beliefs of acquaintances, colleagues, about the person or about other issues that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e430 Individual attitudes of authority personnel - opinions and beliefs of individuals with authority about the person or about other issues (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e440 Individual attitudes of caregivers and personal assistants - opinions and beliefs of caregivers and personal assistants about the person or about other aspects (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e445 Individual attitudes of strangers - opinions and beliefs of strangers about the person or about other aspects (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e450 Individual attitudes of health professionals - opinions and beliefs of health professionals about the person or about other aspects (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e455 Individual attitudes of other professionals - opinions and beliefs of other professionals about the person or about other aspects (social, political and economic) that influence the individual behavior and actions. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e460 Social attitudes - opinions and beliefs of people of a culture, society, about other individual, social, political and economic issues, which influence the behavior and actions of the individual or group. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations:
4. Services, systems and policies
e560 Media Services, systems and policies - services, systems and policies for the provision of mass communication by radio, television, newspapers and the internet. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e5600 Media services - radio, television, closed caption services, press, newspapers, Braille services and mass communication by computer. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e5800 Health services - services and programs aimed to provide intervention to individuals for their physical, psychological and social well-being, such as primary care services, urgent care, rehabilitation, etc. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e5801 Health systems - administrative control that manages the set of services provided to the individual, such as regulations and standards that determine the right to services, provision of devices, assistive technology, or others. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
e5802 Health policies - legislation, regulations and rules managing the set of services provided to individuals, such as policies and rules for determining eligibility for other services, provision of equipment and legislation. Facilitator: [ ] 0 none [ ] +1 mild [ ] +2 moderate [ ] +3 considerable [ ] +4 complete [ ] +8 non-specified [ ] +9 not applicable Barrier: [ ] 0 none [ ] -1 mild [ ] -2 moderate [ ] -3 considerable [ ] -4 complete [ ] -8 non-specified [ ] -9 not applicable
Information sources: [ ] clinical history [ ] anamnesis [ ] record [ ] questionnaire [ ] clinical examination [ ] observation [ ] evaluation protocols. Which? Description and observations: