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ICD HISTORY

ICD HISTORY. 1853 FIRST INTERNATIONAL STATISTICAL CONGRESS FIRST UNIFORM CLASSIFICATION OF CAUSES OF DEATH-INTERNATIONAL CAUSES OF DEATH (ICD) TWO COMPETING APPROACHES 1855 CONGRESS ENTERTAINED BOTH SETS WILLIAM FARR USED ANATOMICAL SITES AS BASIS

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ICD HISTORY

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  1. ICD HISTORY • 1853 FIRST INTERNATIONAL STATISTICAL CONGRESS • FIRST UNIFORM CLASSIFICATION OF CAUSES OF DEATH-INTERNATIONAL CAUSES OF DEATH (ICD) • TWO COMPETING APPROACHES • 1855 CONGRESS ENTERTAINED BOTH SETS • WILLIAM FARR USED ANATOMICAL SITES AS BASIS • MARC d’ESPINE USED NATURE OF DISEASE (GOUTY, HERPETIC, HEMATIC) • INITIAL COMPROMISE--186 RUBRICS • 20 YEARS TO RECONCILE THE DIFFERENCES—FARR WON • NOW ICD REVISED ABOUT EVERY DECADE—HENCE ICD-10

  2. ICD/ICF HISTORY • 1979 NINTH REVISION OF ICD/ICD-9 • RECOMMENDED “PROVISIONAL PROCEDURES CLASSIFICATIONS” BE PUBLISHED TO NINTH REVISION--CPT CODES BEGIN 1980 RECOMMENDED IMPAIRMENTS AND HANDICAPS CLASSIFICATIONS AS SUPPLEMENT Provisional acceptance--INTERNATIONAL CLASSIFICATION OF IMPAIRMENTS, DISABILITIES, AND HANDICAPS (ICIDH) 1993 REVISION OF ICIDH BEGUN 2001 International Classification of Functioning, Disability, and Health (ICF) APPROVED BY THE WORLD HEALTH ASSEMBLY

  3. ICF AIM AND PRINCIPLES • AIM—PROVIDE A UNIFIED AND STANDARD LANGUAGE AND FRAMEWORK FOR THE DESCRIPTION OF HEALTH STATES • PRINCIPLES • UNIVERSAL NATURE OF DISABILITY EXPERIENCE • CROSSES THE LIFE SPAN— BIRTH TO DEATH • ETIOLOGY NEUTRAL— PHYSICAL, EMOTIONAL,etc. • NEUTRAL LANGUAGE— FUNCTION, ACTIVITY, PARTICIPATION, ENVIRONMENT

  4. Body function&structure(Impairment) Activities (Limitation) Participation (Restriction) Environmental Factors Personal Factors ICF Conceptual Framework Health Condition (disorder/disease)

  5. ICIDH - ICF

  6. BODY FUNCTIONS Mental Sensory Voice, speech Cardiovascular, haematological,immunological & respiratory Digestive, metabolic, endocrine Genitourinary & reproductive Neuromusculoskeletal, & movement related functions Skin & related structures Body Functions & Structures/Impairments BODY STRUCTURES Nervous system Eye, ear & related structures Voice & speech structures Cardiovascular, immunological & respiratory structures Digestive, metabolism & endocrine Genitourinary structures Movement related structures Skin & related structures

  7. Activities and Participation:Limitations/Restrictions 1 Learning & Applying Knowledge 2 General Tasks and Demands 3 Communication 4 Movement 5 Self Care 6 Domestic Life Areas 7 Interpersonal Interactions 8 Major Life Areas 9 Community, Social & Civic Life

  8. Body function&structure(Impairment) Activities (Limitation) Participation (Restriction) Environmental Factors Personal Factors ICF Conceptual Framework Health Condition (disorder/disease)

  9. Environmental Factors:Barriers/Facilitators 1. Products and technology 2. Natural environment and human-made changes to the environment 3. Support and relationships 4. Attitudes 5. Services, systems and policies

  10. Example: Polio • May have caused paralysis of legs (Body Function) • Affects ability to walk or climb stairs (Activity) • Impedes ability to attend school or find employment within the current environment (Participation) BUT….

  11. Example, continued • Mobility related activities, such as getting around the house or community can be improved with accessible environment and assistive devices • Participation can be increased with reduced stigma, accessible environments and flexible job design • Disability is NOT independent of the environment, and therefore is not static

  12. Need for version of ICF for children & youth • Nature and form of functioning in children different from that of adults—children are not small adults • Child is a “moving target” in classification of function—changes every 6-12 months throughout developing years, esp. activities • Primary environments and participation areas differ for children • ICF version for children and youth facilitates continuity of documentation e.g. transitions from child to adult services and communication among professionals and with parents

  13. Need for ICF-CY • Developing child as “moving target”

  14. Need for ICF-CY • Activities differ from those of adults

  15. Need for ICF-CY • Precursors of participation and life roles

  16. Need for ICF-CY • Emerging habitual, frequent and occasional environments

  17. Development of the ICF-CY • Structure ICF main volume maintained • Inclusion/exclusion criteria for codes were expanded • New content added to unused codes at 4, 5 and 6 character level to address needs outlined before • 2nd draft prepared for review on WHO website fall of 2005 • Publication expected 2006

  18. Development of the ICF-CY

  19. ICF-CY: Example of new code for Body Functions • b120 General cognitive functions • General mental functions required to represent, and constructively integrate knowledge of objects, events and experiences and apply that knowledge in tasks requiring mental rather than physical activity. • Exclusion: higher level cognitive functions (b164)

  20. ICF-CY: representative new A/P codes • d1200-03 mouthing, touching, smelling, tasting • d133 Acquiring language • d1330 acquiring single words or meaningful symbols • d1331 combining words into phrases • d1332 acquiring syntax • d2300 Following routines • d2304 Adapting to changes in daily routine • d2305 Adapting to changes in time demands • d2306 Managing one’s time • d5205 Caring for the nose • d53000-10/ Indicating need for urination, defecation • d880 Engagement in play—solitary, onlooker, parallel, shared

  21. Framework for use of ICF-CY in documentation Health Conditions- Syndrome, diagnosis, category Activities (assessment) Participation (assessment) Body Structures & Functions: (Assessment) Environmental Personal Factors: (Assessment) Factors

  22. Learning & applying knowledge General tasks & demands Communication Mobility Self-care Domestic life Interpersonal interactions & relationships Major life areas Community, social & civic life ACTIVITIES and PARTICIPATION

  23. BASIC LEARNING Copying Rehearsing Learning to read Learning to write Learning to calculate Acquiring skills APPLYING KNOWLEDGE Focusing attention Thinking Reading Writing Calculating Solving problems Making decisions LEARNING & APPLYING KNOWLEDGE

  24. General interpersonal interactions Basic interpersonal interactions Social cues Physical contact Complex interpersonal interactions Forming relationships Interacting according to social rules Particular interpersonal relationships Relating with strangers Formal relationships Persons in authority Informal relationships Other students Family relationships Intimate relationships INTERPERSONAL RELATIONSHIPS

  25. Disabilities Associated with ADHD • d160 Focusing attention • Intentionally focusing on specific stimuli, such as by filtering out distracting noises

  26. Disabilities Associated with ADHD • d7202 Regulating behaviors within interactions • Regulating emotions and impulses, verbal aggression and physical aggression in interactions with others, in a contextually and socially appropriate manner

  27. Disabilities Associated with ADHD • d820 School education • Gaining admission to school, engaging in all school-related responsibilities and privileges, and learning the course material, subjects and other curriculum requirements in a primary or secondary education program, including attending school regularly, working cooperatively with other students, taking direction from teachers, organizing, studying and completing assigned tasks and projects, and advancing to other stages of education

  28. Documenting Disabilities: QUALIFIERS • How much difficulty, do you have • Focusing attention? 0 NO difficulty 1 MILD difficulty 2 MODERATE difficulty 3 SEVERE difficulty 4 COMPLETE difficulty

  29. Disabilities Associated with ADHD

  30. Disabilities Associated with ADHD

  31. ADHD Activities Limitations: focused attention Participation Restriction: Problems moving across education levels, succeeding in program; school life Body functions: ImpairmentsAttention, impulse regulation, higher cognitive functions Environmental Factors special education Personal Factors

  32. Activity limitations are not unique to any disorder, either physical or mental • Activity limitations can be characteristic of certain disorders • ICF is developed to encompass lifespan • ICF is dynamic, captures change • ICF includes effects of health condition and environment on functioning and disabilities

  33. Framework for use of ICF-CY in documentation Health Conditions- Syndrome, diagnosis, category Activities (Intervention/Outcome) Participation (Intervention/ Outcome) Body Structures & Functions: (Assessment/ Intervention) Environmental Personal Factors: (Assessment/ Factors Intervention)

  34. Framework for use of ICF-CY in documentation Health Conditions- Syndrome, diagnosis, category Activities (assessment) Participation (assessment) Body Structures & Functions: (Assessment) Environmental Personal Factors: (Assessment) Factors

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