Reliability in assigning ICF codes to children with special health care needs using a developmentally structured interview.
OBJECTIVE
The purpose of this study was to determine if two teams of raters could reliably assign codes and performance qualifiers from the Activities and Participation component of the International Classification of Functioning, Disability, and Health (ICF) to children with special health care needs based on the results of a developmentally structured interview.


METHODS
Children (N = 40), ages 11 months to 12 years 10 months, with a range of health conditions, were evaluated using a structured interview consisting of open-ended questions and scored using developmental guidelines. For each child, two raters made a binary decision indicating whether codes represented an area of need or no need for that child. Raters assigned a performance qualifier, based on the ICF guidelines, to each code designated as an area of need. Cohen's kappa statistic was used as the measure of inter-rater reliability.


RESULTS
Team I reached good to excellent agreement on 39/39 codes and Team II on 38/39 codes. Team I reached good to excellent agreement on 5/5 qualifiers and Team II on 10/14 qualifiers.


CONCLUSIONS
A developmentally structured interview was an effective clinical tool for assigning ICF codes to children with special health care needs. The interview resulted in higher rates of agreement than did results from standardized functional assessments. Guidelines for assigning performance qualifiers must be modified for use with children.
Kronk
Rebecca A
RA
Department of Paediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA15213, USA.
Ogonowski
Julie A
JA
Rice
Carryn N
CN
Feldman
Heidi M
HM
D000203:Activities of Daily Living; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D002986:Clinical Trials as Topic / Q000295:instrumentation / Q000379:methods; D003142:Communication; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases / Q000295:instrumentation*; D007398:Interpersonal Relations; D007407:Interviews as Topic / Q000379:methods*; D007858:Learning; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results