WEBVTT Kind: captions; language: en-us NOTE Treffsikkerhet: 91% (H?Y) 00:00:01.700 --> 00:00:11.300 hi my name is Linn Stokke Guttormsen and thank you so much for listening to this lecture I'm very 00:00:11.300 --> 00:00:18.549 sorry that I couldn't be here in the auditorium earlier today NOTE Treffsikkerhet: 85% (H?Y) 00:00:18.549 --> 00:00:26.000 I'm so sorry for the inconvenience for you and that is glad to however thank you so much for 00:00:26.000 --> 00:00:39.400 listening to this lecture I hope that we can have some good sessions here I will divide the lectures 00:00:39.400 --> 00:00:47.750 into four parts and lasting approximately 15 to 20 minutes each NOTE Treffsikkerhet: 85% (H?Y) 00:00:47.750 --> 00:00:58.600 I will share my screen with you. I have uploaded the slides in Canvas for you to see. NOTE Treffsikkerhet: 91% (H?Y) 00:00:59.300 --> 00:01:02.099 yeah here they are, NOTE Treffsikkerhet: 88% (H?Y) 00:01:02.099 --> 00:01:10.500 I'm going to give this lecture today on the ICF model that's the international classification of 00:01:10.500 --> 00:01:13.500 functioning, disability and health NOTE Treffsikkerhet: 89% (H?Y) 00:01:13.500 --> 00:01:24.850 now I've been asked to do this because in my PhD I investigated the impact or how how stuttering 00:01:24.850 --> 00:01:30.600 effects young children young children's lives NOTE Treffsikkerhet: 73% (MEDIUM) 00:01:31.400 --> 00:01:41.300 when I investigated this I use assessment tool called The Oasis and the Oasis NOTE Treffsikkerhet: 84% (H?Y) 00:01:41.600 --> 00:01:55.550 it's founded the basis for the Oasis is the ICF model so in my PhD I wrote about the model and I 00:01:55.550 --> 00:01:59.000 even though the ICF isn't NOTE Treffsikkerhet: 82% (H?Y) 00:01:59.000 --> 00:02:09.000 always directly similar to the model I think that I've through working with the iICF with both the 00:02:09.000 --> 00:02:15.750 model but also with the assessment tool I have gotten an understanding of NOTE Treffsikkerhet: 88% (H?Y) 00:02:15.750 --> 00:02:27.200 how this model can contribute to assessment and also our perspective when evaluating treatment 00:02:27.200 --> 00:02:40.300 effects and defining disorders so I hope I can provide some examples from my PhD to you today with 00:02:40.300 --> 00:02:46.000 children who stutter and then also go deeper into NOTE Treffsikkerhet: 80% (H?Y) 00:02:46.000 --> 00:02:49.000 into the ICF model NOTE Treffsikkerhet: 72% (MEDIUM) 00:02:49.100 --> 00:02:59.900 yeah and I worked as a postdoc in The X Project now that is a research project that investigates the 00:02:59.900 --> 00:03:04.300 effect of treatment for young children stutter NOTE Treffsikkerhet: 91% (H?Y) 00:03:05.700 --> 00:03:15.200 in this lecture I will start by giving an overview of the ICF model and and the different components 00:03:15.200 --> 00:03:28.000 in that model I will aim to give examples of how the model can contribute to a holistic 00:03:28.000 --> 00:03:36.050 understanding of disorders and I hope to stimulate reflections concerning how the ICF can be used NOTE Treffsikkerhet: 83% (H?Y) 00:03:36.050 --> 00:03:42.800 when assessing the finding disorders and also investigating treatment NOTE Treffsikkerhet: 73% (MEDIUM) 00:03:45.600 --> 00:03:57.600 for this lecture I use the ICF practical manual that is on your curriculum and I've also looked into 00:03:57.600 --> 00:04:09.200 the ICF for children and youth I've also included some papers from the ICF model and I also have 00:04:09.200 --> 00:04:15.000 some literature from the field of stuttering NOTE Treffsikkerhet: 87% (H?Y) 00:04:16.100 --> 00:04:22.700 to begin with I want to introduce the aims of the ICF NOTE Treffsikkerhet: 88% (H?Y) 00:04:22.700 --> 00:04:32.800 the ICF is the aims of the ICF is to provide a framework for understanding all aspects of health and 00:04:32.800 --> 00:04:34.900 health issues NOTE Treffsikkerhet: 81% (H?Y) 00:04:35.300 --> 00:04:44.850 the components in the model is worded neutrally so that that it's possible to use across disorders 00:04:44.850 --> 00:04:47.400 and also across functioning NOTE Treffsikkerhet: 88% (H?Y) 00:04:47.400 --> 00:04:57.900 you can you can use the model even though and even though functioning isn't a negatively affected NOTE Treffsikkerhet: 88% (H?Y) 00:04:57.900 --> 00:05:08.950 it is also it also aims to provide a common language for different health professionals for instance 00:05:08.950 --> 00:05:16.800 and to ease the communication for instance when speech language pathologists and 00:05:16.800 --> 00:05:23.799 doctors are talking about the functioning of a patient NOTE Treffsikkerhet: 87% (H?Y) 00:05:23.799 --> 00:05:31.900 it's also aims to provide a scientific foundation for understanding and assessing health and health 00:05:31.900 --> 00:05:34.000 related states NOTE Treffsikkerhet: 76% (H?Y) 00:05:34.000 --> 00:05:45.600 and treatment effects and in that it's aims to be a framework that can be used so that we can have 00:05:45.600 --> 00:05:55.700 comparable data across different disorders that are collect that are collected and also collected in 00:05:55.700 --> 00:05:57.800 different nations NOTE Treffsikkerhet: 85% (H?Y) 00:05:59.900 --> 00:06:10.300 it is a universal model in life it's it's worded so that it can be used across for all people and 00:06:10.300 --> 00:06:16.800 it's also a relational model because it does not only focus on the individual it also takes the 00:06:16.800 --> 00:06:27.800 context into understanding when when looking at the person's functioning and disability NOTE Treffsikkerhet: 91% (H?Y) 00:06:28.800 --> 00:06:37.000 and in that it's particularly relevant for the field of special needs education NOTE Treffsikkerhet: 77% (H?Y) 00:06:41.100 --> 00:06:50.600 yeah and then what I also wanted to say that the focus is not on the diagnosis itself it's on the 00:06:50.600 --> 00:06:59.750 person's functioning and that means the whole picture actually a holistic perspective into NOTE Treffsikkerhet: 71% (MEDIUM) 00:06:59.750 --> 00:07:11.300 how the person's well-being and life is so an in that it needs to be said that it's a supplement to 00:07:11.300 --> 00:07:23.500 the diagnose manual ICF but it also shows us that the medical diagnosis isn't enough to predict what 00:07:23.500 --> 00:07:30.200 the individual actually have of needs of need for services for instance NOTE Treffsikkerhet: 90% (H?Y) 00:07:30.200 --> 00:07:35.200 the needs that we need to plan for when we planning treatments NOTE Treffsikkerhet: 72% (MEDIUM) 00:07:35.600 --> 00:07:48.000 so in that the ICF is is more holistic and also it shows how that person's functioning is and not 00:07:48.000 --> 00:07:55.300 only saying something about the diagnosis that person can have because when diagnosis can live to 00:07:55.300 --> 00:08:03.800 eat can cause very different kind of functioning for different people in different contexts NOTE Treffsikkerhet: 86% (H?Y) 00:08:04.900 --> 00:08:14.100 so functioning is defined in the ICF as a dynamic interaction between a person's health condition 00:08:14.100 --> 00:08:22.300 environmental factors and personal factors the health condition is the disorder and then you have 00:08:22.300 --> 00:08:27.450 the environmental factors and the personal factors and I will go more into that NOTE Treffsikkerhet: 74% (MEDIUM) 00:08:27.450 --> 00:08:35.900 while health is defined as a state of complete physical mental and social well-being and not merely 00:08:35.900 --> 00:08:40.900 the absence of disease or infirmity infirmity NOTE Treffsikkerhet: 77% (H?Y) 00:08:40.900 --> 00:08:52.200 so health is when a person experiences well-being and not just not being sick NOTE Treffsikkerhet: 90% (H?Y) 00:08:53.700 --> 00:09:07.000 impairment that is the loss or abnormality in either structures in a person's body or functions well 00:09:07.000 --> 00:09:17.900 this disability is them the impairment itself but disability is more than the impairment it is the 00:09:17.900 --> 00:09:22.500 limitations in activity experienced by that person NOTE Treffsikkerhet: 89% (H?Y) 00:09:22.500 --> 00:09:28.450 so restriction in participation that person NOTE Treffsikkerhet: 91% (H?Y) 00:09:28.450 --> 00:09:31.100 experiences NOTE Treffsikkerhet: 89% (H?Y) 00:09:32.400 --> 00:09:40.200 and the relation between these are described in the model which we will come to very soon late NOTE Treffsikkerhet: 85% (H?Y) 00:09:40.200 --> 00:09:51.300 but before that I would also like to talk about one more constructing that this qualifier qualifier 00:09:51.300 --> 00:10:02.750 is used as a comes as qualifiers to construct that reflects the severity of either the impairment NOTE Treffsikkerhet: 90% (H?Y) 00:10:02.750 --> 00:10:13.150 to what degree is for instance if we're talking about blindness to what degree is is the structure 00:10:13.150 --> 00:10:17.150 and the functioning in the eye impaired NOTE Treffsikkerhet: 88% (H?Y) 00:10:17.150 --> 00:10:31.250 but then it it can also be used to say something about how to what degree is the person limited in 00:10:31.250 --> 00:10:46.150 these are her functioning and that is activities that the person who can can can execute NOTE Treffsikkerhet: 90% (H?Y) 00:10:46.150 --> 00:10:53.700 and it can also be used to talk about restriction in participation and also barriers NOTE Treffsikkerhet: 81% (H?Y) 00:10:53.700 --> 00:11:02.800 to what degree are there barriers in that person's environment are these barriers large for instance 00:11:02.800 --> 00:11:06.800 is the person living in a environment NOTE Treffsikkerhet: 91% (H?Y) 00:11:07.900 --> 00:11:17.800 that doesn't have any options for people who are blind or does the person live in an environment 00:11:17.800 --> 00:11:30.800 with few barriers and maybe good services for instance so and then you can scale is from no problem 00:11:30.800 --> 00:11:36.700 at all or no barriers at all for instance to complete NOTE Treffsikkerhet: 88% (H?Y) 00:11:36.700 --> 00:11:40.900 problem or complete barriers NOTE Treffsikkerhet: 91% (H?Y) 00:11:42.400 --> 00:11:52.700 the components in the ICF model has is divided into two main parts the first main part is 00:11:52.700 --> 00:12:02.200 functioning and disability and that includes impairment in body functions and structures and it also 00:12:02.200 --> 00:12:06.200 includes activities and participation NOTE Treffsikkerhet: 91% (H?Y) 00:12:06.200 --> 00:12:16.600 and these two terms can be worded either positively, in positive terms and then we say activities and 00:12:16.600 --> 00:12:25.100 participation but it can also be worded in negative terms and then we say activity limitation and 00:12:25.100 --> 00:12:27.900 participation restrictions NOTE Treffsikkerhet: 91% (H?Y) 00:12:28.800 --> 00:12:38.800 and then we have the contextual factors and that is the environmental factors but also the factors 00:12:38.800 --> 00:12:43.000 in the person him or herself NOTE Treffsikkerhet: 91% (H?Y) 00:12:44.800 --> 00:12:48.300 so here is the model NOTE Treffsikkerhet: 85% (H?Y) 00:12:58.100 --> 00:13:03.000 yeah just checking that I got everything here NOTE Treffsikkerhet: 88% (H?Y) 00:13:05.100 --> 00:13:10.050 yep and here you can see NOTE Treffsikkerhet: 91% (H?Y) 00:13:10.050 --> 00:13:20.800 the example that I pull out with with being blind then the health condition is blindness and then 00:13:20.800 --> 00:13:32.300 one could describe how body function and structure is impaired so function would then be not being 00:13:32.300 --> 00:13:39.550 able to see and structure would be structure in the eye what what kind of NOTE Treffsikkerhet: 83% (H?Y) 00:13:39.550 --> 00:13:43.600 sickness is leading to the blindness NOTE Treffsikkerhet: 87% (H?Y) 00:13:43.600 --> 00:13:54.700 and then activity could then word it in negative terms would then be activity limitation and that 00:13:54.700 --> 00:14:07.100 means what kind of activities is the person not able to execute him or herself and then you have 00:14:07.100 --> 00:14:15.100 participation and where the negatively then it would be participation restriction and NOTE Treffsikkerhet: 76% (H?Y) 00:14:16.200 --> 00:14:30.800 entails what kind of life events is that person restricted from participating in and as you can see NOTE Treffsikkerhet: 91% (H?Y) 00:14:30.800 --> 00:14:41.200 here's a arrow between body function and structure to activity and then to participation so the 00:14:41.200 --> 00:14:49.300 model shows that but if function and structure effects activity and participation but what we also 00:14:49.300 --> 00:14:55.350 see here in the model is that the factors within the person himself or herself NOTE Treffsikkerhet: 80% (H?Y) 00:14:55.350 --> 00:15:08.500 also effects activity and participation and also factors within the person's environment now will go 00:15:08.500 --> 00:15:14.500 more deeply into all of these components in in the manual NOTE Treffsikkerhet: 88% (H?Y) 00:15:14.700 --> 00:15:22.700 but when I do so I'm going to use examples from the stuttering literature so therefore I would first 00:15:22.700 --> 00:15:32.300 like to just say something a bit general about stuttering and also to say something about the 00:15:32.300 --> 00:15:44.000 assessment tool that I've applied in my PhD to measure the impact of how of the disorder but means 00:15:44.000 --> 00:15:44.900 how a person is NOTE Treffsikkerhet: 88% (H?Y) 00:15:44.900 --> 00:15:55.000 affected by the disorder. That is how body function and structure is affected but also activity and 00:15:55.000 --> 00:16:06.700 participation and also the environmental and personal factors and how these affect each other NOTE Treffsikkerhet: 89% (H?Y) 00:16:08.100 --> 00:16:17.400 the OASES is the assessment tool that I used in my PhD and it's short for overall assessment of the 00:16:17.400 --> 00:16:20.599 speaker's experience of stuttering NOTE Treffsikkerhet: 77% (H?Y) 00:16:20.599 --> 00:16:31.400 it entails 60 -100 questions depending a bit on the age group and these questions assess general 00:16:31.400 --> 00:16:34.000 knowledge about the stuttering NOTE Treffsikkerhet: 91% (H?Y) 00:16:34.700 --> 00:16:49.200 and also fluency so that relates to mostly to body function and structure or mostly functional NOTE Treffsikkerhet: 79% (H?Y) 00:16:49.300 --> 00:16:59.200 it measures reactions to stuttering that is within personal factors, measures communication 00:16:59.200 --> 00:17:08.750 difficulties that is the activity limitation that people who stutter most commonly experienced 00:17:08.750 --> 00:17:17.500 difficulties in different communication situations and also quality of life and that relates to 00:17:17.500 --> 00:17:20.300 participation NOTE Treffsikkerhet: 90% (H?Y) 00:17:21.200 --> 00:17:38.000 and stuttering is commonly described by using the iceberg analogy and this is used because 00:17:38.000 --> 00:17:47.450 stuttering is a disorder where we can hear repetitions for instance my my my my my my name is Lynn 00:17:47.450 --> 00:17:49.199 or NOTE Treffsikkerhet: 77% (H?Y) 00:17:49.199 --> 00:17:56.750 nations for instance my name is Lynn NOTE Treffsikkerhet: 91% (H?Y) 00:17:56.750 --> 00:17:59.400 or blocks NOTE Treffsikkerhet: 78% (H?Y) 00:18:01.000 --> 00:18:03.800 I live in NOTE Treffsikkerhet: 90% (H?Y) 00:18:04.000 --> 00:18:07.000 Oslo NOTE Treffsikkerhet: 91% (H?Y) 00:18:07.500 --> 00:18:19.800 but stuttering is so much more than the speaking behavior that we do the speaking behavior is what 00:18:19.800 --> 00:18:31.200 is above the surface what is visible for everyone but then my thoughts my feelings, my avoidance of 00:18:31.200 --> 00:18:36.400 communication situations, my fear NOTE Treffsikkerhet: 65% (MEDIUM) 00:18:37.000 --> 00:18:47.200 how stuttering affect my well-being my self-confidence that is the consequences of the disorder that 00:18:47.200 --> 00:18:53.100 is underneath the surface that is unobservable NOTE Treffsikkerhet: 91% (H?Y) 00:18:53.600 --> 00:19:06.300 and for many people who stutter the disorder is fairly similar to to the iceberg because with 00:19:06.300 --> 00:19:13.500 icebergs you only see the top of the surface the largest part is below the surface NOTE Treffsikkerhet: 81% (H?Y) 00:19:13.500 --> 00:19:24.600 and stuttering is very commonly assessed by I'm an SLP so I could listen to a person who stutter and 00:19:24.600 --> 00:19:33.100 then rate the severity of the suffering on a scale from 1 to 10 for instance I can rate how severe 00:19:33.100 --> 00:19:39.950 the blocks where how long he or she was stuck in a block I could raise tension NOTE Treffsikkerhet: 91% (H?Y) 00:19:39.950 --> 00:19:45.050 or secondary behaviors like blinking with your eyes NOTE Treffsikkerhet: 90% (H?Y) 00:19:45.050 --> 00:19:53.600 but I couldn't write what's below that below the surface and NOTE Treffsikkerhet: 82% (H?Y) 00:19:53.600 --> 00:20:04.000 for me I think that first ring it makes so much sense to assess the whole picture the whole 00:20:04.000 --> 00:20:12.100 experience of the disorder and not only how severe this stuttering moments are or how frequent they 00:20:12.100 --> 00:20:13.500 are happening NOTE Treffsikkerhet: 88% (H?Y) 00:20:13.500 --> 00:20:25.700 so with the OASES and with the ICF as a foundation there's a holistic view to assessment of 00:20:25.700 --> 00:20:38.000 suffering in all all age groups but I have to say that this this assessment tool is worded so that 00:20:38.000 --> 00:20:43.750 it's it only assess this the negative effects of stuttering NOTE Treffsikkerhet: 89% (H?Y) 00:20:43.750 --> 00:20:53.400 that is actually because it was tested out by the authors and NOTE Treffsikkerhet: 91% (H?Y) 00:20:53.400 --> 00:21:00.900 by sending the questionnaire to people who stutter they saw that there were no positive effects that 00:21:00.900 --> 00:21:11.150 was reported on as a consequence of suffering so that is why they only focus on the negative terms 00:21:11.150 --> 00:21:19.300 as in them ICF model activity limitation and the participation restriction and also negative 00:21:19.300 --> 00:21:20.750 factors NOTE Treffsikkerhet: 84% (H?Y) 00:21:20.750 --> 00:21:27.900 or negative yeah negative factors within the environment and person him or herself NOTE Treffsikkerhet: 83% (H?Y) 00:21:27.900 --> 00:21:37.000 okay and in the next video I will go into more specifics if you plan into going to different components 00:21:37.000 --> 00:21:39.400 in the ICF model