The β-2 draft of the international classification of impairment, disabilities and handicap: Application to communication disorders

Background. In 1980 the World Health Organization (WHO) published the ICIDH, International Classification of Impairments, Disabilities and Handicap. The ICIDH is considered as a precise coding of impairments, disabilities and handicaps and/or as a conceptual framework for understanding disablement. Despite its acceptance, the ICIDH model and classification scheme has received its share of criticism. In 1993 a revision process of the 1980 ICIDH was begun by WHO and in 1999 a "β-2" draft of the ICDH-2 has been completed. Aim of our study is to verify the applicability of ICIDH-2 in the field of Communication Disorders in developmental and adult populations. Methods. A prospective study was conducted. Patients were interviewed and clinically examined as out-patient at the "S. Giovanni Battista" Hospital of Turin. Ten adults and 10 children, with communication disorders of different kind took part in the study. Time needed to code each subject, intra-rater and inter-rater agreement were calculated. Easiness and pertinence of the classification were subjectively judged. Results. Mean time used in coding was 48 min in adult population and 67 min in children population. Overall inter-rater agreement was 70% and intra-rater agreement 80%. Pertinence and easiness were considered medium. Conclusions. ICIDH-2 it is not only a clinical tool, but also a communication tool between health care workers and health care administrators; its applicability to outcome research makes it useful for different professions of the rehabilitation world. Our study shows that ICIDH-2 is a useful tool for research purposes, but cannot be used as such in clinical practice because of the amount of time needed in coding. The conceptual framework is highly appreciated because of the holistic view it gives.