Presentation on theme: "I-CAN: Classification of Disability Support Needs ARC Linkage project partners: University of Sydney Royal Rehabilitation Centre & Centre Developmental."— Presentation transcript:
I-CAN: Classification of Disability Support Needs ARC Linkage project partners: University of Sydney Royal Rehabilitation Centre & Centre Developmental Disability Studies
Problems with past assessment Eligibility for service provision determined by disability definitions & classifications Focus on strengths and weaknesses - deficit model People with disabilities feel they are made to fit available programs Significant gaps and overlaps in service provision occur Fragmentation with different disciplines and different agencies working more or less in parallel
Requirements A rigorous and robust system to accurately determine the type and intensity of support needed Using a team approach Permit people with disabilities to pursue their personal goals and chosen life activities Ensure an equitable resource allocation
CONCEPTUAL FRAMEWORKS AAMR (1992, 2002) conceptualization of supports. WHO International Classification of Functioning, Disability and Health (ICF) (2001) Health & Well Being Activities & Participation Environment & personal factors
SUPPORTS “Supports are the resources and strategies that aim to promote the development, education, interests, and personal well-being of a person and that enhance individual functioning.” (AAMR, 2002, p. 151) Supports enable individuals to live meaningful and productive lives that they choose.
Bio-psycho-social approach The medical model views disability as a problem of the person, directly caused by disease, trauma or other health related conditions, & requiring medical care through individual treatment by professionals The social model sees disability as a complex collection of conditions, many created by the social environment, & requiring social action & environmental modifications for full participation of people with disabilities in all areas of social life ICF seeks a synthesis of these 2 opposing models
Functioning, Disability & Health Functioning encompasses all human functions; at the level of the body, the individual and society Disability is perceived as a multi-dimensional phenomenon resulting from the interaction between people and their physical and social environment Health is defined as ‘a state of complete physical, mental and social well-being and not merely the absence of disease’. (ICF, WHO, 2001 )
Interaction of Concepts Health Condition (disorder/disease) Environmental Factors Personal Factors Body function & structure (Impairment ) Activities(Limitation)Participation(Restriction)
ARC RESEARCH PROJECT Development & trial of instrument & process NSW, ACT, Vic & Qld In residential & some day program settings Process engaging 5071 participants Trained facilitators 1012 complete data sets
People with disability N=1012 Aged 17 - 77 years Average age 41 years Male 58% female 42%
Disability Groupings Multiple disabilitiesN=29028.7% Intellectual only (ID) N=23222.9% ID & neurological N=15615.4% ID & mental illnessN= 78 7.7% ID & sensory disabilitiesN= 73 7.2% ID & physical disabilityN= 56 5.5% Other e.g. physical, ABIN=12712.5%
Health and Well Being Scales Physical health Mental emotional health Behaviour Health Services Health and Well being Total
Activity & Participation Activity is the execution of a task or action by an individual. Participation is involvement in a life situation. Activity limitations are difficulties an individual may have in executing activities. Participation restrictions are problems an individual may experience in involvement in life situations.
Activities & Participation Scales Knowledge and Tasks (KAT) Mobility (Mob) Communication (Com) Self care & Domestic Life (SCDL) Interpersonal Interaction & Relationships (IIR) Community, social & civic life (CSCL) AP Total
Test -Retest Reliability Overall reliability.21 to.94 Retest 6-12 months r =.21 Physical Health Scale r =.93 Mobility Scale Retest at 2 years r =-.22 Mental Emotional Health r =.94 Mobility Scale
Validity Studies Moderate and significant correlations between I-CAN domain scores and ICAP Service Level Score co-efficients -.39 to -.62 Low to moderate correlations I-CAN Total & QOL-Q (Schalock & Keith, 1993) Significant correlation between I-CAN Mental Emotional Health, Communication and IIR Scales and QOL-Q Community Integration/Social Belonging.
Participant evaluations Positive feedback from: People with disabilities Trained facilitators Family members and advocates
Support hours Multiple regression analyses against –Day time support hours –Night support hours –24 hour support clock Allocation of support hours includes up to 40% factors relating to the individual but the remainder appear to relate to organisational factors such as policies, staffing, resources
References for ICF World Health Organization (2001). International Classification of Functioning, Disability and Health. Geneva: Author. AIHW (2003) ICF Australian User Guide Version 1.0 http://www.aihw.gov.au/disability/icf ug/index.html