Week Three - ICF & Self-Assessment Flashcards
What is the goal of the ICF?
Provide a common language for describing health conditions
True/false: The ICF only focuses on physical health.
False, the ICF is a biopsychosocial model.
It combines biological, psychological and social elements into the one model.
True/false: The ICF is a social model
Neither true nor false.
The ICF incorporates aspects of the social model (disability is a socially created problem) but also the medical model (disability is solely a feature of the person).
It portrays disability as a function of many different factors.
What is a potential limitation of the ICF model?
It can be too simplistic in that it only describes the interactions of a single health condition.
In reality, many people have more than one health condition that can impact functioning in many different ways.
What does the middle row of the ICF model describe?
Aspects of disability and functioning
Body functions and structures:
- Aspects of the person’s body that are affected by the health condition
- The negative expression is impairment (problems with body structures and/or functions)
Activity:
- Something a person would like to do
- Negative expression is activity limitation - something the person would like to do but can’t because of their impairment
Participation
- Being involved in life events
- Negative expression: Participation restriction - not being able to engage socially in life events
What does the bottom row of the ICF model describe?
Contextual Factors
Environmental factors:
- Anything in the environment (physical, social, or attitudinal).
- Can be positive (environmental facilitators) or negative (environmental barriers)
Personal Factor:
- Anything about a person that improves or hinders their functioning (age, financial status, personality, education, past experiences)
What is third party disability?
The impact of a person’s health condition on those around them
True/false: Each element of the ICF can be assessed
True. Each element can be assessed
Impairment can be assessed through standardised assessment.
Contextual factors are assessed through self-assessment.
How does WHO define a “disabling” hearing impairment?
Adults: permanent unaided hearing impairment above 40dB HL.
Children: Unaided hearing impairment above 30dB HL in the better ear.
A point of contention between audiologists and WHO is the exclusion of unilateral hearing impairment in the disabling category.
What is a self-assessment?
A type of assessment in which people provide information about themselves
What is a construct in regards to self assessment tools?
A construct is the domain the tool assesses (e.g., hearing aid use, hearing aid benefit, hearing aid satisfaction).
This should be the first thing to find out when selecting the assessment you use.
What are the different ways self-assessments can be administered?
Self-administration
- The client completes the self assessment tool without your help
- Good use of clinical time
Clinician administration
- The clinician sits with the client and administers the self-assessment tool
- Incorporates clinician expertise and helps to get good responses
Need to keep in mind both client burden and clinician burden.
What is critical difference?
- Relates to reliability
- It is the smallest amount of change needed to indicate an actual effect of the intervention, compared to change that may just be a result of random variability
What is reliability?
How likely you are to get the same answers over multiple administrations of the tool - without intervention.
Important as you want to make sure an outcome is due to your intervention, not just as a by-product of the tool itself.
What is validity?
- You are measuring what you think you are measuring
What is it called when a tool measures more than one construct?
- Sub-scales
- It is important to find research that establishes these sub scales (find factor analyses to define the sub-scales)
True/false: good self-assessment tools do not provide norms
False, good assessment tools provide norms.
Norms are based on a large heterogeneous sample that provides context for the client’s results.
Often includes percentiles e.g., the person is in the 90th percentile (90% of the sample scored at or below this)
What are some self-assessment tools that can be used with adults and have good psychometric properties?
The Abbreviated Profile of Hearing Aid Benefit (APHAB)
- Pre-fitting and post-fitting assessment
The Expected Consequences of Hearing Aid Ownership (ECHO)
- Pre-fitting assessment only
The Hearing Handicap Inventory (HHI)
- One of the oldest and most widely used assessment tools
- Does not have sub-scales or norms
- Some outdated language (e.g., handicap, eldery)
The Client Orientated Scale of Improvement (COSI)
- Measure outcomes and establish needs for clients
- Doesn’t have any items (clients are asked about what they specific listening needs are)
What are some self-assessment tools that can be used with children and have good psychometric properties?
The Little Ears Auditory Questionnaire (LEAQ)
- Assesses auditory behaviours
- birth to 2 years
Children’s Home Inventory for Listening Difficulties (CHILD)
- Child completes the questionaire
- 3 to 12 years
Parent’s Evaluation of Aural/Oral Performance of Children (PEACH)
- Any age
- Parent completed
Client Orientated Scale of Improvement- Child (COSI-C)
- works in the same way as the adult version
What are two self-assessment tools you can use to assess third party disability?
The Significant Other Scale for Hearing Disability (SOS-HEAR)
The Hearing Impairment Impact - Significant Others (HII-SOP)
Details of the APHAB self-assessment?
- Abbreviated profile of hearing aid benefit
- Psychometric properties: validity, reliability, sub scales and norms
- Sub scales: ease of communication, background noise, reverberation, aversiveness
- Has reverse scoring
- Pre-fitting and post-fitting assessment
Details of the ECHO assessment?
- Expected consequences of hearing aid ownership
- Psychometric properties: reliability, validity, sub-scales, norms
- Sub scales: Positive effect, service and cost, negative features, personal image
- Used as a pre-fitting assessment
- Includes reverse scoring
