Figure 91.1 The ICF framework
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Neurological problems
The International Classification of Functioning, Disability and Health (ICF) provides a standardized and validated framework on which to base assessment of children with multiple needs, particularly those with neurological or developmental deficits. The ICF is used to measure all aspects of health throughout the child’s life and focuses on health and functioning rather than on disability.
The ICF can be used for several areas involving clinical, research and policy development issues. This can be at the individual level (e.g. what interventions could maximize functioning), at the institutional level (e.g. what health care services are needed) and at the social level (e.g. is the child eligible for social benefits).
The ICF describes four main elements; these elements are described in detail and incorporated with information about the child’s environment to provide a thorough and standardized method of holistic assessment and documentation and include the following conditions.
Cerebral palsy
Cerebral palsy occurs in 2 per 1000 live infants with a higher incidence in males (Forsyth and Newton 2007) and is one of the most common causes of childhood disability and a major cause of severe disability in children. Cerebral palsy is an umbrella term describing a group of disorders that occur during the development of the fetal or infant brain and result in disorders of movement and posture. Dependent on the cause of cerebral palsy, disturbances of sensation, cognition, communication, perception or seizure disorder can also occur.
Some 80–90% of children will survive into adulthood, causes of death being mainly attributed to seizures and respiratory infections (Forsyth and Newton 2007). Management requires interdisciplinary care and therapy and is based on the needs of the individual child, with the focus on enabling functional activity and participation for individuals as well as with other clinical conditions. Outcomes are influenced by personal and environmental factors, including families’ socioeconomic status, all of which can serve as barriers or facilitators to functioning.
Headache
Headache is not uncommon in children. The symptoms are dependent on the child’s age and the type of headache. The majority of headaches in children are not sinister and are secondary to a viral illness or sinusitis. Differential diagnosis can include tension or cluster headaches and migraine. Less commonly, the cause may be raised intracranial pressure, hypertension, trauma, cerebral haemorrhage or serious infection such as meningitis.
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