發展遲緩兒童聯合評估中心綜合報告書與「國際健康功能與身心障礙分類系統—兒童及青少年版」嬰幼兒重要位碼之連結度

The Linkage between Evaluation Reports of Children Development and Important Infant Categories of the Classification of Functioning, Disability and Health-Children and Youth

目前發展遲緩兒童評估綜合報告書設計主要依據發展觀點，並涵蓋少部份環境因素評估。本研究針對三歲以下之動作發展遲緩∕障礙嬰幼兒，以國際健康功能與身心障礙分類系統—兒童及青少年版（International Classification of Functioning, Disability and Health–Children and Youth Version, ICF-CY）「嬰幼兒重要位碼」為參照，將十份評估報告書連結至「嬰幼兒重要位碼」，用於了解目前評估報告書必填部份或整份報告內容與ICF-CY 連結度。首先將每份報告書中評估結果進行意義概念識別，並連結至「嬰幼兒重要位碼」各位碼及給予限定值，計算必填部份與整份報告（必填部份與附加資料）之編碼連結率。十份評估報告書共可識別2428 個意義概念。107 個「嬰幼兒重要位碼」中共有76 個位碼可被連結，必填部份平均編碼連結率為16%，整份報告則為44%。各成份連結率以活動與參與成份最高，身體功能次之，身體構造與環境因素最低。以ICF-CY 觀點，現有評估報告書內容提供足夠有關活動與參與之資訊；但多出自附加資料，使得評估報告書品質易受專業人員個別性影響。較低的環境因素連結率顯示出目前聯合評估對於環境資料收集之不足，不易推論環境因素對兒童發展之影響。此外，「嬰幼兒重要位碼」中未被連結位碼對動作發展遲緩∕障礙幼兒早期療育之重要性則有待進一步探討。

Current Evaluation Reports for children with developmental delays are based on the developmental-specific viewpoint that include few assessment of environmental factors. For infants under three years of age and with motor delay/disabilities, the purpose of this study was to explore the content of current Evaluation Reports in terms of the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY), with linkage of 10 Evaluation Reports to the Important Infant Categories of ICF-CY (107 categories). The meaningful concepts were identified from the Evaluation Reports, and then were linked to the linking table of the Important Infant Categories and assigned generic qualifiers or denotations. The mean code linking percentages were calculated respectively for the compulsory part and the whole report (compulsory part and additional part) for content exploration. There were 2428 meaningful concepts identified from the 10 Evaluation Reports. Seventy-six categories in the code set were linked; the mean code linking percentage was 16% of the compulsory part and 44% of the whole report. The linking percentage was highest in Activities and Participation, followed by Body Functions, and was lower in Body Structures and Environmental Factors. In view of the ICF-CY, current reports contained sufficient information regarding Activities and Participation, but only small part was presented in the compulsory part, made the quality easily influenced by individual professional. The lower linking percentage in Environmental Factors indicated insufficient information obtained, making it difficult for health professionals to judge the impact of environment. The importance of those unlinked categories to the infants with motor delay/disabilities in early intervention needs further examination.