scholarly journals Dysphonia in adults with developmental stuttering: A descriptive study

Author(s):  
Anél Botha ◽  
Elizbé Ras ◽  
Shabnam Abdoola ◽  
Jeannie Van der Linde

Background: Persons with stuttering (PWS) often present with other co-occurring conditions. The World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) proposes that it is important to understand the full burden of a health condition. A few studies have explored voice problems among PWS, and the characteristics of voices of PWS are relatively unknown. The importance of conducting future research has been emphasised.Objectives: This study aimed to describe the vocal characteristics of PWS.Method: Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI) and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study.Result: Only two participants (10%) obtained a positive Dysphonia Severity Index (DSI) score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18) scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia) of voice (35%), while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08) have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41).Conclusion: The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

2015 ◽  
Vol 20 (4) ◽  
pp. 3-8
Author(s):  
Malcolm Bond

Abstract This article begins with a consult of a patient using the International Classification of Functioning, Disability, and Health (ICF), published by the World Health Organization in 2001. The ICF framework serves as the conceptual model for the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition. In contrast to the issues of morbidity-centric documentation schemas, the ICF platform provides a standardized nomenclature to chart functioning, specifically an integrative biopsychosocial model of functioning that defines the components of functioning. The ICF qualifier serves as the titratable dimension of function; the qualifier not only satisfies the need for charting progress but also, when aggregated, provides the possibility of identifying the quantitative metrics of a cohort (eg, service needs, length of hospitalization, level of care, functional outcomes, and return-to-work potential). Implementing ICF into routine documentation moves practitioners toward the concept of functioning not as a consequence of disease but rather toward the real-life dynamics among health condition, body function, body structure, and environmental factors that determine functioning. ICF will be an essential basis for the standardization of data concerning all aspects of human functioning and disability around the world. ICF will be useful for persons with all forms of disabilities, not only for identifying health care and rehabilitative needs but also in identifying and measuring the effect of the physical and social environments.


2017 ◽  
Vol 5 (7) ◽  
pp. 374-389
Author(s):  
Wolfgang Seger ◽  
Sabine Grotkamp ◽  
Wolfgang Cibis

Motivation / Background: A broad and common understanding of the nature of Personal Factors is deemed to be necessary to gain and assess a comprehensive perspective regarding an individual’s health condition and accurately allocate social and medical benefits and interventions. Personal Factors have an impact on the functioning of individuals as facilitators or barriers. They play an essential role in the International Classification of Functioning, Disability and Health (ICF). To date, the World Health Organisation has not classified Personal Factors for global use. Method: A consensus group representing a broad spectrum of medical and social security professionals, research societies together with representatives of self-help organisations developed and published a proposal to classify relevant Personal Factors. Results: To face ongoing discussions misunderstandings are addressed, critics and suggestions balanced and positions created with pointed explanations and supplemented literature. Core messages summarise each position in a condensed form. Conclusions: Personal Factors may exert a powerful influence on the goal definition, goal achievement and type, complexity and length of necessary medical, social or rehabilitation benefits. Transparency, explicitness, fairness (standardisation) and the possibility for well-founded claims comprise additional arguments for reporting Personal Factors. They may be crucial to reach the goal of the highest degree of participation considering individual resources.


2008 ◽  
Vol 13 (1) ◽  
pp. 1-12
Author(s):  
Christopher R. Brigham ◽  
Robert D. Rondinelli ◽  
Elizabeth Genovese ◽  
Craig Uejo ◽  
Marjorie Eskay-Auerbach

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, was published in December 2007 and is the result of efforts to enhance the relevance of impairment ratings, improve internal consistency, promote precision, and simplify the rating process. The revision process was designed to address shortcomings and issues in previous editions and featured an open, well-defined, and tiered peer review process. The principles underlying the AMA Guides have not changed, but the sixth edition uses a modified conceptual framework based on the International Classification of Functioning, Disability, and Health (ICF), a comprehensive model of disablement developed by the World Health Organization. The ICF classifies domains that describe body functions and structures, activities, and participation; because an individual's functioning and disability occur in a context, the ICF includes a list of environmental factors to consider. The ICF classification uses five impairment classes that, in the sixth edition, were developed into diagnosis-based grids for each organ system. The grids use commonly accepted consensus-based criteria to classify most diagnoses into five classes of impairment severity (normal to very severe). A figure presents the structure of a typical diagnosis-based grid, which includes ranges of impairment ratings and greater clarity about choosing a discreet numerical value that reflects the impairment.


2014 ◽  
Vol 19 (5) ◽  
pp. 13-15
Author(s):  
Stephen L. Demeter

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.


2017 ◽  
Vol 41 (S1) ◽  
pp. S105-S105
Author(s):  
M. Barrios ◽  
G. Guilera ◽  
O. Pino ◽  
E. Rojo ◽  
S. Wright ◽  
...  

IntroductionIn 2001, the World Health Organization (WHO) created the International Classification of Functioning, Disability and Health (ICF) to offer a comprehensive and universally accepted framework to describe functioning, disability and health. The ICF Core Sets (ICF-CS) are a selection of categories that serve as a minimal standard for the assessment of functioning and disability in a specific health condition. The ICF-CS for schizophrenia was created in 2015 based on four preliminary studies that intend to capture different perspectives.ObjectivesThe aim of this study is to describe the similarities (i.e. overlap) and discrepancies (i.e. unique contribution) between the clinical, patient and expert perspectives on the most relevant problems in functioning of individuals with schizophrenia, being focused on the European WHO region.MethodsForty-four experts from 14 European countries participated in an expert survey, patients with schizophrenia were involved in four focus groups, and health professionals assessed 127 patients in relation to daily life functioning. Information gathered from these three preliminary studies was linked to the ICF.ResultsData showed that although a considerable number of second-level ICF categories agreed on the three preparatory studies (n = 54, 27.7%), each perspective provided a unique set of ICF categories. Specifically, experts reported 65 unique ICF categories, patients 23 and health professionals 11.ConclusionsEven though there were similarities between perspectives, each one underlined different areas of functioning, showing the importance of including different perspectives in order to get a complete view of functioning and disability in individuals with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Silvia Cozzi ◽  
Andrea Martinuzzi ◽  
Vincenzo Della Mea

Abstract Background The International Classification of Functioning, Disability and Health (ICF) is a classification of health and health-related states developed by the World Health Organization (WHO) to provide a standard and unified language to be used as a reference model for the description of health and health-related states. The concept of functioning on which ICF is based is that of a “dynamic interaction between a person’s health condition, environmental factors and personal factors”. This overall model has been translated into a classification covering all the main components of functioning. However, the practical use of ICF has highlighted some formal problems, mainly concerning conceptual clarity and ontological coherence. Methods In the present work, we propose an initial ontological formalization of ICF beyond its current status, focusing specifically on the interaction between activities and participation and environmental factors. The formalization has been based on ontology engineering methods to drive goal and scope definition, knowledge acquisition, selection of an upper ontology for mapping, conceptual model definition and evaluation, and finally representation using the Ontology Web Language (OWL). Results A conceptual model has been defined in a graphical language that included 202 entities, when possible mapped to the SUMO upper ontology. The conceptual model has been validated against 60 case studies from the literature, plus 6 ad-hoc case studies. The model has been then represented using OWL. Conclusions This formalization might provide the basis for a revision of the ICF classification in line with current efforts made by WHO on the International Classification of Diseases and on the International Classification of Health Interventions.


2010 ◽  
Vol 90 (11) ◽  
pp. 1660-1672 ◽  
Author(s):  
Doreen J. Bartlett ◽  
Lisa A. Chiarello ◽  
Sarah Westcott McCoy ◽  
Robert J. Palisano ◽  
Peter L. Rosenbaum ◽  
...  

This perspective article provides an example of a study planned using guidelines for comprehensive rehabilitation outcomes research, an approach that is believed to give service providers meaningful evidence to support practice. This line of investigation has been guided by the World Health Organization's International Classification of Functioning, Disability and Health. The short title of a study under way is Move & PLAY (Movement and Participation in Life Activities of Young Children). The article briefly describes the conceptual model, provides guidelines on how indicators and measures are selected, alludes to the details of selected measures, and describes processes of preparing for data collection, including obtaining ethics approval, preparing data collection booklets, training assessors and interviewers, and sampling. The aim of this investigation is to gain a better understanding of the multiple child, family, and service factors associated with changes in mobility, self-care, and play of preschool children with cerebral palsy as a result of using this research method. Comprehensive rehabilitation outcomes research holds promise in providing evidence that supports the complexities of planning rehabilitation services with clients with chronic conditions, such as children with cerebral palsy.


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