Development and validation of the ICF-CY-Based Functioning Scale of the Disability Evaluation System-Child Version in Taiwan

Background/Purpose: The International Classification of Functioning, Disability, and Health-Children and Youth version (ICF-CY) depicts human functioning [body functions (b), structures (s), and activities and participation (d) components] as the product of the interaction between health conditions and contextual factors [environmental factors (e) and personal factors]. In Taiwan, testers use the Functioning Scale of the Disability Evaluation System-Child version (FUNDES-Child) to collect information related to b, d, and e for children aged 6.0-17.9 years in the Disability Eligibility System (DES). The purpose of this study was to examine the content and construct validity of the FUNDES-Child. Methods: We developed the FUNDES-Child through translating the existing questionnaires, cross-cultural adaptation, expert consensus, and field tests. Consensus meetings were conducted to link items from the FUNDES-Child to ICF-CY codes. To investigate construct validity, we examined associations among scores from the FUNDES-Child that reflected ICF-CY chapter-linked components. Results: The FUNDES-Child items were successfully linked to all nine d-, five b-, and four e-chapters of the ICF-CY. Moderate correlations were found between scores that were expected to be related to specific chapters in the b, d, and e components. The scores of the b-chapters had stronger relationships with the d independence scores, while attitudes of others (e4) had stronger relationships with the d participation frequency scores. Conclusion: The FUNDES-Child had acceptable content validity and construct validity in the DES. The associations found among the ICF-CY chapter scores provided a model for investigating the impact of body functions and environmental factors on children's activities and participation.