Application of the international classification of functioning, disability, and health in autism and attention-deficit hyperactivity disorder: A scoping review

Abstract

The International Classification of Functioning, Disability, and Health is a biopsychosocial framework of health-related functioning designed to provide a unifying system for health care, social services, education, and policy sectors. Since its publication in 2001, the International Classification of Functioning has been used to guide clinical practice and research in autism and attention-deficit hyperactivity disorder. More recently, to promote its practical application, shorter versions of the International Classification of Functioning, known as Core Sets, have been developed for autism and attention-deficit hyperactivity disorder. This scoping review explored the application of the International Classification of Functioning and the International Classification of Functioning Core Sets in autism and attention-deficit hyperactivity disorder. Electronic database searches were conducted, resulting in 78 studies meeting the inclusion criteria. The results demonstrate a wide-ranging application of the International Classification of Functioning using different methods across various contexts. However, the majority of the research conducted focused on autism and primarily involved children. The review highlights that although the research implemented the International Classification of Functioning, it did not necessarily align with the underlying philosophy of the International Classification of Functioning framework, as the impact of the medical perspective still seems to influence research methodologies and interpretation. Nonetheless, the International Classification of Functioning presents opportunities to facilitate a shift from a strictly medical viewpoint on neurodevelopmental conditions to more comprehensive approaches. Lay abstract The International Classification of Functioning, Disability, and Health (ICF) is a framework designed by the World Health Organization (WHO) to help different sectors, such as healthcare, social services, education, and policy, understand how people with health-related issues function (do the things they want to and need to do) in their daily lives. This framework has also been used to guide clinical practice and research in autism and attention-deficit hyperactivity disorder (ADHD). To make it more practical, shorter versions of the ICF called Core Sets have been developed. We wanted to explore how the ICF and the ICF Core Sets have been used in research relating to autism and ADHD. We looked at the research that had been previously published on this topic by conducting a systematic search and review. Seventy-eight studies meeting our criteria were included in our review. Results show that the ICF has been applied in many ways across various contexts. However, most of the research has focused on autism, mainly involving children. The review highlights that although the ICF was used in some studies, the underlying philosophies of the framework were not always followed. The medical perspective still influenced the way research was done and interpreted. Nevertheless, using the ICF in the right way can help shift research on neurodevelopmental conditions like autism and ADHD toward a more holistic approach, moving away from solely focusing on medical aspects.