The influence of a person’s environment and its modifying potential on participation is well recognized for most childhood disabilities, but scarcely studied for adolescents with autism spectrum disorder (ASD). A scoping review was conducted, the aim of which was to map the existing literature about supporting and hindering environments for the participation of adolescents with ASD. Sources of scientific evidence were searched for in four databases. Inclusion criteria were the perspectives of adolescents between 12 and 21, families, peers, or significant others; ecologic validity; and a clear connection between environment and participation. The publication dates ranged from 2001 to 2014 and partly up to 2018. The International Classification of Functioning, Disability and Health (ICF) served as the guiding framework for inclusion/exclusion during the selection process. Thematic analysis was performed by five independent reviewers. Results were additionally validated by stakeholders. This scoping review identified 5528 articles, and finally included 31 studies. Two main themes were found: “providing security” indicates how the environment, and specifically the parental, physical, and informational environments, have a securing or intimidating effect. The second theme, “helping to connect”, indicates which environments support or hinder social relationships or social activities, and hence participation. An additional third main theme, “tension in participation”, relates to ambiguities that seem essential to understand participation or isolation of adolescents with ASD. Results show that participation is a value-laden concept. This research widens the field of dealing with adolescents with ASD, as it directs attention towards the responsibility of the environment regarding participation.
L2 pronunciation training should unequivocally be linked to complex daily life experiences (Derwing 2017). Each client comes from a different background, participates in a different environmental context and engages in different activities within those contexts (Threats 2008). This is a particularly challenging aspect in the L2 practice (Derwing 2017). The International Classification of Functioning, Disability and Health, also known as the ICF-Model (WHO 2001, 2013), offers a conceptual framework that acknowledges the intricate dimensions of human functioning and incorporates personal and contextual factors that can influence participation in daily live (Heerkens and de Beer 2007; Ma, Threats, and Worrall 2008). This paper provides an exploration of the application of this model to pronunciation and intelligibility difficulties in L2 learning. We apply the model to a specific L2 learner, Mahmout and demonstrate how its use allows for consideration of factors much broader than the phonological or phonetic challenges Mahmout faces. Mahmout must be able to generalize that what he has learned into functional communicative competences to improve his participation. The ICF-model (WHO 2001, 2013) is used globally in a broad array of healthcare professions, including Speech and Language Therapists (SLT’s). Yet, it is not a customary tool, nor probably an obvious one, used by L2-professionals (Blake and McLeod 2019). Of course, our goal is not to classify pronunciation problems of L2 learners as disabilities. The model proves a useful tool to view the individual L2 learner as a whole, and part of a larger system. It may allow L2 professionals to tailor their intervention to the individual’s needs and situation and will consequently be able to establish priorities in instruction to enable appropriate goal setting for each individual (Blake and McLeod 2019). It allows identification of influencing barriers or facilitating factors within the stagnation or improvement of pronunciation (Blake and McLeod 2019; Howe 2008).
Background: A hematopoietic stem cell transplantation (HSCT) has a major impact on the functioning and perceived quality of life of patients. To describe the functioning of patients, a preliminary set of 53 categories of the International Classification of Functioning, Disability and Health (ICF) as relevant for HSCT patients has been selected earlier by a Delphi study. For the implementation of this preliminary ICF core set for patients after HSCT in clinical practice, a feasibility study was requested.Methods: A feasibility study was conducted in an explanatory mixed-methods research design. Qualitative data were collected cross-sectionally by semi-structured interviews based on specific topics related to feasibility regarding the use of the preliminary ICF core set for HSCT patients from the perspective of nurses (five in ICF-trained nurses and five regular, untrained, nurses). Quantitative data, were collected longitudinally by using a mobile health application based on ICF in which the ICF trained nurses registered HSCT patients ' functioning.Results: Qualitative analysis indicated that using the preliminary ICF core set is practical and acceptable for providing information about the functioning of HSCT patients from the perspective of nurses. In addition, nurses indicated a demand for this information due to its impact on multidisciplinary meetings and clinical decision-making by involving relevant aspects of the functioning of patients. Management support, trained staff, and designated time to focus on functioning are mentioned as requirements for successful implementation. Quantitative analysis demonstrated that the most used 30% (n = 17) ICF categories are included in the preliminary ICF core set for HSCT patients (n = 24). Energy (b130) was the most used ICF category. Family relationships (d760) was the most frequently and highly positively associated ICF category.Conclusions: From the perspective of nurses, the preliminary ICF core set for HSCT patients is feasible and relevant in gaining information regarding functioning. Applying this preliminary ICF core set for HSCT patients in the anamnesis and the nursing consultations contributes to this information. Further research is needed to look at the perspective of other professionals and HSCT patients themselves.
MULTIFILE
