Evaluating rehabilitation goals of visually impaired children in multidisciplinary care according to ICF-CY guidelines.

Purpose: To gain qualitative insight into the rehabilitation goals of visually impaired children and how these goals relate to the structure of the International Classification of Functioning, Disability and Health (ICF) and patient characteristics.
Methods: A patient record study was conducted, analysing rehabilitation goals and characteristics of children with a suspected visual impairment in the Netherlands (<18 years) who applied for multidisciplinary services in 2012 (N = 289). Chi-square analyses for trend in rehabilitation content across age bands and additional analyses were performed.
Results: The three most common diagnoses were nystagmus (21.2%), cerebral visual impairment (16.2%) and albinism (6.1%). Rehabilitation goals for children aged <7 years were mostly aimed at 'physical (visual) functioning' (36.7%) and 'environmental factors' (36.7%). For children ≥7 years, significantly more goals were identified on activity and participation (A&P) domains (52.2%). Three A and P domains presented a significant linear trend on the number of rehabilitation goals across age bands: (1) 'Learning and applying knowledge' (13.042, p < 0.001), (4) 'Mobility' (31.340, p < 0.001) and (8) 'Major life areas' (5.925, p = 0.015). Regression analysis showed that both age and visual acuity significantly contributed to the number of A and P goals.
Conclusion: Although analyses were based on a selection of patient records, the number and nature of rehabilitation goals differ significantly with age. Many A and P goals seem underrepresented at the intake procedure, for example: communication, peer interaction and participating in leisure activities. A systematic, standardized procedure is required to catalogue all existing goals and to be able to evaluate progress and potential new or other important goals.
(© 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)