Linking the Esdm Curriculum Checklist for Young Children with Autism to the ICF-CY Who Comprehensive Classification System

Background: Children with Autism Spectrum Disorders are characterized by divers patterns of behavior and level of performance. Such variability translate into different intervention needs that makes planning of individualized intervention programs challenging. Curriculum driven tools that guide decision-making process for intervention goals should rely on critical variables that promote a broad range of children's life skills, that are developmental appropriate and include information on the environmental support (Wilczynski et al., 2017). Approaches to evaluate the quality of curriculum based intervention tools in addressing developmental and educational process in children with autism are lacking. The International Classification of Functioning, Disability and Health version for Children and Youth (ICF-CY, WHO, 2007) may offer a framework by which to approach teaching goals of autism intervention curricula.

Objectives: The aim of the research is to document the utility of linking the Early Start Denver Model Curriculum Checklist (Rogers & Dawson, 2010) to the codes of the ICF-CY.

Methods: The ESDM curriculum checklist is a tool for designing teaching objectives for intervention in children with autism spectrum disorders until ages 4-5 and is divided into logical teaching sequences covering broadly nine developmental domains with a total of 446 items. The ICF-CY provides a classification of functioning and disability form both and individual and societal perspective on Body Functions, Activities and Participation, and Environmental Factors. Deductive content analysis was used to make inferences from textual data. The process of analysis has followed a set of sequential steps using the linking rules (Cieza et al., 2005) on the identification of meaningful concepts. Two independent researchers linked the ESDM curriculum items with the full ICF-CY set. Inter-rater agreement was calculated using Kappa Coefficient. Once final coding of ESDM items was achieved, the derived code set as compared for completeness to a code set of meaningful concepts specifically for autism (Castro & Pinto, 2012; Pinto et al., 2013; Boelte et al., 2016) and developmental core sets for 0-2 and 3-5 years (Ellingsen & Simonsson, 2011), corresponding to the relative age range of the ESDM curriculum.

Results: The ESDM curriculum checklist is addressing mostly the Activities and Participation component of the ICF-CY, focussing essentially on directly observed performance of skills. The Environmental Factors component in which the child is embedded is not addressed, missing inferential characteristics that may be related with limited participation and performance. While the ESDM curriculum checklist covers broadly the developmental core sets, some aspects of meaningful concepts of code sets for children with autism are missing.

Conclusions: The present research document the ICF-CY Environmental Factors component as a supporting tool to improve the intervention goal-setting process in programs for young children with autism. Results may be suggestive of the difficulty in finding a balanced, feel-grounded approach on how to describe disability in pre-school children with autism from a developmental perspective and to address essential aspects of learning and participation for young children with autism in curriculum tools guiding intervention planning.