Code Set

Using ICF-CY for Planning Educational Goals for AAC Students

We present the The Communication Supports Inventory- Children & Youth (CSI-CY), a field-tested code set which provides content and guidance to professionals for the development of AAC-related IEP goals. A code set based on ICF-CY items is "a reduced item classification set that defines standard minimum content areas to document child functioning by developmental age group" (Ellingsen and Simeonsson, 2011). This contrasts with the Uniform Core Sets that have been developed to describe specific diseases and conditions, such as spinal cord injury (Cieza et al., 2010), traumatic brain injury (Bernabeu et al., 2009), multiple sclerosis (Khan and Pallant, 2007), and stroke (Geyh et al., 2004).

We chose to preserve the functional emphasis of the ICF-CY to describe a functional condition (complex communication needs) that is independent of the myriad of diseases or disorders that might be associated with that condition. Table 1 offers an overview of the contents of each section. Table 2 contains all of the individual items in the code set. We include the ICF-CY code numbers (ie., d880) for reference to the original ICF-CY items upon which we based our Inventory items.

Table 1: List of the sections of the CSI-CY, with a brief description of each subsection.

RESTRICTIONS IN PARTICIPATION CAUSED BY COMMUNICATION LIMITATIONS

SCHOOL RELATED ACTIVITIES

This section lists a wide variety of activities that happen during the school day or after the school day in which the student may potentially partake and may have difficulty participating due to communication restrictions. This includes activities in the community that are part of a vocational training or transition program. This section is used to emphasize that instruction is not occurring in a pull-out model.

INTERPERSONAL INTERACTION AND RELATIONSHIPS

This section considers whether the student has difficulty with a specific type of relationships or communication partner due to communication restrictions.  This section does not include specific skills found in Functions of Communication or Rules of Social Interaction. It addresses relationships, as opposed to specific social or communication skills.

COMMUNICATION LIMITATIONS

RECEPTIVE Language and Literacy

The student’s activities related to comprehension of typical spoken and written language. This includes reading, decoding, sight words. Reading skills are not covered under AAC Receptive.

EXPRESSIVE Language and Literacy

The student’s activities related to typical speaking and writing language (as opposed to expression using AAC). This section does not include oral motor skills, articulation, quality of voice and speech production, which are located in the Body Function section. This section also includes all writing skills (whether using AAC or not). Writing skills are not covered under AAC Expressive.

FUNCTIONS OF COMMUNICATION

The student’s reasons for communicating, the purposes for communicating or specific communicative intents (includes refusing/rejecting, requesting, gaining/directing attention, social conventions, exchanging information, telling someone to do something, and conveying an abstract idea).

RULES OF SOCIAL INTERACTION IN CONVERSATION

The skills needed to have a conversation.  These are the discreet skills needed to initiate, sustain, modulate and end a conversation.

AUGMENTATIVE AND ALTERNATIVE COMMUNICATION: RECEPTIVE STRATEGIES

The skills involved in understanding the symbol system of a particular AAC system.

AUGMENTATIVE AND ALTERNATIVE COMMUNICATION:  EXPRESSIVE MODES AND STRATEGIES

The skills involved in using a particular AAC system to express thoughts and ideas.    

AUGMENTATIVE AND ALTERNATIVE COMMUNICATION: MOTOR ACCESS

The skills that are needed or may be needed to physically operate a particular AAC system.

IMPAIRMENTS IN BODY FUNCTIONS THAT LIMIT COMMUNICATION

(NO SUBSECTIONS)

This section broadly addresses those physical functions that are needed to communicate, including hearing, vision, oral motor, sensory, respiratory, intellectual and motor functions. Articulation, Speech Production, Hearing (including sound discrimination).

ENVIRONMENTAL FACTORS THAT SERVE AS BARRIERS OR FACILITATORS FOR COMMUNICATION

PHYSICAL ENVIRONMENT

Those factors in the physical space that may help or hinder the student’s communication.

ASSISTIVE TECHNOLOGY

The products and technology for AAC in the student’s environment that help or hinder communication.

PEOPLE

The type of support that the people in the student’s environment provide for communication (physical, emotional or knowledge base).

SERVICES AND POLICIES

Those services or policies that are in the environment that help or hinder the student’s communication by their presence or absence.

Table 2: The CSI-CY Code Set:  The first column lists the inventory items as they appear on the CSI-CY. The second column provides the code(s) for the ICF-CY items upon which the Inventory items are based.

Restrictions in Participation Caused by Communication Limitations
School Related Activities
Play as an educational activity d880
Classroom activities (attending classes and interacting appropriately to fulfill the duties of being a student) d8201
Communal activities (classroom games, assemblies, eating in the cafeteria, field trips) d550, d2203
Recreation (physical education, recess, playground games) d5701, d9200, d9201
Creative activities (art classes, orchestra/band, chorus) d9202
Civic activities (school paper, student government, school club, serving as student aid, safety patrol member) d835
Other academic activities (computer labs, science labs, library use, gifted/talented classes) d3601
Social activities (school dances, pep rallies, hanging out with friends at school) d9205, d9100
Social independence activities (driver's ed., home economics/shop, after school organized sports) d475, d9201
Vocational training (community work experience, community college, community based recreation) d825
Transition planning (independent living skills practicum, transportation training) d6108, d570
Looking after one's safety at school (avoiding risks that can lead to injury or harm) d571
Maintaining one's health (caring for oneself by being aware of and doing what is required for one's health) d5702
Interpersonal Interaction and Relationships
Relating to teachers, and other adults at school. d7400
Relating with peers at school d750
Making and maintaining friends d7500
Dating or romantic relationships d7700
Relating to persons in the home (family or other co-inhabitants) d760

Relating to a new people 

d730
Communication Limitations
RECEPTIVE Language and Literacy
Intentionally attending to human touch, face and/or voice d1600
Comprehending the meaning of single spoken words d3100
Comprehending the meaning of 2-3 spoken word phrases d3101
Comprehending the meaning of spoken sentences d3102
Comprehending the meaning of a spoken narrative d3102
Understanding sound/symbol relationships (sounding out letters) d1401
Comprehending the meaning of single written words d325, d1660
Comprehending the meaning of written sentences d325, d1661
Comprehending the meaning of a written narrative d325, d1661
EXPRESSIVE Language and Literacy
Using body language, facial expressions and gestures to communicate d3350
Using non-speech vocalizations for communication (e.g., laughing, cooing, "hmmm") d331
Using single spoken words to communicate (includes word approximations) d1330, d330
Combining spoken words into 2-3 word phrases d1331, d330
Using sentences with appropriate syntax in spoken communication d1332, d330
Combining sentences to convey a cohesive topic in spoken communication d1332
Choosing correct spoken and/or written words d1330
Demonstrating knowledge of sound/symbol relationships (writing a letter for a given sound) d1451
Using single written words to communicate d1700
Using written sentences to communicate d325, d1702
Using a written narrative to communicate d325, d1702
Using correct spelling conventions d345, d1701
Functions of Communication
Refusing or rejecting something d3501
Gaining the attention of another person d3500
Requesting more d3501
Requesting something specific d3501
Directing another person's attention d3501
Using social conventions (e.g., hello, good-bye, polite forms of address, please and thank you) d3500
Exchanging information (e.g., asking, answering, naming, or commenting) d3501
Telling someone to do something d3503
Conveying an abstract idea d3501
Rules of Social Interaction in Conversation
Orienting towards communication partner through eye contact or body positioning d3350
Making and responding to physical contact appropriately d7105
Keeping socially appropriate distance between oneself and others d7105
Adjusting language according to one's social role when interacting with others (e.g., "what's up?" to a friend versus "How are you, sir?" to an authority figure) d7203
Starting a conversation appropriately d3500
Sustaining a conversation appropriately d3501
Revising conversation or repairing breakdowns during interaction appropriately (e.g., able to repeat, restate, explain so as to successfully communicate) d3501
Ending a conversation appropriately d3502
Conversing in a group d3504
Augmentative and Alternative Communication: Receptive Strategies
Comprehending the meaning of body gestures (facial expressions, posture, hand gestures or movements) d3150
Comprehending 3-dimensional objects/representations used to communicate d3150
Comprehending the meaning of drawings and photographs used to communicate d3152
Comprehending the meaning of manual sign language (e.g., ASL, finger spelling, signed English, etc.) b16702
Comprehending the meaning of single AAC signs/symbols (e.g., MinSpeak icons, Blissymbols, Rebus symbols, Picture Communication Symbols, etc.) d3152, d325
Augmentative and Alternative Communication: Expressive Modes and Strategies
Using 3-dimensional objects/representations to communicate d3352
Using drawings, pictures or photographs to communicate d3552
Using manual sign language to communicate d340
Using Braille to communicate d3602
Using communication devices and technologies d360
Using single AAC signs/symbols to communicate. d1330
Combining AAC signs/symbols to communicate d1331, d3351
Conveying a cohesive topic with AAC signs/symbols d1332
Operating communication device correctly (e.g., on/off, volume, speed of scanning, rate enhancement, etc.) d3608
Knowing how to access needed vocabulary d3608
Changing communication strategies depending on social and physical environment (dependent on partner feedback and skills; background noise, etc.) d369
Giving partner instructions when necessary d369
Expressing the need for additional vocabulary d3501
Augmentative and Alternative Communication: Motor Access
Control of involuntary movements that may interfere with communication such as tremors, tics, stereotypies, motor perseveration, or mannerisms. b755
Maintaining a body position as needed for communication purposes (including head control). b7355, d4158
Control of gross motor skills (upper and lower extremities) needed to use a communication device or materials (e.g., carrying, pushing, pulling, kicking, turning or twisting) b760
Control of fine motor skills needed to use gestures, manual signs or a specific device to communicate (e.g., grasping, manipulating, picking up and releasing). b760
Using eye gaze for message selection b215
Impairments in Body Functions that Limit Communication
Hearing function b230
Vision function b210
Touch functions (e.g., ability to sense surfaces, their texture or quality; includes numbness, anesthesia, or tingling) b265
Oral motor function adequate for intelligible speech, including articulation, fluency, resonance, and rate of speech b3101, b320, b330, b3301, b3303, b3302
Respiratory function b440
Intellectual functions b117, b164
General gross and fine motor functions b789
Environmental Factors that Serve as Barriers or Facilitators for Communication
Physical Environment
Sound intensity and/or sound quality e2500, e2501
Light intensity or quality e2400, e2401
Arrangement of physical space e299
Level of surrounding activity e215, e298
Assistive Technology
Adapted or specially designed HIGH tech products/technology developed for the purpose of improving communication (e.g., speech generating device, FM system, specialized writing device) e1251
Adapted or specially designed LOW tech products/technology developed for the purpose of improving communication (e.g., systems that have no electricity/battery requirement, such as picture communication board) e1251
General products and technology for communication (e.g., computers, telephones, or other equipment used by the general public) e1250
Assistive products and technology for education (for acquisition of knowledge, expertise or skills) e1301
Assistive products and technology for mobility and transportation e1201
Assistive products and technology for generalized use in school (e.g., prosthetic and orthotic devices, glasses , hearing aids, cochlear implants, etc.) e1151
People
Providing physical support at school (e.g., supporting body posture appropriately, making glasses available) e325
Providing emotional support at school e325
Knowledge of skills needed to support communication in school (e.g., knowing manual sign language, knowing how to use the communication device, etc.) e325
Providing physical support at home e310
Providing emotional support at home e310
Knowledge of skills needed to support communication at home (e.g., knowing manual sign language, knowing how to use the communication device, etc.) e310
Services and Policies
Special education services (includes therapy and providers of services) e5853
Regular education services e5850
School transportation services e5400
School food services e1100
School social services e5750
Before and after school care services e57502
School-based health services e5800
Special education policies (e.g., school and/or family responsibility for purchasing and maintaining AAC equipment)

e5855, e1650 


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