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The scales of the suggested qualifiers, including the generic or uniform qualifier, require calibration with existing measures and assessment tools, and more description as to rating. Many existing assessment tools are in use and are firmly embedded in measurement and even payment methods in services around Australia.
In Australia some calibration and mapping has already been undertaken in the disability services field (see the CSTDA NMDS module in Section 10.1). It would be of benefit if it were undertaken in other new developments including aged care 'dependency' measures and health status measurement, as well as in assuring continuing alignment of disability population surveys with the new ICF.4 Such work will enable final data elements in the NCSDD V3 to be fully useable in the range of applications to which the new classification should be applied.
The challenge then is how to use the classification in a consistent way when much work remains to be done on qualifiers, i.e. measurement. In 1999 a range of measurement issues that needed consideration in the ICF were suggested (Madden 1999), including:
the need to clarify purpose before deciding method
the importance of understanding the role played by 'perception' in measurement (i.e. who measures - sometimes oversimplified as a distinction between 'objective' and 'subjective') and, related to this point,
the vital role played by people with disabilities in the ICF revision.
Testing and development
WHO envisages that, in the early period of ICF implementation, users will wish to experiment with the different approaches suggested in the classification. During the early implementation period of the new ICF in Australia, it will be fruitful to promote testing and development within broad spheres of application and to record and share experience. This would allow the ICF to be more widely explored and reported on for a period, as users in various application areas come to grips with it.
Current work in Australia includes:
developing and discussing the draft data elements for the NCSDD V3 (see Section 7)
continuing work on the types of developments outlined in this User Guide - this will involve having regard to national and international consistency, using the best available tools, and avoiding 'premature closure', i.e. recommending Australian solutions that do not suit all Australian applications
encouraging potential users to undertake discussion and development, and to refer to and contribute to this User Guide
engaging in discussion of health applications
organising further consultation within Australia and staying involved in the international communication.
4 The Australian Bureau of Statistics Survey of Disability, Ageing and Carers is now undertaken at 6-yearly intervals. Since the first survey in 1981, it has been reasonably well aligned with some ICF (and previously ICIDH) concepts.
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