0~3岁发育障碍婴幼儿早期家庭教育与康复：基于ICF的目标设置与服务体系研究

doi:10.3969/j.issn.1006-9771.2025.06.003

Abstract

Abstract:

Objective To construct a theoretical framework for early home-based education and rehabilitation for infants and toddlers with developmental disabilities, using the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF).

Methods On the base of integrating ecosystem theory, neuroplasticity theory, family systems theory and rehabilitation concept of World Health Organization, a home-based education and rehabilitation system encompassing biological, psychological, social and policy dimensions was developed.

Results Within the ICF framework, it was set the operational intervention goals for infants and toddlers in dimensions of motor, language, cognition, emotion and social interaction, while personalized goals were formulated in consideration of different types of developmental disabilities. Furthermore, a home-based education and rehabilitation system was designed, including early screening and assessment, development of personalized intervention plans, home-based education and rehabilitation training, continuous monitoring and adjustment, digital empowerment and remote guidance, as well as disability prevention, and early education and rehabilitation. It involved five stages: needs assessment, plan development, plan implementation, dynamic assessment and feedback, and summary and referral.

Conclusion This study has constructed a five-stage process, providing an effective framework for the comprehensive rehabilitation of infants and toddlers. ICF framework provides both theoretical and practical guidance for early intervention in infants and toddlers with developmental disabilities.

Key words: infants and toddlers, developmental disability, early, home-based education, rehabilitation, International Classification of Functioning, Disability and Health

CLC Number:

R197

ZHU Chenchen, LIAO Sisi, PAN Jianming, XIA Bihua, HONG Ningjie. Early home-based education and rehabilitation for infants and toddlers with developmental disabilities: construction of goal and service system using ICF[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 635-641.

Figures/Tables 2

Table 1

Table 2

References 28

[1]	BISHOP D V M, SNOWLING M J, THOMPSON P A, et al. Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: terminology[J]. J Child Psychol Psychiatry, 2017, 58(10): 1068-1080. doi: 10.1111/jcpp.12721 pmid: 28369935
[2]	ZWAIGENBAUM L, BAUMAN M L, STONE W L, et al. Early identification of autism spectrum disorder: recommendations for practice and research[J]. Pediatrics, 2015, 136(Suppl 1): S10-S40.
[3]	PLATT J M, KEYES K M, MCLAUGHLIN K A, et al. Intellectual disability and mental disorders in a US population representative sample of adolescents[J]. Psychol Med, 2019, 49(6): 952-961. doi: 10.1017/S0033291718001605 pmid: 29996960
[4]	HYMAN S L, LEVY S E, MYERS S M. Identification, evaluation, and management of children with autism spectrum disorder[J]. Pediatrics, 2020, 145(1): e20193447.
[5]	WADE M, MCLAUGHLIN K A, BUZZELL G A, et al. Family-based care buffers the stress sensitizing effect of early deprivation on executive functioning difficulties in adolescence[J]. Child Dev, 2023, 94(1): e43-e56.
[6]	STUCKI G, CIEZA A, MELVIN J. The International Classification of Functioning, Disability and Health (ICF): a unifying model for the conceptual description of the rehabilitation strategy[J]. J Rehabil Med, 2007, 39(4): 279-285. doi: 10.2340/16501977-0041 pmid: 17468799
[7]	姜静远, 邱卓英, 王国祥, 等. 世界卫生组织国际健康分类家族在康复中系统应用的方案与路线图[J]. 中国康复理论与实践, 2020, 26(11): 1241-1255. doi: 10.3969/j.issn.1006-9771.2020.11.001
	JIANG J Y, QIU Z Y, WANG G X, et al. Systematic implementation of World Health Organization Family International Classifications in rehabilitation: protocol and roadmap[J]. Chin J Rehabil Theory Pract, 2020, 26(11): 1241-1255.
[8]	邱卓英, 李伦, 陈迪, 等. 基于世界卫生组织国际健康分类家族康复指南研究:理论架构和方法体系[J]. 中国康复理论与实践, 2020, 26(2): 125-135. doi: 10.3969/j.issn.1006-9771.2020.02.001
	QIU Z Y, LI L, CHEN D, et al. Research on rehabilitation guidelines using World Health Organization Family International Classifications: framework and approaches[J]. Chin J Rehabil Theory Pract, 2020, 26(2): 125-135.
[9]	杨亚茹, 郝传萍. 基于ICF构建智力残疾儿童适应性体育课程体系[J]. 中国康复理论与实践, 2022, 28(6): 659-669. doi: 10.3969/j.issn.1006-9771.2022.06.006
	YANG Y R, HAO C P. Construction of adapted physical education curriculum for children with intellectual disabilities using ICF[J]. Chin J Rehabil Theory Pract, 2022, 28(6): 659-669.
[10]	杨同念, 肖辉. 残疾儿童青少年身体活动及其健康效果:系统综述的系统综述[J]. 中国康复理论与实践, 2022, 28(11): 1299-1308. doi: 10.3969/j.issn.1006-9771.2022.11.009
	YANG T N, XIAO H. Physical activity and its health benefits for children and adolescents with disabilities: a systematic review of systematic reviews[J]. Chin J Rehabil Theory Pract, 2022, 28(11): 1299-1308.
[11]	RICHTER L, BLACK M, BRITTO P, et al. Early childhood development: an imperative for action and measurement at scale[J]. BMJ Glob Health, 2019, 4(Suppl 4): e001302.
[12]	周静, 易玲, 陈建超, 等. 基于ICF的听力障碍儿童言语与语言康复服务:理论架构与服务体系[J]. 中国康复理论与实践, 2024, 30(7): 745-751. doi: 10.3969/j.issn.1006-9771.2024.07.001
	ZHOU J, YI L, CHEN J C, et al. Speech and language rehabilitation services for children with hearing impairment based on ICF: theoretical framework and service system[J]. Chin J Rehabil Theory Pract, 2024, 30(7): 745-751.
[13]	ALHARBI M, DU H, HARRIS D, et al. Evaluating the impact of virtual reality game training on upper limb motor performance in children and adolescents with developmental coordination disorder: a scoping review using the ICF framework[J]. J Neuroeng Rehabil, 2024, 21(1): 95.
[14]	SCHMUTZ E A, LEEGER-ASCHMANN C S, KAKEBEEKE T H, et al. Motor competence and physical activity in early childhood: stability and relationship[J]. Front Public Health, 2020, 8(3): 39.
[15]	LIDBECK C, HÄBEL H, MARTINSSON C, et al. Motor development in children with cerebral palsy in Sweden: a population-based longitudinal register study[J]. Children (Basel), 2023, 10(12): 1864.
[16]	CAMARATA S. Early identification and early intervention in autism spectrum disorders: accurate and effective?[J]. Int J Speech Lang Pathol, 2014, 16(1): 1-10. doi: 10.3109/17549507.2013.858773 pmid: 24410017
[17]	DURGUNGOZ F C, ST CLAIR M C. Enhancing parental understanding of emotions in children with developmental language disorder: an online parent-led intervention program[J]. Healthcare (Basel), 2024, 12(16): 1571.
[18]	OPIE J E, MCINTOSH J E, ESLER T B, et al. Early childhood attachment stability and change: a meta-analysis[J]. Attach Hum Dev, 2021, 23(6): 897-930.
[19]	FROSCH C A, SCHOPPE-SULLIVAN S J, O'BANION D D. Parenting and child development: a relational health perspective[J]. Am J Lifestyle Med, 2021, 15(1): 45-59.
[20]	GURALNICK M J. Early intervention for children with intellectual disabilities: an update[J]. J Appl Res Intell Disabil, 2017, 30(2): 211-229.
[21]	DATE S, MUNN E, FREY G C. Postural balance control interventions in autism spectrum disorder (ASD): a systematic review[J]. Gait Posture, 2024, 109: 170-182. doi: 10.1016/j.gaitpost.2024.01.034 pmid: 38320424
[22]	ROWE M L. Environmental influences on early language and literacy development: social policy and educational implications[J]. Adv Child Dev Behav, 2022, 63: 103-127. doi: 10.1016/bs.acdb.2022.04.001 pmid: 35871819
[23]	World Health Organization. Integrated people-centred ear and hearing care: policy brief[M]. Geneva: World Health Organization, 2021.
[24]	TAMIS-LEMONDA C, KUCHIRKO Y, SONG L. Why is infant language learning facilitated by parental responsiveness?[J]. Cur Direct Psychol Sci, 2014, 23(4): 121-126.
[25]	LILLO-MARTIN D C, GALE E, PICHLER D C. Family ASL: an early start to equitable education for deaf children[J]. Topics Early Child Spec Educ, 2023, 43(2): 156-166.
[26]	CHADHA S, KAMENOV K, CIEZA A. Health system requirements for hearing care services[J]. Bull World Health Organ, 2019, 97(10): 647-647A.
[27]	SINGH A, YEH C J, BOONE BLANCHARD S. Ages and Stages Questionnaire: a global screening scale[J]. Bol Med Hosp Infant Mex, 2017, 74(1): 5-12. doi: S1665-1146(17)30010-2 pmid: 29364814
[28]	ISLAM M Z, JOHNSTON J, SLY P D. Green space and early childhood development: a systematic review[J]. Rev Environ Health, 2020, 35(2): 189-200. doi: 10.1515/reveh-2019-0046 pmid: 32167931

类别	描述	设置方法	个性化目标
运动发育	改善肌张力，提升粗大运动和精细运动技能，增强平衡和协调能力	使用贝利量表和家庭观察记录；设定短期和长期阶段性训练目标	轻度运动发育迟缓侧重基础运动训练；重度运动障碍强化协调训练^[14-15]
语言与认知	提高语言理解和表达能力，促进注意力、记忆和思维发展	使用格林斯潘筛查表、家庭语言观察记录；制定阶段性语言和认知目标	孤独症谱系障碍侧重非言语交流和情景对话；言语障碍侧重发音和词汇积累^[16]
情感与社交	建立安全依恋，增强情绪调控和社交互动能力	应用亲子关系量表和情感表达记录；设定情绪识别和社交互动训练目标	情绪不稳定者侧重情绪调控训练；社交障碍者侧重社交技能训练^[17-18]
家庭干预能力	提升家长干预知识和操作技能，优化家庭康复环境	组织系统家长培训；家长自评和知识考核；制定家庭干预操作指南	根据家长初始水平，初级培训与进阶培训相结合，提供个性化学习模块^[19]
残疾预防	降低长期残疾风险，通过早期干预实现功能改善和持续康复	定期筛查和评估；建立转介和跟踪机制；动态调整干预方案	重度发育迟缓侧重高频干预和转介；轻度障碍侧重维持正常发展轨迹^[20]

领域	目标	主要策略	关键措施
早期筛查与评估	早期发现发育异常，全面掌握婴幼儿发展状况	使用标准化评估工具结合家庭观察，建立家庭评估档案	贝利量表、格林斯潘筛查、家庭问卷调查、数字记录与定期评估
个性化干预方案制定	针对个体差异制定科学干预方案，确保干预精准有效	家长与专家联合制定方案，依据评估数据确定干预目标和计划	家庭-专家联合会诊、个性化训练计划、阶段性目标设定与反馈
家庭教育与康复训练	在家庭环境中促进运动、语言、认知、情感和社交功能的全面提升	利用亲子互动、感觉刺激、运动训练和情境教学进行综合康复	亲子游戏、角色扮演、情境模拟、日常活动干预、康复工具包使用
持续监控与调整	动态跟踪干预效果，及时调整干预策略，确保干预持续适应婴幼儿发展	家长定期记录观察，利用简易评估工具反馈干预效果，与专家讨论并调整方案	家庭观察记录、定期自评、远程或现场反馈会议、数据动态监控
数字赋能与远程指导	实现实时数据共享与远程指导，提升干预个性化和灵活性	建立数字平台，支持远程视频咨询、在线培训和资源共享	数字平台建设、远程互动系统、在线家长论坛和资源库建设
残疾预防与早期教育和康复	降低长期残疾风险，实现婴幼儿功能综合改善	建立早期筛查、转介和持续跟踪机制，结合家庭干预预防发育障碍加剧	定期家庭和社区筛查、转介机制、预防性干预措施、持续跟踪与评估

Early home-based education and rehabilitation for infants and toddlers with developmental disabilities: construction of goal and service system using ICF

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 2

References 28

Related Articles 15

Metrics

Comments

Recommended 0

[1]	CAO Jing, LIU Jing, ZHANG Xiaoyan, GAO Shaoyu. Construction of competency evaluation indicator system for special education teachers based on World Health Organization rehabilitation competency framework [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 621-627.
[2]	GU Yiqing, CHENG Shupeng, LI Yongqiang, MAO Erli, LI Jian'an. Capping versus non-capping decannulation strategy in adult tracheostomized patients: a systematic review [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 666-673.
[3]	LIU Xuan, GAO Ling, CHU Fengming, CHEN Jie, ZHANG Ming. Effect of brain-computer interface combined with upper limb rehabilitation robot on upper limb function of stroke patients [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(6): 703-710.
[4]	YI Ling, ZHOU Jing, LIANG Yongsheng, CHEN Xuefen, CAO Yanjing. Developing on-campus training bases for speech and hearing rehabilitation programs in higher vocational colleges [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 529-538.
[5]	WU Aihong, ZHANG Qing, WU Jiaming, XIE Junxia, WU Dang. Construction of a competency-based and functioning-oriented training curriculum system for inclusive education teachers in primary and secondary schools [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 539-547.
[6]	ZENG Bin, GUO Shuang, YE Haiyan, YE Jinqun, XU Zihan, XU Guangqing, ZHANG Lei. Investigation for research competency of undergraduate interns in rehabilitation therapy using WHO rehabilitation competency framework [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 548-552.
[7]	LAI Haifang, LIU Benhui, CUI Lijun, HUA Longang, XIE Qing. Application of transcranial magnetic stimulation in rehabilitation field: a bibliometric analysis from 2014 to 2024 [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 581-591.
[8]	ZHANG Xiaoyan, CAO Jing, QIU Zhuoying, YAN Zixue, CHEN Yanke. Characteristics of adaptive behavior in children with intellectual and developmental disabilities [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(5): 592-600.
[9]	ZHANG Qing, WU Jiaming, JIA Wenrong, YU Fayou. Competency framework and contents for primary and secondary school teachers in inclusive education settings based on RCF and ICF [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 406-414.
[10]	GUAN Shan, SUN Meili, GUAN Yi, XUE Yifan, ZHONG Yuliang⁴, LI Xinqin. Developing a curriculum framework for vocational competency in college students with disabilities: based on RCF and ICF [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 415-422.
[11]	ZHU Haifeng, QIAN Guifeng, DAN Yuqin, GAO Jingchun, TANG Tingting, HUO Ming, XIE Shaodong. Ultrasound-guided sacral canal injection of Neurotropin and comprehensive rehabilitation for the aftermath of severe sacral plexus injury: a case report [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 476-483.
[12]	LI Fan, LIN Keyu, XIAO Yongtao. Relationship between metaphor comprehension and theory of mind in children with autism spectrum disorder [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 484-489.
[13]	SHEN Junfan, GENG Ayan, HU Wenxuan, KAN Chaojie, WANG Tong, GUO Chuan. Application of corticomuscular coherence in the field of rehabilitation medicine: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(3): 274-286.
[14]	ZHU Chenchen, LIAO Sisi, LIU Yue, PAN Jianming, ZHU Zhulin, XIA Bihua, XIE Ying. Policy framework and support systems for early family education and rehabilitation for infants and toddlers with developmental impairments [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(3): 324-330.
[15]	CHEN Yuanyue, ZHU Jun, HU Jingjun, GUO Chuan, ZHU Lan. Intervention and duration of work-related injury rehabilitation, and related factors [J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(3): 348-355.