ObjectiveTo develop a novel precision rehabilitation service model for structural problems in rural rehabilitation services for persons with disabilities in China, such as shortages of professional resources, imprecise assessment and lack of service continuity, guided by International Classification of Functioning, Disability and Health (ICF) and supported by digital technologies. MethodsUsing ICF as an analytical tool and rural disability rehabilitation services as the application scenario, this study adopted a problem-oriented approach focused on current service challenges. Through literature review, situation analysis and strategy exploration, elements of body functions and structures, activities and participation, environmental factors, and digital technologies were organically integrated to form systematic solutions. ResultsA precision rehabilitation service model developed for rural persons with disabilities was constructed based on ICF and integrated with digital technologies such as the Internet of Things, big data and telerehabilitation. The model encompassed three dimensions: precise assessment of body functions, precise matching of intervention modalities and precise adjustment of environmental factors. An implementation pathway for digital technology-empowered precision rehabilitation in rural areas was proposed. ConclusionThe digitally empowered precision rehabilitation service model based on ICF is helpful for addressing the challenges of equity and precision in rural rehabilitation services in China, promoting access fairer, more accessible and systematically continuous rehabilitation services.

Objective To construct a conceptual framework and methodology for developing disability eligibility/standard using the bio-psycho-social model of disability,and classification theory and methods of the International Classification of Functioning,Disability and Health(ICF).Methods Based on the ICF's bio-psycho-social model,and aliged with the United Nations Convention on the Rights of Persons with Disabilities and the World Health Organization technical documents in the fields of disability statis-tics and services,this study explored the systematic implementation of ICF to construct a conceptual framework and methodology for disability eligibility/standards,including core concepts and terminology of functioning and disability,methods and system of classification and grading,coding system,standardization of disability survey questionnaires and protocols,and assessment/evaluation tools,as well as standard system of disability data.Results The establishment of disability standards should be based on specific application contexts and functions.Stan-dards for surveys and statistics emphasized data collection and analysis,applied to the design of survey question-naires and methodologies.Standards for service eligibility focused on determining service qualification through structured assessments/evaluation of functioning and disability.Comprehensive standards served both purposes.A well-rounded disability standard integrated a clear theoretical framework,scientific classification,grading and coding systems,and standardized disability reporting and evaluation/assessment methods/tools.The conceptual framework and methodological system for disability standards based on ICF comprised five core aspects:a core conceptual and terminological system for disability;disability classification and grading methods and systems;a scientifically structured classification,grading,and coding system;standardized disability reporting and assess-ment/evaluation methods and procedures;and standardized disability data systems.Applying ICF in practice in-volved systematically integrating the theoretical framework into the development of disability classification and grading systems,constructing coding systems using ICF,implementing standardized disability reporting and as-sessment/evaluation tools derived from the ICF,designing and standardizing disability survey instruments,ques-tionnaires/protocols,and assessment/evaluation tools and protocols,and establishing ICF-based disability data standards.Conclusion ICF provides a robust conceptual framework and methodology for the development of disability eligibility/standards.The bio-psycho-social model,conceptual framework and methodological approaches of classification,grading and coding of functioning and disability,and ICF-based standardized survey and assessment/evaluation tools,enable the establishment of core disability concepts and terminology,disability classification and grading systems,disability coding systems,disability survey questionnaires and protocols and assessment/evaluation tools and programs,and disability data standards.The systematic application of the ICF framework and method-ology enhances the scientific rigor,inclusivity and applicability of disability eligibility/standards.

Objective To compare six existing Chinese standards related to visual disability,including Disability Assessment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(Elderly Stan-dard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard).Methods Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF)and International Classification of Diseases,the 11th Revision(ICD-11),and with reference to World Report on Vision(WRV),this study analyzed and compared five key dimensions of visual disability across the six stan-dards:definition,classification,grading,assessment methods and coding systems.Results In terms of definition,the insurance,work injury,military,and disability classification standards emphasized vi-sual structure and function,focusing on visual acuity and visual field;the insurance and elderly standards incor-porated activities and participation,reflecting the concept of functional vision;the judicial standard lacked a dedi-cated definition of visual disability.In terms of grading,each standard graded visual disability into different lev-els acoording to different functional indicators.In terms of coding,only the insurance standard adopted the ICF framework,while others used non-ICF numeric codes or lacked standardized coding.In terms of assessment tools,the elderly standard employed a customized perceptual and participation scoring system,while others re-lied primarily on vision charts.Conclusion Most current Chinese standards focus on impairments in visual function,with limited attention to activity limitations and participation restrictions.It is needed for incorporating the concept of functional vision,aligned with ICF and WRV,to establish a unified conceptual framework,terminology,coding system for visual disability,and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and en-vironmental interaction.

Objective To compare six representative Chinese standards related to hearing disability in terms of conceptual frame-works,definitions,classification,grading and assessment.Methods Using the framework of International Classification of Functioning,Disability and Health(ICF),World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0),International Classification of Diseases,Elev-enth revision(ICD-11),and World Report on Hearing(WRH),six national standards,such as Disability Assess-ment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(El-derly Standard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Stan-dard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard),were analyzed in dimensions of defini-tions,coding systems,classification and grading methods,and assessment approaches.Results In terms of definitions,Insurance Standard was relatively comprehensive,covering the dimensions of body func-tion,activities and participation in ICF,which was consistent with the definition of functional hearing in the WRH.Elderly Standard focused on body function.Judicial,Work Injury and Military Standards were more in-clined to physiological damage,emphasizing auditory structure and sensory functions.Although Disability Clas-sification Standard covering dimensions of activities and participation,it did not elaborate on functional out-comes.In terms of classification and grading,different from the WRH's recommendation of 20 dB HL as the stan-dard for hearing impairment,most of the six standards still used 40 dB HL or above as the threshold.For grading levels,Insurance Standard had nine grades,while Judicial,Work Injury and Military Standards had seven grades,Elderly Standard had three grades,and Disability Classification Standard had four grades.The basis for grading relied more on physiological measurements rather than functional performance.In terms of coding systems,only Insurance Standard referred to ICF codes,while the others mostly used self-defined numerical sequences or grade codes.In terms of assessment methods,the WRH advocated a comprehensive assessment integrating auditory ability,self-reports and participation restrictions.However,currently,only Elderly Standard involved subjective sensory scoring,and the others still mainly relied on objective methods,such as pure-tone audiometers,lacking assessment dimensions for social participation and environmental factors.Conclusion Hearing disability should be defined from three levels:hearing structure and function,activity and participa-tion,and environmental factors.However,China's six standards adopt different definitions,classifications,grad-ing systems and assessment methods due to their varying purposes and application scenarios.The majority of these standards are primarily based on body function,specifically hearing loss.Future standards for hearing dis-ability need to consider the introduction of the concept of functional hearing,to determine hearing loss and its im-pact on activity and participation.

Objective To systematically compare five physical disability-related standards widely used in the fields of insurance,work related injury,forensic appraisal,and disability evaluation.The comparison covers definition,coding,classi-fication,grading,and assessment methods to reveal each standard's framework and methodology,and to provide evidence for integrating and optimizing physical disability standards.Methods Based on International Classification of Functioning,Disability and Health(ICF)and International Classifica-tion of Diseases,11th Revision(ICD-11),we analyzed and compared five physical disability-related standards,including Disability Assessment and Code for Life Insurance(Insurance Standard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disabili-ty Classification Standard).We examined definition,coding systems,classification,grading scales and assess-ment.Results According to the ICF framework,at the level of body functions and structures,physical disability mainly in-volved neuromusculoskeletal and movement related functions(b7),including joint and bone functions(b710-b729),muscle functions(b730-b749),and movement functions(b750-b789).At the activities and participation level,it primarily concerned mobility(d410-d499)and self care(d510-d599).Related conditions were commonly found in Certain infectious or parasitic diseases(01),Diseases of the nervous system(08),Diseases of the muscu-loskeletal system or connective tissue(15),Developmental anomalies(20),and Injury,poisoning or certain other consequences of external causes(22),etc.Among the five standards,only Disability Classification Standard ex-plicitly defined physical disability,yet its terminology did not followed ICF categories.Regarding coding,only the Insurance Standard adopted ICF codes;and the other four used self devised coding systems.The sub catego-ries in these physical disability standards did not fully cover all ICF categories relevant to physical disability.In terms of grading,Disability Classification Standard used a four level grading,whereas the other four standards employed ten level grading.Concerning assessment,all five emphasized evaluation of body structures and func-tions and involved daily activity capacity;however,WHO Disability Assessment Schedule(WHODAS 2.0)for comprehensive functional assessment,had not been proposed for evaluation of general functioning.Conclusion China has developed different physical disability standards to meet diverse needs.There are differences in definition,structure and content.It is necessary to revise and refine the relevant components of physical disabili-ty,including definition,classification,grading,coding and assessment,based on ICF and ICD-11,and to intro-duce WHODAS 2.0 as a comprehensive functional assessment tool.

Objective To examine overall adaptive behavior,structural profiles and teacher-parent rating differences in children with intellectual disability(ID)and autism spectrum disorder(ASD),and to explore the association between adaptive behavior and intellectual level.Methods From March to June,2024,65 children with intellectual and developmental disabilities from Handan Special Education Center School,Xingtai Special Education School and Zhengding County Special Education School were selected and 57 valid cases were retained,who were divided into ID group(n=37)and ASD group(n=20).Adaptive behavior was assessed using the Chinese version of Adaptive Behavior Assessment System-II(ABAS-II)by parents and teachers familiar with the children.Group differences were compared,teacher-parent rating consistency was evaluated,and the relationship between adaptive behavior and intelligence quotient(IQ)was examined.Results Mean General Adaptive Composite(GAC)scores were significantly below normative values,as well as all three domains and specific skill subsets underperforming.ASD group exhibited higher self-management scores but lower community application scores than in ID group.Teacher-parent ratings showed moderate-to-high correla-tion across dimensions,which was mainly stronger in ASD group than ID group.IQ demonstrated significant pos-itive correlations with GAC and all three domain scores(rs=0.82 to 0.91,P<0.001).Conclusion Children with intellectual and developmental disabilities show markedly lower levels of adaptive behavior than their typically developing peers.Parents generally rate adaptive behaviors higher than teachers.Both ID and ASD groups exhibited a developmental pattern that practical skills are strongest,followed by social skills,while conceptual skills are weakest.Specific skills such as self-care,health/safety and school/home living were relative-ly stronger,while learning function,social interaction and community application lagging.ASD children under-perform in community application compared to ID peers but outperform in self-management.Adaptive behavior is closely tied to intellectual functioning.ABAS-II results may serve as a reference for assessing disability severi-ty in practice.

Objective Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF),this paper compared the classification and grading methods of disability standards in four areas in China,focusing on definition,classification,grading,coding systems and assessment tools.Methods Four disability standards including Disability Assessment and Code for Life Insurance(insurance standard),Classification of Disability Degrees for Human Body Injury(judicial standard),Grading of Disability for Work-Related Injuries and Occupational Diseases(work-related injury standard),and Classification and Grading of Dis-abilities for Persons with Disabilities(disability eligibility standard)were systematically analyzed.Each standard was reviewed to identify core elements of disability definitions,classification,and grading methods.Content analysis was used to extract and compare the definitions,classification,grading,coding systems,and assessment tools.The strengths,weaknesses,and practical limitations of each standard were analyzed using the ICF frame-work.Results There were different in disability definitions,classification and grading,coding systems,and assessment tools across the standards.In terms of definitions,the insurance standard emphasized ICF's body structure and function impairments;the judicial standard defined disability as limitations in life and work capacity due to bodily injury,covering ICF's body structure and function,activity and participation;the work-related injury standard focused on loss of labor capacity due to work-related injuries,involving body structure and function,activity and partici-pation;the disability eligibility standard refered to the ICF model,defining disability as impairments in body function and structure,and activity limitations and participation restriction.Regarding classification and grading,the insurance standard divided disabilities into eight categories based on body structure and function,with ten grades of disability severity;the judicial standard first graded disabilities into ten levels and then classified as in-jury site;the work-related injury standard divided disabilities into five categories based on clinical disciplines,grading from one to ten;the disability eligibility standard divided disabilities into seven categories,each with four grades.For coding systems and assessment tools,the insurance standard used ICF coding system,while the disability standard for persons with disabilities used a numerical coding system other from ICF,and the other standards did not use coding systems.Assessment tools varied significantly.The use of World Health Organiza-tion Disability Assessment Schedule(WHODAS 2.0)was proposed but not applying it in grading.Conclusion This study has systematically compared and analyzed four typical disability-related standards in China using the ICF framework.Personal Insurance Disability Assessment and Coding,Grading of Disability Caused by Bodily Injury,and Classification and Grading of Disabilities for Persons with Disabilities are all promulgated af-ter 2011,and adopt ICF concepts and methods to define and classify disabilities,considering body function and structure,activity and participation,and environmental factors.However,due to different purposes,their grading methods and levels vary:except for Classification and Grading of Disabilities for Persons with Disabilities,which uses a four-level grading system,the other standards use a ten-level system,primarily based on body func-tion and structure.In disability assessment,the recommended methods differ by category,showing significant variability.Due to differing classification and grading methods,disability data from various standards are lack in comparability.The international trend advocates for a unified disability standard framework based on ICF and ICD-11 to enhance the comparability and exchangeability of disability data.

Objective Utilizing the International Classification of Functioning,Disability and Health(ICF)framework and Interna-tional Classification of Diseases,the 11th Revision(ICD-11)system,alongside evidence from World Health Or-ganization(WHO)global reports and technical reports from relevant countries,this study systematically exam-ines the definitions,classifications,grading,and assessment methods for visual,hearing,speech,physical,intel-lectual,and mental(psychiatric)disabilities.Methods Employing the ICF's biopsychosocial model,classification,and coding system and ICD-11,and referencing WHO global reports and national technical reports,this study systematically investigated the definitions,classifi-cations,grading and assessment approaches for six prevalent disabilities:visual,hearing,speech,physical,intel-lectual and mental.Results The ICF and ICD-11model and classification system offered a robust framework for defining,classifying,grad-ing and assessing disabilities.Disability definitions should address body function impairments,activity limita-tions,participation restrictions and environmental factors.The definitions,classifications and grading of visual,hearing,speech,physical,intellectual and mental disabilities aligned with ICF categories for body functions and structures,activities and participation and categories of ICD-11.Standardized tools like the WHO Disability As-sessment Schedule(WHODAS 2.0)effectively measured overall activity and participation levels.Conclusion Anchored in the ICF and ICD-11 framework,disabilities are defined,classified,graded and assessed across body functions and structure,activities and participation,and environmental factors.WHODAS 2.0 serves as a universal tool for assessing activities and participation,enabling both comprehensive functional evaluations and the conversion of results from other assessment tools.By analyzing WHO global reports and technical documents in some countries within the ICF and ICD-11 classifications framework,this study highlights global advance-ments in disability definitions,classifications,grading and assessments.Variations in disability statistics stem from differing definitions,diagnostic criteria and assessments.Disability service eligibility criteria should be tai-lored to the needs of recipients and the capacity of providers.

Objective To construct a conceptual framework and methodology for developing disability eligibility/standard using the bio-psycho-social model of disability,and classification theory and methods of the International Classification of Functioning,Disability and Health(ICF).Methods Based on the ICF's bio-psycho-social model,and aliged with the United Nations Convention on the Rights of Persons with Disabilities and the World Health Organization technical documents in the fields of disability statis-tics and services,this study explored the systematic implementation of ICF to construct a conceptual framework and methodology for disability eligibility/standards,including core concepts and terminology of functioning and disability,methods and system of classification and grading,coding system,standardization of disability survey questionnaires and protocols,and assessment/evaluation tools,as well as standard system of disability data.Results The establishment of disability standards should be based on specific application contexts and functions.Stan-dards for surveys and statistics emphasized data collection and analysis,applied to the design of survey question-naires and methodologies.Standards for service eligibility focused on determining service qualification through structured assessments/evaluation of functioning and disability.Comprehensive standards served both purposes.A well-rounded disability standard integrated a clear theoretical framework,scientific classification,grading and coding systems,and standardized disability reporting and evaluation/assessment methods/tools.The conceptual framework and methodological system for disability standards based on ICF comprised five core aspects:a core conceptual and terminological system for disability;disability classification and grading methods and systems;a scientifically structured classification,grading,and coding system;standardized disability reporting and assess-ment/evaluation methods and procedures;and standardized disability data systems.Applying ICF in practice in-volved systematically integrating the theoretical framework into the development of disability classification and grading systems,constructing coding systems using ICF,implementing standardized disability reporting and as-sessment/evaluation tools derived from the ICF,designing and standardizing disability survey instruments,ques-tionnaires/protocols,and assessment/evaluation tools and protocols,and establishing ICF-based disability data standards.Conclusion ICF provides a robust conceptual framework and methodology for the development of disability eligibility/standards.The bio-psycho-social model,conceptual framework and methodological approaches of classification,grading and coding of functioning and disability,and ICF-based standardized survey and assessment/evaluation tools,enable the establishment of core disability concepts and terminology,disability classification and grading systems,disability coding systems,disability survey questionnaires and protocols and assessment/evaluation tools and programs,and disability data standards.The systematic application of the ICF framework and method-ology enhances the scientific rigor,inclusivity and applicability of disability eligibility/standards.

Objective To compare six existing Chinese standards related to visual disability,including Disability Assessment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(Elderly Stan-dard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard).Methods Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF)and International Classification of Diseases,the 11th Revision(ICD-11),and with reference to World Report on Vision(WRV),this study analyzed and compared five key dimensions of visual disability across the six stan-dards:definition,classification,grading,assessment methods and coding systems.Results In terms of definition,the insurance,work injury,military,and disability classification standards emphasized vi-sual structure and function,focusing on visual acuity and visual field;the insurance and elderly standards incor-porated activities and participation,reflecting the concept of functional vision;the judicial standard lacked a dedi-cated definition of visual disability.In terms of grading,each standard graded visual disability into different lev-els acoording to different functional indicators.In terms of coding,only the insurance standard adopted the ICF framework,while others used non-ICF numeric codes or lacked standardized coding.In terms of assessment tools,the elderly standard employed a customized perceptual and participation scoring system,while others re-lied primarily on vision charts.Conclusion Most current Chinese standards focus on impairments in visual function,with limited attention to activity limitations and participation restrictions.It is needed for incorporating the concept of functional vision,aligned with ICF and WRV,to establish a unified conceptual framework,terminology,coding system for visual disability,and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and en-vironmental interaction.