WEBVTT Kind: captions; language: en-us NOTE Treffsikkerhet: 81% (H?Y) 00:00:02.800 --> 00:00:11.900 now we're going to talk about the specific components in the ICF model and first I'm going to start 00:00:11.900 --> 00:00:19.700 off with talking about body function and structure and body function relates to the physiological 00:00:19.700 --> 00:00:23.250 and psychological functions of the body systems NOTE Treffsikkerhet: 91% (H?Y) 00:00:23.250 --> 00:00:32.400 for instance for people who stutter they have difficulties in producing fluent speech that's the 00:00:32.400 --> 00:00:36.900 body function that is affected by the disorder NOTE Treffsikkerhet: 84% (H?Y) 00:00:37.200 --> 00:00:43.500 body structure is that anatomical parts of the body NOTE Treffsikkerhet: 83% (H?Y) 00:00:43.500 --> 00:00:54.200 and for people who stutter we know that brain structure is different from people who produce fluent 00:00:54.200 --> 00:01:05.099 speech so we know that that body structure is deviant from what we see in people who do not stutter NOTE Treffsikkerhet: 91% (H?Y) 00:01:05.099 --> 00:01:17.000 when it comes to body structure we can describe by three different qualifiers that's extent how 00:01:17.000 --> 00:01:25.300 impaired it is for instance it may be easier than to talk about having a disorder that makes you 00:01:25.300 --> 00:01:32.600 blind for instance and then we could say how far has that progress gone NOTE Treffsikkerhet: 90% (H?Y) 00:01:33.100 --> 00:01:37.350 so that's the extent of the impairment NOTE Treffsikkerhet: 81% (H?Y) 00:01:37.350 --> 00:01:48.850 and then the nature of structural change what is happening well as the cells in in the eye is dying 00:01:48.850 --> 00:01:55.600 so that that can be described and then we have the location of the impairment this is just one eye 00:01:55.600 --> 00:02:06.350 or both eyes for instance. When it comes to body functions there's only one qualifier and that is the extent 00:02:06.350 --> 00:02:08.000 of NOTE Treffsikkerhet: 76% (H?Y) 00:02:08.199 --> 00:02:12.500 how the function is affected NOTE Treffsikkerhet: 91% (H?Y) 00:02:15.400 --> 00:02:23.600 yeah then we can move on to activity NOTE Treffsikkerhet: 91% (H?Y) 00:02:23.600 --> 00:02:36.800 an activity that is defined as actions and tasks executed by individuals and put in the negative 00:02:36.800 --> 00:02:43.700 term then we have activity limitation and that refers to the difficulties that them individual 00:02:43.700 --> 00:02:53.600 encounters when executing tasks and actions so for instance for people who stutter we know that NOTE Treffsikkerhet: 85% (H?Y) 00:02:53.600 --> 00:03:03.200 and there's limitations in communication situations because they have difficulties with getting the 00:03:03.200 --> 00:03:14.000 words out so they some people who stutter have huge communication difficulties they might take 2 00:03:14.000 --> 00:03:23.100 minutes to be able to say five sentences for instance and well NOTE Treffsikkerhet: 81% (H?Y) 00:03:23.100 --> 00:03:37.250 While others have have stuttered speech that this less frequent or less severe and then and then 00:03:37.250 --> 00:03:49.200 being then the speech is not causing as much limitations as the more severe stutter speech NOTE Treffsikkerhet: 86% (H?Y) 00:03:49.200 --> 00:03:57.250 however we should also keep in mind but I think that it's how the person himself or herself 00:03:57.250 --> 00:04:06.550 experiences the limitations in communication situations so for instance we can have a person that 00:04:06.550 --> 00:04:18.000 has the same severity and has is stuttering as often as another person but one one of them is 00:04:18.000 --> 00:04:18.799 experience NOTE Treffsikkerhet: 74% (MEDIUM) 00:04:18.799 --> 00:04:28.300 seeing the limitation in speaking situation to be more severe than the others than the other and 00:04:28.300 --> 00:04:40.500 that is how how we interpret ourselves and our environment and there will be variations between 00:04:40.500 --> 00:04:42.600 humans in that NOTE Treffsikkerhet: 91% (H?Y) 00:04:43.500 --> 00:04:46.100 yes NOTE Treffsikkerhet: 88% (H?Y) 00:04:47.300 --> 00:04:56.400 and then it's also important to mention that when it comes to activity and then there's two sets of 00:04:56.400 --> 00:05:06.800 qualifiers so you could you could talk about performance an individual's performance and that is 00:05:06.800 --> 00:05:16.000 what the person does in the environment with helping aids so for instance a blind person what can a 00:05:16.000 --> 00:05:18.800 blind person do with NOTE Treffsikkerhet: 37% (LAV) 00:05:19.200 --> 00:05:21.400 yes NOTE Treffsikkerhet: 91% (H?Y) 00:05:23.700 --> 00:05:26.100 yeah NOTE Treffsikkerhet: 85% (H?Y) 00:05:30.000 --> 00:05:38.500 I don't know the English word but the one that you use when you're walking and for people who 00:05:38.500 --> 00:05:46.000 stutter we can think about for instance there's something called .... technical technological device 00:05:46.000 --> 00:05:56.100 that you hear your voice and delayed and that for many people they experience to have much more 00:05:56.100 --> 00:05:58.450 fluent speech and NOTE Treffsikkerhet: 84% (H?Y) 00:05:58.450 --> 00:06:10.150 and you can then talk about performance with that helping aid and then capacity and that reflects 00:06:10.150 --> 00:06:21.400 the actual functioning in real life without helping aids so you differentiate with between what the 00:06:21.400 --> 00:06:26.700 person can do with helping it and what the person can do without helping its NOTE Treffsikkerhet: 85% (H?Y) 00:06:26.700 --> 00:06:36.100 this may also be medicine for instance, for diagnosis stuff to improve with that NOTE Treffsikkerhet: 88% (H?Y) 00:06:39.600 --> 00:06:52.850 yeah and then if we get information about both of these aspects of activity then you could see what 00:06:52.850 --> 00:07:03.700 changes that they're helping aids are costing and maybe you could also get insight into it there's 00:07:03.700 --> 00:07:10.250 other helping it's for instance that needs to be included as well NOTE Treffsikkerhet: 91% (H?Y) 00:07:10.250 --> 00:07:14.600 to enhance their performance NOTE Treffsikkerhet: 91% (H?Y) 00:07:17.200 --> 00:07:28.600 and then we have the component participation and participation refers to involvement in life 00:07:28.600 --> 00:07:41.500 situations and then participation restriction how is how disorder restricts participation in life 00:07:41.500 --> 00:07:48.000 situations and then the problems that the person experiences NOTE Treffsikkerhet: 73% (MEDIUM) 00:07:48.000 --> 00:07:56.200 in this life situations and that life situations that is very relevant for people who stutter 00:07:56.200 --> 00:08:06.800 relates to communication learning social and civic life and interpersonal relationships and 00:08:06.800 --> 00:08:08.800 interactions NOTE Treffsikkerhet: 84% (H?Y) 00:08:08.800 --> 00:08:19.300 so what we know for people who stutter is that for instance they could choose differently when it 00:08:19.300 --> 00:08:29.900 comes to education and and job and career and you to there stuttering and we also know that it 00:08:29.900 --> 00:08:39.400 affects their performance in both in education and how they are evaluated can also NOTE Treffsikkerhet: 75% (MEDIUM) 00:08:39.900 --> 00:08:44.500 be related to this stuttering and NOTE Treffsikkerhet: 91% (H?Y) 00:08:45.800 --> 00:08:54.200 we also know that it affects how they think about their future and also when it comes to 00:08:54.200 --> 00:09:01.200 relationships we know that for instance people who stutter are more likely to be divorced NOTE Treffsikkerhet: 91% (H?Y) 00:09:01.200 --> 00:09:12.000 so we can then say that on the group level stuttering kindeed affect participation in life or 00:09:12.000 --> 00:09:15.500 cause participation restrictions NOTE Treffsikkerhet: 91% (H?Y) 00:09:18.000 --> 00:09:23.400 and what we know about young children NOTE Treffsikkerhet: 86% (H?Y) 00:09:23.400 --> 00:09:38.300 is that they may experience bullying for instance so and thereby stuttering can be related to their 00:09:38.300 --> 00:09:44.800 interactions and relationships to other children NOTE Treffsikkerhet: 91% (H?Y) 00:09:48.300 --> 00:09:50.800 yeah NOTE Treffsikkerhet: 91% (H?Y) 00:09:51.000 --> 00:09:55.500 and then we're going to talk about NOTE Treffsikkerhet: 90% (H?Y) 00:09:55.500 --> 00:10:05.500 environmental factors and environmental factors you see here is it at the bottom of them model 00:10:05.500 --> 00:10:13.000 together with personal factors and these two together are called contextual factors NOTE Treffsikkerhet: 88% (H?Y) 00:10:13.000 --> 00:10:18.200 so we have the we have the impairments NOTE Treffsikkerhet: 91% (H?Y) 00:10:18.200 --> 00:10:27.650 and then we have how the impairment effects activity and participation and then we see that 00:10:27.650 --> 00:10:38.600 contextual factors influence how also influence activity and participation NOTE Treffsikkerhet: 89% (H?Y) 00:10:39.200 --> 00:10:49.000 and the environmental factors I refer to physical social and attitudinal environment in which people 00:10:49.000 --> 00:10:59.800 live so for instances so for instance what kinds of kinds of attitudes and do people in in the 00:10:59.800 --> 00:11:07.300 society have towards people who stutter but can be one environmental factor NOTE Treffsikkerhet: 80% (H?Y) 00:11:08.300 --> 00:11:15.800 and if you also what kind of attitudes do the mother and father of the child who stutter have to 00:11:15.800 --> 00:11:25.300 watch stuttery that is also a environmental that factor on a more microlevel than attitudes in 00:11:25.300 --> 00:11:35.500 their society and so it's different for instance for people's that there might be differences in how 00:11:35.500 --> 00:11:37.950 people react to start doing and NOTE Treffsikkerhet: 80% (H?Y) 00:11:37.950 --> 00:11:48.050 we know for instance with children you know that one experiment having a fluent puppet, and a 00:11:48.050 --> 00:11:59.150 puppet with a stutter speech we know that the majority of the children would prefer to play with the 00:11:59.150 --> 00:12:06.800 puppet with fluent speech rather than the puppet with stuttered speech so then we know that based on 00:12:06.800 --> 00:12:07.900 that study NOTE Treffsikkerhet: 90% (H?Y) 00:12:07.900 --> 00:12:21.099 but children can evaluate fluency in speech and that having being a child who's better but my affect 00:12:21.099 --> 00:12:24.500 how the other children evaluate NOTE Treffsikkerhet: 89% (H?Y) 00:12:27.000 --> 00:12:32.800 the environmental factors may also be technologies NOTE Treffsikkerhet: 80% (H?Y) 00:12:32.900 --> 00:12:44.000 as support and relationships the natural environment you're living in so for instance technologies 00:12:44.000 --> 00:12:55.500 if we pursue them example with with being blind then you might have technologies that help you 00:12:56.100 --> 00:13:03.600 guiding in your environment you might live together with someone NOTE Treffsikkerhet: 89% (H?Y) 00:13:03.600 --> 00:13:13.650 or you might get support from from an organization maybe you'll get help to to know your rights and 00:13:13.650 --> 00:13:21.450 to know about helping aids for instance and you might get the service giving you guidance in how to 00:13:21.450 --> 00:13:24.349 adapt your apartment for instance NOTE Treffsikkerhet: 90% (H?Y) 00:13:24.349 --> 00:13:29.800 and these all are environmental factors NOTE Treffsikkerhet: 91% (H?Y) 00:13:31.200 --> 00:13:46.200 that can be assessed and we can also then see by assessing the barriers and also the facilitators in 00:13:46.200 --> 00:13:57.700 the environment we can see what what actually enables the person to to function as good as he or she 00:13:57.700 --> 00:14:01.900 has the capacity to and we can also see what restricts NOTE Treffsikkerhet: 58% (MEDIUM) 00:14:01.900 --> 00:14:03.600 person NOTE Treffsikkerhet: 91% (H?Y) 00:14:07.200 --> 00:14:16.450 yeah so when we're talking about the environmental factors we need to remember to talk about 00:14:16.450 --> 00:14:29.050 facilitators and also that has a positive influence on the functioning and also which makes the or 00:14:29.050 --> 00:14:36.000 the performance of the individual is then higher than expected and then we have the barriers which 00:14:36.000 --> 00:14:38.000 have a negative influence on it NOTE Treffsikkerhet: 77% (H?Y) 00:14:38.000 --> 00:14:44.950 on capacity and then performance is been lower than what we would expect NOTE Treffsikkerhet: 87% (H?Y) 00:14:44.950 --> 00:14:49.000 based on on the impairments NOTE Treffsikkerhet: 91% (H?Y) 00:14:50.400 --> 00:14:56.800 and then we have personal factors and that's NOTE Treffsikkerhet: 91% (H?Y) 00:14:58.800 --> 00:15:11.700 factors within the person himself or herself that might be gender related to age lifestyle habits 00:15:11.700 --> 00:15:14.100 education NOTE Treffsikkerhet: 91% (H?Y) 00:15:15.200 --> 00:15:25.150 and all of these are aspects that might influence functioning of the individual NOTE Treffsikkerhet: 86% (H?Y) 00:15:25.150 --> 00:15:28.099 and in the Oasis NOTE Treffsikkerhet: 91% (H?Y) 00:15:28.099 --> 00:15:40.700 personal factors was assessed by asking about reactions to the stuttering and so not as the personal 00:15:40.700 --> 00:15:49.700 factors are very closely linked to to them disorder and we're asking about thoughts concerning your 00:15:49.700 --> 00:15:57.650 way of speaking, emotions related to the stuttering, for instance to what we just what extend NOTE Treffsikkerhet: 91% (H?Y) 00:15:57.650 --> 00:16:08.100 the stuttering can cause anger of course and then also behaviorreactions for instance leaving a 00:16:08.100 --> 00:16:11.300 situation because of the stuttering NOTE Treffsikkerhet: 87% (H?Y) 00:16:11.400 --> 00:16:21.650 and if personal factors or these reactions to stuttering might be related to NOTE Treffsikkerhet: 88% (H?Y) 00:16:21.650 --> 00:16:28.600 for instance the child's temperament if you have a very reactive temperament you might be more 00:16:28.600 --> 00:16:36.000 inclined to have more negative feelings related to the stuttering but it might also be related to 00:16:36.000 --> 00:16:46.900 the environmental factors actually if you experience bullying or your parents have a negative 00:16:46.900 --> 00:16:52.050 attitudes towards stuttering or finds it very difficult difficult that NOTE Treffsikkerhet: 76% (H?Y) 00:16:52.050 --> 00:17:04.700 you are stuttering.. so might be difficult sometimes to tease apart what actually is the origin of 00:17:04.700 --> 00:17:06.750 these factors NOTE Treffsikkerhet: 86% (H?Y) 00:17:06.750 --> 00:17:15.700 it's the personal factors is it because of that is the reactions to the stuttering and and coping 00:17:15.700 --> 00:17:24.099 with the disorder is it due to the personal factors or is it because of the environment this may be 00:17:24.099 --> 00:17:26.599 very intertwined NOTE Treffsikkerhet: 91% (H?Y) 00:17:30.200 --> 00:17:34.500 let's take a small bit