# Mapping of the GEVA Items to the ICF: Preliminary Results Based on the Content of a Tool Guide Used to Assess the Needs of Persons With Disabilities in France

Marie Cuenot

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Marie Cuenot. Mapping of the GEVA Items to the ICF: Preliminary Results Based on the Content of a Tool Guide Used to Assess the Needs of Persons With Disabilities in France. Frontiers in Rehabilitation Sciences, 2021, 2, 10.3389/fresc.2021.721685. [https://ehesp.hal.science/hal-04261642v1](https://ehesp.hal.science/hal-04261642v1)

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# Mapping of the GEVA Items to the ICF: Preliminary Results Based on the Content of a Tool Guide Used to Assess the Needs of Persons With Disabilities in France

Marie Cuenot*

*École des Hautes Etudes en Santé Publique, School of Public Health, Rennes, France*

The aim of this research is two-fold. Firstly, mapping the GEVA items on to the ICF will allow identifying those items that are covered by the ICF and assist in improving the data collection process. Secondly this work will provide a first exploration of the items that are not covered by the ICF and that could lead to potential proposals for updating the ICF. The preliminary results show that the items of the GEVA 2008 general version are partly covered by the ICF 2017 Browser version categories. In every section of the GEVA, some of the items might be coded with ICF codes coming from the following ICF components: Body functions, Activities and Participation, Environmental factors, Personal factors. The items of the section 6 remain those mostly covered by the ICF. Throughout the GEVA, many environmental factors are documented. Although further analysis is needed to better inform the use of qualifiers (performance, capacity, satisfaction) together with the activities and the environmental factors, the identified ICF codes could assist in improving the data collection process. Finally, some items might be discussed to become potential ICF updates proposals.

**Keywords:** ICF, assessment, mapping, France, GEVA disability assessment tool

## OPEN ACCESS

**Edited by:**

Michaela Coenen,
Pettenkofer School of Public
Health, Germany

**Reviewed by:**

Patricia Welch Saleeby,
Bradley University, United States
Olaf Kraus De Camargo,
McMaster University, Canada

**\*Correspondence:**

Marie Cuenot
marie.cuenot@ehesp.fr

**Specialty section:**

This article was submitted to
*Human Functioning,*
a section of the journal
*Frontiers in Rehabilitation Sciences*

**Received:** 07 June 2021

**Accepted:** 13 August 2021

**Published:** 14 September 2021

**Citation:**

Cuenot M (2021) Mapping of the GEVA Items to the ICF: Preliminary Results Based on the Content of a Tool Guide Used to Assess the Needs of Persons With Disabilities in France. *Front. Rehabil. Sci.* 2:721685. doi: 10.3389/fresc.2021.721685

## INTRODUCTION

How should the needs of persons with disabilities be assessed so as to enable to live with optimum independence, and the means to live and participate in accordance to their wishes? In the last 50 years, France has developed a succession of laws progressively building a legal framework that aims to ensure the rights to individualized compensation measures and the rights for general accessibility to all.

The main concepts, principles, values, and rights are well-known and accepted. However, their implementation may be considered as an on-going search for improvements.

France has been involved in several international processes such as (1) the work related to the concept of disability. This includes the collaboration with WHO during the revision of the International Classification of Impairments, Disabilities, and Handicaps (1980), and the on-going maintenance of the International Classification of Functioning, Disability, and Health (ICF, WHO, 2001) and (2) the work related to the UN Convention on the rights of persons with disabilities (2006) development process. In 2010, France, together with the European Union, ratified the UN Convention.
France may broadly be described as a welfare state, and accordingly the provision for persons with disabilities needs is based on the recognition of an administrative status, namely “persons with disabilities.” The administrative system is complex and depends on the origin of the impairments or disabilities (work, health, army, life accident, etc.), and different allowances may be granted.

The 2005-102 Law “For equal rights and opportunities, participation and citizenship of persons with disabilities” has provided a new framework focusing on the right for compensation and accessibility. Firstly, this law gives a definition of disability as: “any limitation to activity or restriction to participation to life in society, that one may undergo in one’s environment, due to substantial, long-term or permanent alteration of one or more physical, sensory, mental or cognitive functions, severe multiple and profound disabilities or a disabling health condition.” Although this definition does contain the concepts found in the ICF, as underlined by the UN Special Rapporteur on the rights of persons with disabilities (1): “[…] the definition of disability [...] focuses on the impairment, instead of a person’s interaction with the environment and existing barriers, and should therefore be revised.” Hence, the implementation of the concepts might be improved.

Nevertheless, this law has led to the set-up of, in each of the 102 French administrative territorial entities, a one-stop counter [Maison Départementale des Personnes Handicapées (MDPH)] that manages the granting of several different disability benefits, one of which being the Prestation de compensation du handicap “PCH” for citizens aged under 60 years. The MDPHs are in charge of assessing the situations and needs for the compensatory support of persons with disabilities. Each is composed of two bodies: (1) a multidisciplinary team (medical doctors, occupational therapists, psychologists, social workers, etc.) in charge of the assessment of the needs; (2) an executive board, the “Commission for the rights and independence of persons with disabilities,” composed of professionals as well as the representatives of organizations of persons with disabilities. These commissions make all decisions related to the provision of financial, technical, and human aid based on the multidisciplinary assessment, related to the development of a personalized compensation plan. The network of local authorities is supported by a national central authority (national fund of solidarity for autonomy—Caisse Nationale de Solidarité pour l'Autonomie (2) in charge of the implementation of a disability policy throughout the country.

In 2008, a national decree (2008-110, February 6, 2008) provided a guide “Guide d’évaluation multidimensionnelle” (GEVA), for the multidimensional assessment of the needs of persons with disabilities. The aim is to ensure, to the greatest extent possible, equality in the treatment of requests of individuals, equity in granting benefits, and a harmonized countrywide assessment of the situation of persons with disabilities in drawing up individualized support plans. It allows the gathering of information about the situation of an individual, summarizes the main key points of the assessment, and supports the decision process. Section 6 of GEVA aiming at supporting the decision taken to allocate the PCH has been explicitly built based on ICF categories and qualifiers.

The general version of this guide, 40 pages, has been developed in 2008 (2) and was first designed to assess the needs of adults aged under 60 years. Several complementary versions do exist, especially some focusing on education and children. As mentioned in a 2014 national study, “Generally speaking, the GEVA is used as a reference framework, but many MDPH have adapted it making their own and simplified versions. Professionals involved in assessment use the sections that seem most relevant and useful to them in relation to the situation. [...] A majority of the MDPH use a tool for gathering information at the individual’s home. Half of these tools are *ad-hoc* tools that contain GEVA items” [(3), p. 36, Translation M. Cuenot].

This initial version provided to the professionals contains no codes and no formal procedure designed to be used for data collection. Only in the annex of the 2008 decree, some hierarchical *ad hoc* codes are provided for each item and each possible response. The hierarchy is organized by the order of GEVA sections.

The aim of this research is two-fold. Firstly, mapping of the GEVA items onto the ICF will allow to identify those items that are covered by the ICF and assist in improving the data collection process. Secondly, this work will provide the first exploration of the items that are not covered by the ICF, and then could lead to potential additional proposals for updating the ICF. After introducing the method used for this mapping, some preliminary results will be described and then discussed.

## METHODS

The items of the general 2008 paper-based version of the GEVA have been used as a reference version for this mapping (2). They have been translated into English by the author of this paper. **Table 1** gives an overview of the content divided up into eight sections. Our analysis did not only take into account the GEVA Section 6 explicitly related to Activities, but also the GEVA Sections 1–5, the Sections 7 and 8 being merely the summaries of the other sections. We hypothesized that some other sections could also be coded with the ICF.

The linking rules formulated by Cieza et al. (4, 5) have guided the mapping work. The ICF 2017 browser version, currently available online, has been used as the reference ICF version for this work. In a general statistic approach, every different GEVA item has been counted in Sections 1–6, thus not including duplicated ones and counting only one ICF category for one GEVA item. The main results presented here are based on a qualitative analysis of the content of the GEVA for the aim is rather showing which ICF categories may be used to code the GEVA items than showing how many GEVA items are coded (several GEVA items may correspond to one same ICF category or are duplicated several times throughout the GEVA).

## RESULTS

Preliminary results show that the GEVA items are partly covered by the ICF. The general statistic approach allows to estimate that 80% (343 of 435) of the GEVA items can be covered by the ICF
<table><caption>TABLE 1 | Overview of the GEVA 2008 sections and corresponding covered ICF components.</caption><thead><tr><th>Sections</th><th>Overview of content</th><th>ICF components</th></tr></thead><tbody><tr><td>Identification:</td><td>Title; Name; ID; Initial reasons of assessment; Life project and wishes of the person; Acquaintances' or legal representative's opinion</td><td>PF</td></tr><tr><td>Section 1: Family, social, and financial situation</td><td>Family status; List of persons currently in the household Social situation in relation to education or employment, including child care arrangements for young children Individual financial resources Elective offices; related needs for human assistance.</td><td>PF; D; E</td></tr><tr><td>Section 2: Housing and living conditions</td><td>Housing: accommodation, housing types and characteristics (accessibility; comfort) Services and building accessibility Transportation: school; human assistance and adaptations</td><td>PF; D; E</td></tr><tr><td>Section 3: Training and professional path</td><td>Education path: background and orientation; learning assessment and adaptations; professionals' opinion Professional path: plan; situation; status; workstation and working conditions arrangements; job coach or psychologist's opinion; arrangements for maintaining a job; skills assessment.</td><td>PF; D; E</td></tr><tr><td>Section 4: Medical information</td><td>Pathological origin of the disabilities; medical background; clinical information (vision; hearing); symptoms; foreseeable evolution Impairments (see regulatory framework); healthcare provision Constraints: personal assistive devices; food; natural environment</td><td>(ICD-10) B; PF; D; E</td></tr><tr><td>Section 5: Psychological assessment</td><td>(Neuro-)Psychological and/or memory assessment</td><td>PF</td></tr><tr><td>Section 6: Activities</td><td>1. General tasks and demands, and interpersonal relationships 2. Mobility 3. Self-care 4. Communication 5. Domestic and daily life 6. Applying knowledge and learning 7. Tasks and demands related to education 8. Tasks and demands related to employment</td><td>B; D; E</td></tr><tr><td>Section 7: Assistance and care provided</td><td>Human assistance (acquaintances, professionals, joint collaboration) Organization of a usual day and week Professionals related to the education project Summary-Key points to be emphasized Discussion with the concerned person about the assessment Eligibility criteria (severe and complete difficulties identified) Identified needs in relation to different activities</td><td>PF; B; D; E</td></tr><tr><td>Section 8: Assessment summary</td><td>Summary of assessment, intended to the Commission's attention</td><td>PF; B; D; E</td></tr></tbody></table>

categories. In each of the six considered sections of the GEVA, some of the items may be coded with the ICF codes. Hence, not only the items of the Section 6 of the GEVA explicitly relate to Activities but also some items of the other GEVA Sections 1–5 belong to the universe of the ICF. The covered items are related to the following ICF components: Body functions (B), Activities and Participation (D), Environmental factors (E), and Personal factors (PF).

Some items are covered by other international classifications. In Section 4, the information related to diseases and rare diseases and to hearing and vision could be coded with ICD-10 codes. Some items may also be covered by the 1980 ICIDH categories. Indeed, some parts of the national regulatory framework still use impairments and disabilities to specifically fix the disability rates (Guide-barème). These impairment-related items may be mapped onto some ICF B categories and a related qualifier (Table 2).

The section in which the GEVA items are mostly covered by the ICF D chapters remains Section 6 (Table 2). Each item

of this section is explicitly intended to be assessed through the two qualifiers: functional capacity and performance. Functional capacity should be assessed with the following scale, which is similar to the one recommended for the ICF: “0”: No difficulty; “1”: Mild difficulty; “2”: Moderate difficulty; “3”: Severe difficulty; “4”: Total difficulty; and “9”: Non-applicable. Performance should be assessed with another scale: a-activity performed alone; b-activity partially performed with human assistance; c-activity performed with continued assistance; and d-activity not performed.

This performance scale provides the information about the environment, especially mentioning the potential impact of human assistance on the performed activity. This means that conceptually the data that might be collected at that stage should contain one related to D and one related to E. The following general five types of E are required to be documented as facilitators or barriers during the performance assessment: human environment [ICF chapter e3 Support and relationships]; technical assistance [e1 Products and technology] housing
<table><caption>TABLE 2 | GEVA items covered by ICF categories (exact matches).</caption><thead><tr><th>GEVA item</th><th>ICF 2nd or 3rd-level codes</th></tr></thead><tbody><tr><td><strong>Section 4</strong><br>Intellectual and cognitive impairments<br>Mental impairments<br>Hearing impairments<br>Language impairments<br>Vision impairments<br>Visceral impairments<br>Motor impairments</td><td><strong>B</strong><br>b1 Mental functions + qualifiers<br>b1 Mental functions + qualifiers<br>b230 Hearing functions + qualifiers<br>b3 Voice and speech functions + qualifiers<br>b210 Seeing functions + qualifiers<br>Functions related to the digestive system (b510-b539) + qualifiers<br>b7 Neuromusculoskeletal and movement-related functions + qualifiers</td></tr><tr><td><strong>Section 6</strong><br>1.1 Orientation to time<br>1.2 Orientation to space<br>1.4 Memorize<br>4.2.1 Hearing sounds<br>4.2.5 Localization of sound source<br>4.3 Seeing<br>8.8.1 Seeing colors<br>8.8.2 Depth perception<br>3.6.1 Using one's respiratory functions<br>2.15 Two-hand coordination</td><td><strong>B</strong><br>b1140 Orientation to time<br>b1144 Orientation to space<br>b144 Memory functions<br>b2300 Sound detection<br>b2302 Localization of sound source<br>b210 Seeing functions<br>b21021 Color vision<br>b21000 Binocular acuity of distant vision<br>b440 Respiration functions<br>b7602 Coordination of voluntary movements<br>d850 Remunerative employment</td></tr><tr><td><strong>Section 6</strong><br>1.3 Focusing attention<br>1.5 Making decisions<br>1.6 Taking initiatives<br>1.6.2 Spontaneously forming relationships<br>1.6.3 Spontaneously undertaking a simple activity<br>1.6.4 Spontaneously undertaking a complex activity<br>1.7 Managing one's own safety<br>1.7.1 Not endangering other's life or one's own life<br>1.7.2 Adapted reaction in a hazardous situation<br>1.8 Respecting social rules<br>1.9 Relating to others according to social rules<br>1.10 Control one's behavior in interactions with others<br>1.11 Relating with peers<br>1.12 Having intimate relationships<br>2.1 Standing<br>2.1.1 Lying down<br>2.1.2 Sitting<br>2.2 Transferring oneself<br>2.3 Shifting the point of support<br>2.4 Maintaining a sitting position<br>2.5 Maintaining a standing position<br>2.6 Walking<br>2.7.1 Moving around within the home<br>2.7.2 Moving around outside the home<br>2.8 Climbing stairs<br>2.9 Using public transportation<br>2.10 Using one's own vehicle<br>2.11 Driving a vehicle<br>2.14 Fine hand use<br>2.16 Lifting and carrying objects (including while moving around)</td><td><strong>D</strong><br>d160 Focusing attention<br>d177 Making decisions<br>d177 Making decisions<br>d7200 Forming relationships<br>d2100 Undertaking a simple task<br>d2101 Undertaking a complex task<br>d570 Looking after one's health<br>d240 Handling stress and other psychological demands<br>d7203 Interacting according to social rules<br>d7202 Regulating behaviors within interactions<br>d7402 Relating with equals<br>d770 Intimate relationships<br>d4104 Standing<br>d4100 Lying down<br>d4103 Sitting<br>d420 Transferring oneself<br>d4106 Shifting the body's center of gravity<br>d4153 Maintaining a sitting position<br>d4154 Maintaining a standing position<br>d450 Walking<br>d4600 Moving around within the home<br>d4602 Moving around outside the home and other buildings<br>d4551 Climbing<br>d4702 Using public motorized transportation<br>d4701 Using private motorized transportation<br>d475 Driving<br>d440 Fine hand use<br>d430 Lifting and carrying objects</td></tr></tbody></table>

(Continued)
<table><caption>TABLE 2 | Continued</caption><thead><tr><td>GEVA item</td><td>ICF 2nd or 3rd-level codes</td></tr></thead><tbody><tr><td>3.1 Washing oneself</td><td>d510 Washing oneself</td></tr><tr><td>3.2 Caring for body</td><td>d520 Caring for body parts</td></tr><tr><td>3.3 Toileting and using the toilets</td><td>d530 Toileting</td></tr><tr><td>3.4 Putting on and taking off clothes</td><td>d5400 Putting on clothes; d5401 Taking off clothes</td></tr><tr><td>3.5 Eating, drinking</td><td>d550 Eating; d560 Drinking</td></tr><tr><td>3.6 Looking after one's health</td><td>d570 Looking after one's health</td></tr><tr><td>3.6.2 Caring for oneself</td><td>d5702 Maintaining one's health</td></tr><tr><td>3.6.4 Monitoring one's own diet</td><td>d5701 Managing diet and fitness</td></tr><tr><td>4.1 Speaking</td><td>d330 Speaking</td></tr><tr><td>4.2.2 /0.3 /0.4 Understanding others' speaking face to face/in a group/in a noisy environment</td><td>d310 Communicating with—receiving—spoken messages</td></tr><tr><td>4.4 Using communication devices and techniques</td><td>d360 Using communication devices and techniques</td></tr><tr><td>4.4.1 Using a phone</td><td>d3600 Using telecommunication devices</td></tr><tr><td>4.4.2 Using other communication devices and techniques</td><td>d3609 Using communication devices and techniques, unspecified</td></tr><tr><td>4.5 Understanding a simple sentence</td><td>d3100 Communicating with - receiving - simple spoken messages</td></tr><tr><td>4.6 Maintaining a conversation</td><td>d350 Conversation</td></tr><tr><td>4.7 Producing and receiving non-verbal messages</td><td>d315 Communicating with - receiving - nonverbal messages; d335 Producing non-verbal messages</td></tr><tr><td>5.1 Shopping</td><td>d6200 Shopping</td></tr><tr><td>5.2 Preparing a simple meal</td><td>d6300 Preparing simple meals</td></tr><tr><td>5.3 Doing housework</td><td>d640 Doing housework</td></tr><tr><td>5.4 Taking care of clothes and garments</td><td>d6400 Washing and drying clothes and garments</td></tr><tr><td>5.5 Taking care of one's own family</td><td>d660 Assisting others</td></tr><tr><td>5.6 / 5.6.1 Managing one's own money daily and administrative tasks</td><td>d860 Basic economic transactions (managing one's budget, administrative tasks)</td></tr><tr><td>5.6.2 Managing one's bank account</td><td>d865 Complex economic transactions (managing one's bank account)</td></tr><tr><td>5.8 Having informal relationships with neighbors</td><td>d7501 Informal relationships with neighbors</td></tr><tr><td>5.9 Participating in community, social and civic life</td><td>d9 Community, social and civic life</td></tr><tr><td>5.9.3 Participating in local life</td><td>d950 Political life and citizenship</td></tr><tr><td>6.1 Reading</td><td>d166 Reading</td></tr><tr><td>6.2 Writing</td><td>d170 Writing</td></tr><tr><td>6.3 Calculating</td><td>d172 Calculating</td></tr><tr><td>6.4 Acquiring know-how skills; 6.5 Applying know-how skills</td><td>d155 Acquiring skills</td></tr><tr><td>7.1 Learning to read</td><td>d140 Learning to read</td></tr><tr><td>7.2 Learning to write</td><td>d145 Learning to write</td></tr><tr><td>7.3 Learning to calculate</td><td>d150 Learning to calculate</td></tr><tr><td>7.6 / 8.1 / 7.6.9 Respecting basic rules in relation to education/employment; Respecting school rules</td><td>d7203 Interacting according to social rules</td></tr><tr><td>7.6.8 / 8.6 Working with a team, in relation to education/employment</td><td>d7402 Relating with equals</td></tr><tr><td>8.1.3 Respecting hierarchical relations</td><td>d8451 Maintaining a job</td></tr><tr><td>8.1.4 Participating in meetings</td><td>d3551 Discussion with many people</td></tr><tr><td>8.7 / 8.7.1 Physical tasks/Lifting and moving heavy objects</td><td>d430 Lifting and carrying objects</td></tr><tr><td>8.7.2 Trunk twisting while working</td><td>d4305 Putting down objects</td></tr><tr><td>8.7.3 Working in various positions</td><td>d4309 Lifting and carrying, unspecified</td></tr><tr><td>8.7.4 Working in a squatting position</td><td>d4151 Maintaining a squatting position</td></tr><tr><td>8.7.9 Using one's feet to use a machine</td><td>d4350 Pushing with lower extremities</td></tr></tbody></table>

adaptations [e1158 Products and technology for personal use in daily living, other specified]; services [e5 Services, systems, and policies]; and animal assistance [e350 Domesticated animals]. Additionally, in this GEVA Section 6, a list of items are given for a more in-depth assessment of the human, technical, and animal assistance provided in each life domain. A related satisfaction

assessment scale is eventually included to collect the point of view of the individual about the situation: complete satisfaction; satisfaction; mild satisfaction; and no satisfaction.

Hence, throughout the GEVA sections, many E are listed that may be documented. **Table 3** presents the corresponding ICF E categories that are covered. Some require additional information
<table><caption>**TABLE 3** | ICF Environmental factors documented throughout the GEVA and related GEVA sections.</caption><tr><td>E1 Products and technology</td><td>6: General Environmental factor technical environment</td></tr><tr><td>e1101 Drugs</td><td>4: Regular treatments</td></tr><tr><td>e1108 Products or substances for personal consumption, other specified</td><td>4: Food constraints</td></tr><tr><td>e1151 Assistive products and technology for personal use in daily living</td><td>4: Urinary ostomy and catheter, digestive ostomy, gastrostomy, jejunostomy, tracheotomy, ventilation unit</td></tr><tr><td>e1158 Products and technology for personal use in daily living, other specified</td><td>4: Dependence on another machine</td></tr><tr><td>e120 Products and technology for personal indoor and outdoor mobility and transportation</td><td>6: General Environmental factor housing</td></tr><tr><td>e1201 Assistive products and technology for personal indoor and outdoor mobility and transportation</td><td>2: Adapted vehicle</td></tr><tr><td>e1251 Assistive products and technology for communication</td><td>4: Walking sticks, wheelchair</td></tr><tr><td>e130 Products and technology for education</td><td>4: Hearing aid</td></tr><tr><td>e1301 Assistive products and technology for education</td><td>3: Adaptations during school assessments</td></tr><tr><td>e135 Products and technology for employment</td><td>6: Adapted teaching material, computers</td></tr><tr><td>e150 Design, construction and building products and technology of buildings for public use;</td><td>3: Workstation accommodation</td></tr><tr><td>e1500 Design, construction and building products and technology for entering and exiting buildings for public use</td><td>2: Accessibility of postal, and education facilities and services</td></tr><tr><td>e1501 Design, construction and building products and technology for gaining access to facilities inside buildings for public use</td><td>2: Accessibility of the housing</td></tr><tr><td>e1508 Design, construction and building products and technology of buildings for public use, other specified</td><td>2: Lift in the housing</td></tr><tr><td>e1550 Design, construction and building products and technology for entering and exiting of buildings for private use</td><td>2: Other elements of accessibility of the housing</td></tr><tr><td>e1551 Design, construction and building products and technology for gaining access to facilities in buildings for private use</td><td>2: Accessibility of shops, banks</td></tr><tr><td>e1650 Assets</td><td>2: Accessibility of living room, kitchen, bedroom, toilets, bathroom, vertical and horizontal inside circulation</td></tr><tr><td>e198 Products and technology, other specified</td><td>2: Owner of housing</td></tr><tr><td>e225 Climate</td><td>4: Equipment</td></tr><tr><td>e2250 Temperature</td><td>4: Weather</td></tr><tr><td>e2251 Humidity</td><td>4: Cold, heat</td></tr><tr><td>e240 Light</td><td>4: Humidity</td></tr><tr><td>e2450 Day/night cycles</td><td>4: Light</td></tr><tr><td>e2458 Time-related changes, other specified</td><td>6: Night work</td></tr><tr><td>e250 Sound</td><td>6: Working assuming schedules modifications</td></tr><tr><td>e2500 Sound intensity</td><td>4: Noise</td></tr><tr><td>e255 Vibration</td><td>6: Working in a noisy environment</td></tr><tr><td>e260 Air quality</td><td>6: Working in an environment with vibrations</td></tr><tr><td>e2601 Outdoor air quality</td><td>6: Working in specific respiratory environments</td></tr><tr><td>e298 Natural environment and human-made changes to environment, other specified</td><td>4: Dust, chemical agents</td></tr><tr><td>e3 Support and Relationships</td><td>4: Other external factor constraints</td></tr><tr><td>e310 Immediate family</td><td>6: General Environmental factor human environment</td></tr><tr><td>e325 Acquaintances, peers, colleagues, neighbors and community members</td><td>6: Spouse, child, parent, brother/sister, other parent</td></tr><tr><td>e340 Personal care providers and personal assistants</td><td>6: Friend, neighbor, mutual support group</td></tr><tr><td>e350 Domesticated animals</td><td>3: Human assistance during school assessments</td></tr><tr><td>e355 Health professionals</td><td>4: Personal care assistant</td></tr><tr><td>e398 Support and relationships, other specified</td><td>6: Personal assistant at school</td></tr><tr><td>e399 Support and relationships, unspecified</td><td>6: General Environmental factor animal environment</td></tr><tr><td></td><td>4: PT, OT, nurse, speech therapist, psychologist</td></tr><tr><td></td><td>6: Cued speech interpreters, technicians in writing, sign language interpreters</td></tr><tr><td></td><td>6: Associated to the general performance qualifier levels b and c</td></tr></table>

(Continued)
<table><caption>**TABLE 3** | Continued</caption><tr><td>e5 Services, systems and policies</td><td>6: General Environmental factor services</td></tr><tr><td>e5250 Housing services</td><td>6: Types of housing facilities</td></tr><tr><td>e5258 Housing services, systems and policies, other specified</td><td>6: Different types of medico-social facilities</td></tr><tr><td>e5300 Utilities services</td><td>2: Heat, gaz, water, electricity, other</td></tr><tr><td>e5350 Communication services</td><td>2: Accessibility of postal services</td></tr><tr><td>e5400 Transportation services</td><td>2: Accessibility of transportation facilities</td></tr><tr><td>e5500 Legal services</td><td>6: Legal protection</td></tr><tr><td>e5550 Associations and organizational services</td><td>2: Accessibility of cultural and leisure services and facilities</td></tr><tr><td>e5650 Economic services</td><td>2: Accessibility of bank services</td></tr><tr><td>e5652 Economic policies</td><td>2: Insurance premiums and restrictions</td></tr><tr><td>e5758 General social support services, systems and policies, other specified</td><td>6: Different types of medico-social supports</td></tr><tr><td>e580 Health services, systems and policies</td><td>4: Healthcare and night care provision, meals delivery services</td></tr><tr><td>e5808 Health services, systems and policies, other specified</td><td>6: Different types of medico-social supports</td></tr><tr><td>e585 Education and training services, systems and policies</td><td>6: Different types of hospitalization</td></tr><tr><td>e5850 Education and training services</td><td>3: Types of schooling/training/examination facilities and services</td></tr><tr><td>e590 Labor and employment services, systems and policies</td><td>6: Remote learning and home schooling services, specialized assistance services for pupils, homework support services</td></tr><tr><td>e5908 Labor and employment services, systems and policies, other specified</td><td>2: Accessibility of school, pre-school, kindergarden services</td></tr><tr><td>e598 Services, systems and policies, other specified</td><td>3: Types of working conditions and workstation arrangements</td></tr><tr><td></td><td>6: Job seeking and support services</td></tr><tr><td></td><td>6: Support and work institutions</td></tr><tr><td></td><td>2: Accessibility of other services</td></tr></table>

to know whether they have an impact on the individual situation, as a facilitator or an obstacle. Others only require to be identified as being provided or not. A more in-depth analysis would allow more information on how they are formulated in relation to the ICF E qualifiers. Nevertheless, these preliminary results show that the ICF E Chapters 1, 2, 3, and 5 are documented throughout the GEVA items. The categories of Chapter 4 related to Attitudes are not represented as such.

Throughout the GEVA, some items are also related to PF. Some additional qualitative information is listed in the GEVA and relates to proxy and points of view of professionals about the situation of an individual (psychological, medical, educational, apprenticeship, and professional).

Finally, some GEVA items might be covered by the ICF but no exact match is really possible. **Table 4** presents them together with the potentially lacking concept. They are mainly related to D and E. Other GEVA items cannot at all be coded with the ICF for they require qualitative information, either the point of view of other persons in relation to the main one asking for an assessment, or administrative information about some applications in progress and time-related information. The satisfaction qualifier is also not a part of the ICF.

## DISCUSSION

These preliminary results of this GEVA-ICF mapping provides a first overview of the ICF coverage potential. The categories stemming from the D chapters and the Environmental chapters, together with the corresponding qualifiers, are well-represented.

Not completely covered items deal in particular with education and employment (see **Table 4**). They raise some issues on how to better implement specific adaptations in these two areas and others so as to facilitate the coding and collection of some precise information.

This also underlines the needs to better document the way of interaction of these components together in some specific areas, in particular such as education or employment, which are the two major areas in the individual life project.

In the ICF education category (d820), additional information could then be added in relation to assessment/examination criteria, organizing and checking one's own work, getting organized in the classroom, getting used to school life, using learning (adapted) materials, taking notes, and participating in after-school activities. Several GEVA items also relate to the learning process: learning how to use communication techniques, or basic social rules, asking for help or assistance.

In the employment area, additional information could be added about organizing and checking one's work, working at height, working with the dominant/non-dominant arm, and working in hazardous environments.

Furthermore, the GEVA satisfaction qualifier is currently used and allows a better understanding of the impact of the E. A more in-depth analysis is needed to firstly better inform the use of qualifiers together with E and secondly to improve the identification of the items directly covered by the ICF definition of PF and others that might not be covered but which provided relevant information for a better understanding of the situation and project of an individual.
<table><caption>TABLE 4 | GEVA items not completely covered by the ICF.</caption><thead><tr><th>GEVA item and related GEVA Section</th><th>Most precise ICF categories</th><th>Potential additional concepts related to ICF chapters</th></tr></thead><tbody><tr><td><strong>Section 1</strong><br>Childcare related services<br>- Engaging in political life<br>- Participation in councils where DPO's representatives are appointed as members by law: Local councils; national or European parliament; other<br>Human assistance required in relation to political life; Other needs</td><td>e5850 Education and training services<br>d950 Political life and citizenship<br>e340 Personal care providers and personal assistants<br>e5950 Political services</td><td>Child care facilities (e)<br>Local<br>National<br>Transnational<br>Other specified<br>Human assistance related to political engagement (e)</td></tr><tr><td><strong>Section 3-4</strong><br>School assessment criteria (adaptations, additional time)<br>Additional time necessary for care provision<br>Infectious agents</td><td>d820 School education<br>e580 Health services, systems and policies<br>e2201 Animals</td><td>Learning assessment criteria<br>Additional time<br>Infectious agents (e)</td></tr><tr><td><strong>Section 6</strong><br>1.6.1 Spontaneously asking for help<br>3.6.3 Expression of a need for healthcare<br>5.9.2 Expression of a request for help in relation to one's own rights<br>2.12 / 13 Grasping using the dominant hand/non-dominant hand<br>3.6.5 Managing one's daily rest<br>5.9.1 Managing one's free time, participating in cultural or sport activities<br>5.10 Going on holiday<br>7.4 Learning communication techniques<br>7.5 Learning basic social rules<br>7.6.3/8.2 Organizing one's work<br>7.6.4/8.3 Checking one's work<br>7.7 Getting organized in the classroom<br>7.6.7 Adaptation to school life<br>7.8 Using learning materials<br>7.9 Using materials adapted to one's disabilities<br>7.10 Taking notes<br>7.11 Adaptation to examination and assessment conditions<br>7.12 Participating in after-school activities<br>8.7.5/8.7.6 Working at height (scale, roof)<br>8.7.7 Working with the dominant arm above the shoulders' height<br>8.7.8/non-dominant<br>8.8.5 Using hazardous tools or machines<br>8.8.9 Working in environments with risks for the skin</td><td>d570 Looking after one's health<br>d940 Human rights<br>d4401 Grasping<br>d570 Looking after one's health<br>d920 Recreation and leisure<br>d9208 Recreation and leisure, other specified<br>d3608 Using communication devices and techniques, other specified<br>d7208 Complex interpersonal interactions, other specified<br>d820 School education<br>d8451 Maintaining a job<br>d820 School education<br>d820 School education<br>d820 School education<br>d820 School education<br>d4158 Maintaining a body position, other specified<br>d4308 Lifting and carrying, other specified</td><td>Asking for help or assistance<br>Dominant hand/Non-dominant hand<br>Managing one's need for some rest<br>Managing one's free time<br>Going on holiday<br>Learning how to use communication techniques<br>Learning basic social rules<br>Organizing one's work<br>Checking one's work<br>Getting organized in the classroom<br>In relation to education<br>In relation to employment<br>Getting used to school life<br>Using learning materials<br>Using materials adapted to one's disabilities<br>Taking notes<br>Adaptation to examination and assessment conditions<br>Participating in after-school activities<br>Working at height<br>Working with the dominant/non-dominant arm above the shoulders' height<br>Using hazardous tools or machines<br>Risks in relation to the skin</td></tr></tbody></table>

In relation to E and PF, there is also a need to distinguish on one hand the content directly inspired by the French regulatory framework and on the other hand the content based on the ICF concepts and implementation rules. The GEVA has been designed in accordance with the French legal framework and not

its whole content may be applied to other social and cultural contexts without adaptation.

The GEVA items not completely covered by the ICF might benefit from the discussions with other ICF experts so as to better evaluate them as potential ICF update proposals.
## CONCLUSION

This mapping approach shows that firstly the items of the GEVA 2008 general version are partly covered by the ICF 2017 Browser version categories. In every section of the GEVA, some of the items might be coded with the ICF codes obtained from the following ICF components: B, D, E, and PF. The items of Section 6 remains those mostly covered by the ICF. Throughout the GEVA, many E factors are documented. Although further analysis is needed to better inform the use of qualifiers (performance, capacity, and satisfaction) together with the D, and the E, the identified ICF codes could assist in improving the data collection process. Finally, some items might be discussed to become potential ICF update proposals.

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## DATA AVAILABILITY STATEMENT

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

## AUTHOR CONTRIBUTIONS

The author confirms being the sole contributor of this work and has approved it for publication.

## ACKNOWLEDGMENTS

The author would like to thank William Sherlaw for reading the first draft in English.

5. Cieza A, Geyh S, Chatterji S, Kostanjsek N, Üstün B, Stucki G. ICF linking rules: an update based on lessons learned. J Rehabil Med. (2005) 37:212–8. doi: 10.1080/16501970510040263

**Conflict of Interest:** The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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