*4.3. Contributions of TEA-CIFunciona to Clinical Settings*

This study proposes a new culturally sensitive ICF-based tool for clinicians working in the field of childhood-onset disabilities, contributing to the few pediatric ICF tools available today [13]. The application of TEA-CIFunciona could facilitate comparison of outcomes and results of intervention across the country and hopefully in other countries in Latin-America. However, clinical experience as well as training in the use and the ICF language, are needed.

### *4.4. Additional Considerations and Contributions to the International Community*

Asking about parents' concerns and opinions also forces us to reconsider what the goals of treatment should be, who should set the priorities for a child, how to assess quality of care and support services, and even when to discontinue treatments. As described by Campos et al. in a recent qualitative study applying the ICF in a pediatric Latin American setting, it is crucial to incorporate parents' perspective when describing functional needs and setting goals for interventions, as parents are the ones who live and experience the main functional limitations of their children [26].

To our knowledge, this study describes the first attempt to operationalize the content of the ICF Core Sets for ASD in a pediatric clinical setting, as such; the multi-step methodology applied for developing TEA-CIFunciona may encourage the international community to replicate our effort in different cultural settings around the globe, and identify the most relevant items or tools to assess the content of the ICF Core Sets for ASD in their countries.

In addition, by providing evidence of functional needs and environmental barriers TEA-CIFunciona has the potential to guide health policies and may be useful guiding data collection at a regional or global level, facilitating comparisons across settings, guiding resource allocation, professional training, and capacitation. Overall, TEA-CIFunciona proved to be a practical framework and guideline for comprehensive assessments of ASD, although the time necessary for the interview may be a limiting factor.
