2.4.2. Translating Clinical Information and Standardized Assessment into ICF Qualifiers

As there is no gold standard to guide the translation of clinical information into ICF qualifiers, we created a guide for our pediatric clinical setting. First, we identified the best content correspondence [21] between item/s from standardized measures used in our ASD clinic and the content of the ICF categories included in TEA-CIFunciona. Then, we followed the ICF generic scale for problem severity (0–4% no problem/5–24% mild problem/25–49% moderate problem/50–95% severe problem/96–100% complete problem) [9,11] and compared it to the grading system of the assessment tools included in the toolbox. Additionally, we coded clinical information directly into ICF categories and qualifiers using our clinical expertise. Some categories were evaluated directly by parents, using the visual analog scale (VAS) as reported in other studies [22], including a visual response card created by the researchers to facilitate parents' understanding when identifying the degree of difficulty experienced by the children in a category. Parents' answers were directly translated into ICF qualifiers. Supplementary Material S1 shows examples of how clinical information and scores from standardized measures were translated into the ICF qualifiers.

#### **3. Results**

The multistep process led to the creation of TEA-CIFunciona version 1.0 and subsequently its application in clinical practice (Figure 1). TEA-CIFunciona version 1.0 consists of 32 ICF categories including, 10 body functions, 15 activities and participation, and 7 environmental factors.

**Figure 1.** Multistep process for the development of TEA-CIFunciona and its clinical application.
