*4.1. Benefits of Using TEA-CIFunciona Version 1.0*

TEA-CIFunciona incorporates the most relevant ICF categories for our cultural and pediatric setting. The application of TEA-CIFunciona helped us to incorporate a familycentered approach in the clinic. Consideration of parental views shifted the focus of follow-up visits towards the aspects of daily living significant to them. This modified the team's perspective; thus, parents' point of view and concerns were prioritized while taking into account the available resources.

In addition, the recognition of children's strengths and abilities was highly appreciated by the parents. For example, use of eating utensils may not be important to the practitioner, but may be essential to them. Generally, these skills can only be appreciated by the professional after a thorough investigation of everyday activities [23].

The systematic consideration of environmental characteristics allows us to draw some general conclusions regarding the difficulties these children and their families must overcome, and which support they considered most important. In most cases, the immediate family was identified as a substantial or complete facilitator, and its absence as an important barrier. This confirms once again not only the importance of a strong family structure, but also the need for support networks in the community and the notion that clinical interventions are successful when the uniqueness and diversity of families are recognized [24].

Another finding was that the pediatrician was identified as a facilitator in only 61% of the cases. The reasons given for this rating were lack of knowledge on ASD, or negative attitude. Often children with ASD do not have a primary care pediatrician and parents navigate a fragmented health care system without guidance. Sometimes the pediatrician is unaware of the family's priorities, and whether treatments or supports are working. Hence, the application of TEA-CIFunciona can improve service provision for ASD, as it explicitly examines the components of functioning that are often left out of traditional health care provision. TEA-CIFunciona could help communicate functional information in a simple

way (for example using an illustration shown in Figure 2), and therefore may encourage the pediatrician to collaborate in teamwork and adopt a social model to evaluate disability.

TEA-CIFunciona showed extremely varied school experiences, being very positive for some children and extremely negative for others. The latter was associated with negative attitudes of the teachers and problems in adopting effective individual educational strategies, such as anticipation pictures, calendars, or communication devices.

Again, TEA-CIFunciona helped us identify the main environmental barrier in our national context. We found that augmentative communication technology was not commonly used. The devices were unknown to many of the parents and therapists but highly valued by those who did use them. Although evidence is limited, different studies have reported on the possible benefits of augmentative communication devices for children with autism. Therefore, the lack of use or restricted use was considered as a barrier, mainly in children with important verbal language impairment [25].
