*2.4. Procedure*

2.4.1. Interprofessional and Family-Centered Approach

The overall purpose of this study was to create a brief culturally sensitive ICF-based tool to standardize assessments of functioning of children with ASD, especially to describe functioning in terms of performance at home, at school, and in the community. In every step of the study, the interprofessional study team, along with parents and caregivers, maintained active communication and collaborated sharing their different perspectives on day-to-day functioning. Thus, a multistep methodology was used to achieve the overall and specific aims, as follows:

• Aim (1) Identify the most relevant categories from the international ICF Core Sets for ASD to describe the daily functioning of children with ASD.

During two months, we conducted weekly sessions to familiarize ourselves with the content of the ICF classification and structure. We reviewed the literature related to the development and content of the comprehensive ASD Core Set [16,17]. In addition, electronic health records were reviewed to capture the main concerns described by families of children with ASD in previous years. Using the main concerns, each team member completed a checklist linking the meaningful concepts to the ICF categories included in the comprehensive ASD Core Set. We followed the ICF linking guidelines proposed by Cieza et al. [21]. ICF categories with an agreement of 75% or greater were included in our shortlist. This ICF-based shortlist was called TEA-CIFunciona.

• Aim (2) Propose measurement scales to evaluate each ICF category included in TEA-CIFunciona.

During the following month, we conducted weekly sessions where measurement tools were sought for each category included in our shortlist. We created a toolbox of measures to assess the categories in TEA-CIFunciona. Specifically, we tried to identify a one-to-one correspondence between an item of a measure and single ICF categories, at times this was not possible. Therefore, we proposed a set of items. When we could not identify a scale or measure to cover the content of the ICF category, we developed questions to assess that category. We ensured that the content of the questions represented the ICF category, using the ICF linking guidelines proposed by Cieza et al. [21].

• Aim (3) Feasibility and psychometric properties of TEA-CIFunciona version 0.0.

TEA-CIFunciona version 0.0 was piloted to check face validity, reliability, and feasibility in 20 patients. Interviews were conducted by two members of the study team who independently applied TEA-CIFunciona. Face validity: A questionnaire was answered by both evaluators to determine if all aspects of the consultations were included in TEA-CIFunciona. In addition, a questionnaire was answered by the parents to ensure that all their concerns were addressed; each family was additionally asked to give their opinion about the interview.

Inter-rater reliability: Two evaluators participated in each interview and independently scored all ICF categories included in TEA-CIFunciona. Cohen's Kappa statistics were used to evaluate inter-rater reliability. *k* of 0.61–0.80 are considered as substantial agreement and *k* > 0.80 as excellent agreement. Categories with a Kappa > 0.60 were maintained on our shortlist. Feasibility: raters were asked to provide feedback on usability, clarity, and objectivity of the TEA-CIFunciona using a brief questionnaire.

• Aim (4) Describe the profile of functioning of children with ASD using TEA-CIFunciona.

Finally, using the final version of TEA-CIFunciona (version 1.0), we described the profile of functioning of a larger group of children with ASD (*n* = 100). We translated clinical information into qualifiers following a self-developed guide, see below.
