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adding d161 from ICF-CY to ICF (old271)

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The title of the proposal

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Update or Revision Proposal: This field shows whether the proposal suggests an update that can be achieved in the usual ICD update cycle or whether it is made for the ICD-11 revision.

Primary Code affected: The primary ICD cide affected by this proposal. (See also the section: Selecting where to attach the proposal in the user's guide)

Secondary Codes affected: See the section: Selecting where to attach the proposal from the User's guide. Volumes Affected: The list of ICD volumes that will be changed as a result of this proposal.

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Change Reason: Similar to above, the originator selects this from a predefined list

Updates Specific to a Language Version*: This field is dislayed only when the proposal is suggesting a change to a specific language version of ICD. Not having this field means that the proposal applies to all language versions.

Detailed Description: This is where the user explains the proposal. He/She may provide the updated version of the ICD text using strikethrough text for the removed parts.

Rationale: This field includes the information on why this change is necessary.

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*optional fields: Displayed if relevant information is available

Proposal ID : 406  -  Proposal State : In Open Discussion Layer Proposal for Update

Originator : Coen H. van Gool  -  Last Update made by : Paula Tonel

Creation Date : 04-Feb-2019 14:54 CET  -  Last Update : 20-Jul-2020 16:17 CET

Previously Discussed in the group(s): FDRG, RVW

Primary Code Affected : d160-d179

Secondary Codes Affected : None

Proposal Type : Addition of new code

Change Reason : Need to identify a new functioning domain.

Detailed Description

d161 Maintaining attention

Intentionally maintaining attention to specific actions or tasks for an appropriate length of time.

Exclusions: sustaining attention (b1400); undertaking a single task (d210); undertaking a complex task (d220)
Archived Versions
20/07/2020 Paula Tonel
04/02/2019 Thomas Maribo
04/02/2019 Coen H. van Gool

This proposal deals with adding more detail to ICF that is already in ICF-CY; it aims to promote the merger of ICF and ICF-CY. Adding code d161 (#271) was left out intentionally when subcodes d1600-d1609 were merged into ICF from ICF-CY. Directing attention was thought to interfere with both d-code (d160) focussing attention and b-code (b1400) Sustaining attention.


At the update workshop 9.1.2019 in Bilthoven the Netherlands, Christine Haas, Andrea Martinuzzi and Coen van Gool, sought to provide more evidence for the above proposal. The group thinks that by changing the word Directing into Maintaining the potential overlap with sustaining attention might be less. Moreover, the code title then holds a verb that comes back in the description note, which is in line with ICF principles.

CSAC Sec. (Apr 1, 2019): IRG review completed: proposal moved to FDRG layer.

CSAC secretariat (May 3, 2019): FDRG review completed: proposal moved to Open Discussion layer.

CSAC Sec. (Jul 14, 2019): proposal moved to Closed Discussion Layer.

CSAC (Jan 30, 2020): proposal moved back to Open Discussion Layer for further work.

CSAC (20 Jul, 2020): proposal was discussed in May 2020. It was decided that it should be reviewed by MSAC. It is temporarily placed here in the Open Discussion layer.
29-Mar-2019 10:16 CET by Ulrike Trinks
Initial review on # 406
Initial Review Period March 2019

1. Has the author correctly entered the “Primary Code Affected” in that field on the Platform? Yes

2. Are there any “Secondary Codes Affected”? No

3. Has the author correctly entered the “Secondary Codes Affected” in that field on the Platform? Yes

4. Does the proposal affect the Descriptive Note in a given ICF code text? No

5. Does the proposal affect Inclusions in a given ICF code text? No

6. Does the proposal affect Exclusions in a given ICF code text? No

7. Is the proposal age specific? No

8. Does the proposal have plausibility as a classification entity in the ICF? Yes

9. Does the proposal add any additional value as a new classification entity? Yes

10. Would the proposal, if adopted, affect the described ICF situations in all cultures? Yes

11. Does the proposal address a genuine underlying need or deficiency within the ICF? Yes

12. Has the author incorporated sufficient rationale to justify adopting their proposal, as written, into a harmonized ICF? Yes

13. Is the author’s rationale for the proposal evidence-based? No

14. Is the proposal consistent with the existing structure and content of the ICF? To be discussed

15. Is the proposal consistent with conceptual and taxonomic principles in the ICF? Yes

16. If adopted, would this proposal be consistent with the goal of ensuring standardization and comparability of data reporting? Yes

Initial Reviewer’s recommendation:
This proposal can go to the FDRG layer for further discussion.
04-Apr-2019 15:31 CET by Judith Hollenweger
FDRG Meeting comment on #406
We (names see proposal 365) agree with the rationale and with the proposal.
04-Sep-2019 14:16 CET by Catherine Sykes
Comment attached to the vote of the user for Round 2 of year 2019. Voted:Can't Decide
Maintain and sustain are synonyms so it may cause confusion to use this verb. There would need to be clear guidance on when to use the body function and when to use the A&P life area.

Would Holding or keeping attention be acceptable?
05-Sep-2019 14:51 CET by Lucilla Frattura
Comment attached to the vote of the user for Round 2 of year 2019. Voted:Can't Decide
the title and description use the same verb. It is useful to define a category using words different from those used in the title. As Catherine said, there is an overlap between attention as a body function and "to maintain attention" as an activity. I prefer "to remain concentrated on" something or someone in the A&P context:
"to focus on someone or something and maintaining concentration for an appropriate lenght of time"
12-Sep-2019 22:13 CET by Coen H. van Gool
Comment attached to the vote of the user for Round 2 of year 2019. Voted:Can't Decide
We find it important that the distinction between focussing d160 and directing attention d161 be implemented in ICF. Rewording d161 seems to be acceptable to several people. Maybe exact wording can be found during csac session in the Banff meeting
13-Sep-2019 00:58 CET by Ann-Helene Almborg
Comment attached to the vote of the user for Round 2 of year 2019. Voted:No
Suggest to merge maintaining and focusing attention to d160 Focusing and maintaining attention, as this is about attention. Suggest to add two specific subcategories such as d1600 Focusing attention and d1601 Maintaining attention.
21-Apr-2020 14:59 CET by Ann-Helene Almborg
Comments to proposal 406 adding d161 from ICF CY
The Nordic ICF-Network (Thomas M, Janna P, Solvejg B, Ann-Helene A) have had a meeting 2020-03-03 to discuss the proposal. We discussed the overlap between the proposed new ICF-code d161 Maintaining attention to d160 Focusing attention (Intentionally focusing on specific stimuli, such as by filtering out distracting noises) but also to b140 Attention functions (Specific mental functions of focusing on an external stimulus or internal experience for the required period of time) with different subcategories such as b1400 Sustaining attention (Mental functions that produce concentration for the period of time required)