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Handicap Quantification (CHART)×Person-Environment Fit (Disability)×
FagområdeDisability StudiesDisability Studies
FamilieLatent structureProcess / pipeline
Oprindelsesår19922001
OphavspersonGale G. Whiteneck and colleagues (Craig Hospital)Ecological models of aging and disability (e.g., Lawton & Nahemow competence-press); aligned with the WHO ICF
TypeObjective, behaviorally anchored measure of handicap at the participation levelAnalytic framework treating disability as misfit between personal capacity and environmental demand
Oprindelig kildeWhiteneck, G. G., Charlifue, S. W., Gerhart, K. A., Overholser, J. D., & Richardson, G. N. (1992). Quantifying handicap: a new measure of long-term rehabilitation outcomes. Archives of Physical Medicine and Rehabilitation, 73(6), 519-526. DOI ↗World Health Organization. (2001). International Classification of Functioning, Disability and Health: ICF. Geneva: WHO. ISBN: 9789241545426
AliasserCHART, Craig Handicap Assessment, Handicap Outcome Measure, Participation-Level Handicap ScoringCompetence-Press Model, Demand-Capacity Fit Framework, Ecological Disability Fit Model, Person-Environment Misfit Analysis
Relaterede33
ResuméHandicap quantification is the approach to measuring long-term rehabilitation outcomes at the level of social roles and participation, implemented in the Craig Handicap Assessment and Reporting Technique developed by Whiteneck and colleagues in 1992. Where earlier outcome measures captured impairment or disability — what is wrong with the body or what activities a person can perform — this method targets handicap in the sense of the World Health Organization's older ICIDH classification: the disadvantage a person experiences in fulfilling normal social roles. It operationalizes the ICIDH handicap dimensions of physical independence, mobility, occupation, social integration, and economic self-sufficiency into objective, behaviorally anchored indicators rather than subjective ratings. Each dimension is scored on a scale to 100, with 100 representing role performance equivalent to that of a person without disability, and the dimension scores are summed into a total. The instrument was designed specifically to detect outcomes that matter for community living, such as employment, mobility, and social contact, which lower-level measures miss.Person-environment fit is an analytic framework that treats disability not as a property of the individual but as a misfit between a person's capacity and the demands their environment places on them. Rooted in ecological models of aging and disability — most famously the competence-press model, in which behavior depends on the balance between personal competence and environmental press — it aligns closely with the biopsychosocial conception of the WHO ICF, where disability emerges from the interaction of the person and contextual factors. The framework asks, for any activity or life situation, whether the environment demands more than the person can supply: when demand exceeds capacity there is misfit and disability is expressed, and when demand is within capacity there is adequate fit and participation proceeds. Crucially, this reframing implies that misfit can be reduced from either side — by raising the person's capacity or, often more powerfully, by lowering environmental demand and adding support. The practical thrust is to target interventions on the environment, not only on remediating the person.
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