Interviewer instructions
<span class="em">Columns P13, P14 and P16 for All 5 Years Old and Over</span>
<br />Columns P13, P14 and P16 are to be accomplished only for household members five years old and over. Thus, if a household member is less than five years old leave columns P13, P14 and P16 blank.</p>
<p><span class="em">P13-Functional Difficulty</span>
<br />As defined by the International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization, functioning is an umbrella term for body functions, body structures, activities, and participation. It denotes the positive aspects of the interaction between an individual (with a health condition) and that individual's contextual factors (environmental and personal factors). Environmental factors include the physical world and its features, the human-made physical world, other people in different relationships and roles, attitudes and values, social systems and services, and policies, rules and laws. Personal factors are factors that relate to individual such as age, gender, social status, life experiences, and so on.
<br />A person with difficulty in functioning may have activity limitations, which means difficulties an individual may have in executing activities. An activity limitation may range from a slight to a severe deviation in terms of quality or quantity in executing the activity in a manner or to the extent that is expected of people without the health condition. In general, functional difficulties experienced by people may have been due to their health conditions. Health conditions refer to diseases or illnesses, other health problems that may be short
<br />or long lasting injuries, mental or emotional problems, and problems with alcohol or drugs. A health condition may also include other circumstances such as pregnancy, ageing, stress, congenital anomaly, or genetic predisposition. Difficulty is usually manifested when a person is doing an activity with increased effort, discomfort or pain, slowness, or changes in the way he/she does the activity.
<br /><span class="pg">[pg. 119]</span>
<br />For the purpose of this census, functional difficulty is classified into six core categories. The concepts and definitions are based on ICF. These difficulties are the following:</p>
<p>Difficulty in communicating
<br /><span class="pg">[pg. 122]</span><div class="i1">Communicating refers to an individual's exchanging information or ideas with other people through the use of language. They may usetheir voices for their exchange or make signs or write the information they want to exchange. It may involve mechanical problems such as hearing or speech impairment, or it may be related to the ability of the mind to interpret the sounds that the auditory system is gathering and to recognize the words that are being used.<br />The purpose of this question is to identify persons who have some problems with talking, listening, or understanding speech such that it contributes to difficulty in doing their daily activities. They can have a problem making themselves understood, or the problem may be that they cannot understand people who talk to them or try to communicate with them.<br />Difficulty may be experienced due to factors relevant to communication such as hearing loss, language problems as after a stroke, stuttering, anxiety, or any other factor related to a health condition.<br />Note the person's usual mode of communication (such as, spoken language, sign language, gestural, or with an assistive device such as hearing aid) and situations such as when others speak quickly, with background noise or with distractions. Difficulty should be assessed with these factors taken into consideration. For instance, difficulty due to the fact that the language spoken is not one's mother tongue should be excluded.</div>
