The Gestalt of functioning in autism revisited: First revision of the International Classification of Functioning, Disability and Health Core Sets.

There is no gold standard for revising ICF Core Sets, and this process was adapted from, rather than a typical, Delphi method. Most evidence came from high-income countries, so the revised sets have not been validated globally. No autistic researchers were part of the expert panel. Stakeholder feedback was informal, so autistic people who did not contact the authors may not have been heard. Some age-appropriate codes may not fit all ages within a set, such as verbal communication for very young children or employment for younger adults.

S.B. has acted as an author, consultant, or lecturer for Medice and Linus Bio in the last 3 years, receives royalties from Hogrefe, Liber, Ernst Reinhardt, Kohlhammer, and UTB, and is a partner in NeuroSupportSolutions. P.B.M. receives royalties for textbooks from Elsevier, Springer, Mac Keith Press, and Thieme. The other authors reported no conflicts. Funding came from the Swedish Research Council for Health, Working Life and Welfare, Trygg-Hansa, Folksam, Stiftelsen Promobilia, Sunnerdahls Handikappfond, Stiftelsen Clas Groschinskys Minnesfond, and SBRI Healthcare.

Do not assume every autism ICF Core Set was updated or validated. The common brief set was not revised, and the authors say global validation is still needed.