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An Introduction to the
International Classification
of Functioning, Disability,
and Health
Presentation Overview
 Introduction to the International
Classification of Functioning,
Disability and Health (ICF)
 How can the ICF inform disability
measurement?
 How does the purpose of data
collection affect measurement
methodology?
What is the ICF?
 A framework for describing the facets
of human functioning that may be
affected by a health condition
 A classification system – not a
measurement tool
Where did the ICF come from?
 Developed by the World Health
Organization (WHO)
 Large international and
multidisciplinary participation
 Extensive field testing
The Aims of the ICF
 To provide a scientific basis for the
consequences of health conditions
 To establish a common language to
improve communications
 To permit comparisons of data across:
Countries
Health care disciplines
Services
Time
 To provide a systematic coding scheme
for health information systems
Human Functioning
 ICF does not measure disability
It describes people’s functional abilities in
various domains
 Health conditions that affect functional
status are not part of classification system
 Disability is not an “all or nothing” concept
There is a wide range of functional limitations
ICF Domains
 Body Function and Structures
 Activities
 Participation
Body Function and Structures
 Physiological and psychological
function of body systems
 Very specific recording of detailed
functional abilities and impairments
 Not linked to cause. For example,
fluency and rhythm of speech
functions – could be from stuttering,
stroke, or autism
Body Functions and Structures
Broken into Eight Chapters
Skin and related structures
Functions of the skin and related
structures
Structures related to movement
Neuromusculoskeletal and
movement-related functions
Structures related to the
genitourinary and reproductive
systems
Genitourinary and reproductive
functions
Structures related to the digestive,
metabolic and endocrine systems
Functions of the digestive, metabolic
and endocrine systems
Structures of the cardiovascular,
immunological and respiratory
systems
Functions of the cardiovascular,
haematological, immunological and
respiratory systems
Structures involved in voice and
speech
Voice and speech functions
The eye, ear and related structures
Sensory functions and pain
Structures of the nervous system
Mental functions
Activities and Participation
 Describes individual’s functioning
as a whole person, as opposed to
function and structure of his/her
body parts
 Range from Basic to Complex
basic would be, for example, dressing,
eating, and bathing
complex include work, schooling, civic
activities
Activities and Participation (cont.)
 UN Washington Group approach
Activities – tasks an individual can do that
require multiple body functions
Participation – higher order activities that
involve integration in the community
 WHO approach
Activities – what people can do inherently
without assistance or barriers
Participation – functioning taking into account
the impact of barriers and facilitators in the
environment
Activities and Participation (cont.)
 What is most important is that there
are a range of activities going from
basic to complex that describe a
person’s ability to live independently
and be integrated into their
communities
Classification of Activities and
Participation
1 Learning &Applying Knowledge
2 General Tasks and Demands
3 Communication
4 Movement
5 Self Care
6 Domestic Life Areas
7 Interpersonal Interactions
8 Major Life Areas
9 Community, Social & Civic Life
Universal Model vs. Minority Model
 Universal Model -- everyone has a
range of functional abilities
A continuum of functioning
Multidimensional
Even those without what is commonly
perceived as “a disability” have functional
needs
 A Minority Model is categorical and uni-
dimensional. People are classified based
on certain impairment groups without
reference to their functioning at the
activity and participation levels
Medical versus Social Model
 PERSONAL vs. SOCIAL
 Medical care vs. social integration
 Individual treatment vs. social action
 Professional help vs. individual and collective
responsibility
 Personal adjustment vs. environmental
adjustment
 Behavior vs. attitude
 Care vs. human rights
 Individual adaptation vs. social change
Health Condition
(disorder/disease)
Interaction of Concepts
Environmental
Factors
Personal
Factors
Body
function&structure
(Impairment)
Activities
(Limitation)
Participation
(Restriction)
Example: Polio
 May have caused paralysis of legs
(Body Function)
 Affects ability to walk or climb stairs
(Activity)
 Impedes ability to attend school or
find employment within the current
environment (Participation)
BUT….
Example, continued
 Mobility related activities, such as getting
around the house or community can be
improved with accessible environment and
assistive devices
 Participation can be increased with
reduced stigma, accessible environments
and flexible job design
 Disability is NOT independent of the
environment, and therefore is not static
Later Presentations
 How to use the ICF to guide in question
and indicator development
What are different purposes for measuring
disability?
How do these purposes align with the ICF
model?
Under what circumstances does it make sense
to focus on Body Function, Activities, or
Participation?
How do you go about deciding who is
“disabled”?

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ICF model.ppt

  • 1. An Introduction to the International Classification of Functioning, Disability, and Health
  • 2. Presentation Overview  Introduction to the International Classification of Functioning, Disability and Health (ICF)  How can the ICF inform disability measurement?  How does the purpose of data collection affect measurement methodology?
  • 3. What is the ICF?  A framework for describing the facets of human functioning that may be affected by a health condition  A classification system – not a measurement tool
  • 4. Where did the ICF come from?  Developed by the World Health Organization (WHO)  Large international and multidisciplinary participation  Extensive field testing
  • 5. The Aims of the ICF  To provide a scientific basis for the consequences of health conditions  To establish a common language to improve communications  To permit comparisons of data across: Countries Health care disciplines Services Time  To provide a systematic coding scheme for health information systems
  • 6. Human Functioning  ICF does not measure disability It describes people’s functional abilities in various domains  Health conditions that affect functional status are not part of classification system  Disability is not an “all or nothing” concept There is a wide range of functional limitations
  • 7. ICF Domains  Body Function and Structures  Activities  Participation
  • 8. Body Function and Structures  Physiological and psychological function of body systems  Very specific recording of detailed functional abilities and impairments  Not linked to cause. For example, fluency and rhythm of speech functions – could be from stuttering, stroke, or autism
  • 9. Body Functions and Structures Broken into Eight Chapters Skin and related structures Functions of the skin and related structures Structures related to movement Neuromusculoskeletal and movement-related functions Structures related to the genitourinary and reproductive systems Genitourinary and reproductive functions Structures related to the digestive, metabolic and endocrine systems Functions of the digestive, metabolic and endocrine systems Structures of the cardiovascular, immunological and respiratory systems Functions of the cardiovascular, haematological, immunological and respiratory systems Structures involved in voice and speech Voice and speech functions The eye, ear and related structures Sensory functions and pain Structures of the nervous system Mental functions
  • 10. Activities and Participation  Describes individual’s functioning as a whole person, as opposed to function and structure of his/her body parts  Range from Basic to Complex basic would be, for example, dressing, eating, and bathing complex include work, schooling, civic activities
  • 11. Activities and Participation (cont.)  UN Washington Group approach Activities – tasks an individual can do that require multiple body functions Participation – higher order activities that involve integration in the community  WHO approach Activities – what people can do inherently without assistance or barriers Participation – functioning taking into account the impact of barriers and facilitators in the environment
  • 12. Activities and Participation (cont.)  What is most important is that there are a range of activities going from basic to complex that describe a person’s ability to live independently and be integrated into their communities
  • 13. Classification of Activities and Participation 1 Learning &Applying Knowledge 2 General Tasks and Demands 3 Communication 4 Movement 5 Self Care 6 Domestic Life Areas 7 Interpersonal Interactions 8 Major Life Areas 9 Community, Social & Civic Life
  • 14. Universal Model vs. Minority Model  Universal Model -- everyone has a range of functional abilities A continuum of functioning Multidimensional Even those without what is commonly perceived as “a disability” have functional needs  A Minority Model is categorical and uni- dimensional. People are classified based on certain impairment groups without reference to their functioning at the activity and participation levels
  • 15. Medical versus Social Model  PERSONAL vs. SOCIAL  Medical care vs. social integration  Individual treatment vs. social action  Professional help vs. individual and collective responsibility  Personal adjustment vs. environmental adjustment  Behavior vs. attitude  Care vs. human rights  Individual adaptation vs. social change
  • 16. Health Condition (disorder/disease) Interaction of Concepts Environmental Factors Personal Factors Body function&structure (Impairment) Activities (Limitation) Participation (Restriction)
  • 17. Example: Polio  May have caused paralysis of legs (Body Function)  Affects ability to walk or climb stairs (Activity)  Impedes ability to attend school or find employment within the current environment (Participation) BUT….
  • 18. Example, continued  Mobility related activities, such as getting around the house or community can be improved with accessible environment and assistive devices  Participation can be increased with reduced stigma, accessible environments and flexible job design  Disability is NOT independent of the environment, and therefore is not static
  • 19. Later Presentations  How to use the ICF to guide in question and indicator development What are different purposes for measuring disability? How do these purposes align with the ICF model? Under what circumstances does it make sense to focus on Body Function, Activities, or Participation? How do you go about deciding who is “disabled”?