International Classification of Functioning, Disability and Health (ICF) Jamie Pomeranz, PhD, CRC September 1, 2005

Purpose of the ICF Model ICF is useful to understand and measure health outcomes. It can be used in clinical settings, health services or surveys at the individual or population level. Thus ICF complements ICD-10 The International Statistical Classification of Diseases and Related Health Problems and therefore is looking beyond mortality and disease.

WHAT IS A MODEL? A Model Can Come in Many Shapes, Sizes, and Styles. A Model Is Not the Real World but Merely a Human Construct to Help Us Better Understand Real World Systems. In General All Models Have an Information Input, an Information Processor, and an Output of Expected Results. "Modeling the Environment" Andrew Ford, 1999. Island Press, Washington D.C.

Medical Model of Disability Disability is a problem with the person Caused by the disease, trauma, or health condition. Management aimed at a cure or the individual’s adjustment or behavioral change. Medical care is viewed as the main issue

Social Model of Disability Socially created problem Matter of full integration of an individual into society. Disability is not an attribute of the individual but rather a complex collection of conditions, many of which created by the social environment Management requires social action, environmental modification, attitudinal and ideological changes. At the political level, a question of human rights.

ICF Model (Biopsychosocial) Integration of both the Medical and Social Models. Synthesis of different perspectives of health from a biological, individual and social perspective.

Background of the ICF Unified and standard language and framework for the description of health and health related states. Developed by the World Health Organization (WHO). Framework to code a wide range of information about health (diagnosis, functioning, disability, reasons for contact with health services). Standardized common language permitting communication about health and health care across the world in various disciplines and sciences.

Background Complementary with WHO’s ICD-10 (International Classifications of Diseases, Tenth Revision). ICF and ICD-10 combine diagnosis plus functioning leading to a broader and more meaningful picture of the health of people or populations.

Applications of the ICF Statistical tool for the collection and recoding of data. Research tool to measure outcomes, quality of life or environmental factors. Clinical tool (PT/OT/SLP, needs assessment, matching treatment with specific conditions, vocational assessments, rehabilitation outcomes evaluation). Social policy tool (Social Security, Compensation Systems). Educational Tool (curriculum tool, raise awareness and undertake social action).

Components of the ICF Body Function Body Structure Impairment Activity Physiological and psychological functions of the body. Body Structure Anatomical parts of the body (organs, limbs, and their components) Impairment Problems in body function or structure such as significant deviation or loss. Activity The execution of a task or action by an individual Participation Involvement in a life situation Environmental Factors Physical, social, attitudinal environment.

(Environmental and Personal) ICF Model Health Condition (disorder or disease) Body Structure/ Function Activity Participation Contextual Factors (Environmental and Personal)

ICF Activity Domain: Movement Activities Maintaining body position Shifting the weight of the body Changing body position Transferring oneself while sitting or lying Activities involving fine hand use Activity involving arm and course hand use Activities aimed at making objects move

ICF Activity Domain: Daily Life Activities Eating and drinking Care of body parts, teeth, nails and hair Dressing Washing oneself Caring for own well-being Dealing with everyday objects and appliances