1. The International Classification of Functioning, Disability and Health (ICF) Section 3 Els R. Nieuwenhuijsen, PhD, MPH, OTR

2.  National Center for Health Statistics: developing improved disability data  Department of Health and Human Services (DHHS) see the report Healthy People 2010 http://www.health.gov/healthypeople http://www.health.gov/healthypeople  American Occupational Therapy Association  American Psychology Association, Procedural manual and guide for the standardized application of the ICF: a manual for health professionals  American Speech and Language Association ICF applications

3. Publications including Applying the ICF to measure childhood disability Functioning and disability associated with mental disorders Condition-related ICF applications for people with stroke, cerebral palsy, stuttering, epilepsy, arthritis, ICF core sets for low back pain, depression, osteoporosis, obesity, obstructive pulmonary disease See also the Handbook of Disability Studies, for models See: Disability and Rehabilitation, Vol 25, Nr 11-12 June 2003 For more references, see www.rivm.nl/who-fic newsletterswww.rivm.nl/who-fic ICF applications

4. Emphasis on Functioning Uniform data collection (e.g., comparing data between nations, data sets, cases, environments) Insight in the complex issues of disability Strengthen team approach, role delineation and clinical reasoning Social change ICF Value

5. Practice ICF A personal story from the Surgeon General Call for Action – 2005 page 14

7. Practice ICF Surgeon General Call for Action – 2005 page 19

8. My theory is: A welcoming community is more effective than a community where “disability is a right” When a community is accessible and offers available and affordable services – this will benefit the health, safety, and functioning of all people in the community (incl. mothers with children, elderly, people using crutches, walkers, canes, scooters, wheelchairs, elderly, people with TBI, autism, Alzheimer disease and many others) Disability friendly community

9. Vancouver: Measuring Up Guide, a rating instrument for consumers – inclusion and accessibility workbook to to identify environmental barriers in the city including architecture, housing, transportation, civic protection, social services, education – all items derived from the ICF. “It is not just the accessibility of the theater, but also the inclusion of people with disability on stage” http://vancouver.ca/getinvolved/documents/Measurin gUpWorkbookSept26.pdf Disability friendly community

10. Measuring Up Guide: 4 parts Support Services Access to Information Economic Participation Community Contribution (social, recreation/sports, cultural, environmental http://vancouver.ca/getinvolved/documents/Measurin gUpWorkbookSept26.pdf Disability friendly community

11. Disability friendly community – Vancouver

12. Disability friendly community- Vancouver

13. Disability friendly community Source: http://www.ptguide.com/restaurants/restaurantaccess05.pdf#search=%22Port %20Townsend%2C%20Washington%20Disability%22 retrieved 9/13/06http://www.ptguide.com/restaurants/restaurantaccess05.pdf#search=%22Port

14. Disability friendly community How the ICF can be a useful tool - the impairment/activity classification to ensure that all people are included in the community – e.g. access to voting - the environment classification to identify barriers and facilitators – e.g. Vancouver - emphasis on neutral language, functioning and people first may remove some of the stigma - collection of uniform data, that can be compared and contrasted with other communities - Team approach

15. Classification of Functioning Assistive Technology Clinical practice Urban planning/architecture Social Change Policy Other

16. ICF - summary ICF is a classification of functioning A tool to: enhance uniform language and data collection systematically identify and remove environmental barriers better understand differences and similarities in functioning among people enhance the full participation for all

17. ICF - summary ICF is the only classification that deals with functioning, disability and health ICF is used world wide ICF is founded on the bio-psycho-social model

18. Last Question What are for you the benefits/draw backs using a Classification of Functioning?

19. References http://www.surgeongeneral.gov/library/disabilities/calltoa ction/calltoaction.pdf http://www.surgeongeneral.gov/library/disabilities/calltoa ction/calltoaction.pdf http://vancouver.ca/getinvolved/documents/MeasuringUp WorkbookSept26.pdf Fuhrer, M. J., Jutai, J. W., Scherer, M. J., & DeRuyter, F. (2003). A framework for the conceptual modelling of assistive technology device outcomes. Disability and Rehabilitation, 25(22), 1243-1251 www.rivm.nl/who-fic www.who.org.

20. ICF – summary Thank you for your participation during this presentation. Hopefully, this information inspires you to learn more about the ICF, to reflect on the benefits of an international classification, and to conduct empirical research in the area of functioning.

21. ADA-ICF ADA: An individual with a disability is defined as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such impairment, or a person who is perceived by others as having such impairment. ICF: Disability is an umbrella term for impairments, activity limitations or participation restrictions. Environmental and personal factors influence all aspects of health, functioning and disability.

22. ADA ICF AimRights, discrimination, opportunities Participation, inclusion, rights Focus Employment, public service, public accommodations and services, telecommunication, miscellaneous Conceptualizing functioning in relation to the environment Charac teristics Law Classification Benefits Policy Comprehensive tool identifying similarities and differences in functioning