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ICF_Framework

ICF

In the 21st century there have been several significant advances in our thinking about health and functioning. These developments are based primarily on the WHO’s International Classification of Functioning, Health and Disability (2001) (the ICF), which provides a modern framework for health. It reminds us that health is manifested by functioning, and that a number of aspects of people’s lives need to be considered together when assessing a person’s situation (and their ‘health’). The ICF recognizes that any health condition has manifestations in ‘body structure and function’. These are called ‘impairments’ and they may interfere with people’s everyday ‘activities’ and limit their ability and opportunity for ‘participation’ (engagement in life in ways that are personally meaningful). The ‘contextual factors’ include many dimensions of the ‘environment’ (human, physical, attitudinal, political and so on), and ‘personal factors’ – specific features of each individual’s life that make them unique. These several aspects of people’s lives are interconnected, reflecting the organic nature of health as a product of all these factors.

F-words

The ICF concepts have been put into practice with the ‘F-Words in Childhood Disability’, grafted onto the ICF framework as examples of how to think about the ICF in practice. Thus, ‘activity’ in the ICF concepts is framed as ‘Function’ (doing things, regardless of the quality of that function). ‘Fitness’ is highlighted as an aspect of ‘body structure and function’ to remind people that being fit is important for everyone, and that in childhood disability this aspect of people’s lives is often ignored. ‘Friends’ are identified with ‘participation’, because friendships are an important part of every person’s development. By identifying ‘Fun’ with ‘personal factors’ the F-words challenge everyone to think about our interventions within the personal realm of the individual – what’s important for them. ‘Family’ is recognized to be the essential, central aspect of the ‘environment’ of children; thus family-centred services are highly valued. Finally, the concept of ‘Future’ is introduced, because although the ICF provides a slice-in-time picture of a person’s situation, childhood is all about ‘being, belonging and becoming’ – identifying change and development as an ever-moving target into the future.

Non-Categorical way of thinking

Consistent with these ICF/F-words concepts is the ‘non-categorical’ way of thinking. This idea reminds people that despite differences and specificity of medical diagnoses, it is essential to recognize the many commonalities across developmental conditions. That means that we must work with kids and their families beyond ‘diagnosis’. Much of the material in this section of the website makes this assumption!