Theoretical Framework: International Classification of Function, Disabilities and Health (ICF)
Figure 1: International Classification of Functional Disability (ICF) applied to CP
- The ICF is a model of functioning and disability (WHO, 2001) that was implemented in 2001 by the 54th World Health Assembly. The ICF children and Youth version of ICF (ICF-CY) was added in 2007
- ICF model fits with the Person-Environment- Occupation (PEO) model (Law, Baum, & Dum 2005).
- ICF is a dynamic model and universal classification that helps describe functioning, disability and health as experienced by the person in the context of his everyday life.
The information on functioning and disability is structured in two components: one related to the body structures of the person, and one related to the activities that people do and the life areas in which they participate (WHO, 2001).
- Body function and structures are referred to as an individual’s physiological functions and anatomical parts of body systems, which are the underlying components.
- Activity involves the execution of either a physical or a mental task or accomplishment.
- Participation refers to the individual’s involvement in life situations with all environment.(WHO, 2001)
The ICF also attributes and individual’s functioning, disability and health to contextual factors. These comprise the physical, social and attitudinal environment in which people live and conduct their lives, and it may act as barriers or facilitators to the person functioning (Law, 2002).
OT assessment and intervention using ICF.
The ICF model is an invaluable guide to implement an occupational intervention to teach keyboard typing skill in children with cerebral palsy. ICF provides a top- down approach to children’s occupational performance and functioning assessment; ICF enables the therapist to navigate with clarity through the process of setting goals, implementing and following up the intervention, and also in measuring outcomes. A clear understanding and a systematic application of the ICF model will support the necessary process of clinical reasoning to make clinical decisions.
The ICF recognizes that the dynamic interplay between the person and the environment influences a person’s functioning. Therefore, identifying
the ICF domains in CP, will allow OTs to identify and modify barriers and facilitators in the acquisition of keyboard typing skills in children with CP. Figure 1 is a preliminary approach to that identification. Further research to confirm this proposal is needed.
The identifications of ICF domains in CP (function, disability, environment, barrier and facilitators) is an ongoing process. For instance, The Canadian Institute named "Child & Family Research Institute (CFRI)" in collaboration with The World Health Organization is currently supporting a research project on development of ICF core sets for children and youth with cerebral palsy. Some of the most recent results on ICF-CY core sets for children and youth with CP were presented in the International Cerebral Palsy Conference, 2012. Pisa, Italy
For more information visit http://www.cfri.ca/our_research/ICF.as
References
Brown, G.T., & Chien, Chi-Wen. (2010). Occupation-centered assessment with children. In S. Rodger (Ed.), Occupation-centered practice with children: A practical guide for occupational therapists pp.135-159. West Sussex: Wiley-Blackwell.
International Classification of Function,Disability and Health. World Health Organization.Available online at: 5http://www.who.int/classifications/icf/
Mpofu, E., & Oakland, T. (2010). Rehabilitation and health assessment. applying ICF guidelines. (2nd ed., pp. 22-35). New York: Springer Publishing Company.
International Classification of Function,Disability and Health. World Health Organization.Available online at: 5http://www.who.int/classifications/icf/
Mpofu, E., & Oakland, T. (2010). Rehabilitation and health assessment. applying ICF guidelines. (2nd ed., pp. 22-35). New York: Springer Publishing Company.