The International Classification of Functioning, Disability and Health (ICF) is a classification of the health components of functioning and disability.
The ICF received approval from all 191 World Health Organization (WHO) member states on May 22, 2001, during the 54th World Health Assembly. Its approval followed nine years of international revision efforts coordinated by WHO. WHO's initial classification for the effects of diseases, the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), was created in 1980. The ICF classification complements WHO's International Classification of Diseases-10th Revision (ICD), which contains information on diagnosis and health condition, but not on functional status. The ICD and ICF constitute the core classifications in the WHO Family of International Classifications (WHO-FIC).
Overview The ICF is structured around the following broad components:
Body functions and structure Activities (related to tasks and actions by an individual) and participation (involvement in a life situation) Additional information on severity and environmental factors Functioning and disability are viewed as a complex interaction between the health condition of the individual and the contextual factors of the environment as well as personal factors. The picture produced by this combination of factors and dimensions is of "the person in his or her world". The classification treats these dimensions as interactive and dynamic rather than linear or static. It allows for an assessment of the degree of disability, although it is not a measurement instrument. It is applicable to all people, whatever their health condition. The language of the ICF is neutral as to etiology, placing the emphasis on function rather than condition or disease. It also is carefully designed to be relevant across cultures as well as age groups and genders, making it highly appropriate for heterogeneous populations.
Impairments The ICF identifies a variety of different possible impairments, including, but not limited to:
Impairments of Body Functions Mental Functions Sensory Functions and Pain Voice and Speech Functions Functions of the Cardiovascular, Haematological, Immunological and Respiratory systems Functions of the Digestive, Metabolic and Endocrine systems Genitourinary and Reproductive Functions Neuromusculoskeletal and Movement related Functions Functions of the Skin and Related Structures Impairments of Body Structures Structures of the Nervous system The Eye, Ear and Related Structures Structures involved in voice and speech Structures of the Cardiovascular, Immunological and Respiratory System Structures related to the Digestive, Metabolism and Endocrine systems Structures related to Movement Skin and Related Structures As well, there are many subcategories to these impairments, such as Emotional functions being a sub-function of one's mental functions, or Weight maintenance being a subfunction of the Functions of the Digestive system. These subcategories are gauged either by the extent of the impairments on a level of 0-4 or as Not Specified or Not Applicable (such as Menstruation often not being applicable for a Male.) The level of impairment is graded as such:
As well, body structures are graded on a nature of the change as follows,
For clarity, the ICF further defines body functions as being both physiological and psychological, meaning that a disability that causes distress in one individual might not be a disability in another individual that experiences no psychological ill-effects therefrom.
Activity Limitations and Participation Restriction Participation is the involvement in a life situation, meaning that a participation restriction would be any problem which a person experiences in life situations. Likewise, activity is the execution of a task or action by an individual, meaning that an activity limitation would be anything which would make executing such tasks more difficult. Some of these activity and participation domains are as follows:
Learning and Applying Knowledge General Tasks and Demands Communication Mobility Self-care Domestic Life Interpersonal Interactions and Relationships Major Life Areas Community, Social and Civic Life These are graded with the two qualifiers of Performance Extent of Participation Restriction and Capacity (without assistance) Extent of Activity limitation on a same scale as impairments are.
Environmental Factors Finally, environmental factors are taken into consideration for both their possible facilitation of the disability and any barriers to which the disability may apply,
Products and Technology Natural Environment and human made changes to environment Support and Relationships Attitudes Services, Systems and Policies For example, a severe social anxiety disorder or schizophrenia may either be barriers to seeking support or services, as well as be possibly facilitated by the technology and relationships of the person in their consumption of harmful forms of social media. These are qualified on a level from 0-4 as follows,
The environmental factors make up the entire physical, social and attitudinal environment in which people live and conduct their lives, including those specific to the individual. In this way, some disabilities can be existent by purely social factors, being both the sole facilitator to the disability, and a blocker toward other environmental factors. It is an interesting observation then that a cult could be considered a form of disabling group which is in-abled within its own environment.
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