Classifying communication disability using the ICF

Abstract

Health classification schemes not only affect funding of speech-language pathology services but the terminology used in the classification affects the way the profession communicates externally to its stakeholders and internally within the profession. This paper describes the classification scheme of the World Health Organization's International Classification of Functioning, Disability and Health (ICF). While the conceptual framework of the ICF has been established within the profession, the detailed classification scheme is becoming increasingly important to speech-language pathologists. The implementation of the classification worldwide presents many opportunities for speech-language pathologists. Details of the ICF, however, continue to be ''work in progress,'' particularly in areas highly relevant to speech-language pathology such as the differentiation of the Activity and Participation components and their qualifiers. This uncertainty, together with other limitations, needs to be acknowledged by the profession. A research agenda is proposed that aims to place the speechlanguage pathology profession firmly at the forefront of ICF developments, so that the full scope of the profession's work is suitably acknowledged in the future.

The International Classification of Functioning, Disability and Health: Contemporary Literature Overview.

“…This team has also been collaborating with Travis Threats, who was the ASHA liaison for the revision of the ICIDH-2 and is currently a Senior Consultant and ASHA representative to the American Psychological Association (APA) for development of the North American clinical implementation manual for the ICF (Threats & Worrall, 2004).…”

“…Current developments suggest that the disability community supports the conceptualization of disability in the most recent iteration of the ICF (see Hurst, 2003;Threats & Worrall, 2004). Hurst (2003) traced the thinking about persons with disabilities before and after the formulation of the ICIDH in 1980, including the ICF in its present iteration.…”

“…For example, the ICF framework has had a direct impact on the scope of practice statement for the speechlanguage pathology profession (ASHA, 2001;Threats, 2003;Threats & Worrall, 2004) and has influenced activities related to data collection, framing assessment interventions, measuring clinical research outcomes (Threats, 2002), and research investigating the role of communication in the quality of life (Threats & Worrall, 2004 (Holloway, 2004;Threats & Worrall, 2004;see Reed et al, 2005, for a review of subsequent developments). A prototype manual for four chapters from the ICF has been disseminated for field testing (Holloway, 2004).…”

“…Rehabilitation psychologists' focus on a broad spectrum of disabling conditions may, in fact, make many aspects of the ICF useful in assessment and treatment planning. ICF core sets of items can be constructed for specific areas within rehabilitation (e.g., stroke, spinal cord injury, traumatic brain injury) to limit coder burden Threats & Worrall, 2004).…”

“…Imrie (2004) evaluated the theoretical underpinnings of the ICF, arguing that the ICF fails to specify in detail the content of some of its main claims about the nature of impairment and disability, which may limit its educational capacity and influence. Imrie opined that the ICF needs further conceptual clarification and development in several key areas.Current developments suggest that the disability community supports the conceptualization of disability in the most recent iteration of the ICF (see Hurst, 2003;Threats & Worrall, 2004). Hurst (2003) traced the thinking about persons with disabilities before and after the formulation of the ICIDH in 1980, including the ICF in its present iteration.…”