Exploring the ICF: Defining Functioning & Disability

The International Classification of Functioning, Disability and Health (ICF) is a framework for describing and organizing information on functioning and disability.  It works particularly well in the field of pediatric physical therapy, where we are increasingly moving away from the medical model and beginning to think of the whole child in terms of functioning (health) and disability.

In a recent Neuro-Developmental Treatment Association Network article, Danielle Heider, CRC, MRC wrote:

As a certified rehabilitation counselor specializing in working with transitioning youth, it is my job to help young adults begin to think about what they want to do for a job, consider if there are any accommodations needed, and help them understand how to ask an employer for accommodations.  This can seem like a daunting task for some young people, especially if they are accustomed to hearing others talk about everything they can’t do.

Continue reading “Exploring the ICF: Defining Functioning & Disability”

Exploring the ICF: The Domains

Ezekiel is a adventurous 10-year old boy who is integrated into regular education and living in a large city.  His diagnosed health condition ICD-10 code is G80.9: Cerebral palsy, unspecified.   The ICF describes his hip migration status, his range of motion, balance and endurance.   We learn of his recreational interests, his home and school environment, his family, and the equipment that supports his movement and communication.  Through the ICF, we can begin to see Ezekiel as a complex and unique person functioning with the health condition of cerebral palsy.

The International Classification of Functioning, Disability and Health (ICF) is a framework for describing and organizing information on functioning and disability.  In this post, we will be looking at the domains that are components of the ICF.   As you can see from the above diagram, the domains of body structure and function, activity, participation, environmental factors and personal factors each interact with one another, creating unique combinations of functioning and disability.  The ICF is composed of the following domains: Continue reading “Exploring the ICF: The Domains”

Exploring the ICF as a Conceptual Framework

In Isaiah Berlin’s essay on The Hedgehog and the Fox–The fox knows many things, but the hedgehog knows one big thing.  It’s hard to be an organized fox, and being a hedgehog may limit innovation.  The conceptual framework of the ICF organizes all the details of one person’s function and edits that information down to the (few) big things which are vital and specific.

The International Classification of Functioning, Disability and Health (ICF) is an example of a conceptual framework for describing and organizing information on functioning and disability.    A conceptual framework is generally defined as an analytical tool used to organize ideas. 

The ICF gathers details about an individual in order to give a specific understanding of their unique functioning.  The microscopic domain describes the tissues and functions of the body.  In contrast, the most macroscopic domain describes how a person successfully participates or has difficulty participating in their unique world.  The ICF, as a conceptual framework,  gives organization to a diverse array of details and shows relationships between the domains.

RESOURCES:

Next in the ICF series:  Exploring the ICF: The Domains

Exploring the ICF: What is a Biopsychosocial Model?

The International Classification of Functioning, Disability and Health (ICF)is a framework for describing and organizing information on functioning and disability.  The ICF is described as a biopsychosocial model of disability;  it simultaneously considers biological factors, psychological factors and societal factors. By incorporating these three factors,  the model is able to create a unique picture of an individual as they manage a health condition.  In contrast, the biomedical model is limited to the biological aspects only.  The biomedical model often overlooks important individual details, increasing chances that therapists and families have a lack of alignment in their goals. Continue reading “Exploring the ICF: What is a Biopsychosocial Model?”

What is the International Classification of Functioning, Disability and Health (ICF)?

Question: Why use the International Classification of Functioning, Disability & Health in pediatric PT?

Answer:  The framework of the ICF will help you access and organize your knowledge to provide a sound foundation for clinical decision making.

The International Classification of Functioning, Disability and Health (ICF) is a framework for describing and organizing information on functioning, health and disability.  The ICF-CY is specific to children and youth.   In 2001, the World Health Organization adopted the ICF as the basis of standardized scientific data on health and disability for use throughout the world.  It is applicable in health fields from mental health to orthopedics, neurology to cardiology.  The Neuro-Developmental Treatment Association (NDT) immediately recognized its importance as a conceptual framework for applying the NDT concept to pediatric physical therapy and began to use the framework in eight-week pediatric courses.  Moving on in time,  in 2008, The American Physical Therapy Association publicly endorsed the use of the ICF.  This set the expectation that ICF language begin to be used in publications, documents and communication.  Already, participation and environmental factors were becoming common points of discussion in pediatric physical therapy.  In current time, therapists are learning that we must begin to use ICF terminology and the ICF framework in our daily practice and communication, but what is it and how does it work?  That is the tricky part.

I was first introduced to the ICF during a section at the 2001 NDTA Conference.  I immediately began to restructure the way I approached and thought about my more complicated clients.  I was a fairly new PT at that time and goodness knows I needed some help prioritizing.  Continue reading “What is the International Classification of Functioning, Disability and Health (ICF)?”

The Sprites

The sprites were the inspiration for this blog.   I wanted to make a home program of sprites doing typical childhood activities.  These activities also have tremendous therapeutic value in building strength, agility, and balance.    My hope is that kids can see themselves or their friends in the drawings and find inspiration.   The sprites can be found doing regular kid-like movement in the Activities and Exercise category.  Moving and enjoying movement are the first steps to increased fitness.  I hope this makes it a little more fun.

Magic Hands

While in the presence of pediatric physical therapists you might hear “Wow, she has magic hands!”  This is often whispered after someone has done the seemingly impossible; laying their hands in the perfect place at the perfect time.   Alternately, you might hear “It’s not like he has magic hands, anyone can learn to do that”.      I’ve always bristled at the mention of “magic” while secretly believing in it.  What is the magic, anyway? Continue reading “Magic Hands”