4. ICF- The Domains

Let’s take a moment to look at the overall representation of the ICF.  As you can see from the above diagram, all of the domains interact with one another.  The International Classification of Functioning is composed of these domains:

  1.  IMPAIRMENTS: (At the level of the body)
    1. Body functions are physiological and psychological functions of the body.
    2. Body structures are the anatomic parts of the body.
  2. ACTIVITIES: (At the level of the individual) This refers to the execution of tasks or actions by individual.
  3. PARTICIPATION: (At the level of family and society) This is involvement in a life situation.
  4. ENVIRONMENTAL FACTORS: (Facilitators and inhibitors) These are the physical, social and attitudinal situations in which people live.
  5. PERSONAL FACTORS: (Facilitators and inhibitors) These are the particular background of individuals’ life and living situation and comprise features that are not part of a health condition.

  • Keep in mind that the ICF classifies functioning not the individual.
  • Each level describes function and also functional limitation (disability) to give a broad picture and a more neutral tone.
  • The health condition is the ICD-10 diagnosis and complements the ICF but is not officially part of the ICF.


The ICF: An Overview

ICF Resources from the World Health Organization

CanChild: ICF for Parents (with video)

From the WHO’s Beginner’s Guide (Above link):

 The ICF is named as it is because of its stress is on health and functioning , rather
than on disability. Previously, disability began where health ended; once you
were disabled, you were in a separate category. We want to get away from this
kind of thinking. We want to make ICF a tool for measuring functioning in
society, no matter what the reason for one’s impairments. So it becomes a much
more versatile tool with a much broader area of use than a traditional
classification of health and disability.
This is a radical shift. From emphasizing people’s disabilities, we now focus on
their level of health.
ICF puts the notions of ‘health’ and ‘disability’ in a new light. It acknowledges
that every human being can experience a decrease in health and thereby
experience some disability. This is not something that happens to only a minority
of humanity. ICF thus ‘mainstreams’ the experience of disability and recognizes
it as a universal human experience. By shifting the focus from cause to impact it
places all health conditions on an equal footing allowing them to be compared
using a common metric – the ruler of health and disability.

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