7. ICF-Impairment

Impairment WordleHere we go…I often begin in the impairment section.  Impairment describes problems that are happening at the structural level.  Impairments are  stated in medical reports and can be listed in preparation for the initial evaluation.  Impairment would include any changes in the following body structures or body functions:

  • Low birth weight and failure to thrive
  • Musculoskeletal system
  • Neurological
  • Special senses and speech (visual, auditory, vestibular)
  • Respiratory system
  • Cardiovascular system
  • Digestive system/gastrointestinal
  • Genitourinary disorders
  • Hematological disorders
  • Skin disorders/ integumentary
  • Endocrine disorders/metabolic
  • Congenital disorders that affect multiple body systems
  • Cognition/perception
  • Immune system disorders
  • Cancer (malignant neoplastic diseases)
  • Pain

Note that Balance and Physical Endurance are contained within in this domain.

Impairments can be divided into primary and secondary:

  • Primary impairments  are motor behaviors that are directly related to changes in any system. Examples: muscle tone, postural stability, motor coordination. (2).  Primary impairments are any impairments that are present at birth such as heart defects, endocrine diagnoses, visual impairments.
  • Secondary impairments  develop over time and frequently as a result of the primary impairments. Examples:  Decreased range of motion, force production and endurance (2)


  1. Social Security Administrations listing of Childhood Impairments (Part B)
  2. Components of Typical and Atypical Motor Development, Lois Bly
  3. Description of Primary and Secondary Impairments in Young Children With Cerebral Palsy. Lynn Jeffries, PT, DPT, PhD, PCS





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