14. Strategies For Filling In the ICF/ NDTA Enablement Model

There are hundreds of medical reports in Kiyoshi’s file.   In addition to oligoarticular juvenile idiopathic arthritis (JIA)  he has uveitis and a seizure disorder.  Kiyoshi has severe pain, joint contractures and difficulty moving around.  Medications are not controlling the inflammation, there have been more seizures lately and his foot orthotics are too small.    How do you begin physical therapy decision-making with a child this complex?

The International Classification of Functioning  (ICF) conceptual framework allows you to apply your knowledge  and skills to challenging situations.  It will take a while to sort information into proper categories and edit. However, once this is complete, connections become clear and sound clinical decision-making will follow.    The question I get asked most often about the ICF is , “where do you start?”.  This post will guide you as you fill in the ICF/NDTA Enablement Model categories for the first time. Continue reading “14. Strategies For Filling In the ICF/ NDTA Enablement Model”


9. ICF-Participation

Screen shot 2016-08-26 at 9.56.26 PMIn my opinion, participation is the most fun part of the ICF.    Participation is using an activity to interact with others or with the environment.  When the activity is walking, participation is walking on the beach with friends, or walking in the grocery store to help with the shopping.  Participation is one of the most motivating and satisfying levels of functioning.  New activities should be put into participation as soon as possible to build motor control.  These happen in many different environments:  Home, friends’ homes, schools, libraries and parks.  Continue reading “9. ICF-Participation”

8. ICF- Activity

ACTIVITY WORDLEHere we start another category of the ICF….activity!  This is the heart and soul of physical therapy, at least in the clinic or during a home visit.  The activity section of the ICF describes what a person can do in a standard environment or their regular environment.  Activity is defined as the execution of a task or action.    The activity section includes the following:

  • developmental skills that babies learn in the first year of life,
  • gross motor skills at any age
  • fine motor skills at any age
  • activities of daily living/self-care
  • gait
  • communication

Continue reading “8. ICF- Activity”

7. ICF-Impairment

Impairment Wordle I often begin in the impairment section of the ICF.  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: Continue reading “7. ICF-Impairment”

5. ICF-Functioning & 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 “5. ICF-Functioning & Disability”

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.

Continue reading “4. ICF- The Domains”

3. ICF- A Conceptual Framework


A conceptual framework is defined as an analytical tool used to organize ideas. 

In Isaiah Berlin’s essay on The Hedgehog and the FoxThe 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. Continue reading “3. ICF- A Conceptual Framework”