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The ICF Framework

The World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) framework is described in detail in ASHA’s Preferred Practice Patterns for the Profession of Speech-Language Pathology (2004). It lists expected outcomes as comprehensive assessment, intervention, and support that address the following components within the ICF framework.

Body structures and functions:

Identify and optimize underlying anatomic and physiologic strengths and weaknesses related to communication and swallowing effectiveness. This includes mental functions such as attention as well as components of communication such as articulatory proficiency, fluency, and syntax.

Activities and participation, including capacity (under ideal circumstances) and performance (in everyday environments): Assess the communication and swallowing-related demands of activities in the individual’s life (contextually based assessment). Identify and optimize the individual’s ability to perform relevant/desired social, academic, and vocational activities despite possible ongoing communication and related impairments. Identify and optimize ways to facilitate social, academic, and vocational participation associated with the impairment.

Contextual factors, including personal factors (e.g., age, race, gender, education, lifestyle, and coping skills) and environmental factors (e.g., physical, technological, social, and attitudinal): Identify and optimize personal and environmental factors that are barriers to or facilitators of successful communication (including the communication competencies and support behaviors of everyday people in the environment). Services may result in a diagnosis of a communication disorder, identification of a communication difference, prognosis for change (in the individual or relevant contexts), intervention and support, evaluation of their effectiveness, and referral for other assessments or services as needed. Although the outcomes of speech, language, or hearing services may not be guaranteed, a reasonable statement of prognosis is made to referral sources, clients/patients, and families/caregivers. Outcomes of services are monitored and measured in order to ensure the quality of services provided and to improve the quality of those services. Appropriate follow-up services are provided to determine functional outcomes and the need for further services after discharge.

References

American Speech-Language-Hearing Association. (2007). Scope of Practice in Speech-Language Pathology [Scope of Practice]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2004). Preferred Practice Patterns for the Profession of Speech-Language Pathology [Preferred Practice Patterns]. Available from www.asha.org/policy.

Berwick, D. (2002). Escape fire: Lessons for the future of health care. New York: The Commonwealth Fund. Retrieved April 12, 2010, from www.commonwealthfund.org.

Douglass, R. (1983). Defining and describing clinical accountability. Seminars in Speech & Language, 4(2), 107–118.

Nelson, N. W. (1996). Seven habits of highly effective change agents (with apologies to Stephen Covey): Focusing on the needs of school-age students. Hearsay: Journal of the Ohio Speech & Hearing Association, 11(1), 11–25.

Roades, C. (2009, July 1). Top 10 implications of reform. Daily Briefing. Washington, DC: The Advisory Board Co. Retrieved July 2, 2009, from, www.advisory.com.

Shreve, J. (2009, May). Changing expectations in healthcare. Milliman Healthcare Reform Briefing Paper. Denver, CO: Milliman.

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