Discussion of the ICIDH-2 in Relation to Occupational Therapy and Occupational Science

Abstract

For the last several years, unbeknownst to many occupational therapists and some occupational scientists, a wave of change has been approaching the international health care horizon that may greatly impact our profession, in terms of daily practices and its standing among the community of healthcare practitioners. That change is the development of the ICIDH-2: International ClassiŽ cation of Functioning, Disability and Health [2], a revision of the original ICIDH, or International ClassiŽ cation of Impairments, Disabilities, and Handicaps [3]. Akin to much of our occupational therapy literature, this document, or classiŽ cation system, recognizes the relevance of everyday activities to health and that ‘‘participation in everyday life by persons with disabilities results from the interaction between person and environment’’ ([4] p.223). Occupational therapy leaders are encouraging the profession to join this wave of change, to begin to study the ICIDH-2 for its usefulness and application in occupational therapy, and to participate in the international discussions related to its development [4, 5]. Use of the document and terminology within occupational therapy is being encouraged by both the American Occupational Therapy Association (AOTA), and the American Occupational Therapy Foundation (AOTF). For these reasons, AOTF sponsored a consensus conference, held in July of 1999, to relate occupational therapy terminology to the language of the ICIDH-2 and ‘‘promote the consistent use of the ICIDH-2 across the profession of occupational therapy’’ ([4] p.223). In the spirit of that directive, this article will attempt to detail the structure and contents of the most recent version of the ICIDH-2, and discuss its concepts in relation to occupational therapy and occupational science. This article is intended to familiarize occupational therapists and occupational scientists with the ICIDH-2 document and the revision process, and echo its relevance to both disciplines. While sections of this article might actually become obsolete during its publication and:or shortly thereafter, it seems timely nevertheless to provide an analysis of the ICIDH-2 from an occupational science perspective for those who are either unfamiliar with it, or have not thought about its relationship to the emerging science. The document is currently undergoing Ž nal revisions and will, no doubt, become the international standard for describing various health states in terms of activity. In this paper, I will present a thorough overview of the ICIDH-2 including the background and history of the ICIDH-2, a general description of the document and its overall aims, and a detailed outline of the most recent draft version of the ICIDH-2, including the classiŽ cation constructs and their interaction. I will also highlight aspects of the ICIDH-2 revision process, in order to clarify the evolution of the document, as well as identify issues addressed in the revision that most closely pertain to questions of occupation. Finally, I will analyze the classiŽ cation system in relation to occupational therapy and occupational science concepts and concerns. My goal is twofold. First, I aim to provide sufŽ cient detail in this overview to enable occupational therapists and occupational scientists to begin to think about the potential use of the ICIDH-2 for research and clinical purposes, and to join the international discussions related to these concepts so familiar to both disciplines. Second, through my analysis of the document in relation to occupational therapy and occupational science, I hope to inspire future projects related to ICIDH-2 concepts that are well suited for occupational therapy clinicians and occupational science researchers.