International Classification of Functioning, Disability, and Health (ICF)

The International Classification of Functioning, Disability, and and Health (ICF) describes how people live with health conditions—not just their diagnosis, but how their diagnosis affects daily life.

The ICF looks at health in the context of three aspects:

  • a person’s environment
  • a person’s support systems
  • personal factors

The World Health Organization (WHO) developed the ICF and updates it regularly. The ICF works with two other tools:

  1. The International Classification of Diseases names diseases and conditions.
  2. The International Classification of Health Interventions classifies health services and treatments.

Together, they paint a complete picture of health, giving professionals a shared language to use across health care, education, research, and policy domains.

Components of the ICF

The ICF has two parts, each with distinct but interconnected components:

  1. Functioning and Disability
    • Body Functions and Structures: Describes the anatomy, physiology, and psychology of the human body.
    • Activity and Participation: Describes the person's ability to do tasks and engage in everyday life—such as communication, interpersonal interactions, learning, mobility, and self-care.
  2. Contextual Factors
    • Environmental Factors: Describes external influences not within the person’s control that help or hinder function—such as physical surroundings, social support, policies, services, and societal attitudes.
    • Personal Factors: Includes individual characteristics like age, gender identity, culture, education, life experience, and coping styles because they are independent of the health condition and may have an influence on how the person functions. Personal factors are not yet coded in the ICF because they vary across cultures.

Key Concepts

Functioning Is Not Just a Consequence of Disease

The ICF does not assume that health conditions determine how a person functions. Two people with the same diagnosis may have very different levels of participation and quality of life.

A Broader Definition of Health

WHO defines health as “complete physical, mental, and social well-being and not merely the absence of disease.” In this view, functioning is a core component of health.

Shared Language Across Settings

The ICF uses standardized terms that support interprofessional collaboration and consistent data collection across disciplines, systems, and countries.

Applications of the ICF

The ICF is used worldwide in clinical care, health and disability research, public health and social policy, data collection, and population monitoring. Health systems are increasingly building the ICF into digital health records.

ICF and Social Determinants of Health

The ICF highlights how environmental and personal factors shape functioning. This is complementary to understanding and addressing social determinants of health—which are nonmedical variables (e.g., housing stability, food security) that influence health and health outcomes.

Relevance to Audiology and Speech-Language Pathology

Two important scope-of-practice documents produced by ASHA—the Scope of Practice for Audiology and the Scope of Practice for Speech-Language Pathology—recognize the role that communication sciences and disorders (CSD) professionals play in using the ICF to develop functional goals and engage in interprofessional collaborative practice. The ICF supports functional, person-centered assessment and intervention in the context of interprofessional practice.

Functional Goal Writing Using ICF

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About ASHA

The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and credentialing association for 247,000 members, certificate holders, and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology assistants; and students.

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