Painting a Conceptual Picture of Disability: Using the International Classification of Functioning, Disability and Health (ICF) to examine disability measures and programs

Disability research, policies and programs are plagued by varied conceptual models, terminology and approaches to measurement (Altman, 2009). Varied conceptual and definitional perspectives shape the rationale, approach and use of disability data collected. Inconsistency in disability programs and measurement are reified in policies and programs that touch the lives of millions of individuals in the United States. Unfortunately, we know little about the variation of content coverage of disability measured across programs and surveys. Our goal is to use the ICF as a single conceptual lens to examine features of varied disability programs and disability measurement.

As a classification scheme premised upon a biopsychosocial model of disability, the ICF provides a single lens through which federal programs can be examined relative to the consistent and comprehensive use of contemporary conceptual components of disability in programmatic processes. Using the domains and associated sub-domains of the ICF components, we have coded key terms of the SSA disability application forms; the SSA Listings, criteria used in determining disability outcomes; and, examined five national surveys capturing data on disability. A manual parsing method was used to link key terms to ICF domains of functioning. Of the four primary components of the ICF (body structure, body functions, activities/participation and environment) our preliminary findings suggest that activity /participation and environmental factors are less likely to be captured in various programs and surveys. Outcomes of this effort create a picture of disability by clarifying conceptual components captured and identifying conceptual gaps.