WHO ICF Framework and Aphasia

WHO ICF Framework

  • Conceptual framework for classifying health and health-related domains, not a strict guideline.
  • Used in research, clinical practice, and higher education.
  • Reshapes how we think about wellness, health, and illness.
  • Various professional organizations were consulted during its development.
  • Threats (2010) was the liaison for ASHA during the framework's development.

Traditional vs. Modern View of Health

  • Traditionally, health was defined as the absence of disease or infirmity.
  • Modern view: Health is a state of complete physical, mental, and social well-being, not just the absence of disease.

Components of the ICF Framework

  • Prior models focused on impairment, disability, and handicap.
  • The ICF framework includes:
    • Part 1: Functioning and disability
    • Part 2: Contextual factors, including:
      • Environmental factors
      • Personal factors
Example Scenario: Stroke Patients and Stair Climbing
  • Two individuals with a stroke equally affecting their ability to climb stairs.
  • Environmental Factors:
    * Individual 1: Lives in a fifth-floor walk-up apartment in New York City.
    * Individual 2: Lives in a ranch home in rural Missouri with one step.
    * Treatment will differ significantly due to environmental differences.
  • Personal Factors:
    * Both individuals need bilateral handrails to get up the stairs.
    * Does one individual have the financial or community support to install a second handrail?
    * Considers socioeconomic status and support systems.

The Art and Science of the Field

  • The field blends arts and sciences.
  • Uses reasoning and judgment to treat each case individually.
  • Applies standardized science to support the foundation of care.

Health, Well-being, and Quality of Life

  • Focuses on health, well-being, and quality of life, which varies for each individual.
  • Example Scenario: Patient with no functional swallow on continuous feeding tube.
    * Patient agreed to the feeding tube only if he could have a piece of chocolate cake while watching football every Sunday.
    * Clinical decision to respect the patient's definition of quality of life while informing them of medical implications.
  • Recognizes that everyone experiences declines in health and ability at some point.

Aphasia and the ICF Framework

  • Therapy for aphasia is moving towards embracing the ICF framework.
  • Evidence-based practices are focusing on client-directed goals.

ASHA Resources for ICF

  • ASHA has a page dedicated to the ICF.
  • Useful for writing goals.
  • The PDF resource provides information on how the ICF is applied to acquired language disorders and patient-centered goals.

Lab Activity: Goal Writing

  • Utilize the provided case study of Mr. Jones, a 64-year-old male with Broca's aphasia post-CVA.
  • Write one short-term goal for naming.
  • Naming is an expressive language task involving recalling and producing the name of an object, picture, or person when presented with the stimuli.
  • Develop a patient-centered activity that aligns with the goal.
  • Example: If the patient is an avid bird watcher, the activity could involve confrontational naming using pictures of bird species.