Contents 
| Contents |
Many people have reservations about the need to define, classify and measure disability, and there are perhaps two major areas of concern - labelling and assessment.
Definition and classification can sometimes seem to involve labelling, and no-one likes to be labelled. People in the disability field can be very blunt when it comes to saying that the wrong terms are being used or that someone does not know enough about the field to classify the experiences of people in it. Many view labelling as an enemy of progress and are very sceptical about its value. These views are all valid. The ICF explicitly states that it does not classify people - its status and codes apply to body structures and functions, activities and areas of participation, and environmental factors (WHO 2001:8).
The second area of concern arises because of the confusion which can occur between definition, classification and assessment.
The distinction is fundamental to the issue of definition. Definition should attempt to go to the core ideas of a phenomenon. Classification assigns things to separate and distinct categories so as to group like with like. Definition and classification are descriptive and, ideally, represent part of a complete framework.
Assessment, on the other hand, is designed to serve a particular purpose, often administrative or clinical, and involves evaluation or measurement against specific criteria. In a disability context, assessment frequently involves taking a deliberately narrow view of one part of a person's life. Sometimes this is done with the aim of focusing on an aspect of disability where a particular profession has a relevant skill, for instance a physiotherapist seeking to diminish a specific impairment.
Assessment may also be done with the aim of restricting access to services to those most in 'need', where need is defined in relation to that service only. For instance, eligibility criteria for the Australian Disability Support Pension concentrate on the health condition (diagnosis) and the impairment aspects of disability. The only focus on activity limitation or participation restriction is in the assessment that someone is unlikely to work full-time at full award wages for the next two years. This assessment does not define disability; nor does it define a person. It merely reflects that the person has crossed over a certain line in the 'administrative sand' (in relation to their impairments and assessed likelihood of working) and so is eligible for a pension. Such an administrative definition does not define disability in the broad sense. It specifies that aspect of disability which Australian society has decided to respond to by the provision of a pension.
Assessment is thus a 'problem area' when it comes to promoting the value of definition and classification. People often associate the specificity and limitations of assessment with definition and classification; often they dislike the idea of being assessed even more than being labelled.
The ICF can help to overcome these problems and clarify the difference between assessment and definition and classification. It provides a broad framework that places assessment in context and clearly indicates its particular, and often narrow, purpose and focus in comparison to the broader processes of definition and classification.
| Contents |