Semin Hear 2016; 37(03): 163-186
DOI: 10.1055/s-0036-1584412
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

What Is the International Classification of Functioning, Disability and Health and Why Is It Relevant to Audiology?

Carly Meyer
1   School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Caitlin Grenness
2   Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia
Nerina Scarinci
1   School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Louise Hickson
1   School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
20 July 2016 (online)


The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is widely used in disability and health sectors as a framework to describe the far-reaching effects of a range of health conditions on individuals. This biopsychosocial framework can be used to describe the experience of an individual in the components of body functions, body structures, and activities and participation, and it considers the influence of contextual factors (environmental and personal) on these components. Application of the ICF in audiology allows the use of a common language between health care professionals in both clinical and research settings. Furthermore, the ICF is promoted as a means of facilitating patient-centered care. In this article, the relevance and application of the ICF to audiology is described, along with clinical examples of its application in the assessment and management of children and adults with hearing loss. Importantly, the skills necessary for clinicians to apply the ICF effectively are discussed.

  • References

  • 1 World Health Organization. ICF: International Classification of Functioning, Disability and Health. Geneva, Switzerland: World Health Organization; 2001
  • 2 Moeller MP. Early intervention and language development in children who are deaf and hard of hearing. Pediatrics 2000; 106 (3) E43
  • 3 Yoshinaga-Itano C, Coulter D, Thomson V. The Colorado Newborn Hearing Screening Project: effects on speech and language development for children with hearing loss. J Perinatol 2000; 20 (8 Pt 2): S132-S137
  • 4 Blamey PJ, Sarant JZ, Paatsch LE , et al. Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing. J Speech Lang Hear Res 2001; 44 (2) 264-285
  • 5 Beal-Alvarez JS, Lederberg AR, Easterbrooks SR. Grapheme-phoneme acquisition of deaf preschoolers. J Deaf Stud Deaf Educ 2012; 17 (1) 39-60
  • 6 DesJardin JL, Ambrose SE, Eisenberg LS. Literacy skills in children with cochlear implants: the importance of early oral language and joint storybook reading. J Deaf Stud Deaf Educ 2009; 14 (1) 22-43
  • 7 Schroedel JG, Geyer PD. Long-term career attainments of deaf and hard of hearing college graduates: results from a 15-year follow-up survey. Am Ann Deaf 2000; 145 (4) 303-314
  • 8 Danermark B, Antonson S, Lundström I. Social inclusion and career development—transition from upper secondary school to work or post-secondary education among hard of hearing students. Scand Audiol Suppl 2001; 30 (53) 120-128
  • 9 Wake M, Hughes EK, Poulakis Z, Collins C, Rickards FW. Outcomes of children with mild-profound congenital hearing loss at 7 to 8 years: a population study. Ear Hear 2004; 25 (1) 1-8
  • 10 Keilmann A, Limberger A, Mann WJ. Psychological and physical well-being in hearing-impaired children. Int J Pediatr Otorhinolaryngol 2007; 71 (11) 1747-1752
  • 11 Strawbridge WJ, Wallhagen MI, Shema SJ, Kaplan GA. Negative consequences of hearing impairment in old age: a longitudinal analysis. Gerontologist 2000; 40 (3) 320-326
  • 12 Kramer SE, Kapteyn TS, Festen JM. The self-reported handicapping effect of hearing disabilities. Audiology 1998; 37 (5) 302-312
  • 13 Garstecki DC, Erler SF. Older adult performance on the Communication Profile for the Hearing Impaired: gender difference. J Speech Lang Hear Res 1999; 42 (4) 785-796
  • 14 Jung D, Bhattacharyya N. Association of hearing loss with decreased employment and income among adults in the United States. Ann Otol Rhinol Laryngol 2012; 121 (12) 771-775
  • 15 Pronk M, Deeg DJH, Kramer SE. Hearing status in older persons: a significant determinant of depression and loneliness? Results from the longitudinal aging study Amsterdam. Am J Audiol 2013; 22 (2) 316-320
  • 16 Pronk M, Deeg DJH, Smits C , et al. Prospective effects of hearing status on loneliness and depression in older persons: identification of subgroups. Int J Audiol 2011; 50 (12) 887-896
  • 17 Li CM, Zhang X, Hoffman HJ, Cotch MF, Themann CL, Wilson MR. Hearing impairment associated with depression in US adults, National Health and Nutrition Examination Survey 2005–2010. JAMA Otolaryngol Head Neck Surg 2014; 140 (4) 293-302
  • 18 Scarinci N, Worrall L, Hickson L. The effect of hearing impairment in older people on the spouse: development and psychometric testing of the significant other scale for hearing disability (SOS-HEAR). Int J Audiol 2009; 48 (10) 671-683
  • 19 Scarinci N, Worrall L, Hickson L. Factors associated with third-party disability in spouses of older people with hearing impairment. Ear Hear 2012; 33 (6) 698-708
  • 20 Kamil RJ, Lin FR. The effects of hearing impairment in older adults on communication partners: a systematic review. J Am Acad Audiol 2015; 26 (2) 155-182
  • 21 Jackson CW, Traub RJ, Turnbull AP. Parents' experiences with childhood deafness: implications for family-centered services. Comm Disord Q 2008; 29 (2) 82-98
  • 22 Lederberg AR, Golbach T. Parenting stress and social support in hearing mothers of deaf and hearing children: a longitudinal study. J Deaf Stud Deaf Educ 2002; 7 (4) 330-345
  • 23 Jackson CW, Turnbull A. Impact of deafness on family life: a review of the literature. Top Early Child Spec Educ 2004; 24 (1) 15-29
  • 24 Meinzen-Derr J, Lim LHY, Choo DI, Buyniski S, Wiley S. Pediatric hearing impairment caregiver experience: impact of duration of hearing loss on parental stress. Int J Pediatr Otorhinolaryngol 2008; 72 (11) 1693-1703
  • 25 Danermark B, Granberg S, Kramer SE, Selb M, Möller C. The creation of a comprehensive and a brief core set for hearing loss using the international classification of functioning, disability and health. Am J Audiol 2013; 22 (2) 323-328
  • 26 Granberg S, Dahlström J, Möller C, Kähäri K, Danermark B. The ICF Core Sets for hearing loss—researcher perspective. Part I: Systematic review of outcome measures identified in audiological research. Int J Audiol 2014; 53 (2) 65-76
  • 27 Granberg S, Möller K, Skagerstrand A, Möller C, Danermark B. The ICF Core Sets for hearing loss: researcher perspective, Part II: Linking outcome measures to the International Classification of Functioning, Disability and Health (ICF). Int J Audiol 2014; 53 (2) 77-87
  • 28 Granberg S, Pronk M, Swanepoel W , et al. The ICF core sets for hearing loss project: functioning and disability from the patient perspective. Int J Audiol 2014; 53 (11) 777-786
  • 29 Granberg S, Swanepoel W, Englund U, Möller C, Danermark B. The ICF core sets for hearing loss project: international expert survey on functioning and disability of adults with hearing loss using the International Classification of Functioning, Disability, and Health (ICF). Int J Audiol 2014; 53 (8) 497-506
  • 30 Grenness C, Hickson L, Laplante-Lévesque A, Davidson B. Patient-centred audiological rehabilitation: perspectives of older adults who own hearing aids. Int J Audiol 2014; 53 (Suppl. 01) S68-S75
  • 31 Laplante-Lévesque A, Hickson L, Worrall L. A qualitative study of shared decision making in rehabilitation audiology. J Acad Rehabilitative Audiol 2010; 43: 27-43
  • 32 Poost-Foroosh L, Jennings MB, Shaw L, Meston CN, Cheesman MF. Factors in client-clinician interaction that influence hearing aid adoption. Trends Amplif 2011; 15 (3) 127-139
  • 33 Moeller MP, Carr G, Seaver L, Stredler-Brown A, Holzinger D. Best practices in family-centered early intervention for children who are deaf or hard of hearing: an international consensus statement. J Deaf Stud Deaf Educ 2013; 18 (4) 429-445
  • 34 Galvin KL, Mok M, Dowell RC. Perceptual benefit and functional outcomes for children using sequential bilateral cochlear implants. Ear Hear 2007; 28 (4) 470-482
  • 35 Hickson L, Meyer C, Lovelock K, Lampert M, Khan A. Factors associated with success with hearing aids in older adults. Int J Audiol 2014; 53 (Suppl. 01) S18-S27
  • 36 Laplante-Lévesque A, Hickson L, Worrall L. What makes adults with hearing impairment take up hearing aids or communication programs and achieve successful outcomes?. Ear Hear 2012; 33 (1) 79-93
  • 37 Laplante-Lévesque A, Hickson L, Worrall L. Stages of change in adults with acquired hearing impairment seeking help for the first time: application of the transtheoretical model in audiologic rehabilitation. Ear Hear 2013; 34 (4) 447-457
  • 38 Meyer C, Hickson L, Lovelock K, Lampert M, Khan A. An investigation of factors that influence help-seeking for hearing impairment in older adults. Int J Audiol 2014; 53 (Suppl. 01) S3-S17
  • 39 Saunders GH, Frederick MT, Silverman S, Papesh M. Application of the health belief model: development of the hearing beliefs questionnaire (HBQ) and its associations with hearing health behaviors. Int J Audiol 2013; 52 (8) 558-567
  • 40 Preminger JE, Oxenbøll M, Barnett MB, Jensen LD, Laplante-Lévesque A. Perceptions of adults with hearing impairment regarding the promotion of trust in hearing healthcare service delivery. Int J Audiol 2015; 54 (1) 20-28
  • 41 Poost-Foroosh L, Jennings MB, Cheesman MF. Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions. J Am Acad Audiol 2015; 26 (3) 247-259
  • 42 Mead N, Bower P. Patient-centred consultations and outcomes in primary care: a review of the literature. Patient Educ Couns 2002; 48 (1) 51-61
  • 43 Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ 1995; 152 (9) 1423-1433
  • 44 Dwamena F, Holmes-Rovner M, Gaulden CM , et al. Interventions for Providers to Promote a Patient-Centred Approach in Clinical Consultations. East Lansing, MI: John Wiley & Sons; 2012
  • 45 West RL, Smith SL. Development of a hearing aid self-efficacy questionnaire. Int J Audiol 2007; 46 (12) 759-771
  • 46 Dillon H, Birtles G, Lovegrove R. Measuring the outcomes of a national rehabilitation program: Normative data for the Client Oriented Scale of Improvement (COSI) and the Hearing Aid User's Questionnaire (HAUQ). J Am Acad Audiol 1999; 10: 67-79
  • 47 Dillon H, James A, Ginis J. Client Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids. J Am Acad Audiol 1997; 8 (1) 27-43
  • 48 Preminger JE, Lind C. Assisting communication partners in the setting of treatment goals: the development of the goal sharing for partners strategy. Semin Hear 2012; 33 (1) 53-64
  • 49 Laplante-Lévesque A, Hickson L, Worrall L. Factors influencing rehabilitation decisions of adults with acquired hearing impairment. Int J Audiol 2010; 49 (7) 497-507
  • 50 Laplante-Lévesque A, Hickson L, Worrall L. Predictors of rehabilitation intervention decisions in adults with acquired hearing impairment. J Speech Lang Hear Res 2011; 54 (5) 1385-1399
  • 51 Russ SA, Kuo AA, Poulakis Z , et al. Qualitative analysis of parents' experience with early detection of hearing loss. Arch Dis Child 2004; 89 (4) 353-358
  • 52 Gilliver M, Ching TYC, Sjahalam-King J. When expectation meets experience: parents' recollections of and experiences with a child diagnosed with hearing loss soon after birth. Int J Audiol 2013; 52 (Suppl. 02) S10-S16
  • 53 Grenness C, Hickson L, Laplante-Lévesque A, Meyer C, Davidson B. Communication patterns in audiologic rehabilitation history-taking: audiologists, patients, and their companions. Ear Hear 2015; 36 (2) 191-204
  • 54 Grenness C, Hickson L, Laplante-Lévesque A, Meyer C, Davidson B. The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. J Am Acad Audiol 2015; 26 (1) 36-50
  • 55 Ekberg K, Grenness C, Hickson L. Addressing patients' psychosocial concerns regarding hearing aids within audiology appointments for older adults. Am J Audiol 2014; 23 (3) 337-350
  • 56 Roter D, Hall JA. Doctors Talking with Patients/Patients Talking with Doctors: Improving Communication in Medical Visits. Westport, CT: Praeger; 2006
  • 57 Ong LML, de Haes JCJM, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med 1995; 40 (7) 903-918
  • 58 Roter DL, Stewart M, Putnam SM, Lipkin Jr M, Stiles W, Inui TS. Communication patterns of primary care physicians. JAMA 1997; 277 (4) 350-356
  • 59 Street Jr RLJ, Gordon HS, Ward MM, Krupat E, Kravitz RL. Patient participation in medical consultations: why some patients are more involved than others. Med Care 2005; 43 (10) 960-969
  • 60 Zimmerman-Phillips S, Robbins AM, Osberger MJ. Assessing cochlear implant benefit in very young children. Ann Otol Rhinol Laryngol Suppl 2000; 185 (12) 42-43
  • 61 Robbins AM, Renshaw JJ, Berry SW. Evaluating meaningful auditory integration in profoundly hearing-impaired children. Am J Otol 1991; 12 (Suppl): 144-150
  • 62 Robbins AM, Osberger MJ. Meaningful Use of Speech Scale (MUSS). Indianapolis, IN: Indiana University School of Medicine; 1990
  • 63 Ching TYC, Hill M. The Parents' Evaluation of Aural/Oral Performance of Children (PEACH) scale: normative data. J Am Acad Audiol 2007; 18 (3) 220-235
  • 64 Galvin KL, Noble W. Adaptation of the speech, spatial, and qualities of hearing scale for use with children, parents, and teachers. Cochlear Implants Int 2013; 14 (3) 135-141
  • 65 Purdy SC, Farrington DR, Moran CA, Chard LL, Hodgson SA. A parental questionnaire to evaluate children's Auditory Behavior in Everyday Life (ABEL). Am J Audiol 2002; 11 (2) 72-82
  • 66 Kühn-Inacker H, Weichbold V, Tsiakpini L, Coninx S, D'Haese P. Little Ears: Auditory Questionnaire. Innsbruck, Austria: MED-EL; 2003
  • 67 Ching TYC, Hill M. Teacher's Evaluation of Aural/Oral Performance of Children (T.E.A.C.H.). Sydney, Australia: Australian Hearing; 2005
  • 68 Kopun JG, Stelmachowicz PG. Perceived communication difficulties of children with hearing loss. Am J Audiol 1998; 7 (1) 30-35
  • 69 Anderson KL, Smaldino JJ, Spangler C. Listening Inventories for Education—Revised (LIFE-R). 2011. Available at: . Accessed August 31, 2015
  • 70 Grimshaw S. The Extraction of Listening Situations Which Are Relevant to Young Children, and the Perception Of Normal-Hearing Subjects of the Degree of Difficulty Experienced by the Hearing Impaired in Different Types of Listening Situations. Nottingham, England: MRC Institute of Hearing Research; 1996
  • 71 Gatehouse S, Noble W. The speech, spatial and qualities of hearing scale (SSQ). Int J Audiol 2004; 43 (2) 85-99
  • 72 Ventry IM, Weinstein BE. Identification of elderly people with hearing problems. ASHA 1983; 25 (7) 37-42
  • 73 Schow RL, Nerbonne MA. Communication screening profile: use with elderly clients. Ear Hear 1982; 3 (3) 135-147
  • 74 Demorest ME, Erdman SA. Development of the communication profile for the hearing impaired. J Speech Hear Disord 1987; 52 (2) 129-143
  • 75 Jennings MB. Audiologic rehabilitation needs of older adults with hearing loss: Views on assistive technology uptake and appropriate support services. J Speech Lang Pathol Audiol 2005; 29 (3) 112-124
  • 76 McConnaughy EA, Prochaska JO, Velicer WF. Stages of change in psychotherapy: measurement and sample profiles. Psychotherapy 1983; 20 (3) 368-375
  • 77 van den Brink RHS, Wit HP, Kempen GIJM, van Heuvelen MJG. Attitude and help-seeking for hearing impairment. Br J Audiol 1996; 30 (5) 313-324
  • 78 Preminger JE, Meeks S. The Hearing Impairment Impact-Significant Other Profile (HII-SOP): a tool to measure hearing loss-related quality of life in spouses of people with hearing loss. J Am Acad Audiol 2012; 23 (10) 807-823
  • 79 ICF Research Branch . 2012. Available at: . Accessed May 23, 2016