Developmental language impairment through the lens of the ICF: an integrated account of children's functioning.
The conceptual framework of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) has the potential to advance understanding of developmental language impairment (LI) and enhance clinical practice. The framework provides a systematic way of unifying numerous lines of research, which have linked a wide array of factors to the functioning of children with LI. The result is an integrated account of LI where children's functioning emerges from the complex interaction of core linguistic processes, the ability to use them in social interactions, and a variety of environmental and personal factors. This account is well-suited to the clinical context because it focuses clinical attention on how such factors may be interacting to maintain a child's functional limitations, and on how they might work together to facilitate optimal everyday functioning, the ultimate goal of intervention. In this paper, the ICF's conceptual framework is described, and the nature of the relationships among its components explained. We explore how the integrated view of LI inspired by this conceptual framework differs from the prevailing impairment-driven account, provide examples from the literature that are consistent with the former view, and discuss its implications for clinical decision-making. As a result of this activity, the reader will be able to: (1) describe the nature of the relationships that exist among components of the ICF; (2) describe how interactions among components may shape the functioning of children with LI; (3) identify ways in which the integrated account of LI engendered by the ICF may improve clinical service.