The ICIDH: format, application in different settings, and distinction between disability and handicap. A critique of papers on the application of the International Classification of Impairments, Disabilities, and Handicaps.

Recent papers on the ICIDH generally agree about the need for and the usefulness of the ICIDH, although inevitably some difficulties are reported in applying it. Some of these stem from the context and professional purpose of the assessments (on the whole the rehabilitation setting was found to be less problematic than community surveys), and others from the application to particular sub-groups, such as children, the elderly, the mentally ill, or those with milder or fluctuating disability. Most problems concerned the nature of the relationship between disability and handicap and the distinction between these concepts. This review suggests an alternative formulation of the disablement model which shows handicap as arising out of an interaction between impairment and disability and the environment in which the individual lives, the resources available, and the social and cultural setting. While on the whole optimistic, the papers reviewed indicate that there is still more work required both on a practical and conceptual level.