Application of the ICF in communication after total laryngectomy.

The World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides a conceptual framework for assessing and treating individuals with communication disorders. This article provides an explanation and application of the ICF to communication after total laryngectomy. To evaluate outcomes associated with total laryngectomy, common assessment tools used in speech-language pathology are described in relation to communication at the levels of Body Functions and Structures, and Activities and Participation. Assessments for Contextual Factors also are discussed. Post-laryngectomy outcomes, including those related to quality of life, also are described relative to the ICF framework. In particular, the role of Environmental and Personal Factors is summarized, and implications are presented for approaches to assessment and treatment of this clinical population. A concluding case example illustrates how all of these concepts can be applied by speech-language pathologists who provide post-laryngectomy rehabilitation.