in combination with the empirical tests of the model, should provide the information necessary to direct effective interventions.
As IOM begins the process of reconsidering its seminal works Disability in America and Enabling America, published nearly 15 and 10 years ago, respectively, clear advances have occurred in the conceptualization of disability, but more work is needed in clarifying concepts. WHO’s ICF has incorporated a major concept advocated by Enabling America—environmental factors—and ICF, as the currently accepted international model, should be the starting point for advocating future conceptual revisions. Seven steps have been outlined to improve the ICF conceptualization, including the differentiation of activities and participation, the addition of quality of life to the model, elaboration of the impact of environmental factors, the development of personal factors, refinement of the graphic depiction of the model, definition of research strategies to better measure the domains of the model, and validation of the model by testing the interrelationships among its concepts and deriving interventions to improve the lives of people with disabilities.
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