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beneficial approach to professional development, SLPs might increase their knowledge about the ICF by asking students to use it on placement, such as in assessment reports or during case debriefing. Transforming practice will require determined attention, including establishing supportive authentic relationships. Mentoring, professional supervision and collegial interactions will help make best use of available resources. While strategies could be tailored to settings identified as having lower ICF uptake, our findings suggest that more comprehensive education and promotion of the ICF in the SLP profession may be appropriate. Further investigation Respondents report having a basic knowledge about the ICF and value its potential for holistic, person-centred care. However, further exploration of the “way of thinking” mindset is warranted to see whether the beginning of a cultural change is occurring. Exploration of the discrepancies in perceived knowledge and use in a range of practice areas is also justified. Studies might involve observation of practice as well as appraising multiple perspectives including those of practitioners from a range of settings, clients and their families to further understand the nature and extent of ICF application in practice. Augmentation by examination of relevant forms, institutional documents and workplace websites could highlight any contributions of the culture and practice across work settings. With more SLPs potentially exposed to ICF principles related to the NDIS, factors such as the impact on practitioners and client perceptions should be investigated. It will be interesting to repeat the current study in a few years’ time using a streamlined tool based on the factor analysis conducted in the present study. Strengths and limitations of the study To our knowledge this is the first broad investigation of use and uptake of the ICF by Australian SLPs. Findings are provisional given the low number of completed surveys and the predominance of South Australian and rural SLP respondents who may all share views of the ICF due to similar geographical and service context factor. Survey fatigue and potential self-selection bias by those aware of the ICF may also have contributed to the low response. In addition, the limited space available for free-text responses likely restricted extended comments and more complex insights. Conclusion The ICF is an important tool for the promotion of holistic, person-centred care. It can advocate for clients, facilitate improved policies and subsequently create enriched futures. This research sought to establish the degree to which the ICF is currently used by Australian SLPs, their level of knowledge of the ICF and their appreciation of its potential. Despite limited uptake and a gap between what is recommended and what occurs in practice, knowledge about, and appreciation and implementation of aspects of the ICF indicate that key features of the ICF infuse practice. Models of effective practice incorporating the ICF for a range of purposes are required. While the findings are preliminary, survey results could be used by academics, professional associations, and employers to identify educational and promotional strategies in order to intensify the shift in practice from an impairment focus to a holistic,

person-centred way of practising in SLP, leading to improved client outcomes and realisation of the 2030 vision (SPA, 2015). Acknowledgements We thank the following for their helpful contributions: Speech Pathology Australia, survey respondents, Pawel Skusa, Karinna Hall, Lucy Way, Cate Pettigrew and two anonymous reviewers. References Alford, V. M., Ewen, S., Webb, G. R., McGinley, J., Brookes, A., & Remedios, L. J. (2015). The use of the International Classification of Functioning, Disability and Health to understand the health and functioning experiences of people with chronic conditions from the person perspective: A systematic review. Disability and Rehabilitation , 37 (8), 655–666. Baylor, C., Burns, M., Eadie, T., Britton, D., & Yorkston, K. (2011). A qualitative study of interference with communicative participation across communication disorders in adults. American Journal of Speech-Language Pathology , 20 (4), 269–287. Bornbaum, C. C., Day, A. M. B., Izaryk, K., Morrison, S., Ravenek, M. J., Sleeth, L. E., & Skarakis-Doyle, E. (2015). Exploring use of the ICF in health education. Disability and Rehabilitation , 37 (2), 179–186. Bornman, J., & Murphy, J. (2006). Using the ICF in goal setting: Clinical application using Talking Mats®. Disability and Rehabilitation: Assistive Technology , 1 (3), 145–154. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology , 3 (2), 77–101. Chapey, R., Duchan, R. J., Elman, R., Garcia, L. J., Kagan, A., Lyon, J. G., & Simmons-Mackie, N. (2008). Life-participation approach to aphasia: A statement of values for the future. In R. Chapey (Ed.), Language intervention strategies in aphasia and related neurogenic communication disorders (pp. 279–289). Philadelphia, PA: Lippincott Williams & Wilkins. Cunningham, B. J., & Rosenbaum, P. L. (2015). A bioecological framework to evaluate communicative participation outcomes for preschoolers receiving speech- language therapy interventions in Ontario, Canada. International Journal of Language and Communication Disorders , 50 (4), 405–415. Di Tondo, S., Ferretti, F., & Bielli, S. (2018). Assessment of core competencies of physical therapists among students and professionals in Italy: A cross-sectional study. Journal of Allied Health , 47 (2), 133–140. Francescutti, C., Fusaro, G., Leonardi, M., Martinuzzi, A., Sala, M., Russo, E., . . . Raggi, A. (2009). Italian ICF training programs: Describing and promoting human functioning and research. Disability and Rehabilitation , 31 (sup1), S46-S49. IBM Corp. (2015). IBM SPSS statistics for windows, Version 23.0. Armonk, NY: Author. Jacob, T. (2013). The implementation of the ICF among Israeli rehabilitation centers: The case of physical therapy. Physiotherapy Theory and Practice , 29 (7), 536–546. Ma, E. P., Threats, T. T., & Worrall, L. E. (2008). An introduction to the International Classification of Functioning, Disability and Health (ICF) for speech-language pathology: Its past, present and future. International Journal of Speech-Language Pathology , 10 (1–2), 2–8.

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