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Constructive Functional Diversity: A new paradigm beyond disability and

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 Disability and Rehabilitation, October – November 2007; 29(20 – 21): 1625 – 1633
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Constructive Functional Diversity: A new paradigm beyond

disability and impairment

PHILIP PATSTON

Diversityworks Group and Trust, Herne Bay, Auckland, New Zealand

Abstract
Aims of the paper. This article presents a more dynamic and constructive paradigm than the current dominant ones (for
example medical or social models), to describe and change the impact of impairment and disability. The reflections
contained are inspired by personal and professional frustration with the existing polarized ideology of human function, which
fails to adequately describe the diversity of physiological and psychosocial function amongst people. It aims to provoke and
inspire dialogue about our current paradigm of human function in relation to value and capacity.
Key findings and implications. Within this paper: I critique society’s biases regarding of functional deficit relative to the
subconscious fear of losing function; I question the polarity of the negatively framed language of impairment and disability; I
offer constructive, creative ‘solutions’ to describe the experience of atypical function. In so doing, an entirely new language of
diverse human function and a concept of Constructive Functional Diversity (CFD) is proposed, which includes a complex
yet logical array of modes and outcomes of function.
Conclusions and recommendations. Finally I suggest the benefits of a more dynamic paradigm of functional change in
enhancing rehabilitative outcomes, including client-directed practice.

Keywords: Conceptual framework, disability, language, models of disability

functional diversity’ to ‘[represent] the most for-

Introduction
A more radical approach is needed: we must demolish
the false dividing line between ‘normal’ and ‘disabled’
[meaning impaired] and attack the whole concept of
physical normality. We have to recognise that disable-
ment [impairment] is not merely the physical state of a
small minority of people.
It is the normal condition of humanity. [1]
Functional diversity is a relatively new way of
thinking about impairment and disability, though
the term itself is used in a variety of contexts: To
describe ecological [2] and biological [3] processes;
to explain the variation in team and workgroup
performance [4]; and to describe a fundamental
characteristic of ageing [5]. Romañach and Lobato
(2005) related it directly to disability and impairment
when they proposed the term ‘women and men with
gotten and discriminated ten per cent of humanity
throughout the history of almost all human societies’
[6, p. 1]. They argued that none of the common
terms used currently to describe this group was
positive or neutral and that even the World Health
Organization’s new International Classification of
Functioning, Disability and Health (ICF) [7], was no
more than a ‘praiseworthy attempt to shift the
‘problem’ of functional diversity from the person to
the environment . . . [while still using] the words
impairment, limitation, restriction, barrier and dis-
ability’ (p. 3).
But functional diversity is far more than simply a
new term to describe the internal experience of
disabled people. It is an innovative way of thinking
that takes away the boxes of impaired (or disabled)
and a comparative normal. It allows all people to
share in the complex array of human function and

Correspondence: Mr P. Patston, Diversityworks Group and Trust, PO Box 46256, Herne Bay, Auckland 1147, Aotearoa New Zealand.
E-mail: philip@diversityworks.co.nz
ISSN 0963-8288 print/ISSN 1464-5165 online ª 2007 Informa UK Ltd.
DOI: 10.1080/09638280701618778
 1626 P. Patston
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benefit from their strengths. Romañich and Lobato
allude to this by ‘[attempting] to go even further and
avoid the social strategy of ‘‘deviationism’’, the one
that produces the ‘‘them’’ and ‘‘us’’ groups, to put
forward that functional diversity is something in-
herent to the human being’ (p. 6). But they contra-
dict this by repeatedly defining functional diversity as
‘a reality in which a person functions in a different or
diverse way from most of society’ (p. 4). In contrast,
the approach presented here recognizes that all
people function in diverse ways.
The deficit mindset of impairment
and disability
The foundation of my concept of Constructive
Functional Diversity (CFD) calls for the complete
removal of any notion of difference or deviation from
a predetermined norm. Otherwise, we simply change
the boxes’ labels from disabled and non-disabled to
diverse and non-diverse. The potential of functional
diversity to truly change the social mindset is to
create one box only, labelled functional diversity, in
which all human beings sit, stand, lie or otherwise
exist. Within this one box, however, I have defined a
complex array of modes and outcomes of function.
These parameters of function allow us to become
aware of our functional similarities and differences.
Each of us has a different capacity to function at
different times and in different situations. Many
activities involve functioning in several ways. For
example, elite athletes need to function at a very high
capacity physically and cognitively. Scientists may
need only cognitive capacity to perform well. Artists’
aesthetic appreciation requires motor, sensory and
creative capacity. We would forgive an athlete’s
temporary lapse in concentration, or a scientist’s
dubious aesthetic discernment. We would not judge
an artist’s capacity because of a tendency to be
reclusive or lack of social skills. In fact, society
forgives people for these deficits because of their
successes. Sometimes their successes are even
attributed to their deficits.
Currently, we categorize impairment and disability
with a framework of comparative levels of ability.
Likewise, Nordenfelt [8] observes a similar contrast
in the medical model of health: ‘The perfectly
healthy person . . . does not have any diseases or
maladies’. He cites the belief of holist health
philosophers that disabled people are in fact un-
healthy: ‘A healthy person has the ability to do what
he or she needs to do, and the unhealthy person is
prevented from performing one or more of these
actions’ (p. 1462). Despite his reference to the ICF’s
distinction between ability/capacity, performance
and opportunity, he makes, of course, the same
assumption that has in turn inspired the social model
of disability. But even the social model, with its
disabled/non-disabled comparison, perpetuates our
dualistic view of society by virtue of function (see
also Gzil et al. in this issue [9]).
Whether from the medical or social model, we
define people as impaired – and as a result disabled –
in relation to their difference from a socially
determined notion of what it is to be unimpaired or
non-disabled. If you can walk, you’re non-disabled;
if you can’t, you’re disabled. This method of
classification is logically flawed, because it does not
acknowledge the impact of context. Imagine compet-
ing at the Olympic Games – you would be physically
impaired by comparison with the athletes. Just like
someone with a limp on a busy street, you may slow
the pace of the Olympic, but you wouldn’t be
considered disabled. Nor do we label someone
disabled if they can’t act, sing, cook, swim or
practice law, just because some people can.
Then why do we define some people by their (or
our own) perceived functional deficit? Why do we
describe a person as blind, rather than incredibly
creative in their ability to navigate the world without
sensory input? Why do we describe people with
Down syndrome as intellectually disabled, rather
than, as is so often the case, intuitive and honest?
Why don’t we applaud the emotional repertoire of
people whom we label as having bipolar disorder?
Similarly, why do we continue to label people
(even ourselves) using medical terminology (Cere-
bral palsy, Down syndrome, Multiple Sclerosis,
Asperger’s syndrome)? We do not invent conditions
for elite athletes, creative geniuses or beautiful people
like Acute Physiological Superiority Syndrome,
Ineptitude Imperfecta (Einstein’s Disease) or Aes-
thetic Arrogance Disorder. I would argue that the
answer is fear – our own fear of losing function.
Dysfunctionphobia – our own fear denied
We are all influenced by the values, beliefs and
attitudes that condition us from birth. Often these
are subconscious and we have little awareness of
them, but most often our response to impairment
and disability is negative. The usual reactions to the
encounter of impairment or disability include sad-
ness, a focus on loss, pity, denial and even shock,
horror and devastation [10].
When I introduce the idea of dysfunctionphobia
and functional diversity at workshops, I ask partici-
pants to tell me how they would react waking up the
next morning with a number of different changes:
. You have different coloured hair;
. You are rich and famous;
. You are the other gender;
. You have a different sexual preference;

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. You are another race;
. You have 50% of your physical, intellectual or
emotional capacity.
I give them the following response options:
! I’d Hate it to happen;
! I’d Fear the unknown;
! I’m Not Sure;
! I’d be at Peace with the world;
! I’d Love it to happen.
Over the last year, in response to a suggestion of 50%
reduction in capacity, most of the people who
participated reported that they would hate it and be
fearful with few exceptions while the other changes
provoke, at worst, uncertainty. Interestingly, most
people laugh at the other possibilities but become
very serious at the mention of functional change.
When I ask participants why this occurs, people
express feelings and fears regarding the ability to
cope. But, as I point out, loss and grief is part of any
change – presumably we would grieve the loss of
black hair when we bleached it, or the loss of being
male if we became female or vice versa. Similarly, a
person’s religious upbringing may make waking up
gay far harder to cope with than being disabled. The
difference, I propose to these groups and also to you,
is that the first five changes are highly unlikely to
happen overnight, without a concerted effort of will
and autonomous decision-making, but the last
change is possible, even statistically likely in some
cases, to happen unexpectedly and involuntarily.
Additionally, we are conditioned to believe that
impairment is ‘wrong’ and unnatural which under-
standably contributes to dysfunctionphobia. It is
further exacerbated by the long history of social
exclusion, devaluation, poverty and discrimination
experienced by disabled people, which people wit-
ness with distress, but without the realization that
they individually and collectively cause it.
Oppression and discrimination against disabled
people is often called abilism (or sometimes dis-
ablism). Abilism is the institutionalized belief that
being non-disabled is better or more natural than
being disabled (in the same way that racism is the
belief that one race is better than another, and
heterosexism is the belief in the superiority of
heterosexuality). It is a belief that legitimizes
society’s ignorance or lack of awareness, insensitivity
or, at worst, cruelty. Dysfunctionphobia explains the
collective, institutional phenomenon of abilism in
individual terms. Similar to homophobia and xeno-
phobia, I explain dysfunctionphobia as an interna-
lized, often subconscious, fear or hatred of losing
function, or becoming unable to function indepen-
dently. This fear stems from an aversion to
Constructive Functional Diversity 1627
dependence, which we might associate with child-
hood, old age and vulnerability. Dysfunctionphobia
seems more ubiquitous than homophobia and
xenophobia. There seems to be decreasing accep-
tance of people who fear or despise people because of
differences in race or sexual preference. But there
seems to be more acceptance of people who fear and
despise the potential for differences in function. In
fact, when I have suggested that we should all
embrace the possibility of functional change or
impairment in each other, or ourselves, some people
have responded with derision and even anger.
The average person lives in denial that at any time
they could have a car accident and become paralyzed
or brain injured; they could have a stroke, develop an
anxiety disorder or become depressed, lose hearing
or sight. I believe this denial causes society to fail to
provide support, remove barriers and challenge
discriminatory attitudes: The things that dis-able
people. This denial occurs in resistance to an
effective societal response, which would require an
admission that a non-disabling society potentially
benefits all people, not just the 20% [11] perceived as
needing the intervention. Importantly, I suggest that
the root fear relates to the inability to cope, rather
than the change or loss of function. We are infinitely
adaptable; disabled people adapt when adequately
supported and newly impaired people share this
potential. Communicating this possibility at the
beginning of a rehabilitation process could impact
in terms of client-directed practice, giving a totally
different potential focus – adaptation – as well as or
instead of restoration.
It is not just non-disabled people who exhibit
dysfunctionphobia – many people who are impaired
either fear or dislike their own functional deficit
and/or the possibility of a further loss of function.
Disabled people often apologize for their inability to
do things, or for their need of support. Some may
even discriminate against others with the same or
different impairment (e.g., physically disabled peo-
ple often do not want to associate, or be associated,
with intellectually disabled people). Young adults
with acquired impairment as a result of accident or
illness may be desperate to return to their commu-
nities or workplaces, but are terrified about appear-
ing in public as a ‘disabled person’. And why
wouldn’t they? They have been raised in the same
dysfunctionphobic society and subjected to the
same negative attitudes and beliefs. As such,
dysfunctionphobia becomes both internalized and
institutionalized.
I would go so far as to say that dysfunctionphobia
is a hidden epidemic in society, caused by our binary
ideologies of human function (impairment and
disability), which needlessly fuels discrimination
[12]. The challenge is to stop people thinking merely
 1628 P. Patston
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in terms of impairment and disability and facilitating
a change in their understanding and value of
function.
The new language of Constructive Functional
Diversity
Crucial to the power of the current mindset is the
language we use. If we express a new mindset – one
of diversity rather than comparative deficit – we need
new words and terms. Edward de Bono emphasizes
the importance of precision in the use of words to
become more expressive [13]. The common trait of
existing language in impairment and disability is
negative and comparative; the focus of the new
language is constructive and solution focused.
Something is constructive when it is ‘carefully
considered and meant to be helpful.’ [14] The
language of impairment and disability is seldom
either. De Bono also asserts that positive thinking
keeps us in undesirable situations if it immobilizes us
from action by perpetuating thinking good things
about bad circumstances. It is constructive thinking
that moves us towards the desirable outcome [15].
I have already proposed that CFD removes the
comparative ideology of impairment and disability.
However, there will, for some time, be a need to
identify verbally the distinction between people
labelled disabled and non-disabled. At this point in
time, I believe it is more important to change how we
do that than whether we do it. The risk of not coining
new terms is that only disabled people will become
known as functionally diverse, which is incorrect,
because all people (all beings, in fact) are function-
ally diverse. The new language, therefore, coins the
phrases ‘people with unique function’ and ‘people
with common function’. The word unique is, in
keeping with de Bono’s recommendation, a powerful
reframe to our understanding of people who do not
have common function, meaning ‘different from
others in a way that is worthy of note.’
Below (Table I) is a beta version1 of a complete
CFD vocabulary, preceded by its impairment/dis-
ability incumbent (including WHO ICF terms).
Further explanation of terms in included in the
following section, which explains the concept of
CFD in more detail.
Constructive Functional Diversity – accepting
our natural variance
In this section I will begin to outline in more detail
the concept of CFD that I am proposing. There are
four core elements:
(i) Modes – how we function;
(ii) Outcomes – why we function;
(iii)Value (or desired state) – the level of
importance placed on function;
(iv) Capacity (or actual state) – the level of ability
to function.
Modes of function
As human beings we function in a variety of different
ways – we taste, we move, we communicate, we
think, we feel, we express. In analysing these and
other means of function I have built a list of nine
modes of function, into which we can place any
manner of function. I suggest also that these are the
aspects of function that we value most. CFD modes
begin with a focus on ‘doing’ and move to a focus on
‘being’ (Figure 1).
. Biological function: Includes basic biological
functions such as chemical reactions in the
brain, circulation, organ function etc.
. Aesthetic function: Includes function in terms
of appearance, beauty, and attraction. One
only has to observe such industries as model-
ling and cosmetics, or the social obsession
with dieting, to recognize the importance
placed on our ability to be appreciated
aesthetically.
. Motor function (or physical function): In-
cludes all aspects of our ability to coordinate
movement and perform activities.
. Sensory function: Sight and hearing, but
includes taste, smell, kinaesthetic sensation,
etc.
. Cognitive function: Our ability to think,
reason, perform intellectual activities; includes
intellectual intelligence.
. Social function: Includes capacity for expres-
sing and interpreting communication (over and
above motor functions of talking and writing);
engaging in relationships; understanding social
mores etc
. Emotional function: Our ability to experience,
interpret and understand emotional feelings;
includes emotional intelligence.
. Creative function: Our ability to imagine
solutions, innovate, design and inspire unique
outcomes.
. Spiritual function: Our attention to being
rather than doing; higher beliefs about life
and self, including how we observe or express
these – through religion, ritual etc.
Sexual and cultural function may seem obviously
missing from this list. I have deliberately not
included them as it seems to me that they involve
all of the listed modes function. Or they may be
better classified as outcomes. Or they might become
 Constructive Functional Diversity 1629
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Table I. Constructive Functional Diversity (CFD) language.

Impairment/disability perspective CFD perspective Explanation of term

Impairment, including functional
impairment (ICF) – ‘significant
deviation from statistical norm’
Diagnosis
Disability; disablement (social model
definition)
People with disability(ies); people with
impairment; disabled people
People without disability(ies); people
without impairment; non-disabled
people
To disable someone
To be disabled
Disability support (service or equipment)
Independence/autonomy
Acquired impairment
Rehabilitation
Adjustment to impairment
Limitation to activity (ICF) – ‘difficulty in
performance of activity’
Restriction to participation (ICF) –
‘problems in involvement’
Barrier (ICF) – ‘environmental factors
that condition functioning’
Disability (ICF) – ‘negative interaction
between person and environment’
Unique function
Origin of unique function
Functional bias
People with unique function
People with common function
To exhibit functional bias
To experience the impact of functional
bias
Functional enhancement (system or
device)
Functional synergy
Functional realignment
Functional reconfiguration
Functional reconciliation
Internal functional opportunity/gap
External functional opportunity/gap
Functional challenge (obstacle)
Functional dissonance
The distinctive capacity and value of
function held by an individual or group
The cause of or reason for an individual’s
unique function
The favouring of a certain capacity to
function over another
People who hold a distinctive capacity
and value around function
The majority of people who exhibit
regular modes of functioning
The active demonstration of favouring a
particular functional capacity or value
The result of being a passive recipient of
functional bias
A system or device that enhances function
by reducing functional gap or
increasing opportunity
A match in functional value and capacity
A significant change in functional capacity
The process to re-evaluate and change the
relationship of functional capacity and
value
The outcome of functional
reconfiguration
The potential/latent value or capacity
created a mismatch between functional
value and capacity due to unique
function
The potential/latent value or capacity
created by a mismatch in value and
capacity due to functional bias
The potential value or capacity created by
removing an obstacle which creates an
external functional opportunity/gap
The discord caused by the presence of a
functional challenge

components of new category. I’m not sure at this

point – look out for them in CFDv2.0!

Outcomes of function
All function is motivated by a desire to achieve (or
value placed on) a particular outcome. Like the
modes, CFD outcomes move from a focus on
‘doing’ to a focus on ‘being’ (Figure 2).

. Task – work or assignment, which may be

Figure 1. Modes of function in CFD.
simple, useful, important or difficult;
. Job – paid trade or profession, something
needing to be done or dealt with;
. Occupation – an activity on which time is
spent, paid or unpaid;
. Role – the usual or expected function of some-
one, the part played in a given social context;
. Meaning – what something means, what some-
one intends to express;
 1630 P. Patston
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. Utility – the quality or state of being useful or
beneficial;
. Purpose – the reason something or someone
exists.
Value (or desired state) and capacity (or actual state)
Value and capacity (also known as actual and
desired states) are the dynamic, changing elements
of CFD. Value changes all the time for individuals,
groups, cultures and societies, for both modes and
outcomes, regardless of whether they have unique
or common function. The match or mismatch in
value and capacity would therefore determine the
level of functional synergy. The proposition there-
fore is that people with common function are more
likely have higher levels of functional synergy than
people with unique function because the capacity
of common function matches the value of com-
mon function (for example, the ability to walk
(CFD motor mode) matches the high value of
walking).
Value (desired state) could be measured internally
and externally (in relation to a person’s internal or
external experience). For example, I can measure
society’s value of being able to sing well or under-
stand meaning, and my own value in relation to my
ability to sing well or understand meaning. When
value and capacity do match CFD suggests we would
experience functional synergy; when they don’t
match, we would experience a functional gap or
opportunity. Capacity could also be measured
internally (ability without support or enhancement)
and externally (assistance to function provided by
people or equipment).
CFD questions the legitimacy of the value of
function and its outcomes, including roles, typically
Figure 2. CFD outcomes.
held by individuals and society. While capacity may
be impossible, difficult or unreasonable to change,
value is relatively abstract and variable and can be
changed (and does change) quite fluidly in indivi-
duals and groups. Hence, one can change functional
synergy by individually or collectively deciding to
value a mode or outcome of function differently.
This is fundamentally different to the ideology of
Social Role Valorisation (SRV), formulated in 1983
by Wolf Wolfensberger:
‘SRV suggests that . . . it is most useful to seek positive
valued roles for the devalued people and groups. SRV
suggests that such role re-valorisation may be consider-
ably more effective than other means of assisting people
in devalued states. Consequently SRV suggests that
enhancing competency and image (of the person and
their surroundings) will result in positive roles being
made a possibility for devalued people.’ [16]
Here is a series of hypothetical pictorial representa-
tions of the interaction between value and capacity
(functional synergy) in CFD modes (represented
separately) and outcomes (combined), where high
value exists. Figure 3 shows low functional synergy
and therefore high opportunity (indicative of some-
one with inadequate enhancement systems or devices
or a recent realignment). Figure 4 shows unbalanced
functional synergy (indicative a high achiever lacking
work-life balance). Figure 5 shows high functional
synergy (indicative of someone with unique function
with adequate enhancements and alignment; or
someone with common function with good work-life
balance).
Figure 3. Low functional synergy.

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Figure 4. Unbalanced functional synergy.
Figure 5. High functional synergy.
Benefits of CFD in enhancing rehabilitative
outcomes
CFD has the potential to have several benefits in
functional reconfiguration (rehabilitation) settings
for both clients and professionals. These are dis-
cussed below.
(1) Psychological benefit
A CFD paradigm can create a shift in thinking
for people who experience functional realign-
ment (acquire impairment). The current
binary paradigm requires people not only to
survive the trauma of the incident that creates
Constructive Functional Diversity 1631
the realignment, but also to join the group of
stigmatized people that they have feared
(dysfunctionphobia). CFD creates the oppor-
tunity for a person with functional realign-
ment to perceive their situation from a
position of value rather than stigma.
(2) Understanding motivation to recover
With the caveat that motivation is extraordi-
narily complex [17], it is clear that some
people demonstrate higher motivation than
others to reconfigure function (rehabilitate)
after a traumatic incident. CFD may be able
to offer an explanation. If someone has lost
capacity to function in a mode or outcome
area that they highly valued, the impact will
be greater than if they placed low value on
that functional area. If the person realizes it
will be impossible to regain that capacity
internally, and isn’t satisfied with the use of
functional enhancements, this will affect
motivation. The options for successful re-
conciliation, therefore, are:
(a) To change the internal value placed on
the affected area of function; and/or
(b) To raise the internal value in another
area of function where capacity has
been unaffected
(3) Client-directed practice
CFD fosters practice where clients can direct
the reconfiguration process by exploring a
dynamic landscape of functional modes,
outcomes, value and capacity (internal and
external). There can be a choice whether
measurement or interpretation are deter-
mined subjectively (by the client) or objec-
tively (by the professional).
Further research options/opportunities
This article provides a conceptual introduction to
CFD based on my theoretical hypothesis and in so
doing, raises several research questions. Does the
CFD approach improve outcomes for people parti-
cipating in rehabilitation services? If so – which
people benefit most (e.g., people with spinal injuries,
people with stroke, people with depression)? Which
services are best for this approach (e.g., acute/post-
acute inpatient rehabilitation or community-based
rehabilitation)? And very importantly, what out-
comes are achieved? If a quantitative study were
pursued, how would the outcome be measured? It
may be useful to study the consequence of applying
the CFD approach to rehabilitation services for
people with functional realignment (e.g., spinal
injury or traumatic brain injury) participating in
 1632 P. Patston
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their first inpatient rehabilitation. Maybe CFD will
positively influence work-status or community inte-
gration two years down the track. Or maybe people
exposed to it will just feel more positive about
themselves and have higher life satisfaction, in which
case the measures of ‘attitudes toward self’ or ‘life
satisfaction’ would be more useful.
Alternatively, a more open-ended research ques-
tion may be applied, e.g., What influence does the
CFD approach have on the experience of rehabilita-
tion? In this case, a qualitative research design might
be more appropriate, such as narrative analysis,
participation action research, grounded theory,
interpretative phenomenological analysis (IPA) or a
focus group methodology. A qualitative approach
would possibly be more useful than a quantitative
approach as this idea is new and there is very little
else to base research on, but it will not demonstrate
causality between intervention and outcome, which
can limit credibility.
Another area of study could be the impact of CFD
on the parents of children with unique function and
what influence it would have on the decisions they
make about the lives of their children. It would also
be interesting to see if it influenced the behaviour of
clinicians towards the people they work with/for.
On a more abstract level it would be interesting to
examine situations where high levels of function are
not necessarily valued – emotional intelligence, for
example. Emotional function is often lowly valued
and matched by low capacity – watch any soap opera
for evidence of this! What is the impact of an
individual having high emotional capacity – a
functional ‘surplus’ – where this is not valued?
Another more complex exploration would be the
impact of emotional or cognitive response to func-
tional gaps in other areas. If emotional capacity is
high, will someone respond more positively to a
functional gap in motor function? If this response is
positive is there, in fact, a gap at all, or does this
indicate a reduction in internal value and, therefore,
the creation of functional synergy?
Summary
Although the term functional diversity has been used
in a variety of contexts, it is a relatively new way of
thinking about impairment and disability. The
concept of Constructive Functional Diversity that I
raise here promotes and operationalizes a strengths-
based approach by removing the notion of a
comparative state of ‘normalness’. It requires a
dynamic analysis of function in terms of the way
we function (modes); why we function (outcomes);
the internal and external value of function; and
internal and external capacity to function. It offers
a new language that is non-medicalized and
constructive. I have suggested CFD provides the
opportunity for benefits in rehabilitation settings, in
relation to client perception of changed function,
motivation to recover and client-directed practice. I
have also proposed areas of research around its use.
Acknowledgements
A huge thank you to Kath McPherson for providing
me the challenge to write this paper, for assisting
with preliminary research and for many provoking
discussions. Profound thanks also to Kate Diesfeld
for such insightful comments and challenges; and for
several sessions of intensive discussion and editing.
Warm appreciation to William Levack for the phone
calls and e-mails, especially about research opportu-
nities. I am also grateful to Kyle Jack-Midgley, Claire
Ryan, Carol Waterman and Martin Sullivan for
enduring hours of conversations about functional
diversity, for their reflection and comment on its
principles and application. Thanks to Sharon Daly
from the US who read an early blog on functional
diversity and took the time to e-mail and tell me of a
time where using the concept changed an outcome
for the better, proving perhaps that it really works!
Finally, to the other authors of this edition, especially
Prof Alain Leplege, who peer-reviewed the first of
many drafts: Thank you for your collegial support
and may this be the first of many published articles
debating the nature of how we perceive and express
our understanding of function.
Dedicated to the memory of Prof Alan Clarke, who
shared my belief that impairment is more complexly about
diversity than deficit.
Note
1. A ‘beta version’ is the first version of computer software
released outside the organization or community that develops it
so that it can be tested in the real world. This is the first release
of the CFD terminology and, like beta software testers, readers
are invited to test the vocabulary and provide feedback.
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