Children with speech impairment form a significant part of many speech language pathology caseloads. Traditionally, assessment and intervention with these children has focused on the level of the impairment. However, the World Health Organization's International Classification of Functioning, Disability and Health (ICF) and ICF- version for Children and Youth provide a framework by which such children can be managed in an holistic manner, with due consideration given to the body structures and functions affected by their impairment, as well as the impact on children's activities and participation. The ICF acknowledges the individuality of each child with a speech impairment, through consideration of barriers and facilitators stemming from environmental and personal factors. In this article, assessment and intervention for speech impairment is described using each component of the ICF. A case study illustrating the use of the ICF with a child who has a speech impairment is provided.