1. Prof. Dr. Judith Hollenweger Zurich University of Teacher Education
International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY)
Prof. Dr. Judith Hollenweger
Zurich University of Teacher Education
Conference on Inclusive Education for Children with Disabilities; Moscow, September 27, 2011

2. Overview
Why is a common framework to understand disability important for inclusive education?
Introduction to the International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY, WHO 2007)
Some flashlights on how the ICF can be used to develop an information system relevant for inclusive education.
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3. Why is a common framework to understand disability important for inclusive education?
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4. Understanding «disability»
Disability can be understood by taking
an economic perspective
an educational perspective
a human-rights perspective
a socio-cultural perspective
a health perspective …
These perspectives represent different conceptual worlds.
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5. Conceptual worlds
«Conceptual worlds» or «knowledge cultures» influence and shape …
… how we explain the creation of disability
… how we analyse the components of disability
… how we fashion interventions for children with disabilities
… how we share information and collaborate with others
… our beliefs and attitudes related to disability
But our conceptual worlds are not necessarily consistent and well organised. This leads to fragmentation, inconsistency and misunderstandings.
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6. Let us go down and confound their speech…
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7. Information for Understanding
Knowledge base
Expertise
Tacit knowledge
«conceptual worlds»
Making sense of data
Information
articulated and verbalised knowledge with
structure added
Understanding data
Data
atomised knowledge: fixed representation and interpretation
Reading data
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8. Meaningful Information Systems
A meaningful system to organise information on disability should…
… allow adequate representation or mapping of all important components relevant for a specific knowledge domain
… provide a way to not only understand entities but also at the relationship between them
… be as complex as necessary and as simple as possible
… enable linkages to other information systems
Some knowledge may be debated; some knowledge may not be important – but not everybody involved will necessarily agree on this – a common framework to map information can help in this process. (maybe make an example)
Entities / relationship:
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9. Quality of Information Systems
Information systems need to…
… provide a reliable linkage between data (e.g. data gained through observations or assessment instruments, self reported data) and knowledge domains (e.g. concepts, theories, models)
… represent knowledge which is meaningful for many people
…provide a framework for data collection that can be used for different purposes
… limit coverage so that information remains manageable
Some knowledge may be debated; some knowledge may not be important – but not everybody involved will necessarily agree on this – a common framework to map information can help in this process. (maybe make an example)
Entities / relationship: 9

10. Introduction to the International Classification of Functioning, Disability and Health
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11. The conceptual worlds of the WHO-FIC
World Health Organisation – Family of International Classifications
International Classification of Diseases; ICD-10 (Alpha Draft of ICD-11 online)
International Classification of Functioning, Disability and Health, ICF and ICF-CY
International Classification of Health Interventions, ICHI (under development)
ICD
ICF
ICF
ICHI
ICF
Diagnosis
Assessment
Planning
Action
Evaluation
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12. Foundations of the ICF and the ICF-CY
Human Functioning - not merely disability
Universal Model - not a minority model
Integrative Model - not merely medical or social
Interactive Model not linear progressive
Parity not etiological causality
Context - inclusive not person alone
Cultural applicability - not western concepts
Operational not theory driven alone
Life span coverage - not adult driven alone
Quality Indicators for Inclusive Education

13. Body Functions and Structures
ICF Model
Health Condition
Body Functions and Structures
Activities
Participation
Environmental
Factors
Personal Factors
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14. Body Component
Functioning from the perspective of the body and body systems Body Functions are physiological functions of body systems (including psychological functions). Body Structures are anatomical parts of the body such as organs, limbs and their components. Impairments are problems in body function or structure such as a significant deviation or loss.
The medical model reduces disability to the body component
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15. A/P component and Environmental Factors
Functioning from an individual and societal perspective (life domains) Activity is the execution of a task or action by an individual. Participation is involvement in a life situation. Activity Limitations are difficulties an individual may have in executing activities. Participation Restrictions are problems an individual may experience in involvement in life situations. Contextual Factors have impact on all components of functioning Environmental Factors make up the physical, social and attitudinal environment in which people live and conduct their lives. Personal factors are also a component of contextual factors but they are not classified in the ICF due to large social and cultural variance
In children, activities and participation are used as signs and symptoms of underlying diseases. This can be very discriminatory and may lead to the wrong actions.
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16. ICF Components Body Functions & Structures Activities & Participation
Environmental Factors
Functions
Structures
Capacity
Performance
Barriers
Facilitators
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17. Body Functions & Structures
Mental functions
Sensory functions and pain
Voice and speech functions
Functions of the cardiovascular,
haematological, immunological and
respiratory systems
Functions of the digestive, metabolic
and endocrine systems
Genitouriary and reproductive functions
Neuromusculoskeletal and movement-
related functions
Functions of the skin and related structures
Structures of the nervous system
The eye, ear and related structures
Structures involved in voice and speech
Structures of the cardiovascular,
haematological, immunological and
respiratory systems
Structures related to the digestive, metabolic and endocrine systems
Structures related to the genitouriary and reproductive systems
Structures related to movement
Skin and related structures

18. Activities and Participation – the Life Domains
Learning & Applying Knowledge
General Tasks and Demands
Communication
Movement
Self Care
Domestic Life Areas
Interpersonal Interactions
Major Life Areas: Education, Work and Employment, Economic Life
Community, Social & Civic Life
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19. Environmental and Personal Factors – Contextual Factors
Products and technology
2. Natural environment and human-made changes to the environment
3. Support and relationships
4. Attitudes
5. Services, systems and policies
Personal factors may include gender, age, social background, past and current experiences, ethnic background, profession. They are understood as the particular background of an individual’s living situation in relation to functioning.
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20. Functioning is understood as a continuum
Differen threshold levels can be identified for different purposes
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21. Different domains can be selected as fit-for-purpose
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22. Structure of the ICF ICF Classification Parts Components Constructs/
Functioning and Disability
Part 2:
Contextual Factors
Parts
Body Functions
and Structures
Activities and
Participation
Environmental
Factors
Personal
Factors
Components
Change in
Body
Functions
Change in
Body
Structures
Capacity
Performance
Facilitator/
Barrier
Constructs/
qualifiers
Item levels:
1st
2nd
3rd
4th
Item levels:
1st
2nd
3rd
4th
Item levels:
1st
2nd
3rd
4th
Item levels:
1st
2nd
3rd
4th
Item levels:
1st
2nd
3rd
4th
Domains and categories
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23. Aims of the ICF and ICF-CY
ICF and ICF-CY are multi-purpose classifications, which aim at:
providing a scientific base for understanding functioning and disability
establishing a common language to improve communication between users
permitting comparisons of data across countries, disciplines, services, time
providing systematic coding scheme for information systems
OECD 2007
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24. Applications of the ICF and ICF-CY
The ICF can be applied for various purposes, for example:
as a statistical tool – for the collection and recording of data
as a research tool – to measure outcomes, quality of life or environmental factors
as a clinical tool – to assess needs, vocational assessment
as a social policy tool – to use for compensation systems, eligibility, policy design
as an educational tool – to raise awareness, teach about disability
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25. Some flashlights on how the ICF can be used to develop an information system relevant for inclusive education
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26. Selecting information that is «fit-for-purpose»
Functioning in ICF
used for mapping
“Deficit orientation”
Understand problems
“Competency orientation”
Plan for intervention
differential diagnostic criteria to establish a syndrome (e.g. learning
disabilities)
components of abilities as criteria to establish competencies (e.g. ability
to learn)
functional properties linked to problem
functional properties linked to participation
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27. Ensure consistency across professional action cycle
Goal Orientation
Checking/
Assessing/
Evaluating
Acting/
Implementing
Planning/
Deciding
Analysing
Situation
Analysis
Planning
Action
Hollenweger & Luder, Sonderpädagogische Förderung heute 2010
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28. Facilitate cross-sectoral cooperation at different levels
Health
Education
Social Services
Rules, regulations and standards to organise, control and monitor services
Macro-Level / Policies
Administrative and organisational mechanisms related to service provision
Meso-Level / Systems
Programmes and operations designed to meet the needs of individuals
Micro-Level / Services
Individuals in the context of institutions
Hollenweger, Disability and Rehabilitation 2010
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29. Develop a System of Indicators for Participation
Chronological Perspective
Situation/ Input
Assessment/ Analysing
Assignment/ Planning
Intervention/ Acting
Evaluation/ Outcome
Policies
Systems
Services
Functioning and Disability of Child
Systems Perspective
European Agency for Development in Special Needs Eudcation, 2011
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30. Expanded ICF-model Educational and developmental goals
Vision of responsible, happy and healthy citizen with capabilities, competence and the ability to adjust to the challenges of society
Methods, provision
and services
Hollenweger, BMC Public Health 2011
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31. Thank you for your attention!
References:
Minow, M. (1985). Learning to Live with the Dilemma of Difference: Bilingual and Special Education, Law and Contemporary Problems, 48(2),
Rogers, R. (2002). Through the eyes of the institution: A critical discourse analysis of decision making in two special education meetings. Anthropology & Education Quarterly, 33(2), 213–237.
OECD (2007). Students with Disabilities, Learning Difficulties and Disadvantages. Policies, Statistics and Indicators. Paris: OECD.
WHO (2001). International Classification of Functioning, Disability and Health. Geneva: WHO (also available in Russian).
WHO (2007). International Classification of Functioning, Disability and Health, Version for Children and Youth. Geneva: WHO.
Available online:
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