International Classification of Functioning, Disability and Health, Version for Children and Youth...

International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY)

Prof. Dr. Judith HollenwegerZurich University of Teacher Education

Conference on Inclusive Education for Children with Disabilities; Moscow, September 27, 2011

Overview

1. Why is a common framework to understand disability important for inclusive education?

2. Introduction to the International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY, WHO 2007)

3. Some flashlights on how the ICF can be used to develop an information system relevant for inclusive education.

Conference on Inclusive Education 10.04.23 2

Why is a common framework to understand disability important for inclusive education?


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.


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.


Let us go down and confound their speech…


Information for Understanding

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Knowledge baseExpertiseTacit knowledge«conceptual worlds»

Making sense of dataInformation

articulated and verbalised knowledge withstructure added

Understanding data Dataatomised knowledge: fixed representation

and interpretation

Reading data

Conference on Inclusive Education

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


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

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Introduction to the International Classification of Functioning, Disability and Health


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)

http://www.who.int/classifications/en/

10.04.23 11 Conference on Inclusive Education

Diagnosis Assessment Planning Action Evaluation

ICD ICF ICF ICFICHI

Foundations of the ICF and the ICF-CY

10.04.23Quality Indicators for Inclusive Education 12

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

ICF Model

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Health Condition

Body Functions and Structures

Activities Participation

Personal FactorsEnvironmentalFactors


Body Component

Functioning from the perspective of the body and body systemsBody 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.


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 functioningEnvironmental 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


ICF Components

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Body Functions& Structures

Activities & Participation

Environmental Factors

Barriers

Facilitators

Functions

Structures

Capacity

Performance


Body Functions & Structures

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Mental functions

Sensory functions and pain

Voice and speech functions

Functions of the cardiovascular,haematological, immunological andrespiratory 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 andrespiratory 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

Activities and Participation – the Life Domains

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1 Learning & Applying Knowledge2 General Tasks and Demands3 Communication4 Movement5 Self Care6 Domestic Life Areas7 Interpersonal Interactions8 Major Life Areas: Education, Work and Employment,

Economic Life1 Community, Social & Civic Life


Environmental and Personal Factors – Contextual Factors

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1. 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.


Functioning is understood as a continuum


Different domains can be selected as fit-for-purpose


Structure of the ICFClassification

Parts

Components

Constructs/qualifiers

Domains and categories

at different levels

ICF

Part 1: Functioning and

Disability

Part 2: Contextual Factors

Body Functions and Structures

Activities and Participation

Environmental Factors

Personal Factors

Change in Body Structures

Capacity Performance Facilitator/Barrier

Item levels:1st 2nd

3rd

4th

Item levels:1st 2nd

3rd

4th

Item levels:1st 2nd

3rd

4th

Change in Body Functions

Item levels:1st 2nd

3rd

4th

Item levels:1st 2nd

3rd

4th10.04.23 22

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

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


Some flashlights on how the ICF can be used to develop an information system relevant for inclusive education


Functioning in ICF used for mapping“Deficit orientation”

Understand problems“Competency orientation”

Plan for intervention

differential diagnosticcriteria to establisha syndrome (e.g. learning disabilities)

components of abilitiesas criteria to establishcompetencies (e.g. ability to learn)

functional properties linked to problem

functional properties linked to participation

Selecting information that is «fit-for-purpose»


Ensure consistency across professional action cycle

Situation Analysis Planning Action

Checking/Assessing/Evaluating

Analysing Planning/Deciding

Acting/Implementing

Goal Orientation


Hollenweger & Luder, Sonderpädagogische Förderung heute 2010

Facilitate cross-sectoral cooperation at different levels

Health Education Social Services

Individuals in the context of institutions

Programmes and operations designed to meet the needs of individualsMicro-Level / Services

Administrative and organisational mechanisms related to service provisionMeso-Level / Systems

Rules, regulations and standards to organise, control and monitor servicesMacro-Level / Policies


Hollenweger, Disability and Rehabilitation 2010

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


European Agency for Development in Special Needs Eudcation, 2011

Syst

ems

Pers

pecti

ve

Expanded ICF-model

Methods, provisionand services

Educational anddevelopmental goals

Vision of responsible, happy and healthy citizen with capabilities, competence

and the ability to adjust to the challenges of society


Hollenweger, BMC Public Health 2011

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), 157-211.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: http://apps.who.int/classifications/icfbrowser/Default.aspx


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