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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?
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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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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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Let us go down and confound their speech…
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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
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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
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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
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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/
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Diagnosis Assessment Planning Action Evaluation
ICD ICF ICF ICFICHI
Foundations of the ICF and the ICF-CY
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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
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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.
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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
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ICF Components
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Body Functions& Structures
Activities & Participation
Environmental Factors
Barriers
Facilitators
Functions
Structures
Capacity
Performance
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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
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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.
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Functioning is understood as a continuum
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Different domains can be selected as fit-for-purpose
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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
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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
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Some flashlights on how the ICF can be used to develop an information system relevant for inclusive education
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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»
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Ensure consistency across professional action cycle
Situation Analysis Planning Action
Checking/Assessing/Evaluating
Analysing Planning/Deciding
Acting/Implementing
Goal Orientation
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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
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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
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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
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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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