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

1. 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. 2 Conference on Inclusive Education 04.06.2014

3. Why is a common framework to understand disability important for inclusive education? 3 Conference on Inclusive Education 04.06.2014

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. 4 Conference on Inclusive Education 04.06.2014

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. 5 Conference on Inclusive Education 04.06.2014

6. Let us go down and confound their speech… 6 Conference on Inclusive Education 04.06.2014

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 Conference on Inclusive Education

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 8 Conference on Inclusive Education 04.06.2014

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 9 04.06.2014

10. Introduction to the International Classification of Functioning, Disability and Health 10 Conference on Inclusive Education 04.06.2014

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) http://www.who.int/classifications/en/ ICF ICD ICF ICHI ICF Diagnosis Assessment Planning Action Evaluation Conference on Inclusive Education

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 - notperson alone Cultural applicability - not western concepts Operational - not theory driven alone Life span coverage - not adult driven alone Quality Indicators for Inclusive Education

13. ICF Model Health Condition Body Functions and Structures Activities Participation Personal Factors Environmental Factors Conference on Inclusive Education

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. 14 Conference on Inclusive Education 04.06.2014

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 15 Conference on Inclusive Education 04.06.2014

16. ICF Components Body Functions & Structures Activities & Participation Environmental Factors Functions Structures Capacity Performance Barriers Facilitators Conference on Inclusive Education

17. Body Functions & 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 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

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 Conference on Inclusive Education

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. Conference on Inclusive Education

20. Functioning is understood as a continuum 20 Conference on Inclusive Education 04.06.2014

21. Different domains can be selected as fit-for-purpose 21 Conference on Inclusive Education 04.06.2014

22. Structure of the ICF ICF Classification Part 1: Functioning and Disability Part 2: Contextual Factors Parts Activities and Participation Body Functions and Structures Environmental Factors Personal Factors Components Constructs/ qualifiers Change in Body Functions Change in Body Structures Capacity Performance Facilitator/ Barrier Domains and categories at different levels 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 22 04.06.2014

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 Conference on Inclusive Education

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 Conference on Inclusive Education

25. Some flashlights on how the ICF can be used to develop an information system relevant for inclusive education 25 Conference on Inclusive Education 04.06.2014

26. Selecting information that is «fit-for-purpose» Functioning in ICF used for mapping “Competency orientation” Plan for intervention “Deficit orientation” Understand problems differential diagnosticcriteria to establisha syndrome (e.g. learning disabilities) components of abilitiesas criteria to establishcompetencies (e.g. ability to learn) functional properties linked to participation functional properties linked to problem 26 Conference on Inclusive Education 04.06.2014

27. Ensure consistency across professional action cycle Goal Orientation Checking/ Assessing/ Evaluating Acting/ Implementing Planning/ Deciding Analysing Action Planning Situation Analysis Hollenweger & Luder, Sonderpädagogische Förderung heute 2010 27 Conference on Inclusive Education 04.06.2014

28. Facilitate cross-sectoral cooperation at different levels Education Social Services Health 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 28 Conference on Inclusive Education 04.06.2014

29. Develop a System of Indicators for Participation SystemsPerspective European Agency for Development in Special Needs Eudcation, 2011 29 Conference on Inclusive Education 04.06.2014

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 30 Conference on Inclusive Education 04.06.2014

31. Thankyouforyourattention! 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). StudentswithDisabilities, Learning DifficultiesandDisadvantages. Policies, StatisticsandIndicators. 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 31 Conference on Inclusive Education 04.06.2014