International Classification of Functioning, Disability and Health (ICF) and
International Classification of Functioning, Disability and Health for Children
and Youth (ICF-CY): New international standards in disability
The International Classification of Functioning, Disability and Health (ICF),
is a relatively young member of WHO’s Family of International Classifications.
It was officially endorsed by all 191 WHO Member States in 2001 as an
international standard to describe and measure health and disability. The ICF
conceptualises disability as multi-dimensional phenomenon arising out of a
dynamic interaction between an individual and its physical and social
environment. It provides a common language and a universal framework for
establishing a shared understanding of disability in various settings,
disciplines, life stages, and policy fields.
Figure: Framework of the ICF
publication, the ICF has become a powerful tool for practitioners, researchers,
service providers and policy makers. It is also particularly useful for planning
and monitoring participation of children and youth in education systems.
In 2007, a derived version of the ICF for children and youth
(ICF-CY) was published. The ICF-CY was prepared by an international
group of experts, taking account of developing characteristics of children and
youth. Like the ICF itself, the ICF-CY helps to document and specify
characteristics of functioning of children and youth in their given
environments, including characteristics of the environments themselves.
Disability data, and the instruments to measure it, should reflect the ICF’s
bio-psychosocial model of disability. Valid and reliable information is
essential to design, implement or evaluate policies and legislation to combat
discrimination and promote social integration, participation and enhance
opportunities. At present, however, data currently being collected, nationally
and internationally, embody conceptual confusions, inconsistencies and
ambiguities about disability and the relationship between health conditions,
impairments and environmental factors.
WHO has developed a very instructive “ICF Beginner’s Guide”
which you can download from WHO’s ICF pages:
Fully browsable versions of ICF and ICF-CY in English and
some other languages can be accessed here:
The free “ICF illustration library”, created by a Japanese
team, contains illustrations of the ICF, giving users a view of
the whole structure, including accompanying codes and texts. The authors note
that the site “can be potentially used as a training aid for understanding the
structure and composition of the ICF, as well as an online aid for using and
interpreting the ICF classification system. […] Although the library has been
specifically designed for dealing with elderly patients in mind, its design
would also lend itself to being adapted for other groups and used in other
The team of “ICF Research Branch” at the University of
Munich develops applications of ICF such as core sets:
2 Specific uses of the ICF-CY in education
To special education, ICF-CY represents a paradigm shift by moving away from
traditional, mostly one-dimensional diagnoses towards a classification of
functional characteristics of children and youth and of their given
environments. Thus, ICF-CY can also help to promote a holistic,
multi-disciplinary and non-stigmatizing approach to disability in education
systems and beyond.
At least seven major contributions can be
identified which ICF-CY can make to special education (Simeonsson et al. 2008):
- ICF-CY can be a standard reference for defining rights of children and for
documenting specific developments and deficits in implementing children’s rights
at universal and national levels.
- It can serve as a framework for integrating multidisciplinary efforts in
assessment, intervention, and monitoring.
- It can be used in the derivation of profiles of child functioning and in
designing eligibility criteria based upon the nature and the extent of
functional limitations in specific contexts.
- It can be used for planning individualized interventions.
- It can guide the selection of instruments for assessment and for outcome
- Through the use of severity qualifiers and codes, it can help in documenting
changes of child functioning and environments.
- It can help to increase the precision of statistical databases used for