This study is the outcome of a systematic literature review on the use of the International Classification of Functioning Disability and Health (World Health Organisation, 2001, ICF) and its Children and Youth version (World Health Organisation, 2007, ICF-CY) in the field of education and specifically education for children with disabilities, special educational needs and those requiring additional support in school. In 2010 Moretti, Alves, and Maxwell (Maxwell et al, 2012; Moretti et al., 2012) carried out a similar ground-breaking review and set the scene for how the ICF is used in the education field. In the intervening decade much has developed with the ICF and it is time for another measure of the situation. Throughout this paper we will refer the “ICF” as both the ICF (2001) and the ICF-CY (2007), unless otherwise specifically indicated.

The ICF is a bio-psycho-social classification framework developed by the World Health Organization based on a non-categorical approach to human functioning contextualizing the functioning of an individual in their current environment without the use of ‘traditional’ categories or diagnoses. The framework incorporates 'all components of health described at body, individual and societal levels’ (WHO, 2007). The ICF is intended for all people but is particularly applicable and appropriate for persons with disability.

The term education in this article means the “development of human potential...personality, talents and creativity as well as...mental and physical abilities”(United Nations, 2006) made in a formal context, usually a school or other setting in which the main aim is not medical or clinical rehabilitation. All education levels are taken into account, from early years, compulsory schooling, further education, and lifelong learning of persons with disabilities and those working with persons with disabilities in a formal educational setting. The educational environment or setting is of importance both in terms of setting the scene in which an activity occurs and as a factor that can facilitate or hinder participation in a setting. The environment can be represented as dimensions that relate to the availability, accessibility, affordability, accommodability and acceptability of the participation situation or experience (Maxwell, 2012). By investigating the educational environment we can shed more light on effective inclusive practices by providing more accurate representations and measures of the participation of children.

The current paper presents the preliminary results from a cross-comparison of the findings from systematic literature searches carried out in different languages in national databases in the partner countries. Partners from Portugal and Brazil, Italy, Mexico, South Africa, Austria and Switzerland, and China and Taiwan carried out searches in Portuguese, Italian, Spanish, English and Afrikaans, German, and Mandarin. Systematic database searches using selected search terms were used.

The main aim of this literature review is to explore how the ICF is currently situated in the field of education in different global contexts. There will be a specific focus on children with disabilities, Special Educational Needs (SEN) and those requiring additional support in school, however the ICF has now become well established so the review will not necessarily limit itself to these fields.

• How are the ICF and the ICF-CY applied at various levels and processes within education systems in different countries?

• What challenges arise when using the ICF/ICF- CY in education?

This paper presents a systematic review of the literature using database electronic searches performed during the second half of 2021 in national research databases in Portugal and Brazil, Italy, Mexico, South Africa, Austria and Switzerland, and China and Taiwan. Given that the ICF was published in 2001, this year was considered the earliest cut-off point. The unit of analysis was academic works, the search included publications in the form of journal articles, books and book chapters, and reports, in the following languages: English, German, Spanish, Afrikaans, Italian, Portuguese, and Chinese. Dissertations and discussion threads were excluded. For all the databases search terms referring to the ICF/ICF-CY components and education were combined. Each language required its own selection and refinement of search terms. The relevance of the chosen search terms was explored through discussions among the authors, with experts in the field, and expert research librarians. The search terms were chosen based on the focus of the study and current debate and were refined to include widely used variations and abbreviations. Search terms had to be related to the ICF/ICF-CY (e.g. ICF, International Classification of functioning, environment*, personal factors, participation) and to education (school, education*, inclusion/inclusive, eligibility, goals, identification) and various abbreviations/ combinations of the phrase special education needs (SNE, SEN, “special needs”, Special Ed, SpecEd, SPED). The final searches were run after qualitative test searches to establish the suitability of the terms: four combinations of the search terms were initially trialled, however difficulties arose relating to translating a number of the terms and concepts into the various languages involved in this study so the search string was condensed into one for the final search. This single string was: ("ICF" OR “International Classification of functioning”) AND (school OR inclus* OR SNE OR SEN OR “special needs” OR Special Ed OR SpecEd OR SPED) This string was translated into Italian, German, Portuguese, Spanish, Afrikaans, and Mandarin, and the search string applied to various national databases. In each national context the selection of studies was then refined further using three protocols: inclusion and exclusion protocols at abstract and full text and extraction levels. Studies exploring the direct relationship between education and the ICF/ICF-CY were sought. A multi-lingual cross-comparison between countries was then carried out.

Initial findings suggest that articles were mainly published in noneducational journals indicating a continuing prevalence of health-related rather than pedagogical research. However, Portugal present an exception as the country previously implemented and then removed the ICF from its education law and so a significantly higher proportion of education-related research publications are found there. A similar exception is seen in Switzerland with a number of German publications reporting data from the study of the use of the ICF in the education system of the canton of Zürich. Overall, the most used ICF components are activity and participation, participation, and environmental factors. From the analysis of the papers included, the results show that the ICF is still used as a research tool, theoretical framework, and tool for implementing educational processes. It is known that the ICF can provide a useful language to the education field where there is currently a lot of disparity in theoretical, praxis, and research issues. This study has highlight cross-national and multi-lingual differences in the implementation of the ICF in education in the last twenty years. Although overall the systematic literature review does not report a high incidence of the use of the ICF in education, the results show that within certain local context (e.g. Portugal and Zürich) the ICF model and classification have shown potential to be applied in education systems.

Maxwell, G. (2012). Bringing More to Participation: Participation in School Activities of Persons with Disability Within the Framework of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). 16 Doctoral thesis, Comprehensive summary, School of Education and Communication, Jönköping. Available online at: http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-18079DiVAdatabase Maxwell, G., Alves, I., and Granlund, M. (2012). Participation and environmental aspects in education and the ICF and the ICF-CY: findings from a systematic literature review. Dev. Neurorehabil. 15, 63–78. doi: 10.3109/17518423.2011.633108 Moretti, M., Alves, I., & Maxwell, G. (2012). A systematic literature review of the situation of the international classification of functioning, disability, and health and the international classification of functioning, disability, and health–children and youth version in education: a useful tool or a flight of fancy?. American Journal of Physical Medicine & Rehabilitation, 91(13), S103-S117. United Nations (2006). UN Convention on the Rights of Persons with Disabilities. New York, United Nations. World Health Organization (2001). International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization. World Health Organization (2007). International Classification of Functioning, Disability, and Health: Children & Youth Version: ICF-CY. Geneva: World Health Organization