Children with disabilities and their parents need opportunities to express opinions and take part of professional knowledge during habilitation processes. However, there is no structured model to identify and assess child participation in everyday life situations (EDLS). ICF-CY based code sets focusing on participation would support  dialogues about what matters most for individual children, causes of failures,  and needs of interventions. This study constituted a trial identifying content in code sets for Sleeping, Mealtimes, and Play.

EDLS specific for children and youth was initially identified by integration of data from measures of participation, professional opinions, and parents’ perspectives. Linkage to the ICF-CY, using existing and additional linking rules, provided comparable data, resulting in two sets of ten EDLS. These were related to the Activities and Participation component, chapters 3-9, and adapted for younger and older children.

ICF-CY categories relevant for children aged 0-6 years to be included in code sets for three of the EDLS were identified by a sequential Delphi process in 3 rounds. Participants were 5 interdisciplinary habilitation teams, altogether 35 professionals, and 7 parents of 13 typical developed preschool children from 6 families. There were no significant correlation between professionals and parents. Their partly different ICF-CY categories suggested high professional focus on Environmental factors compared with  high parental focus on Body functions. Integration of data revealed 12 categories appropriate for Sleeping, 21 for Mealtimes, and 30 for Play. This highlights the importance to integrate opinions and adapt content in code sets to individual EDLS.

Introduction: The complexity of the Child and Youth version of the International Classification of Functioning, Disability and Health, the ICF-CY, is a challenge for occupational therapists and other professionals in clinical work. Code sets including only essential categories help to make it more user-friendly. Thus far, code sets have been developed to reflect functioning for children in different developmental periods. However, there are no code sets that support screening of participation in everyday life situations and can be used across diagnoses. This exploratory study is the first attempt to develop code sets for preschoolers’ (age 0-6 years) everyday life situations.

Method: Using sequential Delphi processes with expert panels consisting of 35 professionals in five interdisciplinary early intervention teams and six parents of children, the study identified content in three code sets: Sleeping, Mealtimes and Play.

Results: A limited number of relevant categories were identified for three code sets: Sleeping (12), Mealtimes (21) and Play (30). Findings suggested a professional focus on Environmental factors compared with a parental focus on Body functions.

Conclusion: It is important to consider the opinions of all involved when developing code sets to provide a common framework for screening of children’s everyday functioning.

Objective:This study explored how professionals in interdisciplinary teams perceived the implementation of the World Health Organization’s International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services.

Design:Descriptive longitudinal mixed-methods design.

Methods:Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years.

Results:Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children’s needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation.

Conclusion:Professionals indicated that the ICF-CY enhanced their awareness of families’ views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation.

Engagement in preschool predicts children's development, learning, and wellbeing in later school years. The time children engage in activities and social interactions is conditional for preschool inclusion. Engagement is part of the construct participation, which is determined by attendance and involvement. Two suggested underlying dimensions of engagement had been identified as essential when assessing children's participation in preschool activities. As engagement is a key question in inclusion of all children, and preschool becomes a common context for them, it is increasingly important to understand the concept of engagement in those settings. In Sweden most children attend preschool but children in need of special support tend not to receive enough support for their everyday functioning. This study aimed to conceptualize child engagement in preschool with ICF-CY as a framework to clarify core and developmental engagement dimensions included in Child Engagement Questionnaire (CEQ). The content of CEQ was identified through linking processes based on ICF linking rules with some exceptions. Specific challenges and solutions were acknowledged. To identify engagement dimensions in the ICF-CY, CEQ items related to ICF-CY chapters were integrated in the two-dimensional model of engagement. Findings showed that engagement measured for preschool ages was mostly related to Learning and Applying knowledge belonging to Activities and Participation but the linkage detected missing areas. Broader perspectives of children's everyday functioning require extended assessment with consideration to mutual influences between activities, participation, body functions, and contextual factors. Related to core and developmental engagement, findings highlight the importance for preschool staff to pay attention to how children do things, not only what they do. Activities related to core engagement include basic skills; those related to developmental engagement set higher demands on the child. Linking challenges related to preschool context were not consistent with those reported for child health. Using the ICF-CY as a framework with a common language may lead to open discussions among persons around the child, clarify the different perspectives and knowledges of the persons, and facilitate decisions on how to implement support to a child in everyday life situations in preschool and at home.

This project, an Erasmus+-KA3 between 2021 and 2023, aimed at developing and implementing innovative methods and practices to foster and facilitate inclusion in education and promote common values. It is based on the International Classification of Functioning, Disability and Health (ICF) as a framework to build bridges between countries with different policies between different professions and theoretical backgrounds. We examined the perception of inclusive education and the impact of using an Inclusive Assessment App, “I AM,” in the classroom, focusing on participation rather than deficiency. Based on an inclusive mindset, the project created a tool that supports teachers in inclusive practices using participatory action research when designing the tool. The tool will be practical for key actors in the field of education and have implications for policy and research.

Inclusive educative systems are characterised by including all students in the sense that students are present, participate and learn in school with other students. The ICF framework of I AM focuses on improving and facilitating inclusion by assessing the school environment, emphasising functioning and participation rather than individual deficiencies. The aim is to address the common challenges most countries face concerning inclusion in a school welcoming all students. A shared challenge is that many students needing additional support often also participate in school activities to a lower degree than others. Another challenge is that teachers face problems attending to individual students and groups simultaneously. Focusing on participation and environmental factors presents a new way to address such issues. Facilitating inclusion through the relationship between participation and the environment relates to Availability, Accessibility, Affordability, Accommodability and Acceptability as different aspects of the environment. These 5 A:s were used to analyse inclusiveness.

In collaboration with teachers, this study aimed to create and evaluate a tool, an app called I AM, that was based on the ICF to examine if it could support teachers in their work. The teacher training consisted of two workshops. The first was related to the ICF framework, participation, and environmental factors. The second workshop focused specifically on using the app, identifying important issues related to usability and discussing applications in the classroom. The intention was to include thirty teachers from four countries each in this pilot study (Austria, Belgium, Germany, and Portugal.) Those teachers, the I AM group, should receive training in using the app based on the ICF, focusing on participation activities rather than individuals’ need for compensatory support. The data collection also included focus group discussions with teachers about the tool’s usability during field trials and questionnaires on their perception of inclusive education before and after piloting the tool. The questionnaires were also administered to a comparison group of teachers. Questionnaires about the tool’s usability were also administered to the I AM group.

There was a challenge in recruiting the number of respondents as planned. Instead of 120 teachers responding twice in the I AM group, we received about 60 teachers in the I AM group and only 40 in the comparison group. At the first measure point, we received 87% of the expected responses in the pilot group and 67% of the comparison groups’ responses on the questionnaires. Teachers did rate their perception of inclusive education relatively high.

No significant differences were found between the initial and subsequent measures, but a detailed breakdown reveals nuanced patterns. The study employs the 5A:s framework (Availability, Accessibility, Affordability, Accommodability, and Acceptability) to assess perceptions of participation and environmental factors supporting inclusive education. While teachers agree upon the Acceptability of all students, the levels of Accessibility and, perhaps even more, the Affordability of working with inclusiveness seem to be lower. Teachers need time to use the tool and fully grasp the ICF mindset. Teachers already acquainted with the ICF framework, with a more inclusive mindset, found it comprehensive and saw the relevance of the I AM and how to use it efficiently as a tool for planning and communicating. The most salient critique concerned aspects relating to suggested interventions offered in the app, which added to complexity by demanding reading scientific literature in English.

Lessons learned from the project highlight the complexity of introducing inclusive education concepts across different countries and the importance of involving teachers, school boards, and administrators. Currently available in English, German, and Portuguese, the I AM tool seeks to maximise accessibility and applicability across countries. The tool encourages a shift in assessment methods to a focus on functioning in everyday life, fostering a more individualised and inclusive approach to education. The project envisions the I AM tool as a sustainable link between theory, policy, and practice, contributing to a more inclusive European education system and, indirectly, increased economic productivity and social participation.

This chapter highlights the importance of providing all children, and particularly those at risk, vulnerable children and children with disabilities, with opportunities for a quality inclusive Early Childhood Education and Care (ECEC). It first sets out the evidence that quality inclusive ECEC provision is essential for all children to develop their potential and lifelong learning competencies that will ensure their successful participation in school and adult life. It then describes the main international and European policies for inclusive ECEC. A more detailed account is given of the five key principles for action towards improving the quality of ECEC provision developed by the thematic working group of the European Commission (2014) ‘Quality Framework for Early Education and Care’ that are also very similar to those proposed by the OECD (2015) ‘Starting Strong IV’. The concluding section underlines the need to address more strongly the provision of enabling opportunities for accessibility to ECEC of children at risk of exclusion. More importantly, it highlights the need to research and improve not only these children’s presence in ECEC but also their level and quality of active participation and engagement in the social and learning activities of early childhood inclusive provision. The chapter reflects the research and policy development work being undertaken by the European Agency for Special Needs and Inclusive Education in its (2015–2017) project on Inclusive Early Childhood Education (IECE) led by the present authors.

Early intervention for children vulnerable to exclusion is currently focused on the child?s effective inclusion in mainstream early childhood education. There is thus a search for developing a shared understanding of what constitutes quality inclusive preschool provision. This was the aim of a qualitative 3-year (2015?17) study of inclusive settings for children from 3 years to compulsory education across European countries, conducted by the European Agency for Special Needs and Inclusive Education. Data consisted of practitioner descriptions of 32 example inclusive preschools from 28 European countries, and more detailed data collected during short visits to eight of the example settings. Qualitative, thematic analysis identified 25 subthemes representing the perceived constituents of inclusive early childhood education provision. These were organised within a framework that intertwined the structure-process-outcome model with the ecological systems model. The resulting adapted ecosystem model for inclusive early childhood education comprises five dimensions: (1) the inclusive education outcomes, (2) processes, and (3) structural factors within the micro environment of the preschool; and the wider (4) inclusive structural factors at community, and (5) at national levels. The framework can be useful for practitioners as well as researchers and policy makers seeking to improve inclusive early childhood education provision.

Symposium Description:

In line with the primary purpose of ISEI, to provide a framework and forum for professionals from around the world to communicate about advances in the field of early intervention, this symposium aims to discuss and raise issues related to the added value of international collaboration in early childhood intervention research and education today and in the future. It is informed by experiences of the EU-US Transatlantic Consortium on Early Intervention (EU-US Atlantis Programme, Excellence Mobility Project 2001-2013) and from collaboration in ISEI. Building on multilateral collaboration and agreements between universities and funding agencies, based on equal standards for quality we can share and learn from each other. By developing joint priorities building on the strengths in individual countries a common theoretical framework for research and education related to early intervention has been created guiding policy and practice.

The wide-ranging educational, economic and social benefits of Early Childhood Education and Care (ECEC), at both individual and societal levels, are increasingly acknowledged in large parts of the world. Major changes in physical, socio-emotional and cognitive areas of development occur during these years, and meaningful educational experiences have been shown to have long-lasting effects upon a child’s cognitive development, socio-emotional development and learning (Pianta, Barnett, Burchinal, & Thornburg, 2009; Shonkoff & Phillips, 2000; Sylva, 2010). International and European communities (EU, 2011; OECD, 2014; UNESCO, 2015; UN, 2015) regard quality of ECEC as a foundation for later school achievement, success in the modern knowledge based economy and lifelong learning.