Abstract
Over the past years, the biopsychosocial model has had a significant impact on the field of Special Education. More specifically, the Children and Youth version of the International Classification of Functioning (ICF-CY, WHO, 2007) emerged as a useful screening tool. Within this framework, the aim of the present study was to explore the understanding of student referral to a pre-diagnosis support program or to a final diagnosis. Teachers' referral decision-making was examined in a structural equation model, which incorporated four latent variables, namely, students' Personal Factors, Activity Performance and Educational Support, as well as teachers' Referral Intentions. To test the capacity of this model, 62 teachers of elementary school classes documented all the needed information for each of their 1092 students. All variables were based on the ICF-CY and they were evaluated accordingly. The verified path structure was to a large extent consistent with the biopsychosocial model. Teachers relied primarily on students' prior educational support when they formed their opinion about student referral. Educational support received by students functioned as a mediator factor between activity performance and referral intention. Overall, results revealed a complex structure with regard to the teachers' decision making processes. The subgroups of students that emerged were discussed, and refinements for future studies were suggested. This study delivered useful implications for educational interventions, referral policy and teacher education.
Highlights
Over the past two decades, the International Classification of Functioning has been disseminated in the scientific fields of health, rehabilitation, education and special education as a conceptually robust and an ecologically valid instrument which serves multiple purposes [13,16,24,33]. This tool is based on the biopsychosocial model and constitutes a comprehensive guide that contributes to the understanding οf the dynamic interplay among the numerous individual and environmental factors of health and well-being
Studies based on the ICF's version for Children and Youth focused, among others, on the involvement of developing people in key life domains, on activity in everyday life situations, on the integration of challenged students in school settings, on the impact of critical environmental factors, and on the individual support needs assessment [3,5,26,37]
The first purpose of the present study was to develop a short list of ICF-CY codes to be used for screening in Greek primary education [11]
Summary
Over the past two decades, the International Classification of Functioning ( abbreviated as ICF [39]) has been disseminated in the scientific fields of health, rehabilitation, education and special education as a conceptually robust and an ecologically valid instrument which serves multiple purposes [13,16,24,33] This tool is based on the biopsychosocial model and constitutes a comprehensive guide that contributes to the understanding οf the dynamic interplay among the numerous individual and environmental factors of health and well-being. The severity qualifier is used to document the amount of difficulty in Body Functions and Structures, Activity and Participation [4,18,39,40] At this point, it is necessary to state that personal factors do not contain any distinctive domains yet. Even though several personal factors –like gender, age, race, upbringing, life experiences and concurrent events– are named, codes and qualifiers are not available [36]
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