Identification of International Classification of Functioning, Disability and Health (ICF) codes most frequently used to describe functioning in children: a systematic review.

OBJECTIVES

To identify and synthesise the International Classification of Functioning, Disability and Health (ICF) categories most used to describe child functioning across health conditions, informing inclusive, context-sensitive assessments and policy frameworks.

DESIGN

Systematic review.

DATA SOURCES: PubMed, Scopus, Web of Science and CINAHL were searched from inception to September 2024 following Cochrane guidelines.

ELIGIBILITY CRITERIA: Peer-reviewed studies using ICF categories to assess functioning in children (0-18 years), regardless of health condition, were included. Eligible designs comprised randomised controlled trials, observational and qualitative studies reporting ICF Core Set (CS).

DATA EXTRACTION AND SYNTHESIS: Two reviewers independently conducted screening, data extraction and risk of bias assessment using the Mixed Methods Appraisal Tool (MMAT, 2018). ICF codes were categorised by domain and synthesised narratively.

RESULTS

Eight studies met inclusion criteria, comprising 29 ICF CS (1665 instances; 194 unique ICF categories after deduplication). Most instances related to activities and participation (40.7%) and environmental factors (30.6%), followed by body functions (27.3%) and body structures (1.4%). Key chapters included learning and applying knowledge, interpersonal interactions, support and relationships and services and policies.

CONCLUSIONS

Findings highlight a shift towards a biopsychosocial model of child functioning, emphasising participation and environmental context. Results support use of the ICF framework in multidisciplinary assessment and policy development and inform development of a Portuguese National Functioning Table for Children.

PROSPERO REGISTRATION NUMBER: CRD42024588533.