Inclusive education refers to “the creation of learning environments that maximize the potential for every young person in … diverse societies to receive a high-quality education alongside their peers in local schools that serve the whole community” (Porter and Towell, 2017). In Canada, although inclusive education is widely accepted as best practice, its implementation varies across the country (Towle, 2015). Indeed, while policy exists to support inclusive education in most jurisdictions in Canada, evidence suggests a gap between these directives and actual practices (Timmons and Wagner, 2009; Thompson et al., 2015). This gap has implications for Canadian children: data from Statistics Canada indicate that children with disabilities who attend inclusive schools are physically and emotionally healthier; participate in more physical and social activities; and require access to fewer health services than children with disabilities who are segregated for all or part of the school day (Timmons and Wagner, 2009). According to Thompson et al. (2015), insufficient human resources to support educators in the classroom appear to be a key barrier to successful implementation of inclusive education in Canada.

One means of addressing this human resource barrier is to enhance collaboration between educators and health-care professionals (HCPs). Educators’ knowledge of curriculum and instruction is complemented by HCPs’ knowledge of specific disabilities and how these may affect students’ functioning and participation (Campbell et al., 2016). Therefore, collaboration between HCPs and educators ostensibly would enhance educators’ knowledge of children with disabilities and support HCPs’ provision of educationally relevant services that are directly embedded in the classroom (Missiuna et al., 2012). Ultimately, this sharing of knowledge and skills between educators and HCPs should assist efforts to implement inclusive education. However, how to best support this collaboration across disciplines remains unknown.

In this study, we suggest that integrating the International Classification of Functioning, Disability and Health (ICF) and Universal Design for Learning (UDL), which are health and education frameworks, respectively, can support interprofessional sharing of knowledge and expertise beyond what either framework could achieve on its own. In particular, we believe these frameworks to be compatible due to a shared underlying philosophy of universality. That is, both frameworks are inclusive of all people and both recognize that human functioning exists along a continuum. To make this case, we will proceed systematically. First, we will introduce and describe each framework. Next, we will compare the two frameworks to demonstrate how they complement one another in their purpose and content. Finally, we will use a hypothetical case example to illustrate how these frameworks could be used interprofessionally to support inclusive education.

The ICF was developed by the World Health Organization (WHO) in 2001 and is a framework that embraces concepts of universality in human health; that is, functioning and ability lie on a continuum and every person is expected to vary on these across the lifespan. The ICF merges concepts from the medical and social models of disability to create a “bio-psycho-social” model that acknowledges the multiple influences on health and functioning (World Health Organization, 2001, 2013).

The ICF consists of two major components: functioning and disability (body structures and function, activities, and participation); and contextual factors (environmental and personal factors) (World Health Organization, 2001). Each of these components consists of multiple domains, which then encompass categories used for classification (World Health Organization, 2001, 2013). A notable advancement in the ICF relative to previous disability models is the incorporation of environmental factors, which acknowledges the impact an individual’s environment can have on their overall life experience (McPherson et al., 2015).

The ICF framework is a tool that can be used as a method of classification in various situations, including healthcare and education (World Health Organization, 2001). When using the ICF as a classification tool, each person is considered in context, specifically looking at the interaction between the individual’s health and level of functioning and the features of their environment (World Health Organization, 2002). Overall, the ICF provides a holistic and strengths-based model, which aims to highlight assets and skills of all individuals (Stewart and Rosenbaum, 2003).

Universal Design for Learning (UDL) is a framework and set of guidelines developed in the 1990s by the Center for Applied Special Technology (2016). UDL emerged from the universal design movement in architecture, which found that planning physical structures and spaces to be accessible to a diverse range of users from the outset was more efficient and effective than retro-fitting individual structures (Rose and Strangman, 2007; Campbell et al., 2016). UDL takes this lesson from architecture and applies it to the educational curriculum. By accounting for student variability and learning differences throughout the initial stages of curriculum design, educators seek to reduce the need for individual student accommodations after-the-fact (Center for Applied Special Technology, 2016).

The UDL guidelines include three main principles: (1) providing multiple ways of representing the curriculum to students; (2) providing multiple ways for students to express what they know and have learned; and (3) providing multiple ways to engage students in the learning process (Meyer et al., 2014). Providing multiple means of representation is considered the “what” of learning. Utilizing different forms of methods and media for students to learn and perceive information is the foundation of this principle (Meyer et al., 2014). Providing multiple means of student action and expression, the second UDL principle, tackles the “how” of learning (Meyer et al., 2014). The educator needs to offer options to allow multiple ways for students to communicate information, including options for physical action and executive functions. Providing an assortment of options to engage students in the classroom, the third UDL principle, targets the “why” of learning (Meyer et al., 2014). This principle focuses on strategies to engage students in the classroom and supports excitement, motivation, and interest in a topic (Table 1).

As shown in Table 1, each UDL principle is further defined by three guidelines and several checkpoints that identify various strategies that can be used to execute the UDL principles (Center for Applied Special Technology, 2011a). The guidelines offer general strategies that can be used to enact each of the principles with the checkpoints providing specific suggestions for implementation. When the three principles are implemented in tandem, the UDL framework supports educators in cultivating students who are knowledgeable, resourceful, goal-directed, and motivated learners (Meyer et al., 2014). Importantly, UDL puts the emphasis on creating dynamic and flexible learning environments that “fit” the student, rather than assuming the student must change to “fit” a standard or static environment (Meyer et al., 2014).

To the best of our knowledge, few authors have explicitly explored the relationship between the ICF and UDL. Therefore, we endeavored to identify similarities and differences between these frameworks by examining their general applications within literature, and the overall goals and components of each framework. Specifically, the first and second authors (Vanessa Tomas and Andrea Cross) contributed expertise on UDL and the ICF, respectively. Both authors examined seminal literature on their respective topics of expertise (World Health Organization, 2001, 2013; Meyer et al., 2014; Center for Applied Special Technology, 2016). Vanessa Tomas and Andrea Cross then engaged in a series of meetings to discuss the various components of each framework as well as to compare each framework’s principles, components, and general applications. This iterative process culminated in the identification of four areas of similarity and four areas of difference.

In considering the example of Daniel, it will no doubt have occurred to the reader that each student will have individualized needs and requirements in the classroom. Thus, how does one reconcile the balance between the needs of one child, such as Daniel, with the needs of the other children in the classroom? The ICF is intended to identify the needs of individual children, while UDL strategies are designed to benefit all, thereby enhancing overall inclusivity within the classroom. Utilization of both frameworks by educators and HCPs could provide different perspectives, enhance knowledge, and increase interprofessional collaboration. HCPs have greater knowledge regarding the ICF and can provide their expertise in classification within the various domains. Educators have greater knowledge regarding UDL and will have knowledge and opinions on different options and strategies. However, through using the frameworks together, we suggest that educators will gain knowledge about the ICF, and HCPs will learn how to utilize UDL strategies. Through collaboration between the professions, the best possible strategies could be determined to increase learning and inclusivity for all students, including students with health and special education needs.

Although we have articulated a conceptually driven position for joint use of the ICF and UDL frameworks in education settings, we fully acknowledge that empirical studies are needed to validate the hypothesized benefits that we have described. However, we also take the position that empirical work is stronger when a strong logical and theoretical foundation is established first. The purpose of this perspective article is to provide that foundation. Certainly, in our own province of Ontario, major initiatives are underway to enhance the integration of health services within school, home, and community (Ontario Ministry of Children and Youth Services, 2016). Moreover, such initiatives are not unique to Canada (e.g., Law et al., 2013; Hutton et al., 2016). Thus, we anticipate that there will be increasing opportunities for the research community to investigate our ideas and determine if they are supported by the evidence.

The ICF is a holistic framework that serves as a starting point in providing a universal language that promotes communication and collaboration between HCPs and educators to assess students’ needs and describe childhood disability (Allan et al., 2006; Sanches-Ferreira et al., 2013). The ICF provides classification of student needs that relate specifically to functions related to schooling (Simeonsson, 2009). There is a priority for research to identify environmental interventions that can then be utilized to benefit student functioning and performance after classification with the ICF (Florian and McLaughlin, 2008). UDL provides a potential solution for providing environmental support and interventions that may not be specified in the ICF.

With respect to interprofessional collaboration, HCPs possess knowledge of the ICF while educators are familiar with UDL. If both frameworks are utilized in tandem, educators would become more familiar with classification using the ICF and HCPs would become more familiar with environmental strategies available through UDL. Each profession could contribute to determining student requirements and services that would provide an enriching and optimal learning environment for all. Ultimately, we suggest that joint use of the ICF framework to identify areas of student need and the UDL framework to develop inclusive strategies will facilitate “bridging” health care and education in support of the greater goal to create schools where all children belong.

With respect to individual contributions, VT, a master’s of Rehabilitation Science candidate at McMaster University, developed and wrote the main content of this manuscript. AC, a doctoral candidate in McMaster University’s School of Rehabilitation Science, cowrote and edited parts of the initial paper, and assisted in editing and enhancing the final manuscript. WC provided guidance on the overall content and organization and structure of the paper; assisted with the editing process throughout; and wrote components of the final manuscript. All the authors have consented to the order of authorship and agree to submission of the manuscript in its current form.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.