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What are the F-words in childhood disability?

Rikke Damkjær Moen - Physiotherapist and Medical Manager
Rikke Damkjær Moen - Physiotherapist and Medical Manager
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The F-words: Fitness, Function, Friends, Family, Fun and Future help practitioners, educators, and families to create a supportive and inclusive environment that focuses on all dimensions of a child’s life. Let us focus on what a child can do!

In this article you can learn more about:

  • What are the International Classification of Functioning, Disability and Health (ICF)? 
  • What are the F-words in childhood disability?
    • Fitness 
    • Functioning 
    • Friends 
    • Family 
    • Fun 
    • Future 
  • How The F-words are used to see the possibilities 
  • How can my family use the F-words when talking to professionals? 

What is the International Classification of Functioning, Disability and Health (ICF)? 

In 2001 the World Health Organisation introduced the International Classification of Functioning, Disability and Health (ICF) which is a frame work developed for describing and categorizing health and health related states and to promote health and wellbeing in people with and without disabilities.  

The ICF represented a paradigm shift from a focus on diagnosis and treatment to a more holistic view on health. This means moving beyond fixing and normality to focusing on functioning and wellbeing for both the individual person and their family.  

ICF model

The ICF Model shows the interaction between a person and their environment. Here you get an overview of what each box means:  

Body function and structures - are the parts of the body and how they work. Such as seeing, hearing, breathing, pain, muscles and joints. It also includes psychological functions.  

Activity - is what an individual is doing, like moving around, communicating, using their hands and taking care of them self, getting along with others.  

Participation - is what an individual does in their day-to-day life at home, school, work or in the community. Such as playing or being with friends, going on trips with their families etc.  

Environmental factors - include the physical environment. Can be for example ramps, sidewalks, stairs and playground. It can be both barriers to and facilitators of a person’s ability to function. 

Personal factors -  include a person’s background and ethnicity, age, gender, likes and dislikes. 

All the factors are connected and if one area is affected it may lead to a change in another area.  

As an example, if a child have difficulties moving around independently, due factors in the body (Body function and structure), a walker or gait trainer (Environmental factor) can be used as an environmental modification to enable the child to walk and maybe participate in the playing with friends outside or at school (Activity and participation). 

girl playing with friends in her nf-walker

What are the F-words in childhood disability? 

Back in 2012 Dr. Peter Rosenbaum and colleagues introduced the F-words for child development. The F-words are built on the ICF framework and is a more fun way of thinking about and talking about the different factors. 

They created six F-words:  

  • Fitness 
  • Functioning 
  • Friends 
  • Fun 
  • Family 
  • Future 

ICF framework


Here follows a description of each word and how they are connected to ICF framework: 

Fitness has to do with “Body function and Body structure” (ICF). Fitness activities are adapted to each child’s capabilities, enhancing their physical capacity and overall health, which are crucial for their growth and independence. 

Functioning is related to “Activity” (ICF) and refers to what people do and not on how they are doing it. 

Friends is referring to “Participation” (ICF). It is about all our friendships in life, and it includes not just friends, but also parents, grandparents, siblings, pets etc.  

Fun is capturing “Personal factors” (ICF) and it is about knowing what the child think is fun to do and what is not. We can take advantages of activities that children think is fun to do, to enhance learning and development effectively.   

Family represents the essential “Environment” (ICF) of all children and youth. By emphasizing the role of the family, this approach recognizes the significant influence family members have on a child's development.  

Future is word number six and is an additional word, not included in the ICF. This because the ICF is a description on what a person is doing today. The sixth F-word: Future is a reminder to us all that children are “work in progress”. They are always change due to growth and development.  

How The F-words are used to see the possibilities 

By using these F-words, practitioners, educators, and families can create a supportive and inclusive environment that focuses on all dimensions of a child’s life. This approach helps in visualizing and working towards a future where children, regardless of their abilities, are able to lead fulfilling lives and participate actively in their communities. It's about seeing and fostering potential in every child, rather than focusing solely on their impairments 

How can my family use the F-words when talking to professionals? 

Using the F-words (Functioning, Family, Fitness, Fun, Friends, and Future) as a framework when talking to professionals can be an effective way for families to ensure a holistic approach to a child’s development, especially in meetings with healthcare providers, educators, and other specialists. Here are some tips on how your family can incorporate these concepts into discussions with professionals: 

1. Prepare Specific Examples and Goals for Each F-word: 

Functioning: Bring notes on your child’s abilities and daily activities. Discuss what your child can do and any recent improvements or skills they have developed. 

Family: Explain how your family supports the child’s development. Discuss any family dynamics or resources that might affect your child's progress. 

Fitness: Share your child’s physical activity routines and any challenges or successes in this area. Highlight the importance of physical health and inquire about possible activities or therapies. 

Fun: Talk about what your child enjoys doing and how these activities benefit their learning and development. Discuss how these can be integrated into therapeutic practices or educational strategies. 

Friends: Share information about your child's social interactions and friendships. Discuss the importance of social skills and ask for advice or resources to help improve these areas. 

Future: Share your hopes and aspirations for your child’s future, including education, employment, and independence. Ask for guidance on preparing your child for these future steps and transitions. 

Encourage you to read this article by a mother who wrote a “F-words agreement” for her son.  

2. Use the F-words to Guide the Agenda of Meetings: 

Structure discussions around these six areas to ensure a comprehensive review of your child’s development from various angles. This helps keep the meeting focused and holistic. 

3. Advocate for Inclusive Practices: 

Use the F-words to advocate for approaches that include your child in as many normal and enriching experiences as possible. Highlight the need for inclusive practices that support participation at home, in school, and in the community. 

4. Request Specific Interventions or Supports: 

Based on each of the F-words, ask what specific interventions, supports, or resources are available that can enhance your child's development in these areas. This can include therapies, educational tools, community programs, etc. 

5. Seek Collaborative Planning: 

Encourage professionals to work collaboratively with you, emphasizing that you are an expert on your child and a key partner in planning their care and education. The F-words can be a framework for this collaborative approach. 

By using the F-words in discussions with professionals, your family can play a proactive role in shaping the support and interventions provided to your child, ensuring they are comprehensive and tailored to your child’s unique needs and potential. This approach not only facilitates better understanding and communication but also empowers your family to advocate effectively for your child’s development. 

To learn more about the F-words in Childhood Disability and join webinars and podcasts on the topic, visit: CanChilds webpage and F-words Knowledge Hub. 








Rikke Damkjær Moen - Physiotherapist and Medical Manager
Rikke Damkjær Moen - Physiotherapist and Medical Manager

Rikke Damkjær Moen brings many years of experience as clinical physiotherapist to the Made for Movement team. Her mission is to ensure that everybody, regardless of mobility problems, should be able to experience the joy and health benefits of physical activity. As our Medical Manager, Rikke is passionate about sharing knowledge so that individuals with special needs, families, and clinicians can discover the possibilities and solutions provided by Made for Movement.

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