Applying the ICF-CY framework to examine biological and environmental factors in early childhood development

J Formos Med Assoc. 2014 May;113(5):303-12. doi: 10.1016/j.jfma.2011.10.004. Epub 2012 May 16.


Background/purpose: Previous cohort studies for the general pediatric population had a limited focus on either environmental or biological influences, or a specific theoretical framework. The child's development, however, is a composite of physical, mental, social, environmental, and personal factors. The framework of the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) provides a comprehensive model for investigating the influential factors of child development within a biopsychosocial perspective.

Methods: A birth cohort study followed up 122 child-parent dyads at birth and when the children were 4 months, 6 months, and 2.5 years old. Structural equation modeling was conducted based on the concept and the definitions of ICF-CY.

Results: The path coefficients linking exposures and outcome variables were significant except for the paths from birth weight to general development of infants and toddlers. Home environment explained 59% of variance of infant developmental outcomes.

Conclusion: The proposed model based on ICF-CY showed acceptable fit to the data and provides support for the importance of the home environment on general development of infants and toddlers.

Keywords: ICF; child development; health promotion; social environment; structural equation modeling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight
  • Child Development*
  • Child, Preschool
  • Cohort Studies
  • Environment
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • International Classification of Functioning, Disability and Health*
  • Male
  • Temperament