# Integrating the ICF and the F-Words Framework to Support Family-Centered Pediatric Care for Children with Neurodevelopmental Disorders: A Narrative Review

## TL;DR

This paper reviews how combining two frameworks can improve family-centered care for children with neurodevelopmental disorders by focusing on functioning and family priorities.

## Contribution

The paper proposes a structured integration of the ICF and F-words framework to enhance family-centered pediatric care.

## Key findings

- Both frameworks are widely used but face challenges in conceptual clarity and family involvement.
- A dual-layer integration approach may improve shared decision-making and communication in clinical practice.
- Further guidance is needed to translate family priorities into measurable outcomes.

## Abstract

What are the main findings?
The ICF and the F-words framework share a strong conceptual alignment with family-centered care, particularly through their emphasis on functioning, participation, and contextual factors meaningful to families.Despite their widespread use, both frameworks face persistent challenges related to conceptual clarity, operationalization, outcome measurement, and the consistent involvement of families in clinical decision-making.

The ICF and the F-words framework share a strong conceptual alignment with family-centered care, particularly through their emphasis on functioning, participation, and contextual factors meaningful to families.

Despite their widespread use, both frameworks face persistent challenges related to conceptual clarity, operationalization, outcome measurement, and the consistent involvement of families in clinical decision-making.

What are the implications of the main findings?
Integrating the ICF and the F-words framework using a structured, complementary approach may enhance family-centered care by improving shared decision-making, goal-setting, and communication between clinicians and families.Clearer conceptual mapping and practice-oriented guidance are needed to translate family priorities into meaningful, measurable outcomes in pediatric care.

Integrating the ICF and the F-words framework using a structured, complementary approach may enhance family-centered care by improving shared decision-making, goal-setting, and communication between clinicians and families.

Clearer conceptual mapping and practice-oriented guidance are needed to translate family priorities into meaningful, measurable outcomes in pediatric care.

Background: Family-centered care is a core principle of contemporary pediatric rehabilitation, particularly for children with neurodevelopmental disorders. Conceptual frameworks emphasizing functioning, participation, and contextual factors are essential to operationalize this approach in clinical practice. The International Classification of Functioning, Disability and Health (ICF) and the F-words framework are widely used models aligned with these principles; however, their practical integration remains challenging. Methods: A narrative literature review was conducted using PubMed, Scopus, and Web of Science databases to identify English-language publications (2005–2025) addressing the ICF, the F-words framework, and pediatric neurodevelopmental disability. Results: Thirty-one publications were included. The findings indicate increasing international adoption of both frameworks in pediatric rehabilitation. However, persistent challenges were identified, including conceptual ambiguity between activity and participation domains, limited operationalization of personal factors, overlap between the ICF and F-words constructs, limited standardization, difficulties in outcome measurement, and inconsistent involvement of families in clinical decision-making. Conclusions: The ICF and the F-words framework offer complementary strengths for advancing family-centered pediatric care. A structured dual-layer integration approach may enhance shared decision-making, clarify goal-setting, and improve communication with families. Further methodological refinement and practice-oriented guidance are needed to support consistent clinical implementation.