Function, not diagnosis: what the Child Functioning Module asks

Ask a parent or a teacher whether a child has a disability, and many will say no, even when the child clearly struggles. The word carries stigma, and it suggests a medical label that most people are not able to give. Ask instead whether the child has difficulty seeing the board, or hearing someone speak from across the room, and you get a far more honest and useful answer.

That is the idea behind the functional approach.

Asking about what a child can do

The Washington Group on Disability Statistics, a United Nations city group, developed short sets of questions that ask about difficulty doing basic activities rather than about conditions. Working with UNICEF, it produced the Child Functioning Module, first published in 2016 for household surveys, with versions for children aged 2 to 4 and 5 to 17.

Instead of asking what a child has, the module asks how much difficulty a child has doing things: seeing, hearing, walking, using their hands, communicating, learning, remembering, concentrating, accepting change, controlling behaviour and making friends. It also asks how often the child seems very worried, nervous or anxious, or very sad or depressed. Answers run on a scale from no difficulty to cannot do at all.

Bringing it into schools

In June 2024, UNICEF and the Washington Group released two new tools for education:

• the Child Functioning Module, Teacher Version (CFM-TV), a teacher-completed questionnaire of 20 questions for children aged 5 to 17, covering domains such as seeing, hearing, mobility, learning and affect;
• the Inclusive Education Module (IEM), which looks at the school environment and what affects a child's participation.

The Teacher Version is designed for school records and school-based surveys, where children are already present, which is far cheaper than finding them through household surveys. It relies on something teachers already have: knowledge of their own pupils and how each one manages in class compared with others. A comparative evaluation was carried out to test how accurately teachers can report on children's functioning.

Why this matters for a teacher

A functional result tells a teacher something they can act on tomorrow. May need support in hearing suggests seating the learner near the front and facing them when speaking. May need support in concentrating suggests shorter tasks and clear routines. None of this waits for a diagnosis, and none of it labels the child.

It also produces numbers that can be added up. When every school asks the same questions, a district can see where learners who may need support are, and whether help is reaching them.

How Tambua uses it, and what it does not claim

Tambua is built on the functional areas of the Child Functioning Module. The questions in Tambua today are our own plain wording, not the official text: the official questionnaires need permission and proper validation before they are used with real children, and we will not cut that corner.

So Tambua screens and flags. It never diagnoses. A flag is a reason to support a child in class and, when needed, to refer them to a qualified professional for assessment.

Sources

• UNICEF and the Washington Group on Disability Statistics, Module on Child Functioning, Teacher Version, and the Inclusive Education Module, released June 2024.
• Washington Group on Disability Statistics, The CFM Teacher Version: A Comparative Evaluation.
• UNICEF and the Washington Group, Module on Child Functioning (household survey version), 2016.