Teachers’ Attitudes Toward Inclusion and the ICF: Evidence from a National Survey in Portugal

Abstract

The “International Classification of Functioning, Disability and Health (ICF)” frames disability as an interaction between individual functioning and contextual factors, promoting participation over deficit-based models. In Portugal, the ICF was mandatory for eligibility decisions between 2008 and 2018 and remains a conceptual reference in inclusive education. However, little is known about teachers’ attitudes toward its use. This study explored Portuguese teachers’ attitudes toward (a) inclusion of students with “special educational needs (SEN)” and (b) the ICF as a framework for educational planning. A cross-sectional online survey was conducted with 417 public-school teachers working across all levels of compulsory education, from pre-school to secondary education. The questionnaire assessed six indicators of inclusion attitudes and a validated 27-item ICF Attitudes Scale. Data were analyzed using descriptive and correlational procedures. Teachers expressed strong support for participation in school life and selective academic integration, while rejecting full-time placement for all SEN students. Attitudes toward the ICF were generally positive, highlighting its perceived usefulness for planning and identifying barriers. Professional background variables showed only weak associations with these attitudes. Teachers value inclusive participation and recognize the ICF’s potential, but practical implementation depends on time, resources, and collaboration. Findings underscore the need for practice-based professional development to strengthen inclusive education.

1. Introduction

“Inclusive education (IE)” has become a central priority in global educational policy, grounded in principles of equity, human rights, and social justice. International agendas—such as the United Nations’ Sustainable Development Goal 4—call for inclusive and equitable quality education for all, emphasizing that inclusion requires not only access but also meaningful participation and a sense of belonging (OECD, 2023; UNESCO, 2020). Recent European projects have emphasized the importance of mediated learning and structured support for inclusive education, as highlighted by Lebeer et al. (2022). Evidence from Spain likewise suggests that teachers often express positive attitudes toward inclusion, while these remain sensitive to training opportunities and contextual resources (Abellán & Fernández-Bustos, 2023). Within this international landscape, the “International Classification of Functioning, Disability and Health (ICF)”, developed by the World Health Organization (WHO, 2001), provides a shared conceptual framework that shifts the focus from diagnostic categories to learners’ functioning, participation, and environmental interaction. This ecological and strengths-based perspective is increasingly recognized as a foundation for inclusive assessment, cross-sector collaboration, and personalized educational planning, improving the link between education and health services in functionality assessment (WHO, 2002).

However, the effective translation of these global frameworks into daily school practice depends largely on teachers. Research consistently highlights that teachers play a pivotal role in shaping inclusive environments and ensuring that learners experience engagement and belonging (UNESCO, 2021; OECD, 2023). Yet, despite widespread normative support for inclusion, uncertainties about preparedness, institutional support, and workload continue to influence teachers’ engagement with inclusive practices. Recent studies indicate persistent doubts among teachers regarding their readiness for inclusion (Gal et al., 2025; Tveitnes et al., 2025), substantial regional disparities in training and confidence (Singh et al., 2025), and the importance of supportive school climates and leadership in strengthening self-efficacy (Jury et al., 2023; Selisko et al., 2024; Wang et al., 2025). These findings reinforce the need to understand not only practices but also the underlying attitudes that shape teachers’ decisions and behaviors in inclusive contexts.

The Portuguese educational system provides a unique case for examining these dynamics. With the enactment of Decree-Law No. 3/2008 (2008), Portugal became one of the few countries to embed the ICF explicitly into national legislation as the basis for identifying support needs, planning inclusive measures, and promoting equitable participation. This shift aimed to overcome longstanding limitations of diagnosis-based models, reduce inequalities, and align education with international human rights standards. By positioning functionality and contextual factors at the center of decision-making, Portugal offers an illustrative example of policy alignment with global inclusion frameworks and an opportunity to understand the conditions under which the ICF can be meaningfully adopted in school settings.

Teachers’ attitudes are central to this process. Far from static traits, attitudes are dynamic psychological constructs integrating cognitive, affective, and behavioral components, shaped by professional preparation, school climate, leadership, and broader social representations of disability and diversity (Bohner & Dickel, 2011; Gjicali & Lipnevich, 2023; Vala, 2007). Evidence from coaching-based interventions also shows that teacher well-being and sustainability are linked to inclusive practices (Candeias et al., 2024). Social cognitive theories further emphasize the importance of perceived self-efficacy (Bandura, 2001; Schnepel et al., 2025) and behavioral intentions (Ajzen & Fishbein, 2005) in determining whether inclusive practices are enacted. Thus, understanding teachers’ evaluative orientations toward the ICF is essential for anticipating how global frameworks might translate into practical classroom strategies.

Nevertheless, despite this strong policy alignment, little empirical evidence exists on how Portuguese teachers understand, interpret, and apply the ICF in their work. Internationally, studies examining teachers’ attitudes toward inclusive education often address inclusion in broad terms, focusing on general perceptions, contextual differences, and challenges that may shape the implementation of inclusive practices (Singh et al., 2025), while attitudes specifically toward the ICF remain underexplored, both in Portugal and globally. This constitutes a significant gap, particularly as the ICF gains increased relevance in educational assessment, curricular planning, and cross-sector coordination. For countries considering integrating the ICF into educational policy, understanding teachers’ attitudes toward this framework is essential for anticipating barriers and designing effective professional development both for initial teacher education programs (Kus et al., 2025) and in-service/continuous professional development (Kang et al., 2025).

This study addresses this gap by examining Portuguese teachers’ attitudes toward the ICF in the context of an inclusive legislative system where the framework is formally mandated. Specifically, it aims to:

• Document baseline attitudes toward the ICF among teachers across educational levels;
• Explore professional and contextual factors associated with these attitudes; and
• Contribute to the international discussion on the conditions that enable global inclusion frameworks to translate into effective school-level practices.

Data collection occurred prior to the implementation of Decree-Law No. 54/2018 (2018), which repealed Decree-Law No. 3/2008 (2008) and introduced a renewed legal framework for inclusive education in Portugal. Consequently, the present study provides a baseline characterization of teachers’ perceptions immediately preceding this legislative reform.

By providing the first large-scale empirical evidence on this topic in Portugal, the study offers insights relevant for policymakers, researchers, and educators seeking to strengthen inclusive education systems grounded in functionality and participation.

2. Materials and Methods

This study followed a quantitative, descriptive, and correlational research design, selected for its suitability in examining teachers’ attitudes and exploring how these attitudes relate to professional and contextual variables. Quantitative approaches are particularly appropriate when the aim is to obtain a systematic overview of patterns across a large group of participants, enabling comparisons across demographic and professional characteristics (Abellán & Fernández-Bustos, 2023; Singh et al., 2025). A descriptive component was essential for documenting baseline attitudes toward the ICF and inclusive education—an area where empirical evidence remains limited, especially in Portugal. The correlational component made it possible to examine how factors such as training, teaching experience, and familiarity with disability relate to teachers’ evaluations of inclusive practices, in line with recent research showing that teacher characteristics meaningfully shape attitudes toward inclusion (Gal et al., 2025).

This design was also justified by the nature of the construct under investigation. Attitudes toward inclusion and toward the ICF are complex, multidimensional, and socially embedded; yet large-scale quantitative studies remain scarce, both internationally and in Portugal. Recent literature has highlighted the need for robust quantitative evidence capable of informing policy development and professional training (Jury et al., 2023). By employing structured, psychometrically evaluated measures and analyzing associations between variables, this methodology provides a rigorous, evidence-based contribution that complements existing qualitative and policy analyses. Moreover, because the dataset predates key legislative changes in Portugal, this design enables the establishment of a pre-reform baseline, offering a valuable historical perspective for comparison with future studies.

2.1. Participants

A total of 417 teachers from public schools across mainland Portugal participated in the study. Although the survey was disseminated nationally to reach educators from different regions and school clusters, a non-probabilistic convenience sampling strategy was used due to its feasibility and the researchers’ established access to the field. This strategy enabled the recruitment of a large and diverse sample but necessarily introduces limitations regarding representativeness and potential selection bias.

The sample closely reflects the demographic profile of the Portuguese teaching workforce: participants had a mean age of 47 years and an average of 23 years of professional experience, suggesting extensive familiarity with school practices and system demands. However, only 14.1% reported specialized training in special education and 17.5% had received any formal training related to the ICF or “International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) (WHO, 2007), indicating that most teachers approached the questionnaire with limited formal knowledge of the framework. This characteristic is important for interpreting the results, as it highlights the gap between the expectations placed on teachers and the training they actually receive.

Participation was voluntary and anonymous, and teachers were informed that the study examined professional perspectives on educational practices. They were not told explicitly that the ICF was the main focus, a decision taken deliberately to minimize social desirability and response inflation.

2.2. Instruments

The questionnaire used in this study was adapted from the original instrument developed by Saragoça (2011), which had been designed to diagnose training needs among special education teachers regarding the ICF-CY. In light of evolving inclusive education policies in Portugal, the instrument was reconceptualized and expanded so that it could be used with all teachers, recognizing that the ICF is increasingly seen as a framework relevant across the teaching profession.

2.2.1. Development and Validation Process

The adaptation process included cognitive validation using the think-aloud method, based on current methodological recommendations (Noushad et al., 2024). Four experts with experience in inclusive education, assessment, and the ICF participated as judges. They provided detailed feedback on item clarity, conceptual alignment, and potential ambiguities. As often occurs in verbal protocol approaches (Willis, 2005), this process generated discussion and refinements that enhanced the clarity and contextual relevance of the items.

Following expert review, the instrument was pilot-tested with five teachers, evaluating linguistic clarity, formatting, completion time, and ease of use following principles suggested by Artino et al. (2014). Minor adjustments were made before final administration.

2.2.2. Instrument Structure

The final questionnaire comprised two sections:

• Attitudes Toward the Inclusion of Students with “Special Educational Needs (SEN)”.

This section contained six Likert-scale items (1 = Strongly Disagree; 4 = Strongly Agree) assessing attitudes toward full, partial, or segregated inclusion. Because these items addressed distinct conceptual positions, they were analyzed individually rather than as a unified scale.

2.

Attitudes Toward the Implementation of the ICF.

This section included 27 Likert-scale items and one open-ended question exploring teachers’ views on the ICF’s clarity, perceived usefulness, relevance for planning, capacity to support interdisciplinary communication, and possible barriers or challenges. Illustrative items include:

• “The ICF supports the planning of educational intervention.”
• “Using a common language among professionals is an added value of the ICF.”
• “The ICF makes it possible to identify barriers to student activity.”
• “Characterizing student functionality using the ICF is time-consuming.”

2.2.3. Psychometric Properties

A thorough psychometric evaluation was conducted. The sample demonstrated excellent suitability for factor analysis (KMO = 0.955). A “principal component analysis (PCA)” using Kaiser’s criterion, scree plot examination, and parallel analysis all supported a single-factor solution, which explained 46% of the total variance. Internal consistency was excellent (Cronbach’s α = 0.939), and item-removal analyses showed no improvement in reliability by deleting any item. Based on this evidence, a global ICF Attitudes Score was computed by summing all 27 items (possible range 27–108), with higher values reflecting more positive attitudes toward the ICF.

2.2.4. Procedure

The study received institutional ethical approval (Register No. 0407200002). The questionnaire was hosted on the LimeSurvey platform and disseminated electronically via school clusters, which were asked to share the link with teachers from preschool, primary, lower, and upper secondary education. Data collection began on 23 April 2014, and remained open until 7 May 2014.

Informed consent was obtained electronically, and the voluntary and anonymous nature of participation was emphasized. No personal identifiers were collected, and participants could withdraw at any time.

Because inclusive education is a politically visible and value-laden topic, the research team took steps to minimize social desirability bias. Teachers were informed broadly that the study focused on educational perspectives rather than specifically on the ICF. Items were phrased neutrally, participation was anonymous, and the online format ensured that responses could be completed privately without pressure from supervisors or colleagues.

2.3. Data Analysis

All analyses were conducted using IBM SPSS (version 28). Data screening involved inspection for outliers, normality, and missing data. Missing values were minimal (<5%) and were handled through listwise deletion, which did not compromise sample size or analytical power.

Data analysis proceeded in several stages:

• Descriptive statistics (means, standard deviations, frequencies) summarized demographic characteristics and item-level responses.
• Psychometric evaluation of the 27-item ICF scale was performed using PCA and reliability analysis (Cronbach’s α).
• Group comparisons (independent-samples t-tests and one-way ANOVAs) were used to examine differences in attitudes based on variables such as training, years of experience, and specialization.
• Pearson correlations explored associations between the ICF Attitudes Score and professional characteristics.

A significance level of α = 0.05 was adopted for all inferential analyses.

3. Results

Data analysis proceeded in several stages to ensure both descriptive and inferential rigor. First, a descriptive examination of response frequencies was undertaken at the level of individual items and questionnaire sections. This allowed us to characterize the main distributional tendencies underlying teachers’ orientations towards “inclusive education (IE)” and their engagement with the “International Classification of Functioning, Disability and Health (ICF)”. In a second step, inferential procedures were implemented to test the study’s guiding hypotheses. All analyses were conducted using IBM SPSS Statistics (Version 28). Descriptive statistics (mean, standard deviation, minimum, and maximum) were computed to summarize overall attitudinal profiles. Bivariate associations between sociodemographic characteristics, professional background variables (for example, specialized training, years of teaching experience, and employment status), and attitudinal indicators were examined using Pearson’s product–moment correlation coefficients (two-tailed). To explore mean differences in attitudes towards the ICF according to professional training background, a series of independent samples t-tests were performed. Assumptions of homogeneity of variance were verified using Levene’s test; standard t-test statistics are reported where assumptions were met, and adjusted values otherwise. Effect sizes were calculated using Cohen’s d and interpreted according to conventional thresholds (0.20 = small, 0.50 = medium, 0.80 = large). Where relevant, we also report 95% confidence intervals (CI) around effects. Statistical significance was established at α = 0.05 (two-tailed).

Finally, qualitative responses to the open-ended item were subjected to conventional content analysis. This procedure aimed to identify recurrent thematic patterns, including perceived strengths, constraints, and conditional factors influencing the implementation of the ICF, as well as indications of insufficient knowledge or limited familiarity with the framework.

3.1. Teachers’ Attitudes Regarding the Inclusion of Students with Special Educational Needs

Analysis of teachers’ perspectives on the inclusion of students with SEN revealed a predominant preference for partial or selective inclusion, rather than full integration or complete segregation. As shown in

Table 1. Distribution of responses to statements on the inclusion of pupils with SEN (N and %).

Statements	Strongly Disagree N (%)	Disagree N (%)	Agree N (%)	Strongly Agree N (%)
Pupils with SEN always in the classroom.	63 (15.1)	272 (65.2)	71 (17.0)	11 (2.6)
Pupils with SEN only in some subjects.	11 (2.6)	73 (17.5)	262 (62.8)	71 (17.0)
Pupils with SEN in Specialized Units.	22 (5.3)	139 (33.3)	207 (49.6)	49 (11.8)
Pupils with SEN should participate in all activities.	3 (0.7)	32 (7.7)	207 (49.6)	175 (42.0)
Pupils with SEN should be set apart.	61 (14.6)	234 (56.1)	110 (26.4)	12 (2.9)
Pupils with SEN integrated at specific times.	16 (3.8)	112 (26.9)	235 (56.4)	54 (12.9)

, most respondents rejected the idea that pupils with SEN should always be in the mainstream classroom, while at the same time clearly supporting their participation in school life and extracurricular activities. Percentages in each row sum to approximately 100%, with minor deviations attributable to rounding.

Teachers expressed broad support for the participation of students with SEN in all school activities. Nearly all respondents agreed or strongly agreed with this statement, and only a very small minority expressed disagreement. At the same time, the majority favored models of limited academic integration, such as attendance in specific subjects or selected learning contexts, combined with the existence of specialized support units. In other words, teachers tended not to endorse either a fully segregated model or a strictly “full inclusion” model; instead, they appeared to value a balanced approach that joins classroom participation with more targeted and specialized assistance where needed.

Overall, 80.3% of teachers disagreed with the full-time presence of students with SEN in regular classrooms, while 79.8% agreed that inclusion should occur in selected subjects. Around 61.4% supported the existence of specialized support units, and 91.6% endorsed the participation of students with SEN in all extracurricular activities. Taken together, these results portray teachers as generally supportive of inclusion, particularly in social and extracurricular domains, but cautiously oriented towards academic inclusion, where they tend to prefer more selective and supported forms.

Analysis of the Correlations

The correlational analysis provides a more nuanced picture of how teachers’ professional backgrounds relate to their views on the inclusion of students with SEN. Overall, the correlations were modest in magnitude, with most coefficients falling within the small effect range (absolute r values below 0.20), indicating that professional background variables explain only a small proportion of variance in inclusion attitudes.

Specialized training in special education was associated with slightly more inclusive positions in specific areas. Teachers with such training were more likely to support the integration of students with SEN in mainstream classes for selected subjects (r = 0.194, p < 0.001), and to endorse the use of specialized support units (r = 0.101, p = 0.039). These effects correspond to small effect sizes (r² of approximately 4% and 1%, respectively), suggesting that training contributes to more nuanced and inclusion-oriented views, but does not radically transform attitudes.

The pattern for experience as a SEN teacher was more complex. Greater experience in this role was negatively correlated with support for full participation of students with SEN in all school activities (r = −0.283, p = 0.006). This correlation approaches a small-to-moderate effect (r² ≈ 8%). One possible interpretation is that prolonged exposure to the day-to-day complexities of SEN support may temper initial enthusiasm for full participation, leading experienced practitioners to adopt more cautious or conditional positions. It is important, however, to interpret this finding carefully: the correlation does not imply that experienced SEN teachers are opposed to inclusion, but rather that their support for full participation may be more contingent on contextual conditions and available resources.

Importantly, teachers’ characteristics showed no meaningful association with strongly polarized positions, such as the belief that students with SEN should always remain in mainstream classrooms or, conversely, that they should be consistently educated in separate settings. This suggests that “all-or-nothing” stances are relatively independent of formal training and professional experience and may be more strongly driven by personal beliefs or school culture.

The detailed correlation coefficients underpinning these interpretations are presented in

Table 2. Correlations between professional variables and teachers’ attitudes toward the inclusion of pupils with SEN.

Statements	Years of Teaching Experience	Specialized Training in Special Education	Work as a SEN Teacher	Years of Service as a SEN Teacher	Train in the Area of ICF
Pupils with SEN always in the classroom.	0.023	−0.072	−0.057	−0.015	0.051
Pupils with SEN only in some subjects.	−0.030	0.130 **	0.075	−0.283 **	0.008
Pupils with SEN in Specialized Units.	−0.045	0.194 **	0.112 *	−0.202	0.047
Pupils with SEN should participate in all activities.	−0.038	−0.092	−0.061	0.113	−0.069
Pupils with SEN should be set apart.	0.010	0.101 *	−0.016	−0.130	−0.002
Pupils with SEN integrated at specific times.	−0.053	0.148 **	0.107 *	−0.209 *	−0.033

*. Correlation is significant at the 0.05 level (2-tailed). **. Correlation is significant at the 0.01 level (2-tailed).

.

3.2. Contribution of the ICF to More Inclusive Practices

3.2.1. Qualitative Insights from Open-Ended Question

The qualitative analysis of teachers’ open-ended responses regarding the contribution of the ICF to more inclusive educational practices revealed a diversified pattern of perceptions. Overall, five principal thematic categories were identified, in addition to a small proportion of non-responses: positive appraisals, critical perspectives, conditional utility, limited knowledge, and non-response.

A substantial group of teachers described the ICF in clearly positive terms, as a helpful pedagogical and diagnostic tool that supports inclusive practices by fostering individualized strategies and more systematic planning. These respondents tended to emphasize that the ICF helps to structure thinking about students’ functioning and to identify barriers and facilitators in a more comprehensive way.

At the same time, almost one-third of teachers articulated critical perspectives, highlighting the bureaucratic, medicalized, and administrative aspects of the ICF. For these respondents, the framework was perceived as potentially distant from the everyday realities of the classroom and sometimes as an additional workload with limited practical value if not supported by time and resources. A further group expressed what can be described as conditional approval: they recognized the potential of the ICF but underscored that it is useful only when implementation is accompanied by effective training, adequate time allocation, and supportive institutional conditions.

Finally, a non-negligible proportion of responses reflected limited knowledge or conceptual mastery of the ICF, and some participants chose not to respond to the open question. Together, these categories suggest that while many teachers see real added value in the ICF, a substantial proportion remain cautious, ambivalent, or insufficiently familiar with the framework. These qualitative insights complement quantitative data by illustrating the tensions between the ICF as an empowering conceptual tool and the perception of it as a demanding or bureaucratic instrument (see

Table A1. Teachers’ responses on ICF’s contribution to inclusive educational practices.

Category	Definition/Description	Illustrative Excerpts	N	% (of Total 412)
Positive Appraisals	Responses expressing a positive view of the ICF, recognizing it as a tool that enhances inclusive education by improving student assessment, enabling differentiated teaching, fostering collaboration among professionals, and strengthening overall inclusive practices.	“The ICF allows us to know the student better and adapt strategies accordingly.”/“It is fundamental for inclusive practices.”/“Provides a more objective evaluation and better planning.”	148	35.9
Critical Perspectives	Responses expressing a negative or skeptical view of the ICF, criticizing it as overly bureaucratic, technical, and medicalized, with a clear gap between policy intentions and actual classroom practice. It is often seen as an administrative tool rather than a pedagogical one.	“The ICF made everything more bureaucratic and complicated.”/“It is focused on disease rather than learning.”/“It does not contribute to inclusion; it only classifies.”	122	29.6
Conditional Utility	Responses recognizing the ICF’s potential value but viewing its effectiveness as conditional on factors like sufficient resources, teacher training, and collaborative implementation, highlighting the dependence of inclusion on broader institutional and contextual supports.	“It contributes only if everyone understands and applies the same framework.”/“Theoretically it helps, but in practice there are no resources.”/“Depends on the teachers’ training and collaboration.”	74	18.0
Limited Knowledge	Responses revealing limited knowledge or experience with the ICF, indicating weak conceptual understanding and a need for further professional training on inclusive assessment frameworks.	“I don’t know enough to have an opinion.”/“I have no training in this area.”/“I am not familiar with the ICF.”	52	12.6
Non-response	Empty or non-substantive answers that show disengagement or refusal to comment. These represent minimal participation or indifference towards the topic.	“No opinion.”/“Nothing to say.”/“—(blank)”	16	3.9
Total	—	—	412	100

, Appendix A.1).

3.2.2. Attitudes Toward the Use of the ICF in Schools

The descriptive analysis of teachers’ responses on the 27-item ICF attitude scale pointed to a generally positive evaluation of the ICF’s educational potential, combined with significant variability between individuals. In standardized form, the overall attitude score had a mean of 0.00 (SD = 1.00), with scores ranging from −4.78 to 2.77 (

Table 3. Descriptive statistics of attitudes towards the ICF.

Variable	M	SD	Min	Max
Attitudes towards the ICF	0.00	1.00	−4.78	2.77

Note. M = Mean; SD = Standard deviation.

), indicating that some teachers were very positive about the framework, whereas others were more skeptical or reserved.

Most respondents recognized the ICF as an effective framework for identifying barriers and facilitators to pupils’ participation and activity, guiding educational planning and goal setting, profiling pupil functioning, and monitoring progress over time. Teachers also appreciated its role in promoting a shared professional language and in improving communication between schools and other services, particularly health and social care.

However, teachers also pointed to several limitations. They noted uneven understanding and use of the ICF among health professionals, and opinions were divided regarding the clarity of its terminology. Collaboration across sectors, especially between education and health, was often perceived as only moderately effective. Furthermore, a notable proportion of teachers appeared to attribute a diagnostic role to the ICF, which suggests some conceptual confusion between functional classification and clinical diagnosis and underlines the need for clearer training (

Table A2. Descriptive analysis of teachers’ responses regarding the use of the ICF in schools.

Statements	Strongly Disagree N (%)	Disagree N (%)	Agree N (%)	Strongly Agree N (%)
The ICF makes it possible to identify barriers to student participation in school.	9 (2.2)	59 (14.1)	302 (72.4)	47 (11.3)
The ICF is a biopsychosocial classification of functionality.	4 (1.0)	50 (12.0)	325 (77.9)	38 (9.1)
The ICF is a classification that supports the planning of educational intervention.	6 (1.4)	45 (10.8)	317 (76.0)	49 (11.8)
The ICF makes it possible to define the objectives of educational intervention.	6 (1.4)	50 (12.0)	301 (72.2)	60 (14.4)
The ICF allows for an assessment of progress in evaluation.	6 (1.4)	92 (22.1)	276 (66.2)	43 (10.3)
The ICF makes it possible to identify facilitators of student activity.	4 (1.0)	45 (10.8)	307 (73.6)	61 (14.6)
The ICF helps to evaluate the results of intervention.	10 (2.4)	81 (19.4)	289 (69.3)	37 (8.9)
The ICF makes it possible to diagnose the child’s disorder.	13 (3.1)	89 (21.3)	266 (63.8)	49 (11.8)
The ICF makes it possible to identify facilitators of student participation.	6 (1.4)	49 (11.8)	323 (77.5)	39 (9.4)
Using the ICF leads to greater interaction between the school and community services.	14 (3.4)	94 (22.5)	265 (63.5)	44 (10.6)
Health professionals use the ICF as a classification tool.	29 (7.0)	146 (35.0)	225 (54.0)	17 (4.1)
With the introduction of the ICF, the multidisciplinary team’s role is to participate in analyzing the student’s educational situation.	6 (1.4)	27 (6.5)	332 (79.6)	52 (12.5)
Using the ICF makes it possible to better understand students’ needs.	7 (1.7)	51 (12.2)	309 (74.1)	50 (12.0)
The possibility of using a common language among all professionals is an added value of the ICF.	6 (1.4)	33 (7.9)	294 (70.5)	84 (20.1)
With the introduction of the ICF, the multidisciplinary team must take part in deciding the student’s eligibility for special education.	6 (1.4)	43 (10.3)	308 (73.9)	60 (14.4)
With the introduction of the ICF, communication among the different professionals working with students has become easier.	13 (3.1)	65 (15.6)	299 (71.7)	40 (9.6)
The language used in the ICF is understood by all those involved in analyzing the students’ needs.	27 (6.5)	191 (45.8)	185 (44.4)	14 (3.4)
Health professionals are proficient in using the ICF.	28 (6.7)	194 (46.5)	184 (44.1)	11 (2.6)
The ICF makes it possible to identify barriers to student activity.	7 (1.7)	51 (12.2)	326 (78.2)	33 (7.9)
The ICF makes it possible to outline the functionality profile of the referred student.	6 (1.4)	24 (5.8)	340 (81.5)	47 (11.3)
Using the ICF allows for better intervention with students with SEN (Special Educational Needs).	10 (2.4)	59 (14.1)	302 (72.4)	46 (11.0)
The ICF makes it possible to improve the quality of educational action.	10 (2.4)	81 (19.4)	278 (66.7)	48 (11.5)
Using the ICF has led to the exclusion of students who traditionally received special education support.	60 (14.4)	202 (48.4)	135 (32.4)	20 (4.8)
The use of the ICF has demonstrated the need for a transdisciplinary approach.	14 (3.4)	53 (12.7)	293 (70.3)	57 (13.7)
There is effective collaboration between education and health services in assessing students with reference to the ICF.	32 (7.7)	160 (38.4)	214 (51.3)	11 (2.6)
The ICF is an asset for classifying children and young people with disabilities.	8 (1.9)	53 (12.7)	311 (74.6)	45 (10.8)
The ICF contributes to the implementation of socio-educational responses.	12 (2.9)	82 (19.7)	293 (70.3)	30 (7.2)

, Appendix A.2).

In addition to descriptive analyses, Pearson product–moment correlations were used to examine associations between educators’ professional characteristics and their attitudes toward the ICF (

Table 4. Correlations between professional variables and teachers’ attitudes toward the use of the ICF in schools.

	Years of Teaching Experience	Specialized Training in Special Education	Work as a SEN Teacher	Years of Service as a SEN Teacher	Train in the Area of ICF
Attitudes towards the ICF	−0.048	0.032	0.121 *	−0.243 *	0.081

*. Correlation is significant at the 0.05 level (2-tailed).

). Most professional background variables were not significantly associated with ICF attitudes. Overall years of teaching (r = −0.048, p = 0.325), specialized training in special education (r = 0.032, p = 0.509), and training specifically on the ICF (r = 0.081, p = 0.101) yielded non-significant and very small effects.

Two associations reached statistical significance but remained small in magnitude. Teachers with prior SEN teaching experience reported slightly more favorable attitudes towards the ICF (r = 0.121, p = 0.013), whereas a greater number of years as a SEN teacher was associated with less favorable attitudes (r = −0.243, p = 0.020, r² ≈ 5.9%). These findings suggest that working with students with SEN may increase openness to the ICF in general, while very long tenure in SEN roles may be associated with a more cautious assessment of its applicability in everyday school contexts. Given the small effect sizes, these interpretations should be seen as indicative rather than definitive.

Finally, independent samples t-tests were used to compare attitudes towards the ICF between teachers with and without ICF training, and between those with and without specialized training in special education. In both cases, differences were small and not statistically significant. For ICF training, teachers who had received training reported slightly less favorable attitudes (M = −0.17, SD = 0.85) than those without training (M = 0.04, SD = 1.03), t(415) = −1.65, p = 0.101, Cohen’s d = −0.21, 95% CI [−0.46, 0.04]. For specialized training in special education, participants with training (M = −0.08, SD = 0.97) reported attitudes similar to those without such training (M = 0.01, SD = 1.01), t (415) = −0.66, p = 0.509, Cohen’s d = −0.06, 95% CI [−0.29, 0.17]. These very small, non-significant effects indicate that the mere presence of training, in its current forms, is not strongly associated with more positive attitudes towards ICF.

Taken together, these results suggest that teachers’ attitudes towards the ICF are shaped only weakly by formal training and background variables and are likely to depend more on the quality and relevance of training, contextual supports, informal mentoring, and the extent to which the framework is meaningfully integrated into school practice.

4. Discussion

The findings of this study provide a nuanced understanding of how Portuguese teachers perceive and operationalize inclusive education and the “International Classification of Functioning, Disability and Health (ICF)” within their daily school contexts. These findings resonate with international research on good practices for inclusion and participation of children with complex support needs (Lebeer et al., 2025) and are consistent with other studies, which report similarly positive attitudes toward inclusion, albeit strongly shaped by training and institutional conditions (Abellán & Fernández-Bustos, 2023). Framed by the WHO’s functionality-based approach (WHO, 2001) and aligned with international agendas emphasizing participation and belonging (OECD, 2023; UNESCO, 2020), the results reveal a pattern of attitudes that is broadly supportive of inclusion yet attentive to the constraints and complexities of real educational practice.

Teachers’ responses indicate a clear endorsement of participation in school life and selective academic inclusion, alongside measured support for specialized units. This pattern is consistent with international research showing that teachers often reconcile inclusive ideals with practical constraints within their professional contexts (Selisko et al., 2024; Singh et al., 2025). Rather than signaling resistance to inclusion, these preferences reflect an effort to navigate the tension between meeting diverse learner needs and ensuring classroom feasibility.

A key contribution of this study lies in explaining why experience, but not formal training, was associated with attitudes towards the ICF. Although earlier research shows that training and meaningful contact can shape more favorable attitudes (Abellán & Fernández-Bustos, 2023; Gámez-Calvo et al., 2025), our findings reveal that the binary presence of training did not significantly predict ICF attitudes. Instead, prior experience working with SEN pupils was linked to slightly more positive views of the ICF, whereas more years in SEN roles were associated with more cautious attitudes.

Several explanations help account for this pattern. First, training varies widely in its quality, depth, and practical relevance; brief or purely theoretical sessions are unlikely to reshape attitudes meaningfully. Second, teachers who seek SEN experience may already hold more inclusive predispositions, suggesting a possible selection effect. Third, practice-based learning, including informal mentoring and multidisciplinary collaboration, may offer “mastery experiences” that foster confidence in functional approaches (Bandura, 2001; Schnepel et al., 2025). Recent empirical work further suggests that sustained engagement in inclusive core practices enables teachers to consolidate their professional confidence through iterative, practice-based learning embedded in everyday classroom interactions and collaborative routines (Obrovská et al., 2025). Finally, prolonged SEN tenure may expose teachers to systemic obstacles—workload pressures, inconsistent interprofessional communication, and limited resources—leading to more guarded evaluations, consistent with recent European studies (Gal et al., 2025; Jury et al., 2023).

Taken together, these patterns reinforce that teacher attitudes cannot be understood solely as individual psychological characteristics. They are embedded in institutional norms, collaborative routines, and perceived behavioral control, as described in Ajzen and Fishbein’s (2005) model. Classical and contemporary theories also highlight that attitudes are durable social representations shaped by shared meanings and practices (Bohner & Dickel, 2011; Vala, 2007). Thus, the weak associations with formal training and the stronger influence of contextual experience underscore the socio-institutional nature of teachers’ orientations toward inclusion and ICF application.

Recent empirical findings bolster this interpretation. Studies consistently show that effective inclusion depends on sustained preparation, school climate, leadership, and interprofessional coherence (Gal et al., 2025; Wang et al., 2025). The present results align with this emerging consensus and illustrate that teachers’ attitudes reflect both personal beliefs and the broader organizational and systemic conditions that enable or constrain inclusive practice.

5. Conclusions and Practical Implications

Overall, the study shows that Portuguese teachers express strong support for inclusive values but tend to apply them through hybrid models combining mainstream participation with specialized support. The ICF is recognized as a conceptually robust and potentially powerful tool for planning and collaboration, yet its practical implementation is challenged by perceived conceptual complexity, administrative demands, uneven uptake across sectors, and limited time and training.

A key implication is that formal training alone does not reliably shape ICF attitudes. Instead, attitudes appear to be shaped more by contextual and experiential factors, particularly the nature and quality of hands-on SEN experience. This finding highlights the need for training that is applied, practice-embedded, and interprofessionally structured, rather than theoretical or episodic.

5.1. Practical Implications

Based on the findings, several practical implications emerge:

• Development of Case-Based and Collaborative Resources

The results highlight the need for accessible, practice-oriented resources that support teachers in applying inclusive education principles consistently. Case-based materials, structured collaborative problem-solving routines and shared decision-making tools can strengthen pedagogical coherence and support teachers in addressing diverse learning needs in a more systematic manner. Within this context, the ICF can function as a shared conceptual and terminological framework that supports mutual understanding across professional groups, thereby facilitating common language in interprofessional dialog, coordinated decision-making and more coherent educational responses (Simon et al., 2024). This perspective aligns with prior research emphasizing the value of practice-based, case-oriented learning and structured collaborative frameworks in enhancing instructional coherence and supporting teachers’ capacity to respond to learner diversity (Galindo et al., 2022; Tveitnes et al., 2025).

• Initial Teacher Education

Initial Teacher Education programs should move beyond theoretical presentations of the ICF and provide systematic opportunities for practice-rich engagement. Activities such as guided case discussions, co-teaching with SEN specialists and collaborative assessment tasks help prospective teachers internalize the ICF as an operational tool rather than an abstract classification. These findings are consistent with evidence supporting the benefits of experience-based learning approaches (Abellán & Fernández-Bustos, 2023; Gámez-Calvo et al., 2025; Kus et al., 2025).

• “Continuous Professional Development (CPD)”

Teachers consistently indicated that the meaningful use of the ICF depends on time, resources and shared understanding within professional communities. CPD should therefore be sustained over time, embedded in everyday practice and supported by structured coaching cycles, collaborative inquiry and guided reflection. Such practice-oriented approaches have been associated with greater coherence in implementation processes and more consistent uptake of inclusive frameworks across school teams (Gal et al., 2025; Wang et al., 2025). Furthermore, evidence from international systematic reviews suggests that, despite the ICF’s recognized conceptual value, its application in educational contexts remains uneven and frequently limited. These findings highlight the need for systematic educator preparation and sustained organizational and policy-level support to ensure that the ICF is translated from a theoretical reference into a pedagogically meaningful and consistently applied tool within inclusive school practices (Kang et al., 2025).

• School Leadership

Leadership emerged as a decisive enabling factor for the sustained use of the ICF. Transformational leadership styles are associated with more positive inclusion climates and higher adherence to inclusive frameworks (Wang et al., 2025). School leaders can promote effective ICF implementation by allocating protected collaboration time, minimizing administrative burden and establishing stable multidisciplinary routines.

• Cross-Sector Collaboration

Concerns raised by teachers regarding inconsistent terminology and fragmented coordination between education and health services point to the need for more integrated cross-sector processes. The establishment of shared documentation templates, joint procedural protocols and designated liaison roles may increase coherence and reduce the misalignment identified both in this study and in international research (Jury et al., 2023; Langelaan et al., 2024).

• Refinement of ICF Training

Training initiatives should prioritize clarity of language, concrete examples and opportunities for hands-on practice in functional assessment and collaborative decision-making. Scenario-based and practice-focused formats are more likely to influence teachers’ attitudes and behaviors than purely technical instruction, as demonstrated in recent work on teacher preparation and inclusive practice (Gal et al., 2025; Langelaan et al., 2024).

In summary, creating inclusive, participation-oriented educational environments requires not only teacher knowledge but also organizational and interprofessional support. Strengthening the coherence, practicality and collaborative potential of ICF implementation may help schools move closer to realizing fully inclusive educational ecosystems grounded in functionality, health and meaningful participation.

5.2. Research Implications

• Adopt longitudinal and multilevel designs to examine how changes in leadership, staffing, and CPD influence teachers’ attitudes and inclusive practices over time;
• Differentiate ICF training by content and implementation fidelity to identify which formats most effectively promote changes in practice;
• Integrate qualitative analyses (e.g., observations of multidisciplinary meetings) to capture how the ICF is negotiated and operationalized in situ.

Collectively, these directions would help to reframe partial inclusion from an endpoint into a transition strategy, ensuring that specialized provisions remain aligned with the rights-based aim of full participation and belonging. Advancing the ICF as a practical, shared professional language—while reducing administrative burden and strengthening interprofessional routines—may move schools closer to truly inclusive environments where functionality, health, and learning are addressed holistically.

6. Limitations of the Study

The study has limitations that should be considered when interpreting its findings. First, the cross-sectional design limits causal inference and prevents analysis of how attitudes evolve over time. Second, the use of a non-probabilistic convenience sample restricts external validity; results cannot be generalized to all Portuguese teachers, as regional and institutional differences were not systematically controlled. Third, although the study combined quantitative and qualitative components, data triangulation was absent. The qualitative element was limited to a single open-ended question, reducing depth and preventing cross-validation of patterns identified in the survey. Fourth, reliance on self-reported data introduces potential social desirability bias, particularly given the normative nature of inclusive education. Finally, the absence of school-level variables (e.g., leadership style, resource allocation, class size) constrains interpretation of contextual influences on attitudes.

Despite these limitations, the study provides the first large-scale empirical evidence on Portuguese teachers’ attitudes toward inclusion and the ICF, offering a valuable baseline for future research and policy development. To strengthen validity and applicability, future studies should adopt longitudinal and mixed-method designs with robust triangulation, integrate interviews or observations to enrich qualitative depth, and use probability sampling and multilevel modeling to capture school-level effects. These improvements would enhance the scientific utility of findings and support more informed strategies for inclusive education.