Elementary School Teachers' Referral Decision Making – A Biopsychosocial Approach

Over the past years, the biopsychosocial model has had a significant impact on the field of Special Education. More specifically, the Children and Youth version of the International Classification of Functioning (ICF-CY, WHO, 2007) emerged as a useful screening tool. Within this framework, the aim of the present study was to explore the understanding of student referral to a pre-diagnosis support program or to a final diagnosis. Teachers' referral decision-making was examined in a structural equation model, which incorporated four latent variables, namely, students' Personal Factors, Activity Performance and Educational Support, as well as teachers' Referral Intentions. To test the capacity of this model, 62 teachers of elementary school classes documented all the needed information for each of their 1092 students. All variables were based on the ICF-CY and they were evaluated accordingly. The verified path structure was to a large extent consistent with the biopsychosocial model. Teachers relied primarily on students' prior educational support when they formed their opinion about student referral. Educational support received by students functioned as a mediator factor between activity performance and referral intention. Overall, results revealed a complex structure with regard to the teachers' decision making processes. The subgroups of students that emerged were discussed, and refinements for future studies were suggested. This study delivered useful implications for educational interventions, referral policy and teacher education.