Child Community Health Inclusion Index
Manual Guide — Pilot Version 2021
Download PDFIntroduction
The inclusion of children in communities through accessible environments, public transportation, information, technology, and all public services and policies is a human right. Participation in community life is very important for a child's physical and mental health and helps develop their sense of identity and independence. Inclusive communities make it easier for children to participate in community life.
The United Nations Sustainable Development Goals for 2030 and other international and national policies support the need to reduce inequalities, promote health, and create sustainable cities as essential outcomes for society.
Despite the advantages and importance of inclusion as a fundamental human right, children with disabilities face restrictions. In Canada, there are more than 800,000 children with intellectual disabilities, 44% of whom report being disadvantaged regarding transportation or recreational services. Many may be denied access to programs, facilities, public parks, and playgrounds, limiting their ability to participate in community activities. Limited access to these opportunities can lead to significant health disparities, with lasting repercussions on child development and family well-being.
The CHILD-CHII has been adapted from the Community Health Inclusion Index (CHII), which was developed in the United States. The CHILD-CHII is a measurement tool used to help families, professionals, teachers, and institutions gather information on the extent to which resources are inclusive for all community members, including children with disabilities.
CHILD-CHII Framework
The CHILD-CHII includes three components: the on-site assessment, the organizational assessment, and the macro-community assessment — and follows a hierarchical structure. The tool evaluates four community sectors: Education, Health, Public Spaces, and Community Institutions/Organizations (Level 1). Within each sector are facilities (e.g., an elementary school) with any number of venues (Level 2) related to community activity and design. The CHILD-CHII evaluates these venues and sectors across five inclusion domains (Level 3): built environment, equipment, programs and services, staff, and policies.
Level 1 — Sectors
Level 2 — Facilities / Venues
Level 3 — Inclusion Domains
Built environment & equipment → on-site assessment · Programs, staff & policies → organizational and macro-community assessments
Figure 1 — CHILD-CHII Framework
Using the CHILD-CHII
Macro-Community Assessment
The macro-community assessment questions relate to transportation services and policies, community design policies and programs, and community wellness initiatives. Responses should reflect currently available programs and initiatives. Assessors answer these questions by conducting online research and interviewing representatives from local transportation agencies and community planners.
Organizational Assessment
Responses to this assessment's questions should be provided by or with the help of the facility. An online version of the assessment can be sent to the facility to be completed by the representative or staff. The goals of the organizational assessment are: 1) to list sites that offer activities and resources for children with disabilities, and 2) to obtain information about programs, policies, and the general attitude of the site toward promoting inclusive health.
Some sites may be difficult to reach by phone or email. In this case, assessors are advised to visit the site directly and conduct the organizational assessment as an interview rather than an online survey. If the facility has agreed, the on-site assessment can also be carried out at that time.
On-Site Assessment
The goal of this assessment is to determine how easy it is to move around the facility and the inclusion characteristics of the facility for children with disabilities. Assessors will answer this assessment's questions for facilities in the four community sectors: education, health, public spaces, and community institutions/organizations. The table below provides examples of the types of sites/facilities found in each sector. The questions are intended to help understand the ease or difficulty of accessing the facility for a child with a disability and their family.
Table 1 — Sectors and examples of corresponding observation sites
| Sector | Observation Site |
|---|---|
| Education | Public elementary or secondary school |
| Health | Hospital, community clinic |
| Public Spaces | Parks, playgrounds |
| Community Institutions / Organizations | Community centre, library |
Specific Sections
Site Circulation: Assessors will observe the safety of the areas surrounding the site to identify factors that affect circulation on the site. Assessors will evaluate the accessibility of the surrounding pedestrian infrastructure. To determine the areas to assess, consider the most important intersections and paths for children with disabilities and families to access the site from the surrounding neighbourhood.
Public Transportation: For communities with public transportation, assessors will examine the accessibility of a nearby transit stop and the frequency of service. It may be easier to look up answers in advance online or by calling the local transit provider for the area around the site.
The internal environment questions ask the assessor to evaluate the built environment and equipment in different areas of the observation site, such as entrances, restrooms, and venues (places that children with disabilities frequent and access).
Restrooms: Assessors will examine the restrooms closest to the sites. Some venues will be sector-specific. Items related to venues that are not applicable to the facility or sector may be skipped.
Specific Venues: Change rooms, exercise equipment/space, pools, playgrounds, splash pads, multi-use trails, waiting rooms, examination rooms.
Question Types
The on-site assessment is composed of several types of questions:
- Yes/No: Used to determine whether an accessibility feature is present or absent. This type of question is also used to determine whether a further series of questions should be asked.
- Check all that apply: Many questions about particular features will have multiple options representing different aspects of the accessibility of those features. You will need to choose all the answers that apply. Sometimes a "Not applicable" option appears at the bottom of the list.