This chapter provides a critical analysis of the usage of the international classification of functioning, disability and health for children and youth (ICF-CY) in German-speaking countries. In addition to the description of concrete initiatives in the field of early childhood intervention, social pediatric care and inclusive kindergartens, the issue of usability and transferability into daily practice is highlighted. The rare examples of ICF-CY's implementation focus on structuring anamnestic information using the ICF-CY; development of code sets, mainly age lists; development of core sets concerning defined health status; and defining areas of intervention. The examples also focus on planning, documentation and evaluation of interventions and ICF-CY as a continuously developing, problem solving tool in pediatric social care. In addition to issues regarding how to connect existing laws with the ICF-CY, the issue of practicability is seen as a major obstacle for clinical transfer. The ICF-CY was introduced into the Swiss school system by means of a top-down-strategy.