This chapter will provide readers with an overview of how a systems-based approach can be used to understand the relationship between culture, environment, language, and disability. It will identify a useful model of ecology, culture, and development that can and should be considered in conjunction with the WHO-ICF framework to guide service delivery in school-based settings. This chapter will also provide an overview of systems-based approaches that can be used when working with children from traditionally marginalized backgrounds. Finally, a case study example will be used to provide guidance on the application of systems-based approaches to service delivery for children in school-based settings.