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Kaelin VC, Anaby D, Werler MM, Khetani MA. School participation among young people with craniofacial microsomia and other childhood-onset disabilities. Dev Med Child Neurol 2024; 66:939-947. [PMID: 37138446 PMCID: PMC10622330 DOI: 10.1111/dmcn.15628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 05/05/2023]
Abstract
AIM To examine how school environment, physical functioning problems, and behavioral problems explain levels of school participation (i.e. attendance and involvement) among young people with craniofacial microsomia (CFM) and other childhood-onset disabilities, and whether participation-focused caregiver strategies play a role in these relationships. METHOD We conducted secondary analyses of a subset of data (n = 260 families: 120 with CFM and 140 with other childhood-onset disabilities) from the second follow-up phase of a longitudinal cohort study. We applied structural equation modeling with data collected from the Participation and Environment Measure - Children and Youth version, the Child Behavior Checklist, and the Pediatric Quality of Life Inventory physical functioning scale. RESULTS Model fit was acceptable to close (comparative fit index = 0.973; root mean square error of approximation = 0.055; standardized root mean squared residual = 0.043; Tucker-Lewis index = 0.958). School environmental support had a positive effect on young people's participation attendance and involvement, and physical functioning problems had a negative effect on participation involvement. The number of disclosed caregiver strategies had a significant positive effect on the relationship between school environmental support and school participation attendance. INTERPRETATION Findings confirm the effect of school environmental support and physical functioning problems on school participation and highlight the role of participation-focused caregiver strategies to intensify the positive effect of school environmental support on school participation attendance. WHAT THIS PAPER ADDS Environmental support had a positive effect on participation attendance and involvement. Physical functioning problems had a negative effect on school participation involvement. Disclosed caregiver strategies intensified the impact of environmental support on participation attendance.
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Affiliation(s)
- Vera C Kaelin
- Occupational Therapy, University of Illinois Chicago, Chicago, USA
- Computer Science, University of Illinois Chicago, Chicago, USA
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | | | - Mary A Khetani
- Occupational Therapy, University of Illinois Chicago, Chicago, USA
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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Rovai G, Santana CAS, Brandão MDB, de Campos AC. Cross-cultural adaptation of the Rotterdam Transition Profile to Brazilian Portuguese: measuring autonomy in participation of Brazilian youth with cerebral palsy. Braz J Phys Ther 2024; 28:101080. [PMID: 38848627 PMCID: PMC11192777 DOI: 10.1016/j.bjpt.2024.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 02/14/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Autonomy in participation of young adults with cerebral palsy (CP) is not well understood due to the lack of appropriate instruments, especially for the Brazilian population. The Rotterdam Transition Profile (RTP) categorizes autonomy in Participation (education, employment, finances, housing, leisure, intimate relationships, sexuality, transportation) and Health Services (care demands, services and aids, and rehabilitation services) domains. OBJECTIVES To cross-culturally adapt the RTP for use in Brazil, and to describe the levels of autonomy in participation and associated factors of Brazilian youth with CP. METHODS RTP was translated and content validity was investigated through an expert panel (n = 4 researchers and n = 4 clinicians); 30 adolescents and young adults with CP provided data for construct validity and internal consistency analysis. To analyze influencing factors, 56 youth with CP, mean age 25 years (SD = 6.9 years), with good cognitive level remotely responded to the RTP, sociodemographic information, and functional classifications (gross motor, manual ability). RESULTS Following translation, content and construct validity were established, with changes made to improve the clarity of items. Cronbach's alpha (0.82) was considered good and test-reliability was fair to good for most items. High levels of autonomy were found in the areas of Leisure and Rehabilitation, with the lowest proportion of participants with autonomy in Housing, Intimate Relationships, and Finances. Autonomy in participation was associated with age, gross motor and manual ability classifications, and with context-related factors. CONCLUSION The Brazilian Portuguese version of the RTP was considered valid and reliable. Findings will support transition planning for young people with CP.
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Affiliation(s)
- Gabriela Rovai
- Child Development Analysis Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Camila Araújo Santos Santana
- Child Development Analysis Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Marina de Brito Brandão
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Carolina de Campos
- Child Development Analysis Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
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Guyard A, Fauconnier J, Muehlan H, Cytera C, Markwart H, Himmelmann K, Schmidt S, Duffaut C, Arnaud C, Thyen U. Differences in participation between young adults with cerebral palsy and their peers: A cross-sectional multicentre European study. Disabil Health J 2024; 17:101554. [PMID: 38129262 DOI: 10.1016/j.dhjo.2023.101554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Children and adolescents with disabilities are known to participate less in most areas of life than their non-disabled peers. OBJECTIVES (1) To estimate differences in participation between young adults with cerebral palsy (CP) and their non-disabled peers; (2) to test the mediating role of financial difficulties and student status; (3) to test the moderating role of personal factors on participation difference; and (4) to test the moderating role of impairment. METHODS A cross-sectional study was conducted in young adults [19-28 years] with CP (n = 228) and non-disabled peers (n = 2861) in France, Germany and Sweden. Participation was assessed using the Questionnaire of Young People's Participation adapted for young adults (QYPP-YA). Differences in five domains of participation were estimated using structural equation modeling with WLSMV method and bias-corrected bootstrap confidence intervals. RESULTS Young adults with CP showed lower participation than others in all domains, with the largest difference in the "intimate relationships" domain (β = 1.71 bcCI95[1.46; 1.95]). Student status mediated the difference in "intimate relationships", "interpersonal relationships" and "independence". Women showed greater differences than men on "independence". Impairments moderated difference in participation. The less severely impaired young adults showed no difference with their non-CP peers in "interpersonal relationships", "social life" and "independence", but made autonomous everyday decisions more often than their peers. CONCLUSIONS Young adults with CP do not have the same opportunities to attain the participation level of non-CP people of the same age. Continuance of education could help to reduce participation difference in "interpersonal relationships" and "independence".
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Affiliation(s)
- Audrey Guyard
- UMR 5525 CNRS / TIMC-IMAG Team MESP, Grenoble Alpes University, Pavillon Taillefer CHU Grenoble CS10217, F-38043, Grenoble, Cedex 9, France.
| | - Jérôme Fauconnier
- UMR 5525 CNRS / TIMC-IMAG Team MESP, Grenoble Alpes University, Pavillon Taillefer CHU Grenoble CS10217, F-38043, Grenoble, Cedex 9, France
| | - Holger Muehlan
- University of Greifswald, Institute of Psychology, Department Health & Prevention, Robert-Blum-Str. 13, 17489, Greifswald, Germany
| | - Chirine Cytera
- University of Greifswald, Institute of Psychology, Department Health & Prevention, Robert-Blum-Str. 13, 17489, Greifswald, Germany; Hospital for Child and Adolescent Medicine, University of Lübeck, DE-23538, Lübeck, Germany
| | - Henriette Markwart
- University of Greifswald, Institute of Psychology, Department Health & Prevention, Robert-Blum-Str. 13, 17489, Greifswald, Germany
| | - Kate Himmelmann
- Institute of Clinical Sciences, University of Gothenburg, Medicinaregatan 3A Plan 500, 413 90, Göteborg, Sweden
| | - Silke Schmidt
- University of Greifswald, Institute of Psychology, Department Health & Prevention, Robert-Blum-Str. 13, 17489, Greifswald, Germany
| | - Carine Duffaut
- UMR 1295 CERPOP, Inserm, Toulouse University III Paul Sabatier, Team SPHERE, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France
| | - Catherine Arnaud
- UMR 1295 CERPOP, Inserm, Toulouse University III Paul Sabatier, Team SPHERE, Hôpital Paule de Viguier, 330 Avenue de Grande Bretagne, TSA 70034, F-31059, Toulouse, France; Clinical Epidemiology Unit, University Hospital, F-31059, Toulouse, France
| | - Ute Thyen
- Hospital for Child and Adolescent Medicine, University of Lübeck, DE-23538, Lübeck, Germany
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Iwanaga Y, Tanaka G, Maruta M, Shiozu H, Kawanaka M, Iwanaga R. Participation Patterns and Associated Factors in Japanese Children With Autism. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241237741. [PMID: 38491761 DOI: 10.1177/15394492241237741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND Children's participation is an important outcome for children, families, and rehabilitation. OBJECTIVES We compared participation patterns (home and community) of 6- to 12-year-old Japanese children with autism and children with typical development (TD) and explored the associations of participation with familial, environmental, and child-related factors. METHOD Twenty-five mothers of children with autism and 21 mothers of TD children completed a survey covering their child's participation and environment, family empowerment, autism symptoms, sensory processing, behavior, and demographic characteristics. RESULTS Children with autism showed restricted home and community participation. Home involvement was associated with family empowerment and the children's age, whereas home frequency was linked to environmental supportiveness and household income. CONCLUSION Japanese children with autism need appropriate support to address decreased participation. Occupational therapists may focus on family empowerment and the child's environment to facilitate the home participation of children with autism.
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Affiliation(s)
- Yuto Iwanaga
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
- Nagasaki City Disability Welfare Center, Japan
| | - Goro Tanaka
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
| | - Michio Maruta
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
| | | | - Mizuho Kawanaka
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
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Krieger B, Moser A, Morgenthaler T, Beurskens AJHM, Piškur B. Parents' Perceptions: Environments and the Contextual Strategies of Parents to Support the Participation of Children and Adolescents with Autism Spectrum Disorder-A Descriptive Population-Based Study from Switzerland. J Autism Dev Disord 2024; 54:871-893. [PMID: 36538129 PMCID: PMC9765345 DOI: 10.1007/s10803-022-05826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 12/24/2022]
Abstract
Environments have a modifying effect on the participation of children and adolescents with autism spectrum disorder (ASD) in all areas of life. This cross-sectional study investigated parental perspectives on supportive or hindering environments and the daily contextual strategies parents used to enhance their children's participation. Qualitative and quantitative data gathered from 115 parents from German-speaking Switzerland using the participation and environment measure-child and youth (PEM-CY) were analyzed. Results revealed 45 environmental supports and barriers at home, at school, and in the community. Contextual strategies were identified in combination with people, activities, time, objects, and places. Parental perspectives on participation and their contextual strategies should be considered in environmental-based interventions to support the participation of children and adolescents with ASD.
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Affiliation(s)
- Beate Krieger
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland.
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands.
| | - Albine Moser
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Thomas Morgenthaler
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland
| | - Anna J H M Beurskens
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Kaelin VC, Saluja S, Bosak DL, Anaby D, Werler M, Khetani MA. Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study. Front Pediatr 2024; 12:1345755. [PMID: 38425659 PMCID: PMC10902462 DOI: 10.3389/fped.2024.1345755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction The purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect of participation-focused caregiver strategies on the relationship(s) between participation-related constructs and community participation attendance and involvement. For the qualitative phase, we solicited caregiver perspectives to explain the quantitative findings. Methods An explanatory sequential mixed-methods design (QUAN > qual) was used. For the quantitative phase, we conducted secondary analyses of data collected during a second follow-up phase of a longitudinal cohort study, including 260 families of children and youth (mean age: 13.5 years) with disabilities and those at risk [i.e., 120 families of children and youth with craniofacial microsomia (CFM); 140 families of children and youth with other types of childhood-onset disabilities]. Data were collected through the Participation and Environment Measure-Children and Youth, the Pediatric Quality of Life Inventory, and the Child Behavior Checklist and analyzed using structural equation modeling. For the qualitative phase, we conducted semi-structured interviews with eight caregivers of children and youth with disabilities and those at risk (i.e., three caregivers of children and youth with CFM; five caregivers of children and youth with other childhood-onset disabilities). Interviews were transcribed verbatim and inductively content-analyzed. Results Our model reached acceptable to close model fit [CFI = 0.952; RMSEA = 0.068 (90% CI = 0.054-0.082); SRMR = 0.055; TLI = 0.936], revealing no significant effect of the number of participation-focused caregiver strategies on the relationships between participation-related constructs (e.g., activity competence, environment/context) and community participation in terms of attendance and involvement. The qualitative findings revealed three main categories for how caregivers explained these quantitative results: (1) caregiver workload and supports needed for implementing strategies; (2) caregivers careful strategy quality appraisal; and (3) community setting characteristics hindering successful strategy implementation. Discussion The findings suggest that the insignificant effect of the number of caregiver strategies may be explained by the intensified need for caregiver effort and support to develop and implement quality strategies that are responsive to community setting characteristics.
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Affiliation(s)
- Vera C. Kaelin
- Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
- Computer Science, University of Illinois Chicago, Chicago, IL, United States
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
- Computing Science, Umeå University, Umeå, Sweden
| | - Shivani Saluja
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
| | - Dianna L. Bosak
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, CA, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United States
| | - Martha Werler
- Epidemiology, Boston University, Boston, MA, United States
| | - Mary A. Khetani
- Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United States
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Alves MLDF, Souto DO, Romeros ACSF, Magalhães EDD, Mendes LG, Ayupe KMA, Chagas PSDC, de Campos AC, Moreira RS, de Toledo AM, Camargos ACR, Longo E, Leite HR, Morais RLDS. Characterization of environmental factors in children and adolescents with cerebral palsy in Minas Gerais: Participa Minas. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2024; 42:e2023043. [PMID: 38359317 PMCID: PMC10877669 DOI: 10.1590/1984-0462/2024/42/2023043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/03/2023] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To characterize the environmental factors of children and adolescents with Cerebral Palsy (CP) in the state of Minas Gerais (MG), Brazil. METHODS This is a cross-sectional study involving 164 caregivers of children/adolescents with CP, aged 1-14 years. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were used to classify the participants' functioning, and environmental factors were evaluated by an on-line questionnaire that examined products and technologies, physical environment, services, and systems. A descriptive analysis was performed using percentage and frequency. RESULTS Most participants had bilateral CP (66.9%) and 45% of them were spastic. Levels II and V of the GMFCS and MACS were the most frequent. About half (49.4%) used anticonvulsants, 27.4% underwent botulinum toxin application, and 29% went through orthopedic surgery in the lower limbs. Among the participants, 71.3% used orthoses in the lower limbs, and 51.8% used the public health care system. Most had access to physiotherapy (91.5%), but found difficulties to access interventions with other professionals, such as psychologists (28%) and nutritionists (37.8%). The school was the most frequently adapted environment (78%), and had the highest level of structural adaptation (42.7%). CONCLUSIONS The results of this study suggest that the barriers to access health services and barriers to the physical environment may impact participation and social inclusion.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Egmar Longo
- Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
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Bani Odeh K, Lach LM. Barriers to, and facilitators of, education for children with disabilities worldwide: a descriptive review. Front Public Health 2024; 11:1294849. [PMID: 38292375 PMCID: PMC10824976 DOI: 10.3389/fpubh.2023.1294849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024] Open
Abstract
Background Inclusionary ideals regarding the education of children with disabilities (CWD) are articulated in various international human rights treaties and instruments such as the United Nations Convention on the Rights (2006), the Salamanca Statement (1994), and the 2030 agenda of the UN's Sustainable Development Goals (SDGs). In the latter, the fourth goal explicitly focuses on the removal of barriers to education and supporting access to quality, equity, and inclusion for people with disabilities. Although data regarding access to education among CWD remains scarce, it is well known that rates of their participation in education remain low, particularly among those in LMICs. The research question of this descriptive review is what are the barriers to and facilitators of education for children with disabilities worldwide aged between 6 and 18 years old? Methods A descriptive review of literature published in English between 2013 and 2021 was conducted following the Joanna Briggs Institute (JBI) guidelines for a scoping review using the following databases: EBSCO, SocINDEX with full text (EBSCO), and ERIC (EBSCO). The search resulted in 7,072 titles and abstracts, which were narrowed down to 1,335 papers for full text review. After data extraction, 54 papers were included in the analysis, with 34 being qualitative, 10 quantitative, and 10 mixed-methods studies. The findings on the facilitators and barriers to education for children with disabilities were analyzed using the International Classification of Function, Disability and Health (ICF) and Urie Bronfenbrenner's Ecological Framework (1979). Results Out of the eligible studies included in our research, 40 were conducted in developing countries, while 14 studies conducted on LMICs. Of the five environmental domains in the ICF, the most significant barriers were found to be that of attitudes and services, while technology and effective communication with school staff were found to play a crucial role in facilitating the education process. Applying Bronfenbrenner's framework, barriers occurred at the micro-system (school level), meso-system (parent and teacher communication), exo-system (services), and macro-system (education policy). Only 3 out of the 54 studies included the voices of CWD. Conclusion Despite documented barriers, facilitators of education for CWD are underexplored, lacking research on their voices. Further investigation is needed.
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Affiliation(s)
- Kifah Bani Odeh
- School of Social Work, McGill University, Montreal, QC, Canada
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Krieger B, Ederer F, Amann R, Morgenthaler T, Schulze C, Dawal B. Translation and cross-cultural adaptation of the young children participation and environment measure for its use in Austria, Germany, and Switzerland. Front Pediatr 2024; 11:1258377. [PMID: 38239598 PMCID: PMC10794623 DOI: 10.3389/fped.2023.1258377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Background Concepts such as participation and environment may differ across cultures. Consequently, cultural equivalence must be assured when using a measure like the Young Children Participation and Environment Measure (YC-PEM) in other settings than the original English-speaking contexts. This study aimed to cross-culturally translate and adapt the YC-PEM into German as it is used in Germany, Austria, and Switzerland. Methods Following international guidelines, two translations were compared, and the research and expert team made the first adaptations. Twelve caregivers of children with and without disabilities from three German-speaking countries participated in two rounds of think-aloud interviews. Data were analyzed by content analysis to look for item, semantic, operational, conceptual, and measurement equivalence to reach a cultural equivalence version in German. Results Adaptations were needed in all fields but prominently in item, operational, and conceptual equivalence. Operational equivalence resulted in graphical adaptations in the instructions and questions to make the German version of YC-PEM, YC-PEM (G), more user-friendly. Conclusion This study presents a cross-cultural translation and adaptation process to develop a German version of the YC-PEM suitable for Germany, Austria, and Switzerland. A culturally adapted YC-PEM (G) is now available for research, practice, and further validation.
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Affiliation(s)
- Beate Krieger
- Institute of Occupational Therapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Friedrich Ederer
- Department of Economic and Social Sciences, Institute for Social Medicine, Rehabilitation Sciences and Health Services Research, Nordhausen University of Applied Sciences, Nordhausen, Germany
| | - Ruth Amann
- Department of Occupational Therapy, Graz University Clinic for Pediatrics and Adolescents Medicine, Graz, Austria
| | - Thomas Morgenthaler
- Institute of Occupational Therapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Christina Schulze
- Institute of Occupational Therapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Britta Dawal
- Department of Education and Social Sciences, South Westphalia University of Applied Sciences, Soest, Germany
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Lo OYH, Wong YM, Kwok NT, Ma PS, Chien CW. Relationship Between Change in Participation and Later Mental Health Problems in Children. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492231216663. [PMID: 38164901 DOI: 10.1177/15394492231216663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Participation in everyday activities is beneficial for mental health. However, little is known about the extent to which changes in children's participation are associated with later mental health. OBJECTIVES To investigate the association between changes in the frequency and involvement in home, school, and community activities and subsequent mental health problems in children. Methodology: We recruited 242 school-aged children. Their parents completed the Participation and Environment Measure for Children and Youth twice, and after 2 years, they completed the Strengths and Difficulties Questionnaire. RESULTS After controlling for demographic factors, hierarchical regression analysis revealed that reductions in children's involvement in home and community activities were significantly associated with elevated levels of externalizing and internalizing problems. Furthermore, an increase in children's involvement in school activities showed significant relationships with better mental health outcomes. CONCLUSION These findings inform participation-based interventions for occupational therapists aimed at mitigating children's future mental health problems.
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Affiliation(s)
- Oi Ying Heidi Lo
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Yi Man Wong
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Nga Ting Kwok
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Pui-Sze Ma
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Chi-Wen Chien
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
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Krieger B, Piškur B, Beurskens AJHM, Moser A. Parents' perceptions: Participation patterns and desires for change for children and adolescents with autism spectrum disorder-A descriptive population-based study from Switzerland. Child Care Health Dev 2024; 50:e13155. [PMID: 37487595 DOI: 10.1111/cch.13155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/21/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Low participation in youth with autism spectrum disorder (ASD) has been reported, but age-related and contextual information is rare. OBJECTIVE This study aimed to describe, from parental perspectives, two patterns of participation and parental desires for change of children (age: 5-11) and adolescents (age: 12-17) with ASD in Switzerland. METHOD A cross-sectional design used the German version of the Participation and Environment Measure-Child and Youth to describe and juxtapose the participation results of 60 children and 55 adolescents with ASD in 45 activities at home, school and in the community and parental desires for change. RESULTS Participation patterns differed between settings and age groups. Both groups were found to participate most at home, followed by school, whereas community participation was either low or nonexistent. Children were more involved at home than adolescents, while school involvement was higher than participation frequency in both age groups. Community participation frequency was generally low but higher in children than in adolescents, while involvement was similarly low in both groups. Half the parents expressed desire for change with three tendencies: (1) widespread desire for change at home due to high support needs, (2) parents of adolescents expressed more desire for change in all settings than those of children and (3) all parents mainly desired to increase participation frequency and involvement. CONCLUSIONS This study informs research and social, health and community service providers to further reshape their programmes to meet parental needs and increase the participation of youth with ASD.
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Affiliation(s)
- Beate Krieger
- School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Hasselt University, Faculty of Rehabilitation Sciences, Hasselt, Belgium
| | - Anna J H M Beurskens
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Albine Moser
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
- Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Wang Z, Golos A, Weiss JA, Anaby D. Participation of Children With Autism During COVID-19: The Role of Maternal Participation. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:13-24. [PMID: 37089012 PMCID: PMC10125891 DOI: 10.1177/15394492231164939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Little is known about participation during adverse times. OBJECTIVES This study described participation of children with autism aged 6 to 13 during COVID-19 pandemic and examined the extent to which child factors, mother's own participation, and environmental barriers/supports explain child participation in home and community. METHOD A total of 130 mothers completed the Participation and Environment Measure for Children and Youth, the Health Promoting Activities Scale, functional issues checklist, and sociodemographic questionnaire. RESULTS Children's participation frequency and involvement were significantly higher at home than in the community. In both settings, mothers desired change in 71% of activities. Multiple regression models indicated that child's age and mother's participation frequency significantly explained child's home involvement (R2 = 21%), where mother's participation (frequency) had a unique contribution (ΔR2 = 10.4%) at home but not in the community. CONCLUSION Findings imply the importance of maternal participation to child's participation at home and suggest redirecting attention for enhancing family participation as a whole.
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Affiliation(s)
- Ziru Wang
- McGill University, Montreal, Quebec, Canada
| | - Anat Golos
- The Hebrew University, Jerusalem, Israel
| | | | - Dana Anaby
- McGill University, Montreal, Quebec, Canada
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Munsell EGS, Coster WJ. How have Participation Outcomes of Autistic Young Adults been Measured? A Scoping Review. J Autism Dev Disord 2023; 53:4424-4437. [PMID: 36068380 DOI: 10.1007/s10803-022-05725-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 11/26/2022]
Abstract
Autistic young adults experience challenges participating in the workforce, post-secondary schooling, and living in the community. We examined how participation outcomes have been measured in autistic young adults. Articles (n = 113) were identified through database searches and citation tracking. Guided by current models in the literature, data were extracted for each measure of participation. Results include a description of the studies in the review, the extent to which participation across life situations has been addressed, and a critical analysis of the measures used to describe participation. While there is some breadth in the investigation of participation across diverse life situations, there is limited depth in what the measures capture and many measures used lack psychometric support.
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Affiliation(s)
- Elizabeth G S Munsell
- Center for Education in Health Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St, Chicago, IL, 60611, USA.
| | - Wendy J Coster
- Occupational Therapy Department, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
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Sakzewski L, Reedman SE, Elliott C, Ziviani J, Novak I, Trost S, Majnemer A, Comans T, Shikako K, Ware RS, McNamara L, Williams S, Keramat SA, Brookes D, Boyd RN. Participate CP 2: optimising participation in physically active leisure for children with cerebral palsy - protocol for a phase III randomised controlled trial. BMJ Open 2023; 13:e075570. [PMID: 37788925 PMCID: PMC10551958 DOI: 10.1136/bmjopen-2023-075570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
INTRODUCTION Children with cerebral palsy (CP) participate less in physical activities and have increased sedentary behaviour compared with typically developing peers. Participate CP is a participation-focused therapy intervention for children with CP with demonstrated efficacy in a phase II randomised controlled trial (RCT) to increase perceived performance of physical activity participation goals. This study will test the effectiveness of Participate CP in a multisite phase III RCT. METHODS AND ANALYSIS One hundred children with CP, aged 8-14 years, classified Gross Motor Function Classification System levels I-IV will be randomised to either (1) receive Participate CP once/week for 1 hour for 12 weeks, or (2) waitlist control, usual care group. The waitlist group will then receive Participate CP following the 26-week retention time point. Outcomes will be assessed at baseline, 12 weeks and then 26 weeks post baseline. The primary outcomes are (1) self-reported participation goal performance on the Canadian Occupational Performance Measure at 12 weeks and (2) daily time in moderate-to-vigorous physical activity. Secondary outcomes include home and community participation frequency, involvement and environmental supportiveness, contextual barriers to participation, quality of life, intrinsic motivation for physical activities, child perception of an autonomy-supportive climate for physical activities and physical literacy at 12 and 26 weeks post study entry. ETHICS AND DISSEMINATION The Children's Health Queensland Hospital and Health Service, The University of Queensland and the New Zealand Health and Disability Ethics Committees have approved this study. Findings will be disseminated in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12618000206224.
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Affiliation(s)
- Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Sarah Elizabeth Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Catherine Elliott
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Science, The University of Queensland - Saint Lucia Campus, Saint Lucia, Queensland, Australia
| | - Iona Novak
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Stewart Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
| | - Tracy Comans
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Keiko Shikako
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Lynda McNamara
- Physiotherapy Department, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sian Williams
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Syed Afroz Keramat
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Denise Brookes
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
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Kaya Kara O, Kara K, Dogan M, Tascioglu EN, Kose B, Cetin SY, Sahin S, Anaby D. How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports? RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 141:104592. [PMID: 37639883 DOI: 10.1016/j.ridd.2023.104592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Children with chronic conditions face participation restrictions and exclusions. AIMS To investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). METHODS AND PROCEDURES The study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners' Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. OUTCOME AND RESULTS In home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). CONCLUSIONS AND IMPLICATIONS When seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges.
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Affiliation(s)
- Ozgun Kaya Kara
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey.
| | - Koray Kara
- University of Health Sciences Turkey, Antalya Training and Research Hospital, Department of Child and Adolescent Psychiatry, Antalya, Turkey
| | - Mert Dogan
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey
| | - Elif Nur Tascioglu
- Pamukkale University, Faculty of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Barkin Kose
- University of Health Sciences Turkey, Faculty of Gülhane Health Sciences, Department of Occupational Therapy, Turkey
| | - Sebahat Yaprak Cetin
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey
| | - Sedef Sahin
- Hacettepe University, Faculty of Health Sciences, Department of Occupational Therapy, Ankara, Turkey
| | - Dana Anaby
- McGill University, Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, Montreal, Canada
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Simpson K, Adams D. Parent-reported environmental factors and strategies to support home and community participation in children on the autism spectrum. Disabil Rehabil 2023:1-10. [PMID: 37772748 DOI: 10.1080/09638288.2023.2261843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Participating in home and community activities can be influenced by environmental factors and parent strategies. Children on the autism spectrum are reported to participate less in home and community activities than their neurotypical peers. Little is known about environmental factors that may influence their participation, and ways parents support their child's participation. MATERIALS AND METHODS Parents of children on the autism spectrum aged 5-6 years (n = 72) and 10-11 years (n = 94) completed the Participation and Environment Measure for Children and Youth. This study reports on the perceived support, barriers, and resources in the home and the community environment. Parents reported strategies they used to support their child's participation in home and the community. RESULTS Home environmental factors were identified as more supportive by the parents of younger children. The sensory quality of activities and social demands were factors identified as making community participation harder for both groups. Parents used a range of different strategies in the home and the community to support their child's participation. CONCLUSIONS Identifying environmental barriers and supports to participation can assist in developing interventions to support meaningful participation in activities for children on the autism spectrum.Implications for rehabilitationSkills required for the activity and preferences of children on the autism spectrum are important considerations when supporting their participation in activities.When exploring a child's level of participation, it may be helpful to ask parents about what their child can do with or without their support.The sensory quality of the environment is a consideration when supporting the participation of children on the autism spectrum in community activities.As sensory processing is an individual experience, the impact of sensory elements of the environment may differ for individuals.
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Affiliation(s)
- Kate Simpson
- School of Education and Professional Studies, Autism Centre of Excellence, Griffith University, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Brisbane, Australia
| | - Dawn Adams
- School of Education and Professional Studies, Autism Centre of Excellence, Griffith University, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Brisbane, Australia
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Shahin S, Ahmed S, DiRezze B, Anaby D. Reliability and Validity of the Youth and Young-Adult Participation and Environment Measure (Y-PEM): An Initial Evaluation. Phys Occup Ther Pediatr 2023; 44:232-247. [PMID: 37415271 DOI: 10.1080/01942638.2023.2232030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
AIM To examine psychometric properties and aspects of utility of the Youth and young-adult Participation and Environment Measure (Y-PEM). METHODS Young people with and without physical disabilities (n = 113) aged 12 to 31 (x¯ = 23; SD = 4.3) completed an online survey containing the Y-PEM and QQ-10 questionnaire. To examine construct validity, differences in participation levels and environmental barriers/facilitators were examined between those with (n = 56) and without disabilities (n = 57) via t-test. Internal consistency was computed using Cronbach's alpha. To examine test-retest reliability, a sub-sample of 70 participants completed the Y-PEM a second time, 2-4 weeks apart. The Intraclass correlation coefficient (ICC) was calculated. RESULTS Descriptively, participants with disabilities had lower levels of frequency and involvement across all four settings: home, school/educational, community, workplace. Internal consistency were 0.71 and above (up to 0.82) across all scales with the exception of home (0.52) and workplace frequency (0.61). Test-retest reliability were 0.70 and above (up to 0.85) across all settings except for environmental supports at school (0.66) and workplace frequency (0.43). Y-PEM was perceived as a valuable tool with relatively low burden. CONCLUSIONS Initial psychometric properties are promising. Findings support Y-PEM's use as a feasible self-reported questionnaire for individuals aged 12-30 years old.
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Affiliation(s)
- Saeideh Shahin
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), CIUSSS Central-West Montreal, Montreal, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), CIUSSS Central-West Montreal, Montreal, Canada
| | - Briano DiRezze
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), CIUSSS Central-West Montreal, Montreal, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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18
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Golos A, Vidislavski S, Anaby D. Participation Patterns of Israeli Children with and without Autism, and the Impact of Environment. Phys Occup Ther Pediatr 2023; 44:143-160. [PMID: 37415267 DOI: 10.1080/01942638.2023.2230269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Abstract
AIMS Participation is vital to children's quality of life, yet it is often limited for those with autism spectrum disorder (ASD). An improved understanding of the factors that may support or hinder their participation is important. This study aims to explore the participation patterns of children with and without ASD in the home, school, and community settings, as well as to explore the impact of environmental factors on the participation of children with ASD. METHODS 78 parents of children aged 6-12, attending mainstream educational settings (30 with ASD; 48 without ASD) completed the Participation and Environment Measure for Children and Youth and a demographic questionnaire. RESULTS Children with ASD were rated significantly lower than children without ASD in participation, and their parents expressed a greater desire to change their participation while reporting lower overall environmental support. Among the ASD group, significant differences in participation were found across the three settings, with the highest participation scores at home. Environmental factors that support or limit children's participation were identified. CONCLUSIONS The results highlight the importance of environmental factors in children's participation. It is essential to evaluate different environmental settings; identifying the supportive and limiting environmental factors will enhance interventions for children with ASD.
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Affiliation(s)
- Anat Golos
- Head of Environment and Participation in Community Laboratory; School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
- Ministry of Education, School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Shira Vidislavski
- Ministry of Education, School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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Amalfi A, Li JY, Théberge-Lamoureux V, Tang C, Rinaldi E, Khayargoli P, Anaby D. Mental health problems among transition-aged youth with physical disabilities: an initial evaluation. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1069464. [PMID: 37214127 PMCID: PMC10196478 DOI: 10.3389/fresc.2023.1069464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/14/2023] [Indexed: 05/24/2023]
Abstract
Aim Decreased participation and complex transitions into adulthood among youth with disabilities may impede their well-being. To advance knowledge on the co-occurrence of mental health problems and physical disability, this brief report describes the frequency of mental health problems, measured by the Behavior Assessment System of Children (BASC-3), among transition-aged youth (14-25 years) with physical disabilities and examines the association between mental health problems and sex, age, and number of functional issues. Methods Thirty-three participants completed a demographic questionnaire and the BASC-3. Frequency of BASC-3 scales falling within 3 categories: "within norms", "at risk", and "clinically significant" were described. Crosstabs and Chi-square tests were used to examine the association between BASC-3 scales and sex, age (< and ≥ 20), and number of functional issues (< and ≥ 6). Results Overall, "somatization", "self-esteem", "depression" and "sense of inadequacy" were the most common subscales being at risk. Participants with a higher number of functional issues (≥6) were more likely to fall within "at risk" or "clinically significant" categories across 20 (out of 22) BASC-3 scales, and female participants tended to fall more within "at risk" or "clinically significant" categories for 8 of BASC-3 scales. Younger participants (<20) were ranked in the "at risk" or "clinically significant" categories for 7 scales. Conclusions Findings lend further support for the occurrence of mental health problems emerging in youth with physical disabilities and highlight initial trends especially across functional levels. Further investigation of such co-occurrences and the factors that affect their development is needed.
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Affiliation(s)
- Amanda Amalfi
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Jia Yin Li
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | - Carmen Tang
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Emilie Rinaldi
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Pranamika Khayargoli
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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Maciver D, Roy AS, Johnston L, Tyagi V, Arakelyan S, Kramer JM, Richmond J, Romero-Ayuso D, Nakamura-Thomas H. Participation-related constructs and participation of children with additional support needs in schools. Dev Med Child Neurol 2023; 65:498-508. [PMID: 36161442 DOI: 10.1111/dmcn.15390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
Abstract
AIM To investigate associations between participation-related constructs and participation frequency and involvement in inclusive schools. METHOD In this cross-sectional study, teachers of children with additional support needs, including intellectual disability, autism, and learning difficulties, completed measures. Participation-related constructs were measured using the School Participation Questionnaire; participation frequency and involvement were measured using the Participation and Environment Measure for Children and Youth. A series of multilevel linear mixed-effects regression models with maximum likelihood estimates and bootstrap confidence intervals with p-values were obtained. Final models included participation-related constructs and participation, controlling for demographic and diagnostic confounders (including age, sex, language, level of school support, and autism). RESULTS Six hundred and eighty-eight children (448 [65.1%] males; mean age 8 years 7 months [range 4 years 10 months-12 years 13 months, standard deviation 2 years 1 months]) were assessed by 252 teachers. Across a series of models, participation-related constructs were consistently associated with more intensive participation (competence, environment, identity p < 0.001; symptoms p = 0.007), independent of confounders. More frequent participation remained associated with three of four participation-related constructs (competence, identity p < 0.001; environment p = 0.021). Age (p = 0.046), language (p = 0.002), and level of school support (p = 0.039) also remained significantly associated with frequency of participation. INTERPRETATION Children with additional support needs in inclusive schools may have several participation barriers. Policies and interventions to improve participation are needed. WHAT THIS PAPER ADDS Across a series of models, participation-related constructs were associated with frequency and intensity of participation. Only participation-related constructs were associated with participation intensity. Demographic and diagnostic variables were associated with frequency, not intensity, of participation. Teacher assessment is valid for assessment of participation and participation-related constructs.
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Affiliation(s)
- Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Anusua Singh Roy
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
- Additional Support for Learning Service, Communities and Families, City of Edinburgh Council, Edinburgh, UK
| | - Vaibhav Tyagi
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Stella Arakelyan
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Jessica M Kramer
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Florida, USA
| | - Janet Richmond
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Dulce Romero-Ayuso
- Department of Physical Therapy, Occupational Therapy Division, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Hiromi Nakamura-Thomas
- Saitama Prefectural University, Graduate School of Health, Medicine and Welfare, Saitama, Japan
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Smith J, Halliwell N, Laurent A, Tsotsoros J, Harris K, DeGrace B. Social Participation Experiences of Families Raising a Young Child With Autism Spectrum Disorder: Implications for Mental Health and Well-Being. Am J Occup Ther 2023; 77:24095. [PMID: 37083974 PMCID: PMC10137595 DOI: 10.5014/ajot.2023.050156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
IMPORTANCE Social participation (SP) is an important facilitator of positive mental health for children and families. Children are dependent on their families to mediate SP, yet families of children with autism spectrum disorder (C-ASD) seemingly limit SP because of behavioral and functional challenges in community environments. The resulting isolation can affect the child's and the family's mental health. OBJECTIVE To distill the essence of everyday SP experiences in the community of families raising C-ASD. DESIGN Data collected via in-depth, semistructured interviews with a purposive sample and analyzed in the phenomenological tradition. SETTING Community. PARTICIPANTS We recruited seven families with English-speaking parents (ages 18-64 yr) raising one C-ASD (age 2-8 yr). Families with more than one C-ASD or those whose C-ASD was diagnosed with complex medical condition or a neurological or genetic disorder were excluded. RESULTS The essence of experiences of SP emerged in the form of three themes depicting the mismatch between societal expectations for SP and families' experience: (1) "the struggle," (2) "it's hard to feel like you belong," and (3) what we "have to do." CONCLUSIONS AND RELEVANCE As a collective, families expressed desire for everyday community SP and could do so only in select environments with core groups. The findings, as interpreted through the lens of mental health promotion, reveal opportunities to reduce barriers and to promote meaningful family SP so as to facilitate positive mental health and well-being through the transactional intersecting characteristics of the child with ASD, the family, and the community. What This Article Adds: This study illuminates the experience of SP of families raising a young C-ASD, highlighting both supports and barriers. Practitioners can use this information to potentially prevent isolation and promote both child and family mental health and well-being.
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Affiliation(s)
- Julie Smith
- Julie Smith, DSc, OTR/L, is Early Intervention Lead, Oklahoma County, Family Health Services, Oklahoma State Department of Health, Oklahoma City, OK. At the time of the study, Smith was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Nicole Halliwell
- Nicole Halliwell, DSc. OTR/L, is Assistant Professor, Occupational Therapy Department, Marjorie K. Unterberg School of Nursing and Health Sciences, Monmouth University, West Long Branch, NJ. At the time of the study, Halliwell was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City;
| | - Amy Laurent
- Amy Laurent, PhD, OTR/L, is Codirector, Autism Level UP!, North Kingstown, RI. At the time of the study, Laurent was Adjunct Faculty, Department of Psychology, University of Rhode Island, Kingston
| | - Jessica Tsotsoros
- Jessica Tsotsoros, PhD, OTR/L, is Associate Professor and International Experience Coordinator, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Tulsa
| | - Katelyn Harris
- Katelyn Harris, OTR/L, is Occupational Therapist, Intervention Center for Early Childhood, Irvine, CA
| | - Beth DeGrace
- Beth DeGrace, PhD, OTR/L, FAOTA, is Director of Kids Ministry, Crossings Community Church, Oklahoma City, OK. At the time of the study, DeGrace was Associate Professor, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
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22
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Guichard S, Coelho V, Grande C. Environment Mediates the Relationship Between Preschoolers Functioning and Involvement in Out-of-School Activities. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:52-60. [PMID: 35382626 DOI: 10.1177/15394492221083943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This study aims to understand the associations between child functioning and environmental barriers and the involvement of preschool children, with and without disabilities, in out-of-school activities, namely, home and community activities. Particularly, we aimed to investigate if environmental barriers mediate the relationship between child functioning and their involvement in these activities. Parents of 116 preschool-aged children (42 children with disabilities) reported on children's involvement and environmental factors at home and in the community. Preschool teachers assessed child functioning. Multiple linear regressions and mediation analysis were performed. Results indicated significant associations between child functioning, perceived environmental barriers, and involvement at home and in the community. A significant indirect association of child functioning on involvement through the perception of environmental barriers was found in both contexts. Findings support the biopsychosocial model of participation and a focus on environmental features by practitioners designing and implementing intervention strategies.
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Affiliation(s)
- Sofia Guichard
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Vera Coelho
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Portugal.,University of Maia, Porto, Portugal
| | - Catarina Grande
- Center for Psychology at University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Yoo PY, Majnemer A, Bolduc LA, Chen K, Lamb E, Panjwani T, Wilton R, Ahmed S, Shikako K. Content development of the Child Community Health Inclusion Index: An evaluation tool for measuring inclusion of children with disabilities in the community. Child Care Health Dev 2023; 49:44-53. [PMID: 35301741 DOI: 10.1111/cch.13004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/16/2022] [Accepted: 03/12/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Addressing barriers in the environment can contribute to health and quality of life for children with disabilities and their families. The Community Health Inclusion Index (CHII) is a measurement tool developed in the United States to identify environmental barriers and facilitators to community health inclusion. The CHII adopts an adult viewpoint and aspects crucial for children may have been omitted. AIMS This study aimed to develop a comprehensive list of items that are relevant for the community inclusion of children with disabilities in the Canadian context. METHODS The relevance and priority of items generated from a review of existing guidelines and best practice recommendations for community inclusion were rated as a dichotomous response and discussed by an expert panel in relevant fields related to children with disabilities. RESULTS A total of 189 items from 12 instruments and best practice guidelines were identified. Expert consensus contributed to a relevant and comprehensive list of items. Expert suggestions were considered to refine and reduce the item list. CONCLUSION This study highlights the importance of a child version of a community inclusion tool, as the needs of children with disabilities differ from those of adults. It can help communities improve inclusion of children with disabilities and inform health promotion initiatives for this population.
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Affiliation(s)
- Paul Yejong Yoo
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Laury-Anne Bolduc
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Karen Chen
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Erin Lamb
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Tanisha Panjwani
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Robert Wilton
- School of Geography and Earth Sciences, McMaster University, Hamilton, Ontario, Canada.,Faculty of Social Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Keiko Shikako
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre Research Institute, Montreal, Quebec, Canada
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Xia C, Jing Q, Chen G, Sun M, Lu J. Association between Participation of Children with Disabilities and the Child, Family, and Environmental Factors in Shanghai, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:615. [PMID: 36612936 PMCID: PMC9819672 DOI: 10.3390/ijerph20010615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Participation is essential to a child's health and well-being, whereas children with disabilities may lack the associated benefits because of physical restrictions. This study aims to examine the association between the participation of children with disabilities and the child, family, and environmental factors. A total of 433 children with disabilities aged 3-18 and their family caregivers were included. Three binary logistic regression models were respectively established to identify the significant factors associated with children's home, school, and community participation. Our main empirical results showed that among 433 children with disabilities, 44.3%, 47.6%, and 58.7% of them never or seldom participated in home, school, and community activities. Child and family factors were found to be dominantly associated with children's participation, and significant factors associated with the home, school, and community participation of children were different, including children's disability type, sleep problems and emotional stability, caregivers' education, mental HRQOL, rehabilitation belief, and number of children in the family. These results highlight that the participation of children with disabilities in mainland China urgently needs to be enhanced, and further research might be focused on validating the causal relationships between participation and significant child and family factors identified in this study.
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Affiliation(s)
- Cong Xia
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Qi Jing
- School of Management, Weifang Medical University, Weifang 261053, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261053, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Mei Sun
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai 200032, China
- China Research Center on Disability, Fudan University, Shanghai 200032, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261053, China
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Kelly G, Wales L, Owen L, Perkins A. Young People's Experiences of Returning to Physical Leisure Activities after a Severe Acquired Brain Injury. Phys Occup Ther Pediatr 2022:1-14. [PMID: 36450702 DOI: 10.1080/01942638.2022.2151394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
AIMS To understand the experiences of young people returning to physical leisure activities following a severe acquired brain injury (ABI). METHODS Seven young people (5 male; 14-19 years) participated. Semi-structured interviews were conducted with young people who sustained a severe ABI 1-3 years prior to the study. Data thematically analyzed using Braun and Clarke's six-phase approach. RESULTS Three main themes were created: My changing sense of identity around physical activity after my brain injury (how important physical activity was to them, how participation changed following their ABI); Why I take part in physical leisure activities (fun, friendships, help with recovery and physical and emotional health); and I can't do it alone (need for trusted adults to practically and emotionally support them to try and activities and continue to participate). DISCUSSION Returning to physical leisure activities after ABI was important to young people, especially if they were active prior to their injury. However, participating with changed abilities was practically and emotionally challenging. Services need a multidisciplinary approach to ensure young people are supported with psychological processes of loss, adjustment, identity and resilience in addition to the practical help necessary to enable meaningful participation in activities they consider fun.
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Daly G, Jackson J, Lynch H. Family life and autistic children with sensory processing differences: A qualitative evidence synthesis of occupational participation. Front Psychol 2022; 13:940478. [PMID: 36389552 PMCID: PMC9651035 DOI: 10.3389/fpsyg.2022.940478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Autistic children with sensory processing differences successfully navigate and engage in meaningful family daily occupations within home and community environments through the support of their family. To date however, much of the research on autistic children with sensory processing differences, has primarily been deficit focused, while much of the caregiver research has focused on issues of distress, burden, effort, and emotional trauma in coping with their child's diagnosis. This study aimed to conduct a qualitative evidence synthesis, using a meta-ethnographic approach to explore the gap identified in understanding successful occupational experiences of family participation and daily family routines when supporting an autistic child with sensory processing differences and to offer an alternative strengths-based perspective. Inclusion criteria were studies which were peer-reviewed qualitative design, published from 2000 to 2021, and that concerned parents/caregivers' perspectives of family occupations of children diagnosed with autism spectrum disorder. Studies were electronically searched in eight databases from October to December 2021 and 23 studies were identified which met the inclusion criteria. Noblit and Hare's seven step approach for conducting analysis in meta-ethnography was used, and three themes identified: (1) sensory processing differences in daily life, (2) what is hard about hard, and (3) orchestrating family life. Results identified the centrality of sensory experiences in understanding family life. Living with unpredictability while orchestrating certainty through routines was core to successful participation. This review provides insights into how parents negotiate the complexities of constructing family life when living with an autistic child. The results can inform the design of future interventions that specifically address the relationship between meaningful participation in family occupations and daily routines and sensory processing in autistic children.
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Salters D, Rios PC, Scharoun Benson SM. Instructors' Perspectives of Social and Motor Influences on Participation in Children With Autism Spectrum Disorder. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:467-478. [PMID: 34252342 DOI: 10.1080/02701367.2020.1864260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/09/2020] [Indexed: 06/13/2023]
Abstract
Participation is key to childhood development and is essential for health and well-being; yet children with Autism Spectrum Disorder (ASD) participate less in social and physical activities compared to their typically developing peers and little is known about how social and motor challenges impact participation patterns. Purpose: The current research garnered experiential insights of the quality and quantity of participation, through the lens of instructors (N = 9) working with a child or children with ASD. Method: Semi-structured qualitative interviews were conducted to capture a comprehensive and informative profile of how social and motor functioning of children with ASD influence involvement in social and physical activities. Results: Thematic analysis revealed consistent viewpoints in four main areas: (1) Viewpoints extend beyond the World Health Organization definition of participation; (2) Participation depends on who is involved; (3) Although motivation, confidence, and competence in social/motor domains underlie participation, social challenges were perceived as the greatest barrier; (4) While acknowledging the benefits of participation, it is necessary to be cognizant of the required supports. Throughout these themes, the notion of heterogeneity was made very clear. Conclusion: Collectively, perspectives offer descriptive insight which may be useful when designing opportunities for participation in social and physical activities among children with ASD.
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Ploypetch T, Buasuk C, Pajareya K. Participation restriction of children with cerebral palsy living in Thailand and influential factors: A cross-sectional study. Dev Neurorehabil 2022; 25:392-399. [PMID: 35226592 DOI: 10.1080/17518423.2022.2047121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore participation in daily activities of children with cerebral palsy(CP) in Thailand and influential factors. METHODS A convenience sample of family-caregivers of 80 children with CP, 6-18 year-old, completed self-administered questionnaires (i.e., frequency of participation, Gross Motor Function Classification System-Family Report) during clinic visits at a university hospital. RESULTS Family-caregivers reported that more than one-third of the children never participated in outdoor activities. The gap in the frequency of participation between groups with high versus low motor function was very high. Better gross motor and communication were strong predictors of participation. Caregiver's education and family income were associated with participation in art/cultural, leisure and tourist activities. CONCLUSIONS Family-caregiver-report suggests that Thai-children with CP, especially those with severe impairments, have limited participation in daily activities. Increasing mobility and communication may promote the participation. Comprehensive intervention is needed to narrow the participation gap found between high and low functioning children.
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Affiliation(s)
- Teerada Ploypetch
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkoknoi, BKK, THAILAND
| | - Chanokbhorn Buasuk
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkoknoi, BKK, THAILAND
| | - Kingkaew Pajareya
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkoknoi, BKK, THAILAND
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Maciver D, Tyagi V, Johnston L, Kramer JM, Richmond J, Todorova L, Romero-Ayuso D, Nakamura-Thomas H, van Hartingsveldt M, O'Hare A, Forsyth K. Psychometric properties of the School Participation Questionnaire: Testing a measure of participation-related constructs. Dev Med Child Neurol 2022; 64:847-854. [PMID: 35100436 DOI: 10.1111/dmcn.15146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 11/03/2021] [Accepted: 11/26/2021] [Indexed: 11/26/2022]
Abstract
AIM To explore concurrent validity, convergent validity, interrater reliability, test-retest reliability, and Rasch model analysis of the School Participation Questionnaire (SPQ), a tool for teachers to assess personal and environmental determinants of school participation. METHOD Teachers of children with additional support needs, including intellectual disability, autism, and learning difficulties completed measures. Data were collected using the SPQ and the Participation and Environment Measure for Children and Youth (PEM-CY). Test-retest and interrater reliability were assessed using intraclass correlation coefficients (ICCs). Internal consistency was assessed with Cronbach's alpha. Concurrent and convergent validity were explored via correlations with the PEM-CY. Further psychometrics were examined using a Rasch model. RESULTS One hundred and eighty-seven children (136 [72.7%] male; mean age 9y [range 5y 6mo-12y 10mo, SD 2y]) were assessed by 67 teachers. Cronbach's alpha, test-retest, and interrater reliability were acceptable-excellent across each SPQ scale (alphas=0.89, 0.9, 0.94, 0.79; test-retest ICCs=0.64, 0.61, 0.78, 0.62; interrater ICCs=0.85, 0.71, 0.90, 0.81). Concurrent and convergent validity were confirmed with significant positive correlations between SPQ and PEM-CY. After Mokken and Rasch model analysis, person and item reliability were good, and unidimensionality was confirmed. Mean administration time was 8.2 minutes. INTERPRETATION The results suggest that the SPQ is a rapid, reliable, and valid tool for assessment of participation-related indicators in schools.
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Affiliation(s)
- Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Vaibhav Tyagi
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
- Additional Support for Learning Service, Communities and Families, City of Edinburgh Council, Edinburgh, UK
| | - Jessica M Kramer
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Janet Richmond
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Liliya Todorova
- Occupational Therapy, Faculty of Public Health and Health Care, University of Ruse, Ruse, Bulgaria
| | - Dulce Romero-Ayuso
- Occupational Therapy Division, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Hiromi Nakamura-Thomas
- Graduate School of Health, Medicine and Welfare, Saitama Prefectural University, Saitama, Japan
| | - Margo van Hartingsveldt
- Faculty of Health, Urban Vitality Centre of Expertise, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Anne O'Hare
- Child Life and Health, Salvesen Mindroom Research Centre, Edinburgh University, Edinburgh, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
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Hodges A, Cordier R, Joosten A, Bourke-Taylor H. Closing the Gap Between Theory and Practice: Conceptualisation of a School-Based Intervention to Improve the School Participation of Primary School Students on the Autism Spectrum and Their Typically Developing Peers. J Autism Dev Disord 2022; 52:3230-3245. [PMID: 34862953 PMCID: PMC9213293 DOI: 10.1007/s10803-021-05362-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 10/29/2022]
Abstract
Limited interventions exist that support student's school participation. This paper describes a theoretical model of school participation and the iterative process that led to the development of an intervention that aims to improve the school participation of students on the autism spectrum and their typically developing peers. Literature on autism, school participation and intervention research were integrated to develop a theoretical model. Focus groups, a Delphi study, online surveys, and reference group consultation helped to develop and refine the intervention. A novel school-based intervention was developed. The impetus to develop interventions with a strong theoretical rationale is discussed.
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Affiliation(s)
- Amy Hodges
- Curtin School of Allied Health, Curtin University, Perth, WA Australia
| | - Reinie Cordier
- Curtin School of Allied Health, Curtin University, Perth, WA Australia
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Annette Joosten
- Curtin School of Allied Health, Curtin University, Perth, WA Australia
- School of Allied Health, Australian Catholic University, Melbourne, VIC Australia
| | - Helen Bourke-Taylor
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, VIC Australia
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Kaelin VC, Valizadeh M, Salgado Z, Sim JG, Anaby D, Boyd AD, Parde N, Khetani MA. Capturing and Operationalizing Participation in Pediatric Re/Habilitation Research Using Artificial Intelligence: A Scoping Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3. [PMID: 35919375 PMCID: PMC9340801 DOI: 10.3389/fresc.2022.855240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background There is increased interest in using artificial intelligence (AI) to provide participation-focused pediatric re/habilitation. Existing reviews on the use of AI in participation-focused pediatric re/habilitation focus on interventions and do not screen articles based on their definition of participation. AI-based assessments may help reduce provider burden and can support operationalization of the construct under investigation. To extend knowledge of the landscape on AI use in participation-focused pediatric re/habilitation, a scoping review on AI-based participation-focused assessments is needed. Objective To understand how the construct of participation is captured and operationalized in pediatric re/habilitation using AI. Methods We conducted a scoping review of literature published in Pubmed, PsycInfo, ERIC, CINAHL, IEEE Xplore, ACM Digital Library, ProQuest Dissertation and Theses, ACL Anthology, AAAI Digital Library, and Google Scholar. Documents were screened by 2–3 independent researchers following a systematic procedure and using the following inclusion criteria: (1) focuses on capturing participation using AI; (2) includes data on children and/or youth with a congenital or acquired disability; and (3) published in English. Data from included studies were extracted [e.g., demographics, type(s) of AI used], summarized, and sorted into categories of participation-related constructs. Results Twenty one out of 3,406 documents were included. Included assessment approaches mainly captured participation through annotated observations (n = 20; 95%), were administered in person (n = 17; 81%), and applied machine learning (n = 20; 95%) and computer vision (n = 13; 62%). None integrated the child or youth perspective and only one included the caregiver perspective. All assessment approaches captured behavioral involvement, and none captured emotional or cognitive involvement or attendance. Additionally, 24% (n = 5) of the assessment approaches captured participation-related constructs like activity competencies and 57% (n = 12) captured aspects not included in contemporary frameworks of participation. Conclusions Main gaps for future research include lack of: (1) research reporting on common demographic factors and including samples representing the population of children and youth with a congenital or acquired disability; (2) AI-based participation assessment approaches integrating the child or youth perspective; (3) remotely administered AI-based assessment approaches capturing both child or youth attendance and involvement; and (4) AI-based assessment approaches aligning with contemporary definitions of participation.
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Affiliation(s)
- Vera C. Kaelin
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Mina Valizadeh
- Computer Science, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
| | - Zurisadai Salgado
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Julia G. Sim
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Andrew D. Boyd
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Physical Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Natalie Parde
- Computer Science, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
- Natalie Parde
| | - Mary A. Khetani
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Mary A. Khetani
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Kaelin VC, Wallace ER, Werler MM, Collett BR, Khetani MA. Community participation in youth with craniofacial microsomia. Disabil Rehabil 2022; 44:253-260. [PMID: 32478589 PMCID: PMC7704849 DOI: 10.1080/09638288.2020.1765031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To examine differences in community participation and environmental support for youth with and without craniofacial microsomia. METHODS This study involved secondary analyses of a subset of data (n = 396) from a longitudinal cohort study. Multiple linear and Poisson regression analyses and Wilcoxon Mann-Whitney tests were used to estimate differences in community participation and environmental support between youth with craniofacial microsomia and youth without craniofacial microsomia, stratified based on their history of education and health-related service use. Chi-square analyses were used to explore item-level group differences in change desired across community activities. RESULTS Statistically significant differences were found in community participation frequency (ES = -0.52; p < 0.001), level of involvement (r = -0.16; p = 0.010), and desire for change in participation when comparing youth with craniofacial microsomia and non-affected peers not receiving services (p < 0.001). There were no statistically significant differences between youth with craniofacial microsomia and non-affected peers receiving services. CONCLUSIONS Results suggest lower community participation in youth with craniofacial microsomia as compared to non-affected peers not receiving services. This may suggest opportunities for designing and testing interventions to promote community participation among youth with craniofacial microsomia, so as to support their transition to adulthood.Implications for rehabilitationYouth with craniofacial microsomia may have unmet rehabilitation needs related to their community participation.Rehabilitation professionals should pay attention to participation of youth with craniofacial microsomia in activities that place a higher demand on involvement with others.Rehabilitation professionals should appraise participation frequency and involvement of youths with craniofacial microsomia to gain accurate insight into their current community participation.
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Affiliation(s)
- Vera C. Kaelin
- Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, USA
| | - Erin R. Wallace
- Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, USA
| | - Martha M. Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Brent R. Collett
- Child Psychiatry at Seattle Children’s Hospital and Departments of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Mary A. Khetani
- Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, USA.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada.,Corresponding Author: Mary A. Khetani, ScD, OTR/L, Department of Occupational Therapy, University of Illinois at Chicago, 1919 West Taylor Street, Room 316A, Chicago, IL 60612-7250 Telephone: +1 312-996-0942, Fax: +1 312-413-0256,
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Waisman-Nitzan M, Ivzori Y, Anaby D. Implementing Pathways and Resources for Engagement and Participation (PREP) for Children with Disabilities in Inclusive Schools: A Knowledge Translation Strategy. Phys Occup Ther Pediatr 2022; 42:526-541. [PMID: 35189769 DOI: 10.1080/01942638.2022.2037809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Aims: To examine the effectiveness of PREP (Pathways and Resources for Engagement and Participation) knowledge translation (KT)-program on (a) change in practice behaviors and improved knowledge of school-based occupational therapists, and (b) participation of children with disabilities in inclusive education.Methods: A mixed-methods design was employed. Therapists (n = 39) completed a 30-hour program. Each therapist applied PREP intervention to one child (n = 39) aged 4-15 (Mean = 9.31, SD = 2.4). Therapists' outcomes included: (a) knowledge of PREP evaluated using a clinical vignette, analyzed descriptively, (b) change in practice behavior measured by the Professional Evaluation and Reflection on Change Tool (PERFECT), analyzed thematically. Change in children' participation pre- and post-KT-program and during follow-up was measured by the Canadian Occupational Performance Measure (COPM), analyzed using ANOVA.Results: Therapists acquired knowledge of PREP (vignette mean score 17.7/20). PERFECT revealed therapists' self-perceived changes in practice: incorporating an environmental perspective, expanding partnerships, and redirecting focus on participation. Completing the KT-program was a primary enabler and reason for change. Children's participation significantly improved post KT-program and during follow-up in both performance (p < 0.001) and satisfaction (p < 0.001).Conclusions. KT strategies, as illustrated in this study, accelerated the uptake of evidence-based interventions, minimizing existing 'know-do' gaps and promoting children's health through participation.
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Affiliation(s)
| | - Yonat Ivzori
- Special education, Oranim Academic College of Education, Tivon, Israel
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC
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Bonello M, Farrugia P, Buhagiar N, Mercieca J. Towards a multi-user experience approach to exploring key requirements to design smart habilitation devices for children with cerebral palsy. J Rehabil Assist Technol Eng 2022; 9:20556683221103164. [PMID: 35656533 PMCID: PMC9152188 DOI: 10.1177/20556683221103164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction This paper takes a multi-stakeholder approach to generate key requirements to design smart habilitation devices for children with Cerebral Palsy. Four groups of different relevant stakeholders of smart-habilitation devices were approached to participate in this study, including children with Cerebral Palsy, their parents, occupational therapists, as well as technical specialists. Methods Profiles of children with Cerebral Palsy were generated to have a concrete idea of their needs and desires. Meanwhile, for the three stakeholders, focus groups were used to gather their insights and requirements on a prospective smart habilitation device for children. Successively, a thematic analysis was conducted to analyse the qualitative data obtained during the focus groups. Results Eight design requirements were developed to generate designs which stimulate high quality user experiences in children and other users of smart habilitation devices. In addition, an initial framework of the process that design engineers would follow to design such devices for children was proposed. Conclusion Adopting this framework, and the respective requirements, will help design engineers to implement a multi-user approach and amend the design according to stakeholders' goals and desires. The resulted design should ensure a high quality user experience for both the active and potential passive users of smart habilitation devices.
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Oliveira KSC, Fontes DE, Longo E, Leite HR, Camargos ACR. Motor Skills are Associated with Participation of Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 53:1403-1412. [PMID: 34669103 DOI: 10.1007/s10803-021-05318-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
Children with autism spectrum disorder (ASD) generally have a delay in the development of motor skills when compared to typical children, however, to date, no study has investigated whether motor limitations can interfere in the participation of these children. The objectives of this study were: verify if the motor skills can explain the frequency, the percentage of number of activities, the involvement and the desire to change in participation at home, school and community of children with autism spectrum disorder (ASD) and; identify if contextual factors would modify the association between motor skills and participation outcomes. The participation and the motor skills were evaluated in 30 children with ASD between 5 and 10 years old. Participation outcomes were measured by the Participation and Environment Measure-Children and Youth (PEM-CY) and the motor skills were assessed by the Timed Up and Go, Timed Up and Down Stairs, Test of Gross Motor Development-2nd edition and Pediatric Balance Scale. The results of the study demonstrated that the motor skills of the locomotion, objects control, change position and balance explained participation outcomes of children with ASD classified from mild to moderate, between 5 and 10 years old. Moreover, the sex variable modified the association between the motor skills and the school participation, with girls performing less activities at this setting.
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Affiliation(s)
- Katherine Simone Caires Oliveira
- Graduate Program of Rehabilitation and Functional Performance, Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Déborah Ebert Fontes
- Graduate Program of Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy (EEFFTO), Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6627 Campus - Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Egmar Longo
- Graduate Program of Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte (UFRN-FACISA), Santa Cruz, Rio Grande do Norte, Brazil
| | - Hércules Ribeiro Leite
- Graduate Program of Rehabilitation and Functional Performance, Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil
- Graduate Program of Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy (EEFFTO), Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6627 Campus - Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Ana Cristina Resende Camargos
- Graduate Program of Rehabilitation and Functional Performance, Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e do Mucuri (UFVJM), Diamantina, Minas Gerais, Brazil.
- Graduate Program of Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy (EEFFTO), Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6627 Campus - Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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Reitzel M, Letts L, Di Rezze B, Phoenix M. Critically Examining the Person–Environment Relationship and Implications of Intersectionality for Participation in Children's Rehabilitation Services. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:709977. [PMID: 36188778 PMCID: PMC9397911 DOI: 10.3389/fresc.2021.709977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/16/2021] [Indexed: 01/03/2023]
Abstract
Participation of children in rehabilitation services is associated with positive functional and developmental outcomes for children with disabilities. Participation in therapy is at risk when the personal and environmental contexts of a child create barriers to accessing services. The International Classification of Functioning, Disability and Health (ICF) provides a framework for conceptualizing the personal and environmental factors linked to a child. However, it does not facilitate critical examination of the person–environment relationship and its impact on participation in children's rehabilitation. This perspective study proposes the use of intersectionality theory as a critical framework in complement with the ICF to examine the impact of systemic inequities on the participation in therapy for children with disabilities. Clinicians are called to be critical allies working alongside children and families to advocate for inclusive participation in children's rehabilitation by identifying and transforming systemic inequities in service delivery.
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Affiliation(s)
- Meaghan Reitzel
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- *Correspondence: Meaghan Reitzel
| | - Lori Letts
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Bloorview Research Institute, Toronto, ON, Canada
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van Engelen L, Ebbers M, Boonzaaijer M, Bolster EAM, van der Put EAH, Bloemen MAT. Barriers, facilitators and solutions for active inclusive play for children with a physical disability in the Netherlands: a qualitative study. BMC Pediatr 2021; 21:369. [PMID: 34454470 PMCID: PMC8401178 DOI: 10.1186/s12887-021-02827-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 07/31/2021] [Indexed: 11/10/2022] Open
Abstract
Background Children with physical disabilities (PD) are less physically active than typically developing peers. The most important contributor to physical activity for primary school-aged children is outside play and therefore this should be part of every child’s life. However, children with PD experience multiple barriers to participation in playgrounds. Despite recent improvements in the accessibility of Dutch playgrounds, the participation of children with PD has not increased. This study aims to explore facilitators, barriers and solutions influencing the participation of children with PD in Dutch outdoor playgrounds, from parents’ and professionals’ perspectives. Methods Twelve semi-structured interviews with parents of children with PD aged 2–12 years and five focus group meetings with professionals working with these children were conducted. To ensure data saturation, we performed three member-check meetings. Two independent researchers analyzed the data using an inductive thematic approach. Results Similar barriers, facilitators and solutions were mentioned by parents and professionals. Three main themes were identified: the emotional barrier versus the physical barrier, play as a part of an inclusive society and the role of professionals in facilitating active inclusive play. The most important personal factors were physical and social problems experienced when children with PD wanted to join outdoor play. Interestingly, parents and professionals believed the social barrier was far more important than the physical one. The most important environmental factor was that the Dutch society is not sufficiently inclusive. Conclusions According to both parents and professionals, the most important barrier to active inclusive outdoor play was social, hindering the participation of children with PD in play with typically developing peers. To overcome such problems, professionals should take an active role in empowering children with PD and their parents. Furthermore, it is important to introduce outdoor active play early, so it becomes part of normal daily life. In addition, a change in the mindset of typically developing children and their parents seems essential to achieve true inclusive active play. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02827-5.
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Affiliation(s)
- L van Engelen
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | - M Ebbers
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | - M Boonzaaijer
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | - E A M Bolster
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | | | - M A T Bloemen
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands. .,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands.
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Hong DG, Jeong Y. Difference in home participation patterns and environmental factors between Korean children with and without disabilities. Disabil Rehabil 2021; 44:6340-6347. [PMID: 34428388 DOI: 10.1080/09638288.2021.1965230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify the participation patterns of Korean children with and without disabilities at home, and the environmental factors affecting their participation. MATERIALS AND METHODS The Korean Participation and Environment Measure for Children and Youth were applied to 184 caregivers of children aged 5 to 13 years in South Korea. To explore home participation patterns and environmental factors at the item level, analysis of covariance, Pearson's chi-square tests, and radar plots were used. RESULTS The largest group differences in participation frequency were in "school preparation" and "homework" and those at involvement level were in "indoor play and games," "getting together with other people," "school preparation," and "homework." More caregivers of children with disabilities desired changes in their children's participation in all activities. They also perceived that "physical, cognitive, and social demands of typical home activities," "supplies," and "money" hindered children's home participation. CONCLUSIONS The findings provide information about how Korean children participated in home-based activities, whether their caregivers desired changes in their participation, and what environmental factors impede their home participation. These can help service providers understand the interaction between participation and environmental factors and offer insight into where their service goals should be focused for the successful participation of children with disabilities at home.Implications for RehabilitationAs children with disabilities spend much time at home, their parents need to consider both how many times their children participate and how much they get involved in home-based activities.Rehabilitation service providers need to focus on whether parents are satisfied with their children's participation in home activities to decide where much effort is needed for meaningfully occupying children's time at home.The goal of rehabilitation services can be to mitigate a poor fit between children's abilities and the demands of activities for successful participation in home activities.Measuring not only the quantity of participation but also the quality of participation is helpful for setting a collaborative goal with parents to improve the participation of children with disabilities at home.
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Affiliation(s)
- Deok-Gi Hong
- Department of Occupational Therapy, College of Medicine, Wonkwang University, Institution of Enviroscience, Iksan, South Korea
| | - Yunwha Jeong
- Department of Occupational Therapy, College of Medical Science, Jeonju University, Jeonju, South Korea
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Milićević M. Exploring participation in family activities among Serbian children with cerebral palsy and children with typical development: diversity, frequency, children's presence, and engagement. Disabil Rehabil 2021; 44:1583-1594. [PMID: 34342549 DOI: 10.1080/09638288.2021.1958931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to characterize the participation in family activities in two groups of children: children with cerebral palsy (CP group) and children with typical development (TD group), with regard to diversity, frequency, children's presence, and engagement. METHOD The convenience sample of this descriptive and comparative cross-sectional study conducted in Serbia included 48 children with CP and 74 children with TD, aged 7-12 years. Parents completed the Child Participation in Family Activities (Child-PFA) questionnaire. Mann-Whitney U test was used for data analysing. RESULTS Children with CP experienced less diverse and less frequent family activities compared to children with TD, with more pronounced differences in the diversity of family activities than in their frequency. In the occurring family activities, children with CP were present in a comparable proportion as children with TD. Once in an activity, children with CP were less engaged. CONCLUSIONS Our results confirmed that children with CP do not have the same opportunities to participate and be engaged in everyday family life activities as children with TD. Greater efforts are needed to address these differences and facilitate access to and engagement of children with CP in a variety of family activities.IMPLICATIONS FOR REHABILITATIONIn comparison to children with typical development, family activities are less diverse and less frequent in families of children with cerebral palsy, and children are less engaged, specifically when activities include family's or children's social network.In line with current practice, this study confirms the importance of addressing opportunities for children with cerebral palsy to be often and more engaged in everyday family life activities.Professionals should support a family context that optimizes the engagement of children with cerebral palsy in activities with other family members, thus providing them everyday natural learning opportunities.
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Affiliation(s)
- Milena Milićević
- Institute of Criminological and Sociological Research, Belgrade, Serbia
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40
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Mckenzie G, Willis C, Shields N. Barriers and facilitators of physical activity participation for young people and adults with childhood-onset physical disability: a mixed methods systematic review. Dev Med Child Neurol 2021; 63:914-924. [PMID: 33559889 DOI: 10.1111/dmcn.14830] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/19/2022]
Abstract
AIM To understand the attitudes, barriers, and facilitators to physical activity participation for young people and adults with childhood-onset physical disability. METHOD Seven electronic databases (Embase, MEDLINE, PsychINFO, AMED, CINAHL, SPORTDiscus, and ERIC) were searched to November 2019. English language studies were included if they investigated attitudes, barriers, or facilitators to physical activity for young people (≥15y) or adults with childhood-onset physical disabilities. Two reviewers applied eligibility criteria and assessed methodological quality. Data were synthesized in three stages: (1) thematic analysis into descriptive themes, (2) thematic synthesis via conceptual framework, and (3) an interpretive synthesis of the thematic results. RESULTS Nineteen studies were included. Methodological quality varied, with only four qualitative studies and one quantitative study meeting all quality items. An overarching theme of 'finding the right balance' emerged. Six subthemes relating to capability, opportunity, and motivation contributed to physical activity participation being seen as 'the right fit' or 'all too hard'. The interpretive synthesis found social connections, social environment support, and an appropriate physical environment were essential to 'finding the right balance' to be physically active. INTERPRETATION Physical activity participation for young people and adults with childhood-onset physical disabilities is primarily influenced by the social and physical environment. What this paper adds Physical activity participation for young people and adults with childhood-onset physical disabilities is primarily influenced by environmental factors. 'Finding the right balance' between enabling and inhibitory factors was important to physical activity participation being perceived as 'the right fit'. The opportunity for social connection is an important motivator for physical activity participation for young people and adults. The physical environment continues to act as a barrier to physical activity participation for those with physical disabilities.
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Affiliation(s)
- Georgia Mckenzie
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Claire Willis
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
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Stelmokaite A, Prasauskiene A, Bakaniene I. Participation patterns and predictors of participation in preschool children with developmental disability. Br J Occup Ther 2021. [DOI: 10.1177/03080226211034415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The research was aimed to evaluate patterns and clinical and environmental predictors of participation in preschool children with developmental disability. Method Cross-sectional design was employed. Caregivers ( n = 98) of children aged 9–70 months (mean = 48, SD = 1.5) with developmental disability completed a health questionnaire and the Lithuanian Young Children’s Participation and Environment Measure (YC-PEM). Descriptive statistics and multiple linear regressions were performed to identify patterns and predictors of participation at home, daycare/preschool, and the community. Results Participation restrictions, based on frequency and variety of activities, were mostly observed in the community setting. Both clinical and environmental factors explained at least two dimensions of participation across all settings. Of the clinical factors, the predictors of participation were found to be the severity but not the number of impairments of body structures and functions and/or activity limitations. Conclusions This study emphasizes the role of the environment and activity limitations in explaining participation of preschool children with developmental disability. Findings can re-direct practitioners’ attention towards context-based assessments and interventions to promote health through participation.
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Affiliation(s)
- Agne Stelmokaite
- Department of Children’s Rehabilitation, Lietuvos sveikatos mokslu universitetas, Kaunas, Lithuania
| | - Audrone Prasauskiene
- Department of Children’s Rehabilitation, Lietuvos sveikatos mokslu universitetas, Kaunas, Lithuania
| | - Indre Bakaniene
- Department of Children’s Rehabilitation, Lietuvos sveikatos mokslu universitetas, Kaunas, Lithuania
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Qi J, Cai JH, Meng X. Impact of the Paralympic Games on the Beliefs of Children with Physical Disabilities Engaging in Sports and Physical Activities: A Chinese Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147296. [PMID: 34299749 PMCID: PMC8307629 DOI: 10.3390/ijerph18147296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this qualitative study was to explore the beliefs of Chinese children with physical disabilities engaging in sports and physical activity (PA), and the impact of the Paralympic Games on these beliefs. Five Chinese children with physical disabilities (female = 2, male = 3) were recruited for participating in the workshops of the Paralympic Games and PA, and received individual semi-structured interviews before and after the workshop implementations. Interview transcripts were analysed and presented as descriptive summaries. Three themes emerged based on the analysis of the participants' interview data: (1) shocked, knowledgeable, and useful; (2) willingness to try, and (3) hope to obtain support. Results indicated that children with physical disabilities in this study acknowledged the positive outcomes of participating in the workshops of the Paralympic Games on the sports and PA engagement attitude change. However, children with disabilities also expressed that they need more related knowledge and information. The results of the study revealed that impairment and contextual factors (i.e., lack of support from family and physical education teachers, unsafe environments, and negative attitudes of peers without disabilities) were barriers to sports and PA engagement among children with physical disabilities in this study.
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The Impact of Anxiety on the Participation of Children on the Autism Spectrum. J Autism Dev Disord 2021; 52:2958-2969. [PMID: 34196892 DOI: 10.1007/s10803-021-05162-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 12/28/2022]
Abstract
Anxiety is common in children on the autism spectrum, however its impacts are not fully understood. Participation is an important outcome, linked to the health and wellbeing of children. This study examined the relationship between anxiety and participation using parent reports for 131 children on the autism spectrum, aged 6-13 years. Hierarchical multiple regressions explored child and family factors in relation to participation in Home and Community settings. Anxiety was a unique, significant predictor of the frequency of children's participation (but not involvement in activities) in both settings, when controlling for autism characteristics, communication skills and family income. Anxiety symptomatology may contribute to the less frequent participation of children on the autism spectrum in home and community activities.
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Vänskä N, Sipari S, Jeglinsky I, Lehtonen K, Kinnunen A. Co-development of the CMAP Book: a tool to enhance children's participation in pediatric rehabilitation. Disabil Rehabil 2021; 44:1709-1719. [PMID: 34033734 DOI: 10.1080/09638288.2021.1921061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of the co-development project was to create a tool that enhances children's active participation and agency in rehabilitation and in everyday life. MATERIALS AND METHODS Action research was the methodological approach. Participants in the different phases of the process (2015-2017) were children with disabilities, parents and rehabilitation professionals. The co-development process included: (1) designing the tool's first version, (2) piloting the tool, (3) evaluating the tool by collecting feedback and reflection, (4) generating the tool's final version. RESULTS Through the co-development process, an accommodating and digital tool called the CMAP Book-a description of the child's meaningful activities and participation-was developed. The CMAP Book is used with an electronic app enabling the identification and description of what is meaningful in daily life from the child's perspective with videos, photos, pictures, recording and writing. The tool enables the child, family and professionals to prepare and build collaboration in rehabilitation with flexibility according to child and family needs. CONCLUSIONS Use of the CMAP Book promotes the active involvement of the child and parents in designing the rehabilitation process in daily life in partnership with professionals. The stakeholder involvement in the co-development facilitated meaningful results and a concrete tool for rehabilitation.IMPLICATIONS FOR REHABILITATIONThe CMAP book is a new tool that enhances the child's active participation and agency in the rehabilitation process based on meaningful activities in everyday life expressed by the child.Identifying and utilising meaningful issues in the child's daily life through collaboration increases the child's commitment and motivation, and thus may enhance the benefits and effects of rehabilitation. Through co-development, the child and his/her family can be active and equal partners not only in development projects but also in the rehabilitation process.In the future, child-specific practices and policies should be developed to promote participatory co-research between families and clinicians linked to the daily lives of families with children.
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Affiliation(s)
- N Vänskä
- Department of Rehabilitation and Examination, Metropolia University of Applied Sciences, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - S Sipari
- Department of Wellbeing, Metropolia University of Applied Sciences, Helsinki, Finland
| | - I Jeglinsky
- Department of Health and Wellbeing, Arcada University of Applied Sciences, Helsinki, Finland
| | - K Lehtonen
- Department of Rehabilitation and Examination, Metropolia University of Applied Sciences, Helsinki, Finland
| | - A Kinnunen
- Department of Health and Wellbeing, Savonia University of Applied Sciences, Kuopio, Finland
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Coussens M, Vitse F, Desoete A, Vanderstraeten G, Van Waelvelde H, Van de Velde D. Participation of young children with developmental disabilities: parental needs and strategies, a qualitative thematic analysis. BMJ Open 2021; 11:e042732. [PMID: 33795296 PMCID: PMC8021744 DOI: 10.1136/bmjopen-2020-042732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/17/2021] [Accepted: 03/09/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Participation refers to a person's involvement in activities and roles that provide interaction with others as well as engagement in family and community activities. Young children with developmental disabilities (DD) such as attention deficit hyperactive disorder, autism spectrum disorder and developmental coordination disorder are limited in their participation compared with their typically developing peers. This study aimed to obtain information regarding parental needs and strategies used to enable their child's participation. DESIGN A thematic inductive approach with in-depth interviews was used to explore parental experiences. Eleven women and two men, between 30 and 40 years of age, who had a child (4-9 years old) with a DD diagnosis based on Diagnostic and Statistical Manual of Mental Disorders criteria, participated in semistructured interviews. RESULTS Two central themes emerged: parental needs and parental strategies used to enable their child's participation. Parental needs were the following: increasing awareness, ameliorating parental burden, providing tailored interventions and supporting parents in finding suitable leisure activities. Parental strategies aimed at increasing their child's resiliency, attaining maximal fit between activity requirements and child capacity, and creating inclusive opportunities and awareness. CONCLUSIONS Understanding what families' needs are and how families use and integrate strategies within the context of their daily lives provides practitioners with insights needed to support families' resiliency in promoting their children's participation. The results have implications for professionals as this information can be used to inform, refine, or tailor participation-based and family-centred services.
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Affiliation(s)
- Marieke Coussens
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Floris Vitse
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Annemie Desoete
- Faculty of Psychology and Educational Sciences, Ghent University, Gent, Belgium
| | - Guy Vanderstraeten
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Hilde Van Waelvelde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
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Huus K, Schlebusch L, Ramaahlo M, Samuels A, Berglund IG, Dada S. Barriers and facilitators to participation for children and adolescents with disabilities in low- and middle-income countries - A scoping review. Afr J Disabil 2021; 10:771. [PMID: 33824860 PMCID: PMC8008013 DOI: 10.4102/ajod.v10i0.771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/26/2020] [Indexed: 11/15/2022] Open
Abstract
Background Research has shown that all children and adolescents have the right to participate in their everyday life. However, little is known about what impacts the participation of children and adolescents with disabilities living in low-and middle-income countries. Objective The present study undertakes a scoping review of research to synthesise the current literature about barriers and facilitators to participation in everyday life for children and adolescents with disabilities living in low- and middle-income countries. Method A scoping review was conducted. The databases Psyc INFO, MEDLINE, CINAHL, Pubmed, ERIC and African Wide information were searched for studies published between 2001 and April 2018. Data was analysed using deductive content analysis. The barriers and facilitators to participation were categorised into personal factors, social factors, environmental factors, and policy and programme factors. Result In the end, 17 articles were included for data extraction as they mentioned barriers and facilitators to participation for children and adolescents with disabilities. Most of the reviewed studies reported on barriers to participation. Only one of the studies was performed in a country classified as a low-income country; all other studies were performed in middle-income countries. The results indicate that some factors, especially social factors, could be perceived as both facilitators and barriers to participation. Conclusion There is a lack of studies describing barriers and facilitators in low- and middle- income countries. Barriers and facilitators in proximity to the child and family are most frequently described in the literature.
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Affiliation(s)
- Karina Huus
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Swedish Institute of Disability Research (SIDR), School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Liezl Schlebusch
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Maria Ramaahlo
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Alecia Samuels
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
| | - Ingalill Gimbler Berglund
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Shakila Dada
- Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
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Children and young people's experiences of living with developmental coordination disorder/dyspraxia: A systematic review and meta-ethnography of qualitative research. PLoS One 2021; 16:e0245738. [PMID: 33661934 PMCID: PMC7932121 DOI: 10.1371/journal.pone.0245738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/06/2021] [Indexed: 12/01/2022] Open
Abstract
Background To date services for children with Developmental Coordination Disorder (DCD) have not been informed by the perspective of children with DCD. This study aimed to synthesise the findings of discrete qualitative studies reporting the lived experiences views and preferences of children and young with DCD using a meta-ethnographic approach to develop new conceptual understandings. Methods A systematic search of ten databases; Academic Search Complete, AMED, CINAHL, ERIC, MEDLINE, PsychArticles, PsychInfo, EMBASE, SPORTDiscus, and Web of Science, was conducted between March and April 2019, and updated in early June 2020. Meta-ethnography, following the method described by Noblit and Hare was used to synthesise included studies. The Joanna Briggs Institute Checklist was used to appraise all included papers. PROSPERO registration number CRD42019129178. Results Fifteen studies met the inclusion criteria. Meta-ethnographic synthesis produced three themes; a) ‘It’s harder than it should be’: Navigating daily activities b) Fitting in, and c) ‘So what? I drop things’: Strategies and supports to mitigate challenges. Children with DCD describe a mismatch between their abilities and performance norms for daily activities that led to a cascade of negative consequences including negative self-appraisal, bullying and exclusion. In the face of these difficulties children described creative and successful strategies they enacted and supports they accessed including; assistance from others (parents, friends and teachers), focusing on their strengths and talents, accepting and embracing their difference, adopting a “just do it” attitude, setting personal goals, self-exclusion from some social activities, using humour or sarcasm, viewing performance expectations as a social construct, and enjoying friendships as a forum for fun, acceptance and protection against exclusion. Conclusion Service provision for children and young people with DCD should address the social and attitudinal environments, focus on friendship and social inclusion and address stigma-based bullying particularly within the school environment. Furthermore, practitioners should identify and foster children’s own strategies for navigating daily life activities with DCD. The identified themes resonate with contemporary disability theory and the International Classification of Functioning. The social and attitudinal environmental context of children and young people with DCD profoundly influences their experiences. Future intervention development and service provision for children and young people with DCD should consider opportunities to address social and attitudinal environmental factors.
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Srinivasan R, Kulkarni V, Smriti S, Teplicky R, Anaby D. Cross-Cultural Adaptation and Evaluation of the Participation and Environment Measure for Children and Youth to the Indian Context-A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1514. [PMID: 33562602 PMCID: PMC7915983 DOI: 10.3390/ijerph18041514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/19/2022]
Abstract
Culturally appropriate measures enable knowledge transfer and quality improvement of rehabilitation services in diverse contexts. The Applied Cultural Equivalence Framework (ACEF) was used in a two-phased mixed methods study to adapt and evaluate the Participation and Environment Measure-Children and Youth (PEM-CY) in India. Cognitive interviews with caregivers of children with disabilities (n = 15) aged 5-17 years established conceptual, item, semantic, and operational equivalence of the Indian PEM-CY. Construct validity was assessed by comparing PEM-CY scores of children with and without disabilities (n = 130) using a case-control design. Cognitive interviews resulted in operational (60.3%), semantic (26.4%), and item-level (13.2%) modifications in the PEM-CY with no changes at the conceptual level. Internal consistency (n = 130) was acceptable to excellent (0.61-0.87) on most scales. Test-retest reliability (n = 30) was good to excellent (ICC ≥ 0.75, Kappa 0.6-1.0) for most scales. Significant differences in all PEM-CY summary scores were found between children with and without disabilities, except for environmental supports. Children with disabilities had lower scores on frequency and involvement in activities across all settings; their caregivers desired greater change in participation and reported experiencing more environmental barriers across settings. Findings suggest the adapted PEM-CY is a valid and reliable measure for assessing the participation of Indian children.
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Affiliation(s)
- Roopa Srinivasan
- Ummeed Child Development Center, Department of Developmental Pediatrics and Occupational Therapy, Mumbai 400011, Maharashtra, India;
| | - Vrushali Kulkarni
- Ummeed Child Development Center, Department of Developmental Pediatrics and Occupational Therapy, Mumbai 400011, Maharashtra, India;
| | - Sana Smriti
- Butterflies Child Development Centre, Hyderabad 500081, Telangana, India;
| | - Rachel Teplicky
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada;
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Shabat T, Fogel-Grinvald H, Anaby D, Golos A. Participation Profile of Children and Youth, Aged 6-14, with and without ADHD, and the Impact of Environmental Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E537. [PMID: 33440680 PMCID: PMC7828023 DOI: 10.3390/ijerph18020537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Children and youth with attention deficit hyperactivity disorder (ADHD) may experience difficulties in participation, but few studies examine their participation and the environmental factors affecting participation. This study explored the participation and the environmental factors of children and youth, with and without attention deficit hyperactivity disorder (ADHD), in the following three settings: home, school, and community. MATERIALS AND METHODS Parents of 65 participants aged 6-14 (M = 9.91, SD = 1.87) with and without ADHD completed the Participation and Environment Measure for Children and Youth (PEM-CY) questionnaire, which evaluates participation and environmental factors, along with demographic and screening questionnaires. RESULTS The ADHD group (n = 31) scored significantly lower than the non-ADHD group (n = 34) in "frequency" at home, "involvement", and overall environmental support in all settings, with parents expressing a greater desire to change their child's home and community participation. For the ADHD group, a relationship was found between environmental support and involvement in all three settings. CONCLUSIONS The findings demonstrated differences in the participation of children and youth with ADHD across different settings, compared to those without ADHD, and confirmed the effect of environmental factors on participation, especially involvement. It is essential to consider participation measures and environmental factors when designing interventions for children and youth with ADHD.
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Affiliation(s)
- Tair Shabat
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel; (T.S.); (H.F.-G.)
| | - Haya Fogel-Grinvald
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel; (T.S.); (H.F.-G.)
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada;
| | - Anat Golos
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel; (T.S.); (H.F.-G.)
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Chien CW, Lin CY. Community Participation of School-Age Children: Who is at Risk of Restricted Participation? Phys Occup Ther Pediatr 2021; 41:447-463. [PMID: 33761819 DOI: 10.1080/01942638.2021.1900489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS This study aimed to identify children with restricted community participation and examine the extent to which the child, family, and environmental factors were associated with restricted participation. METHODS A school-based sample of 92 children with disabilities and 391 children without disabilities aged 5-12 years was recruited in Hong Kong. Parents completed the Participation and Environment Measure for Children and Youth and a demographic questionnaire. Moreover, children completed the Children's Depression Inventory. Rasch analysis was used to determine the criteria that differentiated between children with and without participation restriction, based on frequency of activities. Logistic regression was used to identify the factors associated with participation restriction. RESULTS One hundred seventy-three children (35.8% of the sample), including 42 with disabilities, were identified as having restricted participation. Participation restriction was associated with higher depressive symptoms in children (odds ratio (OR) = 1.05, 95% confidence interval (CI) [1.01, 1.08]), lower environmental resources (OR = 0.97, 95% CI [0.96, 0.99]), and coming from families with three or more children (OR = 2.80, 95% CI [1.44, 5.46]). CONCLUSIONS The results suggest that a sizable number of children are at risk for restricted participation in the community. Healthcare services and strategies that address the associated factors are needed to promote children's community participation.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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