Participation in leisure activities: differences between children with and without physical disabilities

The impact of coping behaviors on perceived competence and social anxiety in the everyday social engagement of autistic adolescents

LAY ABSTRACT

Individuals who cope well with challenges may engage in social situations more successfully. We examined how well autistic adolescents coped, depending on how competent they felt and how much anxiety they experienced during social activities. We included 133 individuals (82 autistic, 51 neurotypical) between the ages of 10 and 16 years. Participants carried a mobile device that prompted them seven times a day for 7 days to record what they were doing, how competent they felt and how much anxiety they experienced. We used the Coping Inventory to understand how well participants coped with environmental challenges and met their needs for growth. Autistic adolescents were more likely than neurotypical peers to feel anxious while doing activities with adults. Autistic adolescents who had more difficulty coping with challenges were more likely to feel anxious when doing leisure activities with peers. Interestingly, autistic adolescents who coped better with challenges tended to feel less competent in social situations. However, those better able to meet their needs for growth tended to perceive their social competence positively. These findings can help practitioners develop strategies and programs to reduce the negative social experiences of autistic adolescents by helping them cope better.

The link between disability and social participation revisited: Heterogeneity by type of social participation and by socioeconomic status

BACKGROUND

While prior literature explores the impact of disability on social participation, the distinct characteristics of diverse social activities could further complicate this relationship. Furthermore, this relationship may exhibit heterogeneity when considering socioeconomic status (SES).

OBJECTIVE

This study aims to investigate whether the relationship between disability and social participation differs depending on the type of social participation, and to what extent this relationship is moderated by SES.

METHODS

Data from seven waves of the Korean Longitudinal Study of Ageing were analyzed. Various types of social participation, including socializing, leisure, volunteer, political, and religious activities, were considered. Individual fixed effects models were employed to account for unobserved individual-level heterogeneity. To investigate the potential moderating role of SES, an interaction term between disability and SES was included.

RESULTS

Disability was associated with a decrease in social participation (b = -0.088). When differentiating types of social participation, the associations were negative for socializing and leisure activities (b = -0.092 and b = -0.012, respectively) and positive for volunteer activities (b = 0.012). The negative association between disability and social participation was generally stronger among higher-SES groups than lower-SES groups. Specifically, the negative association with leisure activities was more pronounced among the high-education groups. In contrast, the positive association with volunteer activities was more evident among the low-education group.

CONCLUSIONS

Disability has a negative association with engagement in socializing and leisure activities and a positive association with engagement in volunteer activities. Policymakers should consider the role of SES in complicating the relationship between disability and social participation.

Usability of Public Play Spaces for Children with Disabilities

Purpose

To investigate the usability of public play spaces for children with disabilities by exploring their experiences in accessing and using these spaces and to further discuss recommendations for designing such spaces that are usable for these children.

Methods

A hermeneutic phenomenological approach was employed to explore the experience of children with disabilities regarding the public play spaces. Seven children and their caregivers from two inclusive elementary schools in Central Java Province, Indonesia, participated in the study. Online semistructured interviews with the children were held using Zoom, followed by telephonic interviews with their parents. In addition, video recordings of the observation of the children's participation in the play spaces were gathered. The interview and video observation data were analyzed using van Manen's hermeneutic phenomenology thematic analysis method.

Results

Five themes arose regarding the experiences of children with disabilities of accessing and using the public play spaces: (1) where time appeared to speed up, (2) "I like the tall one … I like extreme," (3) fostering connectedness, (4) the need for a safe space, and (5) how a play space should be.

Conclusion

The public play spaces have meaningful values for the children with disabilities and their family, as they offered the opportunities to play, explore, interact with friends and families, enjoy nature, interact with animals, and learn. However, it is essential to provide a safe space in which children are free from physical and emotional harm, so that they can fully participate with confidence and a sense of autonomy. Nevertheless, it was also found that children, regardless of their abilities, craved risky and challenging play opportunities. This study also highlights the necessity of awareness-raising intervention programs to foster the inclusion of children with disabilities in public play space settings.

Impact of adapted bicycle riding on outcomes for children and adolescents with disabilities: A systematic review

AIM

To review the evidence for the effects of adapted bicycle riding on body structures and functions, activity, participation, and quality of life outcomes in children with disabilities, along with family-level participation outcomes.

METHOD

A systematic review with searches of nine electronic databases to identify studies involving participants with a developmental disability aged 4 to 18 years who used a dynamic adapted bicycle was completed in August 2021. Risk of bias was assessed based on individual study designs. A narrative synthesis integrated the findings of the included studies. Certainty of evidence was synthesized using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

Ten studies were included with 234 participants. Five studies reported outcomes at the body structures and functions level, ten reported activity-level outcomes, two reported participation-related outcomes, and none assessed quality of life or family participation in social and recreational activities.

INTERPRETATION

Adapted bicycle riding interventions may improve gross motor function, enhance lower-limb muscle strength, and promote physical activity; however, certainty of evidence of effects was rated very low using GRADE. Further research is required to understand the impact of adapted bicycle riding on the participation outcomes of children and adolescents with disabilities and on family-level participation in social and recreational activities.

WHAT THIS PAPER ADDS

Adapted bicycle riding interventions may improve motor functions and physical activity. Evidence about participation outcomes after adapted bicycle riding is limited. Research on adapted bicycle riding interventions in natural settings is needed.

The effect of the adapted soccer programme on motor learning and psychosocial behaviour in adolescents with Down syndrome

BACKGROUND

Numerous studies have proven the significant positive impact of the regular physical activity on general health conditions and quality of life of people with intellectual disability. In practice, various adapted sports activities are used. The current study deals with the effects of the soccer programme.

AIM

The purpose of the study is to evaluate the effects of adapted soccer on the motor learning and some psychosocial characteristics in adolescents with Down syndrome.

METHODS

Twenty-five participants were recruited and randomised into two groups (exercise and control). Adolescents placed in the exercise group carried out a special soccer programme twice a week during 16 weeks, while adolescents placed in the control group continued with their usual daily regime. Specific motor coordination, level of aggression, attention disorders, level of anxiety and depression, and social problems were measured before and after the training period. Mixed ANOVA were used to evaluate the effects of the experimental treatment.

RESULTS

The exercise group had significant improvements (P < 0.05) in one of three motor variables (only in the easiest task) and in all psychosocial variables. There are no one significant change in the control group. The adapted soccer programme influenced more seriously on psychosocial characteristics than on motor learning of adolescent with DS.

CONCLUSIONS

The results suggest that adapted soccer training can decrease aggression, anxiety and depression levels, and improve attention, social behaviour and simple motor skills in adolescents with Down syndrome.

A Swedish cultural adaptation of the participation questionnaire Functional Scale of the Disability Evaluation System - Child version

PURPOSE

The aim was to culturally validate a questionnaire about children's/youth's participation to be used in a Swedish context.

METHODS

FUNDES-Child, based on the well-established CASP, was chosen. Questions about engagement and hindering factors were added to the existing questions about frequency and independence in 20 activity areas. Using a qualitative, explorative design, 16 interviews with children/youths/caregivers were made to explore opinions about the questionnaire. Follow-up interviews confirmed the result of the revised questionnaire. Qualitative content analysis was performed.

RESULTS

The interviews provided support for the questionnaire's relevance by being a tool to assess important aspects of participation, to gain insights into one's own/the child's participation, and to promote ideas about what causes the degree of participation. To achieve comprehensiveness, no activity area was found to be missing nor superfluous. However, some examples were needed to be modified where "parades" are unusual in Sweden and therefore removed, while "singing in choir" was added. In search for comprehensibility, opinions about the layout of the first version were raised and a varying degree of understanding of wording and concepts were found and thus taken into account.

CONCLUSIONS

The questionnaire can be used for establishing meaningful goals and to potentially increase children's participation.Implications for rehabilitationParticipation is of great importance for children's functioning, well-being, and development.Cultural validation of well-established participation questionnaires is a priority and questions about important aspects of participation need to be included.Interviews with children/youth and caregivers guided revisions to reach relevance, comprehensiveness, and comprehensibility of the Swedish FUNDES-Child (FUNDES II-SE).Children/youths, caregivers, and others may increase their awareness concerning the child's/youth's participation by responding to the questionnaire.

Can universal design support outdoor play, social participation, and inclusion in public playgrounds? A scoping review

PURPOSE

To synthesize evidence regarding the physical design features and non-physical aspects of public playgrounds that facilitate/hinder outdoor play, social participation, and inclusion; identify design recommendations; and explore the current discourses and concepts around designing for outdoor play, social participation, and inclusion in public playgrounds in the context of Universal Design (UD).

METHODS

Published studies addressing public playgrounds, inclusion, and design, were identified via a systematic search of eleven databases from health, science, education, and humanities.

RESULTS

Fifteen documents met the inclusion criteria. Three main themes were identified concerning physical design features and non-physical aspects of public playgrounds that facilitate/hinder outdoor play, social participation, and inclusion, with associated design recommendations. Although UD is recognized to have the potential to support the design of public playgrounds, no studies examined UD solutions for playgrounds or tested them for effectiveness.

CONCLUSION

We cannot yet determine whether UD can support outdoor play, social participation, and inclusion in public playgrounds. Research to date has mostly focused on understanding users' perspectives; future research should continue to be informed by diverse users' perspectives to address gaps in knowledge concerning children's voice from migrants, lower socioeconomic communities, and intergenerational users with disabilities alongside researching design solutions for play.Implications for rehabilitationChildren, particularly children with disabilities and their families, continue to experience marginalization and exclusion in public playgrounds, despite a commitment to inclusion in international treaties.Universal design is recognized to have the potential to support the design of public playgrounds, however, the evidence is currently very sparse.While accessibility is an important consideration for playground design, it does not ensure that play occupations can take place.Extending knowledge on universal design as it applies explicitly to playgrounds and play occupation requires multi- and trans-disciplinary collaboration that includes a play-centered perspective.

School and Community Involvement of Adolescents With Chronic Health Conditions

PURPOSE

To investigate associations between chronic health conditions and participation in school and community activities at age 15 years.

METHODS

Secondary analysis of data from an urban U.S. birth cohort study was conducted to investigate associations between chronic health conditions and participation in specific types of school and community activities. Logistic regression was used to adjust for potentially confounding factors.

RESULTS

Over one third of the teens had a chronic health condition. Having a chronic developmental or behavioral health condition (vs. no chronic developmental or behavioral health condition) was associated with lower odds of participation in sports (odds ratio [OR], .714; 95% confidence interval [CI], .577-.883), volunteer activities (OR, .751; 95% CI, 0.611-.924), and any activities (OR, .690; 95% CI, .516-.921), after adjusting for potential confounders. The associations for having a chronic physical health condition were less consistent.

CONCLUSIONS

Chronic developmental or behavioral conditions of teens are negatively associated with school and community participation, particularly sports and volunteering, both of which can substantially enhance their development. Schools can play a role in promoting participation by offering activities designed for students with disabilities that may also include typical students or by referring families to such activities in the community. Clinicians can play a role by educating families about the benefits of extracurricular activities, providing information about laws and regulations requiring schools and other organizations to provide accommodations, and linking families to activities and programs in their community.

A cross-sectional examination of the 24-hour movement behaviours in Canadian youth with physical and sensory disabilities

BACKGROUND

Canada's 24-Hour Movement Guidelines for Children and Youth provide daily recommendations for physical activity (PA), screen time, and sleep for optimal health. The appropriateness of such guidelines for youth with disabilities remains unknown.

OBJECTIVE

To cross-sectionally examine the 24-h movement behaviours and guideline adherence in youth (ages 12-21 years) with physical and sensory disabilities.

METHODS

54 youth with physical and sensory disabilities completed two, 24-h recalls to assess PA, sedentary behaviour, and sleep. Descriptive statistics were used to analyze behavioural patterns and guideline adherence. Gender and age differences were tested using analyses of variance and logistic regressions.

RESULTS

55.5%, 13.0%, and 53.7% of the sample met the individual guidelines for PA, sedentary behaviour, and sleep, respectively. 3.7% of the sample met all three movement guidelines. No significant gender or age differences in guideline achievement were found. Over a 24-h period, youth spent 77 (59) minutes engaging in moderate to vigorous PA, 252 (120) minutes engaging in sedentary activity, and 546 (90) minutes sleeping. Boys reported significantly more time (adjusted M_difference = 11 min) playing passive video games than girls.

CONCLUSION

Overall, our sample of youth with physical and sensory disabilities falls far short of meeting the Canadian 24-Hour Movement Guidelines for Children and Youth. The low proportion of youths' time spent engaging in sport and active play is concerning, highlighting the importance of creating access to these types of PA experiences for this population. Future population-based research is needed among children and youth with all types of disabilities to build an evidence-base of their movement behaviours.

Advancing play participation for all: The challenge of addressing play diversity and inclusion in community parks and playgrounds

Introduction

Outdoor parks and playgrounds are important sites of social inclusion in many urban communities. However, these playspaces are often inaccessible and unusable for many children with disabilities. This paper presents findings from a case study of one urban municipality in Ireland. The study aimed to understand play participation in five local playgrounds by exploring the perspectives of play providers and families with diverse abilities, through the lens of universal design.

Methods

Multiple qualitative methods were used, including playground audits, walk-and-talk observations, and semi-structured interviews. Four play providers, 12 children, and 10 adult users took part. Inductive analysis was conducted to understand the usability and accessibility of playgrounds from a universal design perspective.

Findings

These playgrounds provided high play value for younger children, but low play value for older children and those with disabilities, due to lack of accessibility or usability. While local authorities aimed to provide inclusive playgrounds, they lacked knowledge on universal design for playspaces.

Conclusion

Children with disabilities continue to experience exclusion in community playspaces, despite a commitment to inclusion in local authorities. Play providers need support to tailor principles of universal design to playground design. Occupational therapists are ideally situated to collaborate with local authorities on universal design for enhancing children’s play participation in community settings.

The meaning of leisure to children and young people with significant physical disabilities: Implications for optimising participation

Introduction

The facilitation of meaningful leisure participation for children and young people requires an understanding of what leisure means to them. This study aimed to understand meaningful leisure from the perspective of children and young people with complex physical and communication disabilities.

Method

A hermeneutic phenomenological research design was used. Data was gathered through multiple interviews with six young people supported by photo elicitation, Talking Mats and direct observation. Individual case studies were analysed, together with six autobiographies of people with similar disabilities. Data analysis was iterative and multi-directional, alternating between segments and the whole throughout interpretation.

Results

Leisure experience meanings were uniquely constructed for each person, based on preferences, personality and circumstances. The tree of leisure emerged as a useful metaphor for three essential features (control, engrossing, enjoyment) and four key meanings (escape, exploration, exchange and expression) of leisure. Children and young people experienced five meaningful outcomes that lasted beyond the leisure activity (restoration, protection, construction, reflection and connection).

Conclusion

For children and young people with disabilities, a balanced array of diverse leisure experiences provides a powerful and accessible route to wellbeing. Implications for practice include understanding the individual, focusing on the social environment, supporting self-advocacy and promoting opportunities for free movement.

The convergent validity of the Children's Leisure Assessment Scale (CLASS) and Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC)

Background: Children's play and leisure participation is often assessed by occupational therapists. As such, it is essential that therapists utilize play and leisure scales that are valid, reliable and responsive.Aim: To examine the convergent validity between the Children's Leisure Assessment Scale (CLASS) and Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC).Methods: Forty healthy Australian children (60% female; mean age 9.2 ± 2.01 years) completed the CLASS and CAPE/PAC. Spearman's rho correlations with bootstrapping were completed.Results: A number of the CLASS and CAPE/PAC subscales were significantly correlated. The CAPE's overall scale scores and CLASS's instrumental indoor activities, outdoor activities and games and sport activities subscales were significantly correlated (p > 0.05). The CAPE's Social domain showed several significant correlations with the CLASS's instrumental indoor activities, outdoor activities and self-enrichment activities domains (p < 0.05). Statistically significant relationships were found between the CLASS's outdoor activity preference and the PAC's recreational, physical, formal, informal and overall performance scores (r = 0.466-0.773, p < 0.05).Conclusions and Significance: Preliminary evidence in support of the convergent validity between the CAPE/PAC and CLASS was obtained. Limitations include a small sample size and convenience sampling. Further investigation of the psychometric properties of the CAPE/PAC and CLASS are recommended.

Cross-Cultural Validation of Children's Assessment of Participation and Enjoyment Portuguese Version

Background: Participation is a major pediatric rehabilitation goal according to The International Classification of Functioning, Disability and Health Children and Youth version (ICF-CY). ICF-based leisure participation measures for Portuguese-speaking children with cerebral palsy are currently not available. The aim of this study is to assess validity and reliability of the Portuguese (European) version of the Children's Assessment of Participation and Enjoyment (CAPE). Methods: CAPE Portuguese version was applied to 170 children with cerebral palsy (n = 69) and typical development (n = 101) aged between 8 and 18 years (mean = 12.5 years; SD = 2.91). Construct validity was assessed by using the know-groups method and the correlation between participation and quality of life. Reliability was determined by internal consistency and test-retest. Results: CAPE discriminates between participation scores of children with cerebral palsy and typical development. A positive correlation was found between participation frequency and physical well-being. Internal consistency was not entirely satisfactory but comparable with that from the original CAPE study. Test-retest reliability was considered good. Conclusions: CAPE Portuguese (European) version showed satisfactory validity and test-retest reliability to assess leisure participation in children with cerebral palsy and typical development aged between 8 and 18 years.

Caregiver Strategies to Enhance Participation in Children With Autism Spectrum Disorder

Participation is necessary for childhood development, however, children with disabilities participate in fewer activities than their nondisabled peers. This study identified strategies caregivers use to increase participation in home- and community-based activities for children with autism spectrum disorder. Survey responses of 44 caregivers were analyzed through open and axial coding to develop a central theme and five broad themes. Caregiver strategies which produce a participation outcome fell into five themes: (a) adapters/facilitators, (b) pragmatic considerations, (c) social reframing, (d) sensory adjustments, and (e) desperate measures. Nonproductive strategies were identified where the child did not participate in the activity. Adaptations/facilitators were more likely used in the home, whereas community-based strategies were more often pragmatic considerations. Nonproductive strategies occurred more frequently in the community. When evaluating a child's participation, occupational therapy (OT) practitioners should take into consideration the context of the activity to identify appropriate and helpful strategies.

Cultural adaptation and construct validation of the Arabic version of children's assessment of participation and enjoyment and preferences for activities of children measures

PURPOSE

To establish the construct validity and internal consistency of the Arabic Children Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) and to determine the effects of age, gender, and disability status on diversity and intensity of participation.

METHODS

The World Health Organization guidelines for translation of measures were applied to translate the CAPE and PAC, 75 children with cerebral palsy (mean age = 10.7 ± 2.9 years) and 75 children with typical development (mean age = 10.8 ± 2.7 years) completed the translated measures. The construct validity of the translated measures was demonstrated by principle component analyses in addition to the known-groups method by examining the effects of age, gender, and presence of disability on diversity and intensity scores. The internal consistencies of the extracted components were examined by Cronbach's alpha.

RESULTS

Four components emerged: (1) physical activities; (2) home-based activities; (3) self-improvement activities; and (4) social activities. Cronbach's alpha varied from 0.61 (social activities) to 0.83 (physical activities). Age, gender, and disability were significant determinants of types of activities.

CONCLUSIONS

The Arabic CAPE and PAC are culturally valid in measuring participation of children with or without disabilities in Jordan. The child's age, gender, and disability should be considered to provide participation-based plans of care that are considerate for children and their families. Implications for rehabilitation The Arabic CAPE and PAC are culturally valid measures for participation of children with or without disabilities in Jordan. The Arabic CAPE and PAC measures can guide participation-based plans of care that are meaningful and considerate for children and their families. Child age and gender should be considered to provide appropriate activities and to facilitate participation of children with and without disabilities. Families and service providers in Jordon are encouraged to provide children opportunities to participate in desired physical, self-improvement, and social activities.

Having Fun and Staying Active! Children with Disabilities and Participation in Physical Activity: A Follow-Up Study

AIM

This study investigated change in the participation profile of physical activity over 15 months after a three-week intensive rehabilitation that used physical activity as the main intervention.

METHODS

The Children's Assessment of Participation and Enjoyment (CAPE) was used in a longitudinal prospective study (pre- and post-design) with three measurements over 15 months. Eighty children with physical disabilities (6-17 years old; mean score 11.1; SD 2.4), some with additional cognitive challenges, completed all three measurements.

RESULTS

Participation diversity and intensity of all 55 leisure activities declined significantly over the 15-month period. The largest decline was for children aged between 10 and 13 years. Among physical activities, there was a stable level of participation of the total group, and sub-groups. Boys preferred "active physical activities" to a greater extent, while girls preferred "skill-based activities." Both genders expressed a higher level of enjoyment in their preferred activities according to the Preferences for Activities of Children.

CONCLUSIONS

This intervention may have the potential to maintain the level of physical activity among children and youths with disabilities, yet further controlled studies are needed. Gender differences should be taken into consideration to facilitate stable participation in physical activities with a high level of enjoyment.

Social participation of children age 8-12 with SLI

PURPOSE

Two objectives are being pursued: (1) to describe the level of social participation of children aged 8-12 presenting a specific language impairment (SLI) and (2) to identify personal and family factors associated with their level of social participation.

METHOD

This cross-sectional study was conducted among 29 children with SLI and one of their parents. Parental stress and family adversity were measured as risk factors. The measure of life habits (LIFE-H) adapted to children aged 5-3 was used to measure social participation.

RESULTS

The assumption that social participation of these children is impaired in relation to the communication dimension was generally confirmed. The statements referring to the "communication in the community" and "written communication" are those for which the results are weaker. "Communication at home" is made easier albeit with some difficulties, while "telecommunication" is totally preserved. A high level of parental stress is also confirmed, affecting the willingness of parents to support their child's autonomy.

CONCLUSIONS

The achievement of a normal lifestyle of children with SLI is upset in many spheres of life. Methods of intervention must better reflect the needs and realities experienced by these children in their various living environments, in order to optimize social participation, and consequently, to improve their well-being and that of their families. The need to develop strategies to develop children's independence and to reduce parental stress must be recognized and all stakeholders need to be engaged in the resolution of this challenge.

IMPLICATIONS FOR REHABILITATION

The realization of life habits of SLI children is compromised at various levels, especially in the domain related to "communication in the community" and "written communication". Speech-language pathologists must consider providing ongoing support throughout the primary years of these children and during adolescence, to promote and facilitate the continued realization of life habits of SLI persons. Providing ongoing support throughout the primary years and thereafter is needed to facilitate the continuing realization of life habits of SLI persons. Parents of children with SLI experience considerable stress in relation to the exercise of their parental roles. It is important to intervene and to support parents to promote autonomy for their SLI children.

A pilot investigation using global positioning systems into the outdoor activity of people with severe traumatic brain injury

Background

Little is known about the post-discharge outdoor activities of people who have incurred severe traumatic brain injury (TBI). This study used a body-worn global positioning system (GPS) device to determine the outdoor activity per day performed by this population. Additionally, this study examined the association that mobility, time since injury and injury severity had with levels of outdoor physical activity.

Findings

Seventeen people with TBI and 15 control subjects wore a GPS device for between 3–7 days to monitor their outdoor activity. Based on the individual’s location and speed of movement the outdoor physical activity in minutes per day was derived. Assessments of duration of outdoor activity between groups, and the relationship that duration of outdoor activity had with results on the high-level mobility assessment tool, length of post-traumatic amnesia, and time since injury were performed. No significant (p = 0.153, effect size = 0.26) difference in time spent in outdoor physical activity was observed between the TBI (median[IQR] = 19[3–43]mins) and control (median[IQR] = 50[18–65]mins) group. Interestingly, 35% of TBI subjects performed <10 mins of outdoor activity per day compared to 13% of the control group. The TBI group also recorded three of the four highest values for outdoor physical activity. Higher levels of mobility were associated with more outdoor activity (Spearman’s rho = 0.443, p = 0.038). No other significant associations were observed.

Conclusions

While preliminary, our results indicate that a sub-group of people with TBI exists who restrict their outdoor activities. GPS has potential as an activity tracking tool, with implications for rehabilitation and exercise prescription.

Accessibility to information and communications technology for the social participation of youths with disabilities: a two-way street

The current study examined by mixed method the effectiveness of an accessibility to Information and Communications Technology (ICT) program that provided computers, assistive technology, tutors, and internet connection to 65 youths with severe disabilities (aged 13.22 ± 3.4 years) in their homes. The quantitative evaluation included assessment of computer task performance, computer skills, and participation in social ICT leisure activities before and after the program. Findings revealed low baseline and significant progress on most outcome measures 6 months after the program, mostly among those youths who had tutors. Additional in-depth interviews were conducted 1 year later with 10 participants to explore their ICT use and its impact on their social participation. The analysis revealed a significant contribution of the ICT use, while critical thinking about its risks and some disappointment with the social needs that ICT does not address. Our findings raise awareness of 'two-way streets' policies and programs to ensure e-inclusion.