Home participation of children with and without cerebral palsy in Serbia: an exploratory study

Factors Associated with Performance of Activities and Participation of Brazilian Children and Adolescents with Cerebral Palsy: A Cross-Sectional Study

The aim of this study was to investigate factors related to performance in daily activities, mobility, social/cognitive skills, and responsibility of Brazilian children/adolescents with cerebral palsy (CP). Multivariate binary logistic regression analyses were performed. A total of 190 children/adolescents participated. Most participants performed below expected in mobility, which could be explained by age, locomotion ability, and anatomical distribution of motor impairment (R2 = 0.50). Performance in daily activities (R2 = 0.44) and responsibility (R2 = 0.23) were explained by age and locomotion ability. This study contributes to understanding the factors that explain the functioning of children/adolescents with CP in Brazil, a low/middle-income country.

Building independence in self-care and household tasks: a qualitative study with adolescents with cerebral palsy and their caregivers

PURPOSE

Adolescents with cerebral palsy (CP) may experience limitations in self-care and household tasks. The aim of the study was to understand the process of building independence in self-care and household tasks from the perspective of adolescents and their caregivers.

MATERIALS AND METHODS

We conducted a qualitative study with a phenomenological approach with 10 adolescents (15-17 years old) and 11 caregivers from a transition service in Brazil. Semistructured, remote interviews were conducted with each participant. The interviews were recorded for transcription and content analysis.

RESULTS

Two thematic categories emerged: (1) "Thinking about independence" and (2) "Possible ways to foster independence." The first category was divided into three subcategories: "Expectations and the desire to be independent," "Obstacles to independence," "Concerns about the future." The second category was divided into four subcategories: "People and places," "Opportunities for practice," "Personal attitude" and "Adaptations that facilitate."

CONCLUSION

Adolescents' independence in several everyday activities involves physical, socioemotional and environmental aspects. Enabling opportunities for practice, an adapted environment, support from rehabilitation services and developing collaborative relationships with caregivers are elements that may favor the independence of adolescents with CP.

Personal and environmental factors and household assistance in Down syndrome: cross-sectional study

According to a biopsychosocial framework, personal and environmental factors might be mediators or facilitators/barriers, respectively, to functioning. However, it is not known how these factors can impact independence in household chores in children/adolescents with Down syndrome (DS). This study explored whether and how personal/environmental factors are associated with the independence level in household chores of children/adolescents with DS in Brazil. Caregivers of twenty-eight children/adolescents with DS were interviewed using the CHORES and a standardized questionnaire about personal (child's age and sex) and environmental (socioeconomic level and maternal schooling) factors. Multiple linear regression analysis identified if/how these factors are associated with level of independence. For CHORES self-care and CHORES total, sex was a significant variable explaining 21.8% and 15.8%, respectively, of the variation in the outcomes. For the outcome CHORES family care none of the variables was significant. Female sex was associated with a lower need for assistance. We conclude that only the personal factor assessed related to female sex in children with DS was associated with the independence level in household chores. This finding highlights the importance of health care providers and families to encourage the independence in chores regardless of sex and promote opportunities for both boys and girls.

Home participation and personal and environmental factors in children and adolescents with Down syndrome

AIM

To describe current home participation (frequency, involvement) and caregiver's desire for change in home participation of children and adolescents with Down syndrome, as well as home environmental factors, and to explore the associations of personal and environmental factors with current participation and caregiver's desire for change.

METHOD

Eighty-two caregivers (mean age = 45 years 10 months) of children and adolescents with Down syndrome (mean age = 10 years 7 months) were surveyed about the child's home participation and environmental factors using the Participation and Environment Measure-Children and Youth. Furthermore, children's personal and environmental factors were collected. Results are reported using descriptive analysis and correlations (Spearman's rank correlation coefficients and Mann-Whitney U test) to describe the relationship between current participation and caregiver's desire for change, with personal and environmental factors as ordinal and nominal variables respectively (p < 0.05).

RESULTS

Children's participation was highest with regard to personal care management and lowest with regard to school-related activities. Most caregivers desired change in homework and household chores. Greater frequency was associated with male sex, caregiver less rigorous social distancing due to the COVID-19 pandemic, and children receiving therapies. Greater involvement was associated with younger age in children and higher environmental support. Older age in children was associated with caregiver's greater desire for change.

INTERPRETATION

Personal and environmental factors correlated with participation in specific ways. Creative strategies to promote participation that consider caregiver's wishes should be undertaken.

Participação em casa e fatores pessoais e ambientais em crianças e adolescentes com síndrome de Down

Objetivo

Descrever a participação em casa atual (frequência, envolvimento) e o desejo do cuidador por mudança na participação em casa de crianças e adolescentes com síndrome de Down, bem como fatores ambientais da casa, e explorar as associações de fatores pessoais e ambientais com a participação atual e o desejo do cuidador por mudança.

Método

Oitenta e dois cuidadores (média de idade = 45 anos e 10 meses) de crianças e adolescentes com síndrome de Down (média de idade = 10 anos e 7 meses) foram entrevistados sobre a participação em casa da criança e fatores ambientais utilizando a Medida de Participação e do Ambiente ‐ Crianças e Jovens. Além disso, foram coletados fatores pessoais e ambientais das crianças. Os resultados são relatados por meio de análise descritiva e correlações (coeficientes de correlação de Spearman ou teste U de Mann–Whitney) para descrever a relação entre a participação atual e o desejo do cuidador por mudança, com fatores pessoais e ambientais, para as variáveis ordinais e nominais, respectivamente (p < 0,05).

Resultados

A participação das crianças foi maior em cuidados pessoais e menor em atividades relacionadas à escola. A maioria dos cuidadores desejava mudança nas lições de casa e nas tarefas domésticas. Maior frequência de participação foi associada ao sexo masculino, distanciamento social menos rigoroso do cuidador devido à pandemia de covid‐19 e crianças recebendo terapia. O maior envolvimento na participação foi associado a uma idade mais jovem nas crianças e a um maior apoio do ambiente. A idade mais avançada das crianças foi associada ao maior desejo por mudança do cuidador.

Interpretação

Fatores pessoais e ambientais são correlacionados com a participação de formas específicas. Devem ser realizadas estratégias criativas para promover a participação e que considerem os desejos do cuidador.

Association between Participation of Children with Disabilities and the Child, Family, and Environmental Factors in Shanghai, China: A Cross-Sectional Study

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.

The relationship between family empowerment and fine motor, gross motor and cognitive skills in young children with cerebral palsy

BACKGROUND

Family empowerment in families of young children with cerebral palsy (CP) is an important consideration because the first few years of life can be overwhelming for parents. The purpose of this research was to investigate the relationship between family empowerment, fine motor (FM), gross motor (GM) and cognitive development in children with CP who were under 3 years of age.

METHODS

Forty-one children with a mean age of 23.8 months participated in this study. The Family Empowerment Scale (FES) was completed by the participants' parents, whereas the FM, GM and cognitive subscales of the Bayley Scales of Infant and Toddler Development Third edition (B-III) were administered by physical therapists.

RESULTS

Statistically significant positive correlations were found between the FES total and B-III raw scores for FM, GM and cognitive subscales with coefficients ranging from 0.35 to 0.41. Significant relationships were also found between the FES Community subscale and the B-III FM, GM and cognitive subscales.

CONCLUSIONS

This study provides evidence of a relationship between family empowerment and FM, GM and cognitive abilities in young children with CP, with a greater severity of impairments related to lower levels of caregiver empowerment.

Exploring participation in family activities among Serbian children with cerebral palsy and children with typical development: diversity, frequency, children's presence, and engagement

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.