Exploring the international uptake of the "F-words in childhood disability": A citation analysis

Disseminating the F-Words for Child Development to Parents of Children With Developmental Disabilities in Iran: A Qualitative Pilot Feasibility Study

BACKGROUND

Attitudes toward childhood disability have historically focused on biomedical efforts on 'fixing'. The introduction of WHO's ICF framework for health and Canadian researchers' 'F-words' (functioning, fitness, fun, friends, family and future) have significantly changed the field. To explore whether the F-words ideas influenced parents' perspectives on their child's abilities and rehabilitation goals, this qualitative pilot study introduced the F-words to Iranian parents with a child with a developmental disability.

METHODS

This study was conducted in Tabriz, Iran, in 2023, using Iranian educational F-words materials built on ideas available on the CanChild F-words Knowledge Hub. Data were collected through semistructured interviews with five mothers of children <5 years old with a developmental disability before and after attending an 'F-words Awareness Session' and analysed using thematic analysis.

RESULTS

In the preinterviews, six themes (and 20 subthemes) were identified: (i) routines (5); (ii) challenges (4); (iii) parental concerns (3); (iv) child's needs and priorities (3); (v) the role of parents in satisfying needs and challenges (2); and (vi) expectations of rehabilitation (3). In the postinterview, the same six themes and four additional subthemes emerged.

CONCLUSION

Findings from the pilot study showed that the intervention had an impact on the attitudes and behaviours of participants. Specifically, teaching about the F-words reduced parents' emphasis on the concept of 'normality'. Families' positive response to the 'F-words Awareness Session' indicates their openness to incorporating this approach into their daily lives. These findings highlight the potential benefits of utilizing the F-words in rehabilitation in Iran. Studies like these can serve as a foundation for developing effective strategies for integrating the F-words into existing rehabilitation practices in Iran.

Perspectives in childhood-onset disabilities: integrating 21st-Century concepts to expand our horizons

PURPOSE

A powerful aphorism states: "If I hadn't believed it, I wouldn't have seen it!" This challenging notion reminds us how strongly we are influenced by prevailing ideas, and how we interpret things according to current fashions and teachings.

MATERIALS AND METHODS

In this paper we present and discuss contemporary perspectives concerning childhood-onset disability and the evolving nature of how people are thinking and acting. We illustrate these ideas by reminding readers of how we have all traditionally been trained and acculturated to think about many dimensions of neurodevelopmental disability ("What?"); reflect on the impact of these ways of thinking in terms of what we have conventionally "seen" and done ("So What?"); and contrast those traditions with contemporary concepts that we believe or know impact the field ("Now What?").

RESULTS

Many of the concepts discussed here will be familiar to readers. In taking this analytically critical perspective we aim to illustrate that by weaving these individual threads together we are able to create a coherent fabric that can serve children with childhood-onset NDD, their families, service providers, the community, and policy-makers. We do not purport to offer a comprehensive view of the whole field.

CONCLUSIONS

We encourage readers to consider the integration of these new ways of thinking and acting in our still-evolving field of "childhood-onset disability".

Percepções dos pais sobre uma intervenção de esportes modificados para crianças com paralisia cerebral

O Sports Stars Brasil tem como objetivo promover a participação em atividades de lazer. O Sports Stars foi uma intervenção agradável, de curto prazo, com dosagem pequena, focada na participação. Os pais dos participantes do Sports Stars Brasil perceberam benefícios em todas as "minhas palavras favoritas". Esta intervenção de esportes modificados foi capaz de integrar todas as "minhas palavras favoritas".

Parents' perceptions of a modified sports intervention for children with cerebral palsy

AIM

To explore the perceptions of parents of children with cerebral palsy (CP) participating in a modified sports intervention, Sports Stars Brazil.

METHOD

Parents of children with CP (n = 15, 6-12 years old, nine males, six females), classified in Gross Motor Function Classification System levels I and II, who participated in the Sports Stars Brazil intervention, were recruited for this descriptive qualitative study. Children received the 8-week (1 hour per week) modified sports intervention. After the intervention, parents participated in a focus group. The F-word (fitness, family, fun, functioning, friends, and future) interpretation of the International Classification of Functioning, Disability and Health was used to guide the discussion. Participants were invited to report their experience of participating in the intervention using the F-words for a childhood disability model. Transcripts were coded using content analysis.

RESULTS

Parents reported positive experiences of the Sports Stars Brazil intervention, including a decrease in sedentarism (fitness), improvement of motor skills (functioning), greater connection between child and family (family), better socialization (friends), increased participation in pleasurable activities (fun), and awareness of the importance of physical activity (future). All positive experiences were interconnected.

INTERPRETATION

This study presents the ability of the Sports Stars Brazil intervention to integrate all aspects of functioning and supports its role as an engaging and promising intervention option for ambulant children with CP.

WHAT THIS PAPER ADDS

The parents of children participating in Sports Stars Brazil perceived benefits across all F-words. This modified sports intervention integrated all F-words into one concept.

Reflexive thematic analysis of a coaching-based, holistic approach to child development

BACKGROUND

The F-words Life Wheel (FWLW) approaches child development by hybridizing a holistic model in the F-words for Child Development, and a coaching model in Occupational Performance Coaching, along with a life-flow approach in the Kawa model. We report the impact of the FWLW as experienced by families.

METHODS

This was a qualitative interview study of parents of children with developmental needs and experts in child development using reflexive thematic analysis.

RESULTS

From 13 interviews, we developed three themes: 1) overwhelming, 2) power rebalance and 3) connectedness. The overwhelming theme addresses how life with developmental needs is challenging, engaging with the health and disability system is difficult and the focus on deficits can lead to a sense of being overwhelmed. The power rebalance theme addresses the transition from professionals calling the shots to giving agency to the child and family. Holistic goal setting empowers parents and children to direct and prioritize therapy, and helps shift from a deficit-focused to a 'can-do' attitude. The connectedness theme addresses the linkages between psychological health, physical health, the extended family and the planet as a whole.

CONCLUSIONS

The FWLW approach appears to be empowering and motivating for children and families.

Rehabilitation Practices Delivered by Physical and Occupational Therapists to Brazilian Children With Congenital Zika Syndrome: A Cross-Sectional Study

INTRODUCTION

Congenital Zika syndrome (CZS) is a health condition that has affected the development of thousands of children in Brazil. Because it is a new condition, its understanding is an ongoing process. Therefore, it is important to know the rehabilitation interventions being delivered to improve the functioning of these children. We aimed to describe the practices of physical therapists (PTs) and occupational therapists (OTs) who provide follow-up care for children with CZS in Brazil.

METHODS

This cross-sectional study included PTs and OTs who assist children with CZS in Brazil. An online questionnaire was used to verify the participants' personal characteristics and professional work environment, as well as the rehabilitation programs they implemented in Brazil for children with CZS. Data were analyzed using descriptive statistics.

RESULTS

A total of 116 professionals (79 PT and 37 OT) who work mainly in public health services (81.9%) participated in the study. Of these, 24.1% plan interventions based on reading scientific articles, 66.4% did not report using the biopsychosocial model, 52.6% do not perform any assessments before starting an intervention, 31.9% use neurodevelopmental treatment, and 22.4% use sensorimotor stimulation interventions. The majority of the interventions are delivered 1 to 2 times a week, lasting up to 1 hour.

CONCLUSIONS

Professional training and knowledge translation strategies are needed to implement evidence-based practices and improve the quality of rehabilitation programs for Brazilian children with CZS.

Assigning F-words as ingredients of interventions for children with cerebral palsy functioning at GMFCS IV and V: A scoping review protocol

Introduction

Children with Cerebral Palsy (CP) functioning at Gross Motor Function Classification System (GMFCS) levels IV and V require "on time" identification and intervention. Interventions offered continue to be a challenge, in high-, but even more so in middle-, and low-income countries.

Aim

To describe the methods developed to explore the ingredients of published studies on early interventions in young children with cerebral palsy (CP) at highest risk of being non-ambulant based on the "F-words for child development framework" and the design of a scoping review exploring these ingredients.

Method

An operational procedure was developed through expert panels to identify ingredients of published interventions and related F-words. After sufficient agreement among researchers was reached, a scoping review was designed. The review is registered in the Open Science Framework database. The "Population, Concept and Context" framework was used. Population: young children (0-5 years with CP and at highest risk for being non-ambulant (GMFCS levels IV or V); Concept: non-surgical and non-pharmacological early intervention services measuring outcomes from any ICF domain; Context: studies published from 2001 to 2021. After duplicated screening and selection, data will be extracted and quality will be assessed with the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and Mixed Methods Appraisal (MMAT) tools.

Results

We present the protocol to identify the explicit (directly measured outcomes and respective ICF domains) and implicit (intervention features not explicitly intended or measured) ingredients.

Conclusion

Findings will support the implementation of the F-words in interventions for young children with non-ambulant CP.

Exploring 10 years of dissemination of the F-words for Child Development: A multifaceted case study

BACKGROUND

There is growing interest in exploring how to move research findings into practice. Since 2014, a team of families and researchers has been working to promote and study the dissemination of the "F-words for Child Development" (Function, Family, Fitness, Fun, Friends, and Future). This case study describes our dissemination strategies and uses the Diffusion of Innovation theory to understand the factors contributing to the uptake of the F-words-a function-promoting, strengths-based, and family-centred innovation in child health and development.

METHODS

Between November 2011 and November 2021, we collected data from multiple sources: our dissemination strategies, including affiliated documents/artefacts (e.g., videos and presentations) and evaluation data (e.g., surveys and Google/video analytics). We used a two-step analysis: (1) a chronological time series to describe the processes involved along with indicators of dissemination over time (e.g., increase knowledge and awareness); and (2) Diffusion of Innovation theory to explore the factors that contributed to the uptake of the F-words.

RESULTS

Multifaceted dissemination strategies were essential to raise awareness and increase families' and service providers' knowledge of the F-words. These included three primary strategies: (i) development and distribution of educational materials; (ii) presentations at educational meetings; and (iii) educational outreach visits. Additional strategies, such as the use of mass media, collaboration with early adopters/champions, and the involvement of family members further supported dissemination efforts. Diffusion of Innovation factors (innovation characteristics, time, social systems, and communication channels) all contributed to the uptake of this innovation.

CONCLUSIONS

Purposeful planned dissemination practice, to increase knowledge and awareness of an innovation, is an important step in the knowledge translation process. Over a period of 10 years, through the use of multiple dissemination strategies conducted in partnership with families and service providers, the F-words have spread globally. Diffusion of Innovation theory has served to help understand how and why the F-words are being shared and adopted around the world.

Parenting a Child with a Neurodevelopmental Disorder

Purpose of Review

Traditional thinking and focus in ‘childhood disability’ have been on the child with the impairment — with the imperative to make the right diagnosis and find the right treatments. The implicit if not direct expectation was that interventions should aim to ‘fix’ the problems. Professionals have led the processes of investigation and management planning, with parents expected to ‘comply’ with professionals’ recommendations. Much less attention has been paid to parents’ perspectives or their wellbeing.

Recent Findings

In the past two decades, we have seen a sea change in our conceptualizations of childhood disability. The WHO’s framework for health (the International Classification of Functioning, Disability and Health (aka ICF)) and CanChild’s ‘F-words for Child Development’ inform modern thinking and action. We now recognize the family as the unit of interest, with parents’ voices an essential element of all aspects of management. The goals of intervention are built around the F-words ideas of function, family, fun, friendships, fitness and future.

Summary

There has been world-wide uptake of the F-words concepts, with increasing evidence of the impact of these ideas on parents and professionals alike. There are important implications of these developments on the structure, processes and content of services for children with neurodevelopmental disorders, their families and the services designed to support them.

"People Associate Us with Movement so It's an Awesome Opportunity": Perspectives from Physiotherapists on Promoting Physical Activity, Exercise and Sport

Insufficient physical activity (PA) is a critical public health issue especially in the context of COVID-related deconditioning. Health professionals are well placed to promote community-based PA but there is little supporting implementation research. We aimed to explore physiotherapists' knowledge, views, attitudes and experiences regarding the promotion of physical activity, exercise and sport within daily clinical practice in order to guide development of strategies to support implementation of PA promotion by physiotherapists, in particular those treating older people, and adults and children with a disability. We conducted interviews and focus groups with 39 physiotherapists. Two researchers coded transcripts with an iterative coding approach. Analysis returned five main themes: putting principles into practice; working with conflicting priorities; multiple client barriers; connections build confidence; and the battle for information. The physiotherapists accepted their legitimate role in PA promotion. Limited clinical and administrative time and acute treatment priorities often superseded PA promotion but the lack of updated information regarding suitable community-based PA opportunities and lack of trust in community providers were the biggest barriers. Strategies to enhance PA promotion by physiotherapists should address time and information constraints, and build partnership connections between health professionals and community-based PA providers.

Service Providers' Perspectives on Using the 'F-Words in Childhood Disability': An International Survey

AIMS

The 'F-words in Childhood Disability' - operationalizing the International Classification of Functioning, Disability and Health Framework - have attracted great interest around the world. However, we have yet to learn how service providers (SPs) are using them. The aim of this study was to explore international SPs' attitudes toward and use of the 'F-words'.

METHODS

A survey was administered, guided by the Theory of Planned Behavior, including Likert-scaled statements and an open-ended question. Ninety-one SPs working with children with impairments from 27 countries completed the survey.

RESULTS

While 82 agreed the 'F-words' are good practice, only 60 are using the 'F-words'. Similarly, 52 SPs agreed that their colleagues approved of their use and 54 felt they were easy for families to use and understand. Respondents reported three main uses: (i) support of preexisting clinical approaches, (ii) direct integration into practice, and (iii) being taught in higher education. They also identified barriers to implementation (e.g., alternative clinical approaches and limited resources).

CONCLUSIONS

Findings provide insights in how the 'F-words' are being used and the limitations thereof, which can inform future directions to support international implementation. With international SPs, we need to develop adapted dissemination tools to support uptake by individuals worldwide.