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Kang LJ, Huang HH, Wu YT, Chen CL. Initial evaluation of an environment-based intervention for participation of autistic children: a randomized controlled trial. Disabil Rehabil 2024; 46:1851-1861. [PMID: 37183406 DOI: 10.1080/09638288.2023.2209743] [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: 09/23/2022] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE To evaluate the efficacy of environment-based intervention on participation outcomes and parent efficacy in autistic children. MATERIALS AND METHODS Twenty-one autistic children 6-10 years old and their parents were randomized to environment-based intervention (n = 11) or usual care (n = 10). The environment-based intervention targets individualized participation goals in leisure and community activities through changing environment and activity demands. The study outcomes were Canadian Occupational Performance Measure (COPM), Goal attainment scaling (GAS), and Parent Empowerment and Efficacy Measure (PEEM). Assessments included baseline, 12 weeks (post-test), and 24 weeks (follow-up). Mixed ANOVAs were used to examine within-group and between-group effects in outcome variables. RESULTS The COPM performance and satisfaction scores and GAS T-scores increased after environment-based intervention from baseline to 12 weeks and 24 weeks (p < 0.001) but did not significantly differ from usual care. The medium to large effect sizes of COPM performance and GAS T-scores favored the environment-based intervention. For the PEEM scores, no significant differences were found. CONCLUSIONS Environment-based intervention may support school-age autistic children to participate in self-chosen activities over time. The intervention effects on participation goals and parent efficacy, however, were inconclusive and need further research.
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Affiliation(s)
- Lin-Ju Kang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsiang-Han Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Ling Chen
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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Cross A, Soper AK, Tomas V, Grahovac D, Brocklehurst J, Kay D, Baptiste S, Gorter JW, Rosenbaum P. Exploring 10 years of dissemination of the F-words for Child Development: A multifaceted case study. Child Care Health Dev 2022; 48:751-762. [PMID: 35128716 DOI: 10.1111/cch.12983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Alice Kelen Soper
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Vanessa Tomas
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada
| | - Danijela Grahovac
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Julie Brocklehurst
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Diane Kay
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Sue Baptiste
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Allonsius F, de Kloet A, Bedell G, van Markus-Doornbosch F, Rosema S, Meesters J, Vliet Vlieland T, van der Holst M. Participation Restrictions among Children and Young Adults with Acquired Brain Injury in a Pediatric Outpatient Rehabilitation Cohort: The Patients' and Parents' Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041625. [PMID: 33567741 PMCID: PMC7914578 DOI: 10.3390/ijerph18041625] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022]
Abstract
Improving participation is an important aim in outpatient rehabilitation treatment. Knowledge regarding participation restrictions in children and young adults with acquired brain injury (ABI) is scarce and little is known regarding the differences in perspectives between patients and parents in the outpatient rehabilitation setting. The aims are to describe participation restrictions among children/young adults (5–24 years) with ABI and investigating differences between patients’ and parents’ perspectives. At admission in 10 rehabilitation centers, patients and parents were asked to complete the Child and Adolescent Scale of Participation (CASP; score 0–100; lower score = more restrictions) and injury/patient/family-related questions. CASP scores were categorized (full/somewhat-limited/limited/very-limited participation). Patient/parent-reported outcomes were compared using the Wilcoxon signed-rank test. 223 patients and 245 parents participated (209 paired-samples). Median patients’ age was 14 years (IQR; 11–16), 135 were female (52%), 195 had traumatic brain injury (75%). The median CASP score reported by patients was 82.5 (IQR: 67.5–90) and by parents 91.3 (IQR: 80.0–97.5) (difference = p < 0.05). The score of 58 patients (26%) and 25 parents (10%) was classified as ‘very-limited’. Twenty-six percent of children and young adults referred for rehabilitation after ABI had “very-limited” participation. Overall, parents rated their child’s participation better than patients themselves. Quantifying participation restrictions after ABI and considering both perspectives is important for outpatient rehabilitation treatment.
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Affiliation(s)
- Florian Allonsius
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Correspondence: (F.A.); (M.v.d.H.)
| | - Arend de Kloet
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA 02155, USA;
| | - Frederike van Markus-Doornbosch
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Stefanie Rosema
- National Department Level, Specialists in Youth and Families, 1105 AZ Amsterdam, The Netherlands;
| | - Jorit Meesters
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Centre of Expertsie in Health Innovations, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands
| | - Thea Vliet Vlieland
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Menno van der Holst
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence: (F.A.); (M.v.d.H.)
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Chien CW, Lai YYC, Lin CY, Graham F. Occupational Performance Coaching with Parents to Promote Community Participation and Quality of Life of Young Children with Developmental Disabilities: A Feasibility Evaluation in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217993. [PMID: 33143189 PMCID: PMC7662925 DOI: 10.3390/ijerph17217993] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/17/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
Participation in community activities contributes to child development and health-related quality of life (HRQOL), but restricted participation has been reported in children with disabilities. Occupational performance coaching (OPC) is an intervention that targets participatory goals in child performance through coaching parents, with evidence of effectiveness for pediatric populations. Little is known about the feasibility of OPC in Hong Kong, or its effect on children's community participation and HRQOL. A mixed-methods case study design was applied to explore Hong Kong parents' experience of OPC in relation to goal achievement, community participation, and HRQOL change in children. Four parents of young children with developmental disabilities (aged five to six years) received OPC for three to eight sessions within one to three months. Quantitative pre- and post-intervention data were analyzed descriptively. Semi-structured interviews with parents were conducted at post-intervention, and analyzed using content analysis. Results showed a trend of improvement in goal performance, child involvement in community activities, and specific aspects of HRQOL among most participants. Parents perceived undertaking OPC positively, described gaining insights and skills, and felt supported. The findings suggest that OPC warrants further investigation for use in Hong Kong, to promote children's community participation and quality of life.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China; (Y.Y.C.L.); (C.-Y.L.)
- Correspondence: ; Tel.: +852-2766-6703; Fax: +852-2330-8656
| | - Yuen Yi Cynthia Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China; (Y.Y.C.L.); (C.-Y.L.)
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China; (Y.Y.C.L.); (C.-Y.L.)
| | - Fiona Graham
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington South 6242, New Zealand;
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