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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