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Quartermaine JR, Rose TA, Auld ML, Johnston LM. Participation measures that evaluate attendance and involvement for young people aged 15 to 25 years with cerebral palsy: a systematic review. Disabil Rehabil 2024; 46:1734-1750. [PMID: 37195908 DOI: 10.1080/09638288.2023.2207042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE To identify participation-focused measures used for young people with cerebral palsy (CP), evaluate their psychometric evidence, and map item content to the International Classification of Functioning, Disability, and Health (ICF), and family of Participation-Related Constructs (fPRC) frameworks. METHODS Four databases (PubMed, Embase, Web of Science, CINAHL) were searched for papers that involved young people with CP aged 15 to 25 years and reported original data from a participation measure. Each measure was examined for validity, reliability, responsiveness (using the COSMIN checklist), clinical utility, the inclusion of accessible design features, self- and/or proxy-report from people with communication support needs, and item content according to ICF and fPRC. RESULTS Of 895 papers, 80 were included for review. From these, 26 measures were identified. Seven measures (27 papers/resources) were participation-focused, capable of producing a score for participation Attendance and/or Involvement. Of these, all measured Attendance (n = 7) but fewer than half measured Involvement (n = 3). Few included studies (37%) reported including some self-report of people with communication support needs. CONCLUSIONS Participation measures for young people with CP are evolving but require more: (i) emphasis on measurement of involvement; (ii) investigation of psychometric properties; and (iii) adaptation to enable self-report by young people with communication support needs.
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Affiliation(s)
- Jacinta R Quartermaine
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
- Choice, Passion, Life, Brisbane, Australia
- Queensland Cerebral Palsy Register, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
| | - Megan L Auld
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
- Choice, Passion, Life, Brisbane, Australia
- Queensland Cerebral Palsy Register, Brisbane, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
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Kerem-Günel M, Arslan UE, Seyhan-Bıyık K, Özal C, Numanoğlu-Akbaş A, Üneş S, Tunçdemir M, Çankaya Ö, Özcebe H, Green D. Evaluation of daily and social participation of children with Cerebral Palsy across different age groups with a focus on the 'F'-words: Function, family, fitness, fun, friends and future. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 140:104588. [PMID: 37562097 DOI: 10.1016/j.ridd.2023.104588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 06/09/2023] [Accepted: 07/29/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND The impact of disability differs across cultures. This study aimed to determine the predictors of participation in children with cerebral palsy (CP) in Turkey, based on the six F-words. METHODS Cross-sectional study exploring participation profiles of 450 children with CP, aged between 2 and 18 years. Pediatric Evaluation of Disability Inventory (PEDI) evaluated functional skills, and Assessment of Life Habits (LIFE-H) version 3.0 assessed daily and social participation. Hierarchical linear regression models were done to determine the predictors of participation in daily activities (PDA) and social roles (PSR) in three age groups (2-4, 5-13 and 14-18 years) based on the 6 F-words (mobility of PEDI for 'fitness'; four classification systems and self-care of PEDI for 'functioning'; social functions of PEDI for 'friends'; demographic information by parents for 'family'; the recreation of LIFE-H for 'fun'; and different stages of development for 'future'). RESULTS The most important predictors for total PDA by age group were: self-care (p = 0.012) of PEDI in 2-4 y; self-care (p = 0.001) and mobility (p = 0.005) of PEDI in 5-13 y; GMFCS (p = 0.006) and mobility (p = 0.002) of PEDI in 14-18 y. Significant predictors for PSR differed by age group: self-care (p = 0.001) of PEDI in 2-4 y; self-care (p = 0.023) and mobility (p = 0.006) of PEDI in 5-13 y; and GMFCS (p = 0.004) and MACS (p = 0.003) in 14-18 y. CONCLUSIONS Six F-words of function and fitness focussed on self-care in younger children with an increasing emphasis on mobility and ability levels according to age. Therefore, rehabilitation for different aspects of the functional levels is needed to improve participation in life across the six F-words framework; plus take into consideration context, age-differences, family's expectations, life requirements, environmental needs, and cultural differences.
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Affiliation(s)
- Mintaze Kerem-Günel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Umut Ece Arslan
- Department of Health Research, Institue of Public Health, Hacettepe University, Ankara, Turkey
| | - Kübra Seyhan-Bıyık
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cemil Özal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ayşe Numanoğlu-Akbaş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
| | - Sefa Üneş
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Tunçdemir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Özge Çankaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kütahya Health Sciences University, Kütahya, Turkey
| | - Hilal Özcebe
- Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Dido Green
- Department of Rehabilitation, Oxford Brookes University, Oxford, England, UK
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Sarac C, Nelissen RGHH, van der Holst M, Malessy MJA, Pondaag W. Differences in the perspectives of functioning and health in the ICF model between patients with brachial plexus birth injury and their parents versus healthcare professionals. Disabil Rehabil 2022; 45:1805-1810. [PMID: 35611466 DOI: 10.1080/09638288.2022.2075475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To explore and compare the perspectives of patients and their parents (PPs) with a brachial plexus birth injury (BPBI) with those of health care professionals (HCPs). MATERIALS AND METHODS We conducted a study using a questionnaire among PPs and HCPs. Importance of different outcome categories was scored on a Likert scale. Items were linked to corresponding categories of the International Classification of Functioning, Disability and Health. Means were compared using analysis of variance (ANOVA). RESULTS Data were collected from 184 patients and 65 HCPs. We found a difference in 7/14 outcome categories between joint PP groups and HCPs. Parents scored outcome evaluation categories as more important than patients, categories filled out together by patient and parent scored in between (p < 0.05). The majority of PPs and HCPs rated outcome assessment as important in more domains than "Body functions" and "Body structures". The biggest difference was found in the importance of evaluation of pain. CONCLUSIONS Outcome assessment in the domains "Activities and participation" and "Environmental factors" was rated as important by both PPs and HCPs. Evaluation of pain was more often scored as important by PPs. Different domains seem to be underestimated by HCPs and need more attention during consultation. Implications for rehabilitationThe importance of outcome evaluation concerning "Pain", "Interaction with peers", and "Interaction with medical and paramedical specialists" should be taken into account in the rehabilitation for this specific group of patients and their parents (PPs).Comparison of perspectives on functioning between brachial plexus birth injury (BPBI) PPs and health care professionals.Outcome assessment in domains "Activities and participation" and "Environmental factors" is important.Health care professionals undervalue the importance of pain evaluation in BPBI as compared with PPs.
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Affiliation(s)
- Cigdem Sarac
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Rob G H H Nelissen
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Menno van der Holst
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.,Basalt Rehabilitation, Leiden, The Netherlands
| | - Martijn J A Malessy
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Willem Pondaag
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
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Gilmore R, Sakzewski L, Ziviani J, Mcintyre S, Smithers Sheedy H, Hilton N, Williams T, Quinn K, Sarandrea AM, Laugeson E, Chatfield M. Multicentre, randomised waitlist control trial investigating a parent-assisted social skills group programme for adolescents with brain injuries: protocol for the friends project. BMJ Open 2019; 9:e029587. [PMID: 31462477 PMCID: PMC6720336 DOI: 10.1136/bmjopen-2019-029587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Adolescents with brain injury frequently have difficulties with social competence, which persist into adulthood affecting their participation in daily life. To date, there has been limited research into the efficacy of social competence interventions in this population. Research from the Program for the Education and Enrichment of Relational Skills (PEERS) has demonstrated significant improvements in social competence skills, maintained at 1-year to 5-year follow-up, for adolescents with autism spectrum disorder. PEERS has not yet been tested among adolescents with brain injury. This protocol describes a pragmatic, parallel two-group pre-test post-test randomised waitlist control trial across two sites in Australia, which aims to evaluate the feasibility, acceptability and efficacy of PEERS in adolescents with brain injury compared with usual care. METHODS AND ANALYSIS Forty adolescents with an acquired brain injury or cerebral palsy will be randomly assigned to either the 14-week PEERS group or waitlist care as usual group. The waitlist group will then receive PEERS following the 26-week retention time point. Outcomes will be assessed at baseline, 14 weeks (immediately postintervention) and 26 weeks follow-up (retention). The primary outcomes are self-report and parent report on the Social Skills Improvement System Rating Scales immediately post PEERS at 14 weeks. Secondary outcomes include increased frequency of get-togethers with peers with reduced conflict and increased adolescent self-reported knowledge of social skills. Acceptability and feasibility will be examined through qualitative analysis of focus group data collected after the completion of each group. ETHICS AND DISSEMINATION Ethics approval has been granted by the Medical Research Ethics Committee Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/17/QRCH/87), The University of Queensland (2017000864) and the Cerebral Palsy Alliance Ethics Committee (20170802/HREC:EC00402). The findings will be disseminated in peer-reviewed journals, by conference presentation and newsletters to consumers. TRIAL REGISTRATION NUMBER ACTRN12617000723381.
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Affiliation(s)
- Rose Gilmore
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Queensland, Australia
| | - Hayley Smithers Sheedy
- Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Queensland, Australia
| | - Nicola Hilton
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Tracey Williams
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Kirsten Quinn
- Youth Services Department, Cerebral Palsy Alliance, Sydney, NSW, Australia
| | - Anne Marie Sarandrea
- Kids Rehab, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Elizabeth Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
| | - Mark Chatfield
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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Lopes PB, Shikako-Thomas K, Cardoso R, Simões Matsukura T. Social participation: the perspectives of adolescents with cerebral palsy and their mothers. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:263-272. [PMID: 34408861 PMCID: PMC8366635 DOI: 10.1080/20473869.2019.1623596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 06/13/2023]
Abstract
BACKGROUND Social participation is a complex construct, thus different factors may facilitate or restrict engagement. Adolescents with Cerebral Palsy (CP) and their mothers often experience barriers in social participation. Therefore, they are frequently facing challenges in order to engage in meaningful activities, in different contexts. OBJECTIVE We aimed at exploring the perspectives of mothers and adolescents with CP on their social participation. METHOD This is a cross-sectional and exploratory study, with a qualitative design. Seven adolescents with CP, aged from 11 to17 years old and their mothers, participated in a semi-structured interview, in São Paulo, Brazil. Data from interviews were analyzed with the Collective Subject Discourse (CSD) technique. RESULTS Mothers believed that their parenting practices contribute to the social participation of their children. Mothers revealed concerns about how to support the autonomy of their children and how to help them to establish meaningful and mature relationships. Adolescents with CP reported to engage in a range of social activities, with friends in different contexts, such as restaurants, cinema, concerts, parks and school. They also reported to appreciate social participation and to look for strategies in order to engage. CONCLUSIONS This work can contribute to the understanding of social participation of adolescents with CP, under the perspective of these people and their mothers by allowing them to express their thoughts and voice their fears and limitations. Healthcare providers should adopt a lifespan approach to disabilities and recognize the unique challenges of adolescence in the life of both child and parents.
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Affiliation(s)
| | - Keiko Shikako-Thomas
- School of Physical and Occupational Therapy, McGill University, Researcher, CRIR/Centre de réadaptation MAB-Mackay, Montreal, QC, Canada
| | - Roberta Cardoso
- Department of Occupational Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Thelma Simões Matsukura
- Department of Occupational Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Schiariti V, Fowler E, Brandenburg JE, Levey E, Mcintyre S, Sukal-Moulton T, Ramey SL, Rose J, Sienko S, Stashinko E, Vogtle L, Feldman RS, Koenig JI. A common data language for clinical research studies: the National Institute of Neurological Disorders and Stroke and American Academy for Cerebral Palsy and Developmental Medicine Cerebral Palsy Common Data Elements Version 1.0 recommendations. Dev Med Child Neurol 2018. [PMID: 29542813 DOI: 10.1111/dmcn.13723] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED To increase the efficiency and effectiveness of clinical research studies, cerebral palsy (CP) specific Common Data Elements (CDEs) were developed through a partnership between the National Institute of Neurological Disorders and Stroke (NINDS) and the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM). International experts reviewed existing NINDS CDEs and tools used in studies of children and young people with CP. CDEs were compiled, subjected to internal review, and posted online for external public comment in September 2016. Guided by the International Classification of Functioning, Disability and Health framework, CDEs were categorized into six domains: (1) participant characteristics; (2) health, growth, and genetics; (3) neuroimaging; (4) neuromotor skills and functional assessments; (5) neurocognitive, social, and emotional assessments; and (6) engagement and quality of life. Version 1.0 of the NINDS/AACPDM CDEs for CP is publicly available on the NINDS CDE and AACPDM websites. Global use of CDEs for CP will standardize data collection, improve data quality, and facilitate comparisons across studies. Ongoing collaboration with international colleagues, industry, and people with CP and their families will provide meaningful feedback and updates as additional evidence is obtained. These CDEs are recommended for NINDS-funded research for CP. WHAT THIS PAPER ADDS This is the first comprehensive Common Data Elements (CDEs) for children and young people with CP for clinical research. The CDEs for children and young people with CP include common definitions, the standardization of case report forms, and measures. The CDE guides the standardization for data collection and outcome evaluation in all types of studies with children and young people with CP. The CDE ultimately improves data quality and data sharing.
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Affiliation(s)
- Verónica Schiariti
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Eileen Fowler
- University of California Los Angeles, Los Angeles, CA, USA
| | - Joline E Brandenburg
- Department of Physical Medicine and Rehabilitation, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Eric Levey
- Health Services for Children with Special Needs, Inc., Washington, DC, USA
| | - Sarah Mcintyre
- Cerebral Palsy Alliance, University of Sydney, Sydney, NSW, Australia
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sharon L Ramey
- Virginia Tech Carilion Research Institute, Virginia Polytechnic Institute, Roanoke, VA, USA
| | - Jessica Rose
- Stanford University School of Medicine, Stanford, CA, USA
| | - Susan Sienko
- Shriners Hospitals for Children, Portland, OR, USA
| | | | - Laura Vogtle
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - James I Koenig
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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Furtado SRC, Sampaio RF, Vaz DV, Pinho BAS, Nascimento IO, Mancini MC. Brazilian version of the instrument of environmental assessment Craig Hospital Inventory of Environmental Factors (CHIEF): translation, cross-cultural adaptation and reliability. Braz J Phys Ther 2016; 18:259-67. [PMID: 25003279 PMCID: PMC4183498 DOI: 10.1590/bjpt-rbf.2014.0036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 01/21/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Environmental factors are essential for the characterization of human functioning and disability; however, the shortage of standardized instruments to assess environmental factors has limited the design of scientific investigations directed at identifying barriers to and facilitators of social participation of people with disabilities. OBJECTIVES To translate to Brazilian Portuguese, cross-culturally adapt, and verify the reliability of an environmental assessment questionnaire, entitled Craig Hospital Inventory of Environmental Factors (CHIEF). METHOD The questionnaire was translated to Portuguese, analyzed, translated back to English, and compared with the original version. The final version (CHIEF-BR) was submitted to 47 caregivers of children and adolescents with cerebral palsy (CP). The intra-rater reliability was tested using quadratic kappa and intraclass correlation coefficients (ICC), through interviews of 23 caregivers drawn from the total sample, on two occasions 10 days apart. Results : During submission of the questionnaires, it was observed that examples were needed in order to facilitate the understanding of the questions related to the politics sub-scale. Quadratic kappa showed that test-retest reliability of each question varied from 0.28 to 1.0 for the frequency score and from 0.30 to 0.98 for the magnitude score. Intraclass correlation coefficients for total scores showed high consistency indices (ICC ≥ 0.92) for test-retest. CONCLUSION The Brazilian version of the CHIEF was reproducible and applicable to the study sample. It may serve as an instrument to characterize the environmental barriers as well as a way to document the effects of interventions aimed at minimizing the impact of such barriers on the participation of children and adolescents with CP.
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Affiliation(s)
- Sheyla R C Furtado
- Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rosana F Sampaio
- Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Daniela V Vaz
- Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Marisa C Mancini
- Occupational Therapy Department, UFMG, Belo Horizonte, MG, Brazil
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Kreider CM, Bendixen RM, Young ME, Prudencio SM, McCarty C, Mann WC. Social networks and participation with others for youth with learning, attention, and autism spectrum disorders. Can J Occup Ther 2016; 83:14-26. [PMID: 26755040 PMCID: PMC4710853 DOI: 10.1177/0008417415583107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Social participation involves activities and roles providing interactions with others, including those within their social networks. PURPOSE This study sought to characterize social networks and participation with others for 36 youth, ages 11 to 16 years, with (n = 19) and without (n = 17) learning disability, attention disorder, or high-functioning autism. METHOD Social networks were measured using methods of personal network analysis. The Children's Assessment of Participation and Enjoyment With Whom dimension scores were used to measure participation with others. Youth from the clinical group were interviewed regarding their experiences within their social networks. FINDINGS Group differences were observed for six social network variables and in the proportion of overall, physical, recreational, social, and informal activities engaged with family and/or friends. Qualitative findings explicated strategies used in building, shaping, and maintaining social networks. IMPLICATIONS Social network factors should be considered when seeking to understand social participation.
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HIDECKER MARYJOCOOLEY, HO NHANTHI, DODGE NANCY, HURVITZ EDWARDA, SLAUGHTER JAIME, WORKINGER MARILYNSEIF, KENT RAYD, ROSENBAUM PETER, LENSKI MADELEINE, MESSAROS BRIDGETM, VANDERBEEK SUZETTEB, DEROOS STEVEN, PANETH NIGEL. Inter-relationships of functional status in cerebral palsy: analyzing gross motor function, manual ability, and communication function classification systems in children. Dev Med Child Neurol 2012; 54:737-42. [PMID: 22715907 PMCID: PMC3393796 DOI: 10.1111/j.1469-8749.2012.04312.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To investigate the relationships among the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) in children with cerebral palsy (CP). METHOD Using questionnaires describing each scale, mothers reported GMFCS, MACS, and CFCS levels in 222 children with CP aged from 2 to 17 years (94 females, 128 males; mean age 8 y, SD 4). Children were referred from pediatric developmental/behavioral, physiatry, and child neurology clinics, in the USA, for a case-control study of the etiology of CP. Pairwise relationships among the three systems were assessed using Spearman's correlation coefficients (r(s) ), stratifying by age and CP topographical classifications. RESULTS Correlations among the three functional assessments were strong or moderate. GMFCS levels were highly correlated with MACS levels (r(s) = 0.69) and somewhat less so with CFCS levels (r(s) = 0.47). MACS and CFCS were also moderately correlated (r(s) = 0.54). However, many combinations of functionality were found. Of the 125 possible combinations of the three five-point systems, 62 were found in these data. INTERPRETATION Use of all three classification systems provides a more comprehensive picture of the child's function in daily life than use of any one alone. This resulting functional profile can inform both clinical and research purposes.
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Affiliation(s)
| | - NHAN THI HO
- Department of Epidemiology, Michigan State University, East Lansing, MI
| | - NANCY DODGE
- Department of Neurodevelopmental Pediatrics, Helen DeVos Children’s Hospital, Grand Rapids, MI
| | - EDWARD A HURVITZ
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - JAIME SLAUGHTER
- Department of Epidemiology, Michigan State University, East Lansing, MI
| | | | - RAY D KENT
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - PETER ROSENBAUM
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - MADELEINE LENSKI
- Department of Epidemiology, Michigan State University, East Lansing, MI
| | - BRIDGET M MESSAROS
- Department of Biomedical Research and Informatics Core, Michigan State University, East Lansing, MI
| | | | - STEVEN DEROOS
- Department of Neurology, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
| | - NIGEL PANETH
- Department of Epidemiology, Michigan State University, East Lansing, MI
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