"My Child May Be Ready, but I Am Not": Parents' Experiences of Their Children's Transition to Inclusive Fitness Settings

More than just having fun! Understanding the experience of involvement in physical activity of adolescents living with cerebral palsy

Purpose: To explore the experiences of involvement of adolescents living with cerebral palsy, and their parents, while participating in physical activity. Understanding involvement in physical activity may be used to guide future participation.Methods: Eight adolescents (mean age 13 years 11 months, SD 1 year 6 months) with cerebral palsy participated in a New Zealand-based high-level mobility programme (HLMP) focused on running skills, twice per week for 12 weeks. The adolescents and 12 parents were interviewed before, after the 12 weeks and 9-months following the HLMP. Guided by interpretative description, 38 interviews were coded, analysed, and interpreted.Results: Four themes were: "Turning up is not enough" ("There's no point being there if you're not involved"); "In it all the way", "Changes on a dime", and "What works for me." Perceptions of involvement varied between adolescents and parents. Being "very involved" related to high levels of focus, concentration, effort; but not always enjoyment.Conclusions: Focusing on enjoyment as the key experience of involvement understates the complexity and dynamic nature of involvement. "Being involved" is not always easy and may not mean the absence of discomfort or effort. Optimising the individuals' involvement continuum during physical activity may be essential to promote lifelong participation.IMPLICATIONS FOR REHABILITATIONAdolescents living with cerebral palsy and their parents have differing perspective of involvement and utilise different strategies to encourage being and staying active.Teaching adolescents living with cerebral palsy about their involvement continuum and optimal level of involvement for each activity, context and environment could promote sustained participation.To ensure adolescents are "being involved" in physical activity, opportunities for engagement, motivation and persistence are important; enjoyment is a possible, but not essential attribute of involvement.Encouraging involvement in physical activity can be a source of family conflict from a young age therefore clinicians have a role as an essential supporter, motivator and educator.

"Sports for All"-An Evaluation of a Community Based Physical Activity Program on the Access to Mainstream Sport for Children with Intellectual Disability

Access to club sports is still not a given for children with ID. Parents and children report numerous structural and social barriers to accessing mainstream sports. Sports clubs, on the other hand, want to include this group of people, but often do not know how to do it. Using a community-based approach, children with intellectual disabilities (8-15 years) and their parents were given the opportunity to participate in an 8-week sports program in four mainstream clubs organized by a self-help organization for people with intellectual disabilities. Focus groups were conducted with all participants (parents, children, and club representatives) before and after the program and evaluated by means of a thematic analysis. The children rated participation very positively and only very occasionally reported that they had been excluded. The parents confirmed this experience, but were nevertheless more critical in their assessment. Outside the research context of this study, the sports clubs hardly provided good support, which can also be deduced from previous negative experiences of the parents. The sports clubs themselves received valuable information about what their failings were: sufficiently available and qualified staff, better access to sports facilities, and a wider range of inclusive groups are needed. On the other hand, there was hardly any prejudice on the part of the non-disabled club members towards the new members with ID, which was evaluated extremely positively, albeit surprisingly, by the sports clubs.

Development of a survey measuring parental physical activity support in parents of children with disabilities

PURPOSE

The purposes of the current study were to develop a questionnaire to measure parental physical activity (PA) support in parents of children with disabilities and to examine factors associated with parental PA support.

MATERIALS AND METHODS

A questionnaire measuring parental PA support in parents of children with disabilities (PPSQ for PCD), consisting of three constructs (encouragement, co-PA, and logistic support) with 19 items, was initially developed and evaluated by the Confirmatory Factor Analysis. Three independent multiple regression analyses were conducted to examine associations between the three constructs and parental PA orientation variables.

RESULTS

With the item deletion approach, the final model with 12 items (four items in each construct) was developed, which revealed an excellent model fit (x2= 78.42 [df = 51, p = .008], CFI = 0.98, GFI = 0.94. RMSEA = 0.05). The multiple regression analyses revealed that parental orientation variables were differently associated with each construct of the PPSQ for PCD.

CONCLUSIONS

The PPSQ for PCD consists of three constructs, differently associated with parental orientation variables. This questionnaire can be used as an instrument to assess parental PA support. Implications for RehabilitationThe Parental Physical Activity Questionnaire (PPAQ) can be used to assess parental physical activity support in parents of children with disabilities.The PPAQ measures three constructs (i.e., types) of parental physical activity support including encouragement, co-physical activity, and logistic support.Parental physical activity orientations (e.g., importance, enjoyment, and behavior) are differently associated with each construct of parental physical activity support.

Parents' perceptions of the foundational and emergent benefits of residential immersive life skills programs for youth with disabilities

PURPOSE

To examine parents' views of the benefits of residential immersive life skills programs for youth with disabilities.

METHOD

Three- and 12-month post-session interviews were held with ten parents of youth with disabilities who had attended one of three residential immersive life skills programs in one of three years of data collection. A deductive thematic analysis was conducted to describe the types of benefits reported by parents.

RESULTS

Parents discussed foundational benefits that were common to youth and more individualized emergent benefits. The foundational benefits included acquisition of life skills, greater awareness of future possibilities, and enhancements to self-confidence. The emergent benefits included greater comfort in new situations, and changes in motivation and initiative, maturity and responsibility, and community involvement.

CONCLUSIONS

Parents reported diverse benefits from involvement in these youth transition programs. In the eyes of parents, these programs prepared youth for transition to adult roles by enhancing awareness of life possibilities, amplifying existing capacities, and accelerating growth in adaptability, motivation, and maturity, as well as community involvement. The findings indicate the utility of RILS programs, and can be used to explain the diverse effects of these programs to parents and youth contemplating enrollment.

Do Paediatric Physiotherapists Promote Community-Based Physical Activity for Children and Youth with Disabilities? A Mixed-Methods Study

Purpose: Although the importance of increased physical activity for children with disabilities is widely acknowledged, formal links between rehabilitation practitioners and community physical activity programmes are often lacking. The role of physiotherapists in the promotion of community physical activity is also often unclear. This study set out to describe the beliefs, knowledge, and practices of Canadian physiotherapists related to promoting community-based physical activity for children with disabilities. Method: We used a mixed-methods design: a survey of Canadian physiotherapists and qualitative focus group interviews with physiotherapists. Results: A total of 116 therapists participated in the survey. Of these, 80 (69.0%) considered the promotion of community-based physical activity programmes to be a physiotherapy role, and 89 (76.7%) recommended programmes to families. Therapists with less than 6 years of paediatric experience were less likely to recommend programmes to families (χ2 4 = 40.46, p < 0.001). Qualitative analysis resulted in three themes: (1) lack of clarity regarding the physiotherapy role, (2) "it's not easy" - challenges related to community-based physical activity promotion, and (3) one size does not fit all. Conclusions: Various factors shaped physiotherapists' ability to promote community physical activity, specifically their knowledge, practice setting expectations, and beliefs about their role. Concerted efforts to promote community-based physical activity may increase community capacity to support all children in physical activities.