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Brugnaro BH, Fernandes G, De Campos AC, Pavão SL, Pfeifer LI, De Camargo OK, Hlyva O, Rocha NACF. Participação em casa e fatores pessoais e ambientais em crianças e adolescentes com síndrome de Down. Dev Med Child Neurol 2024. [PMID: 38698694 DOI: 10.1111/dmcn.15930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
ResumoObjetivoDescrever a participação em casa atual (frequência, envolvimento) e o desejo do cuidador por mudança na participação em casa de crianças e adolescentes com síndrome de Down, bem como fatores ambientais da casa, e explorar as associações de fatores pessoais e ambientais com a participação atual e o desejo do cuidador por mudança.MétodoOitenta e dois cuidadores (média de idade = 45 anos e 10 meses) de crianças e adolescentes com síndrome de Down (média de idade = 10 anos e 7 meses) foram entrevistados sobre a participação em casa da criança e fatores ambientais utilizando a Medida de Participação e do Ambiente ‐ Crianças e Jovens. Além disso, foram coletados fatores pessoais e ambientais das crianças. Os resultados são relatados por meio de análise descritiva e correlações (coeficientes de correlação de Spearman ou teste U de Mann–Whitney) para descrever a relação entre a participação atual e o desejo do cuidador por mudança, com fatores pessoais e ambientais, para as variáveis ordinais e nominais, respectivamente (p < 0,05).ResultadosA participação das crianças foi maior em cuidados pessoais e menor em atividades relacionadas à escola. A maioria dos cuidadores desejava mudança nas lições de casa e nas tarefas domésticas. Maior frequência de participação foi associada ao sexo masculino, distanciamento social menos rigoroso do cuidador devido à pandemia de covid‐19 e crianças recebendo terapia. O maior envolvimento na participação foi associado a uma idade mais jovem nas crianças e a um maior apoio do ambiente. A idade mais avançada das crianças foi associada ao maior desejo por mudança do cuidador.InterpretaçãoFatores pessoais e ambientais são correlacionados com a participação de formas específicas. Devem ser realizadas estratégias criativas para promover a participação e que considerem os desejos do cuidador.
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Affiliation(s)
- Beatriz Helena Brugnaro
- Departamento de Fisioterrapia, Laboratório de Análise do Desenvolvimento Infantil (LADI), Universidade Federal de São Carlos, São Carlos, Brazil
| | - Gesica Fernandes
- Departamento de Fisioterrapia, Laboratório de Análise do Desenvolvimento Infantil (LADI), Universidade Federal de São Carlos, São Carlos, Brazil
| | - Ana Carolina De Campos
- Departamento de Fisioterrapia, Laboratório de Análise do Desenvolvimento Infantil (LADI), Universidade Federal de São Carlos, São Carlos, Brazil
| | - Silvia Letícia Pavão
- Departamento de Prevenção e Reabilitação em Fisioterapia, Universidade Federal do Paraná, Curitiba, Brazil
| | - Luzia Iara Pfeifer
- Departamento de Terapia Ocupacional, Laboratório de Ensino e Pesquisa em Terapia Ocupacional, Infância e Adolescência, Universidade Federal de São Carlos, São Carlos, Brazil
- Departamento de Neurociências e Ciências do Comportamento da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Olaf Kraus De Camargo
- Departamento de Pediatria, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Oksana Hlyva
- Departamento de Pediatria, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Nelci Adriana Cicuto Ferreira Rocha
- Departamento de Fisioterrapia, Laboratório de Análise do Desenvolvimento Infantil (LADI), Universidade Federal de São Carlos, São Carlos, Brazil
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Brugnaro BH, Fernandes G, De Campos AC, Pavão SL, Pfeifer LI, Kraus de Camargo O, Hlyva O, Rocha NACF. Home participation and personal and environmental factors in children and adolescents with Down syndrome. Dev Med Child Neurol 2024. [PMID: 38526024 DOI: 10.1111/dmcn.15891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 01/14/2024] [Accepted: 02/07/2024] [Indexed: 03/26/2024]
Abstract
AIM To describe current home participation (frequency, involvement) and caregiver's desire for change in home participation of children and adolescents with Down syndrome, as well as home environmental factors, and to explore the associations of personal and environmental factors with current participation and caregiver's desire for change. METHOD Eighty-two caregivers (mean age = 45 years 10 months) of children and adolescents with Down syndrome (mean age = 10 years 7 months) were surveyed about the child's home participation and environmental factors using the Participation and Environment Measure-Children and Youth. Furthermore, children's personal and environmental factors were collected. Results are reported using descriptive analysis and correlations (Spearman's rank correlation coefficients and Mann-Whitney U test) to describe the relationship between current participation and caregiver's desire for change, with personal and environmental factors as ordinal and nominal variables respectively (p < 0.05). RESULTS Children's participation was highest with regard to personal care management and lowest with regard to school-related activities. Most caregivers desired change in homework and household chores. Greater frequency was associated with male sex, caregiver less rigorous social distancing due to the COVID-19 pandemic, and children receiving therapies. Greater involvement was associated with younger age in children and higher environmental support. Older age in children was associated with caregiver's greater desire for change. INTERPRETATION Personal and environmental factors correlated with participation in specific ways. Creative strategies to promote participation that consider caregiver's wishes should be undertaken.
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Affiliation(s)
- Beatriz Helena Brugnaro
- Department of Physical Therapy, Child Development Analysis Laboratory, Federal University of São Carlos, São Carlos, Brazil
| | - Gesica Fernandes
- Department of Physical Therapy, Child Development Analysis Laboratory, Federal University of São Carlos, São Carlos, Brazil
| | - Ana Carolina De Campos
- Department of Physical Therapy, Child Development Analysis Laboratory, Federal University of São Carlos, São Carlos, Brazil
| | - Silvia Letícia Pavão
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba, Brazil
| | - Luzia Iara Pfeifer
- Department of Occupational Therapy, Teaching and Research Laboratory in Occupational Therapy, Childhood, and Adolescence, Federal University of São Carlos, São Carlos, Brazil
- Department of Neurosciences and Behavioral Sciences at the Ribeirão Preto Medical School at the University of São Paulo, Ribeirão Preto, Brazil
| | - Olaf Kraus de Camargo
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Oksana Hlyva
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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Kaelin VC, Saluja S, Bosak DL, Anaby D, Werler M, Khetani MA. Caregiver strategies supporting community participation among children and youth with or at risk for disabilities: a mixed-methods study. Front Pediatr 2024; 12:1345755. [PMID: 38425659 PMCID: PMC10902462 DOI: 10.3389/fped.2024.1345755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction The purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect of participation-focused caregiver strategies on the relationship(s) between participation-related constructs and community participation attendance and involvement. For the qualitative phase, we solicited caregiver perspectives to explain the quantitative findings. Methods An explanatory sequential mixed-methods design (QUAN > qual) was used. For the quantitative phase, we conducted secondary analyses of data collected during a second follow-up phase of a longitudinal cohort study, including 260 families of children and youth (mean age: 13.5 years) with disabilities and those at risk [i.e., 120 families of children and youth with craniofacial microsomia (CFM); 140 families of children and youth with other types of childhood-onset disabilities]. Data were collected through the Participation and Environment Measure-Children and Youth, the Pediatric Quality of Life Inventory, and the Child Behavior Checklist and analyzed using structural equation modeling. For the qualitative phase, we conducted semi-structured interviews with eight caregivers of children and youth with disabilities and those at risk (i.e., three caregivers of children and youth with CFM; five caregivers of children and youth with other childhood-onset disabilities). Interviews were transcribed verbatim and inductively content-analyzed. Results Our model reached acceptable to close model fit [CFI = 0.952; RMSEA = 0.068 (90% CI = 0.054-0.082); SRMR = 0.055; TLI = 0.936], revealing no significant effect of the number of participation-focused caregiver strategies on the relationships between participation-related constructs (e.g., activity competence, environment/context) and community participation in terms of attendance and involvement. The qualitative findings revealed three main categories for how caregivers explained these quantitative results: (1) caregiver workload and supports needed for implementing strategies; (2) caregivers careful strategy quality appraisal; and (3) community setting characteristics hindering successful strategy implementation. Discussion The findings suggest that the insignificant effect of the number of caregiver strategies may be explained by the intensified need for caregiver effort and support to develop and implement quality strategies that are responsive to community setting characteristics.
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Affiliation(s)
- Vera C. Kaelin
- Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
- Computer Science, University of Illinois Chicago, Chicago, IL, United States
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
- Computing Science, Umeå University, Umeå, Sweden
| | - Shivani Saluja
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
| | - Dianna L. Bosak
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, CA, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United States
| | - Martha Werler
- Epidemiology, Boston University, Boston, MA, United States
| | - Mary A. Khetani
- Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
- Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, CA, United States
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Lin CL, Lin HY, Wang PJ. Association between Mastery Motivation, Executive Function, and Daily Participation of Young Children with and without Global Developmental Delays. CHILDREN (BASEL, SWITZERLAND) 2024; 11:220. [PMID: 38397332 PMCID: PMC10887173 DOI: 10.3390/children11020220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
This study aimed to examine the group differences in participation level between children with and without global delays and to explore the associations between mastery motivation, executive function, and participation in young children with and without global developmental delays (GDD). Methods: we recruited 26 children with GDD aged 2 to 5 years and 26 children with sex- and mental age-matched developing typically (TD). The participants were assessed child development using the standardized developmental test, and their mothers were asked to fill in questionnaires, including the revised Dimension of Mastery Questionnaire (DMQ 18) with preschool version to assess mastery motivation, the Behavior Rating Inventory of Executive Function with preschool version (BRIEF-P) to assess executive function, and the Young Children's Participation and Environment Measure (YC-PEM) used to obtain participation levels. Results and conclusions: young children with GDD showed significantly lower participation levels at home, daycare, and community than TD group. We found that for young children, child mastery pleasure, health condition, and total persistence were significant predictors of child participation. Therefore, coaching parents to observe and facilitate their children's motivation and executive function, as well as child developmental abilities, is important in order to enhance children's participation in daily activities.
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Affiliation(s)
- Chien-Lin Lin
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404327, Taiwan;
| | - Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung 413305, Taiwan;
| | - Pei-Jung Wang
- Department of Physical Therapy, Asia University, Taichung 413305, Taiwan
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Brugnaro BH, Kraus de Camargo O, Pfeifer LI, Pavão SL, Hlyva O, Rocha NACF. Association between participation at home and functional skills in children and adolescents with Down syndrome: A cross-sectional study. Child Care Health Dev 2024; 50:e13197. [PMID: 37955102 DOI: 10.1111/cch.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/02/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND According to a biopsychosocial approach to health and disability, participation at home and functional skills are important components of the functioning. Therefore, knowledge about interactions between these components allows for targeting specific interventions. OBJECTIVE This study investigated whether participation opportunities (frequency and involvement) for children/adolescents with Down syndrome (DS) in a realistic environment at their own home are associated with the functional skills related to the domains of Daily Activities, Mobility, Social/Cognitive and Responsibility. METHODS This was an observational study. Forty-eight children/adolescents with DS participated (mean age: 10.73 ± 3.43; n = 27 females). Participants were evaluated using the Participation and Environment Measure for Children and Youth (PEM-CY) home environment setting (raw frequency and engagement scores) and Pediatric Evaluation of Disability Inventory speedy version (PEDI-CAT-SV) (continuous score). RESULTS Significant and positive correlations were found between the frequency of participation at home with Daily Activities (ro = 0.320), Social/Cognitive (ro = 0.423) and Responsibility (ro = 0.455). For involvement, significant and positive correlations were found with Daily Activities (ro = 0.297), Social/Cognitive (ro = 0.380) and Responsibility (ro = 0.380). For the PEDI-CAT-SV Mobility, no significant correlation was found. CONCLUSIONS Higher frequency and involvement of participation at home are associated with greater functional skills assessed, except for Mobility. This study provided pioneering insights about the relationships between the level of home participation and functional skills in DS, generating evidence that could guide approaches to participation-focused intervention.
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Affiliation(s)
- Beatriz Helena Brugnaro
- Department of Physical Therapy, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | | | - Luzia Iara Pfeifer
- Department of Occupational Therapy, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Silvia Letícia Pavão
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba, Brazil
| | - Oksana Hlyva
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Villegas VC, Bosak DL, Salgado Z, Phoenix M, Parde N, Teplicky R, Khetani MA. Diversified caregiver input to upgrade the Young Children's Participation and Environment Measure for equitable pediatric re/habilitation practice. J Patient Rep Outcomes 2023; 7:87. [PMID: 37639038 PMCID: PMC10462549 DOI: 10.1186/s41687-023-00627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Practitioner and family experiences of pediatric re/habilitation can be inequitable. The Young Children's Participation and Environment Measure (YC-PEM) is an evidence-based and promising electronic patient-reported outcome measure that was designed with and for caregivers for research and practice. This study examined historically minoritized caregivers' responses to revised YC-PEM content modifications and their perspectives on core intelligent virtual agent functionality needed to improve its reach for equitable service design. METHODS Caregivers were recruited during a routine early intervention (EI) service visit and met five inclusion criteria: (1) were 18 + years old; (2) identified as the parent or legal guardian of a child 0-3 years old enrolled in EI services for 3 + months; (3) read, wrote, and spoke English; (4) had Internet and telephone access; and (5) identified as a parent or legal guardian of a Black, non-Hispanic child or as publicly insured. Three rounds of semi-structured cognitive interviews (55-90 min each) used videoconferencing to gather caregiver feedback on their responses to select content modifications while completing YC-PEM, and their ideas for core intelligent virtual agent functionality. Interviews were transcribed verbatim, cross-checked for accuracy, and deductively and inductively content analyzed by multiple staff in three rounds. RESULTS Eight Black, non-Hispanic caregivers from a single urban EI catchment and with diverse income levels (Mdn = $15,001-20,000) were enrolled, with children (M = 21.2 months, SD = 7.73) enrolled in EI. Caregivers proposed three ways to improve comprehension (clarify item wording, remove or simplify terms, add item examples). Environmental item edits prompted caregivers to share how they relate and respond to experiences with interpersonal and institutional discrimination impacting participation. Caregivers characterized three core functions of a virtual agent to strengthen YC-PEM navigation (read question aloud, visual and verbal prompts, more examples and/or definitions). CONCLUSIONS Results indicate four ways that YC-PEM content will be modified to strengthen how providers screen for unmet participation needs and determinants to design pediatric re/habilitation services that are responsive to family priorities. Results also motivate the need for user-centered design of an intelligent virtual agent to strengthen user navigation, prior to undertaking a community-based pragmatic trial of its implementation for equitable practice.
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Affiliation(s)
- Vivian C Villegas
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | - Dianna L Bosak
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | - Zurisadai Salgado
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA
| | - Michelle Phoenix
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, USA
| | - Natalie Parde
- Department of Computer Science, University of Illinois Chicago, Chicago, IL, USA
| | - Rachel Teplicky
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, USA
| | - Mary A Khetani
- Children's Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA.
- Department of Occupational Therapy, University of Illinois Chicago, 1919 West Taylor Street, Room 316A, Chicago, IL, 60612-7250, USA.
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Soref B, Robinson GL, Bart O. The Effect of a Short-Term Occupational Therapy Intervention on the Participation and Personal Factors of Preschoolers with Developmental Disabilities. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1401. [PMID: 37628400 PMCID: PMC10453018 DOI: 10.3390/children10081401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Preschoolers with developmental disabilities are referred to occupational therapy due to their decreased participation in daily life occupations. The purpose of this study was to evaluate the improvement in preschoolers' participation and sensory-motor abilities following an occupational therapy intervention. MATERIALS AND METHODS A prospective cohort study of 38 preschoolers and their parents was conducted using an interrupted time-series design, including assessments at three time points: base line (upon referral to an occupational therapy assessment), pre-intervention, and post-intervention after 9-12 sessions of occupational therapy interventions. Children were evaluated with the Developmental Test of Visual-Motor Integration, as well as the balance and fine motor precision sub tests of the Bruininks-Oseretsky Test of Motor Proficiency. Parents completed the Children's Participation Questionnaire and the Child Performance Skills Questionnaire. Each intervention session was documented by the therapists using the Documentation of Occupational Therapy Session Intervention form. RESULTS Significant improvement in children's sensory-motor abilities were found in balance, visual integration, and fine motor precision post-intervention. There were also improvements in the measures of diversity, children's independence, and parental satisfaction. CONCLUSIONS A short-term occupational therapy intervention applied to preschoolers with developmental disabilities is effective in improving their sensory-motor abilities, as well as in promoting their participation in daily activities.
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Affiliation(s)
- Bosmat Soref
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel;
- The Child Developmental Unit, Clalit Health Services, Tel Aviv 6816323, Israel;
| | - Gary L. Robinson
- The Child Developmental Unit, Clalit Health Services, Tel Aviv 6816323, Israel;
| | - Orit Bart
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel;
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Rizk S, Kaelin VC, Sim JGC, Murphy NJ, McManus BM, Leland NE, Stoffel A, James L, Barnekow K, Papautsky EL, Khetani MA. Implementing an Electronic Patient-Reported Outcome and Decision Support Tool in Early Intervention. Appl Clin Inform 2023; 14:91-107. [PMID: 36724883 PMCID: PMC9891850 DOI: 10.1055/s-0042-1760631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE The aim of the study is to identify and prioritize early intervention (EI) stakeholders' perspectives of supports and barriers to implementing the Young Children's Participation and Environment Measure (YC-PEM), an electronic patient-reported outcome (e-PRO) tool, for scaling its implementation across multiple local and state EI programs. METHODS An explanatory sequential (quan > QUAL) mixed-methods study was conducted with EI families (n = 6), service coordinators (n = 9), and program leadership (n = 7). Semi-structured interviews and focus groups were used to share select quantitative pragmatic trial results (e.g., percentages for perceived helpfulness of implementation strategies) and elicit stakeholder perspectives to contextualize these results. Three study staff deductively coded transcripts to constructs in the Consolidated Framework for Implementation Research (CFIR). Data within CFIR constructs were inductively analyzed to generate themes that were rated by national early childhood advisors for their relevance to longer term implementation. RESULTS All three stakeholder groups (i.e., families, service coordinators, program leadership) identified thematic supports and barriers across multiple constructs within each of four CFIR domains: (1) Six themes for "intervention characteristics," (2) Six themes for "process," (3) three themes for "inner setting," and (4) four themes for "outer setting." For example, all stakeholder groups described the value of the YC-PEM e-PRO in forging connections and eliciting meaningful information about family priorities for efficient service plan development ("intervention characteristics"). Stakeholders prioritized reaching families with diverse linguistic preferences and user navigation needs, further tailoring its interface with automated data capture and exchange processes ("process"); and fostering a positive implementation climate ("inner setting"). Service coordinators and program leadership further articulated the value of YC-PEM e-PRO results for improving EI access ("outer setting"). CONCLUSION Results demonstrate the YC-PEM e-PRO is an evidence-based intervention that is viable for implementation. Optimizations to its interface are needed before undertaking hybrid type-2 and 3 multisite trials to test these implementation strategies across state and local EI programs with electronic data capture capabilities and diverse levels of organizational readiness and resources for implementation.
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Affiliation(s)
- Sabrin Rizk
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, United States
| | - Vera C. Kaelin
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Julia Gabrielle C. Sim
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Natalie J. Murphy
- Department of Health Systems, Management, and Policy, University of Colorado, Aurora, Colorado, United States
| | - Beth M. McManus
- Department of Health Systems, Management, and Policy, University of Colorado, Aurora, Colorado, United States
| | - Natalie E. Leland
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Ashley Stoffel
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, United States
| | - Lesly James
- Department of Occupational Therapy, Lenoir-Rhyne University, Columbia, South Carolina, United States
| | - Kris Barnekow
- Department of Occupational Therapy, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, United States
| | - Elizabeth Lerner Papautsky
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, Illinois, United States
| | - Mary A. Khetani
- Children's Participation in Environment Research Lab, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, United States,Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States,CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada,Address for correspondence Mary A. Khetani, ScD, OTR/L Department of Occupational Therapy, University of Illinois Chicago1919 West Taylor Street, Room 316A, Chicago, IL 60612-7250United States
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Anjum A, Ahammed T, Hasan MM, Chowdhury MAB, Uddin MJ. Mother's functional difficulty is affecting the child functioning: Findings from a nationally representative MICS 2019 cross-sectional survey in Bangladesh. Health Sci Rep 2022; 6:e1023. [PMID: 36582634 PMCID: PMC9793826 DOI: 10.1002/hsr2.1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Background Functional difficulties in children can be transmitted from mother to child, which is a major concern. We sought to determine whether there was a correlation between a mother's functional difficulty and functional difficulty in kids between the ages of 2-4 and 5-17. We also want to evaluate other fundamental aspects that influence on child's functionality. Methods We used Multiple Indicator Cluster Survey (MICS) data sets. For two different age groups, the children's difficulty status was evaluated. The sociodemographic factors served as explanatory variables in this study. We used χ 2 tests and survey logistic regression models to analyze the data. Results Functional difficulties were less common in children aged 2-4 years (2.78%) but 8.27% in those aged 5-17 years. The study specifies that the mother's functional difficulty (odds ratio [OR]: 2.66, confidence interval [CI]: 1.35-5.24 for children aged 2-4 years and OR: 3.36, CI: 2.80-4.03 for children aged 5-17 years) were significantly associated with the functional difficulty of both age groups' children. Not attending early childhood education programs (OR: 1.89, CI: 1.16-3.10 for children aged 2-4 years and OR: 2.66, CI: 2.19-3.22 for children aged 5-17 years) and divisions were also significantly affecting the functional difficulty of both age groups' children. Moreover, area of residence and gender were significant factors for the older age group. Conclusions The prevalence of difficulty among children in Bangladesh is high. Children's functional difficulty, regardless of age, is greatly influenced by the functional difficulty of their mothers, their absence from early childhood education programs, and divisions. Reducing the prevalence of child functioning difficulties will be more successful if the government and NGOs consider these factors while developing appropriate intervention programs.
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Affiliation(s)
- Aniqua Anjum
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh
| | - Tanvir Ahammed
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh
| | - Md Mahedi Hasan
- Faculty of Business StudiesBangladesh University of Professionals (BUP)DhakaBangladesh,Department of Mathematics and StatisticsWashington State UniversityPullmanWashingtonUSA
| | - Muhammad Abdul Baker Chowdhury
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh,Department of NeurosurgeryUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Md. Jamal Uddin
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh,Department of General Educational Development (GED)Daffodil International UniversityDhakaBangladesh
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Bruno N, Richardson A, Kauffeldt KD, Tomasone JR, Arbour-Nicitopoulos K, Latimer-Cheung AE. Exploring experiential elements, strategies and outcomes of quality participation for children with intellectual and developmental disabilities: A systematic scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:691-718. [PMID: 35174582 DOI: 10.1111/jar.12982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Quality participation, defined as satisfying and enjoyable involvement, is one of the most valued life outcomes for children with intellectual and developmental disabilities. To broaden understandings of quality participation, our review explored participation experiences of children with intellectual and developmental disabilities. METHOD Utilising an established systematic scoping review methodology, data were collected using three search tools (peer-reviewed databases, grey literature databases and Google). Inclusion criteria required that children with intellectual and developmental disabilities and/or their proxies provided descriptions of quality participation experiences in any life domain. RESULTS A total of 35 articles met the inclusion criteria. Quality participation strategies (30 total) and outcomes (8 total) were categorised according to six experiential elements (autonomy, belongingness, challenge, engagement, mastery and meaning). CONCLUSION Findings provide novel insight for building quality experiences across current and future participation initiatives.
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Affiliation(s)
- Natasha Bruno
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Alanna Richardson
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Kaitlyn D Kauffeldt
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Kelly Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, Mental Health and Physical Activity Research Centre, University of Toronto, Toronto, Ontario, Canada
| | - Amy E Latimer-Cheung
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
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11
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Kaelin V, Villegas V, Chen YF, Murphy N, Papautsky E, Litfin J, Leland N, Maheshwari V, McManus B, Khetani M. Effectiveness and scalability of an electronic patient-reported outcome measure and decision support tool for family-centred and participation-focused early intervention: PROSPECT hybrid type 1 trial protocol. BMJ Open 2022; 12:e051582. [PMID: 34983760 PMCID: PMC8728410 DOI: 10.1136/bmjopen-2021-051582] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Early intervention (EI) endorses family-centred and participation-focused services, but there remain insufficient options for systematically enacting this service approach. The Young Children's Participation and Environment Measure electronic patient-reported outcome (YC-PEM e-PRO) is an evidence-based measure for caregivers that enables family-centred services in EI. The Parent-Reported Outcomes for Strengthening Partnership within the Early Intervention Care Team (PROSPECT) is a community-based pragmatic trial examining the effectiveness of implementing the YC-PEM e-PRO measure and decision support tool as an option for use within routine EI care, on service quality and child outcomes (aim 1). Following trial completion, we will characterise stakeholder perspectives of facilitators and barriers to its implementation across multiple EI programmes (aim 2). METHODS AND ANALYSIS This study employs a hybrid type 1 effectiveness-implementation study design. For aim 1, we aim to enrol 223 caregivers of children with or at risk for developmental disabilities or delays aged 0-3 years old that have accessed EI services for three or more months from one EI programme in the Denver Metro catchment of Colorado. Participants will be invited to enrol for 12 months, beginning at the time of their child's annual evaluation of progress. Participants will be randomised using a cluster-randomised design at the EI service coordinator level. Both groups will complete baseline testing and follow-up assessment at 1, 6 and 12 months. A generalised linear mixed model will be fitted for each outcome of interest, with group, time and their interactions as primary fixed effects, and adjusting for child age and condition severity as secondary fixed effects. For aim 2, we will conduct focus groups with EI stakeholders (families in the intervention group, service coordinators and other service providers in the EI programme, and programme leadership) which will be analysed thematically to explain aim 1 results and identify supports and remaining barriers to its broader implementation in multiple EI programmes. ETHICS AND DISSEMINATION This study has been approved by the institutional review boards at the University of Illinois at Chicago (2020-0555) and University of Colorado (20-2380). An active dissemination plan will ensure that findings have maximum reach for research and practice. TRIAL REGISTRATION NUMBER NCT04562038.
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Affiliation(s)
- Vera Kaelin
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, Illinois, USA
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Vivian Villegas
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Yi-Fan Chen
- Center for Clinical and Translational Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Natalie Murphy
- Health Systems, Management & Policy, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Elizabeth Papautsky
- Biomedical & Health Information Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jodi Litfin
- Rocky Mountain Human Services, Denver, Colorado, USA
| | - Natalie Leland
- Occupational Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Varun Maheshwari
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Beth McManus
- Health Systems, Management & Policy, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mary Khetani
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, Illinois, USA
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
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12
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Stelmokaite A, Prasauskiene A, Bakaniene I. Participation patterns and predictors of participation in preschool children with developmental disability. Br J Occup Ther 2021. [DOI: 10.1177/03080226211034415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The research was aimed to evaluate patterns and clinical and environmental predictors of participation in preschool children with developmental disability. Method Cross-sectional design was employed. Caregivers ( n = 98) of children aged 9–70 months (mean = 48, SD = 1.5) with developmental disability completed a health questionnaire and the Lithuanian Young Children’s Participation and Environment Measure (YC-PEM). Descriptive statistics and multiple linear regressions were performed to identify patterns and predictors of participation at home, daycare/preschool, and the community. Results Participation restrictions, based on frequency and variety of activities, were mostly observed in the community setting. Both clinical and environmental factors explained at least two dimensions of participation across all settings. Of the clinical factors, the predictors of participation were found to be the severity but not the number of impairments of body structures and functions and/or activity limitations. Conclusions This study emphasizes the role of the environment and activity limitations in explaining participation of preschool children with developmental disability. Findings can re-direct practitioners’ attention towards context-based assessments and interventions to promote health through participation.
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Affiliation(s)
- Agne Stelmokaite
- Department of Children’s Rehabilitation, Lietuvos sveikatos mokslu universitetas, Kaunas, Lithuania
| | - Audrone Prasauskiene
- Department of Children’s Rehabilitation, Lietuvos sveikatos mokslu universitetas, Kaunas, Lithuania
| | - Indre Bakaniene
- Department of Children’s Rehabilitation, Lietuvos sveikatos mokslu universitetas, Kaunas, Lithuania
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Coussens M, Vitse F, Desoete A, Vanderstraeten G, Van Waelvelde H, Van de Velde D. Participation of young children with developmental disabilities: parental needs and strategies, a qualitative thematic analysis. BMJ Open 2021; 11:e042732. [PMID: 33795296 PMCID: PMC8021744 DOI: 10.1136/bmjopen-2020-042732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/17/2021] [Accepted: 03/09/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Participation refers to a person's involvement in activities and roles that provide interaction with others as well as engagement in family and community activities. Young children with developmental disabilities (DD) such as attention deficit hyperactive disorder, autism spectrum disorder and developmental coordination disorder are limited in their participation compared with their typically developing peers. This study aimed to obtain information regarding parental needs and strategies used to enable their child's participation. DESIGN A thematic inductive approach with in-depth interviews was used to explore parental experiences. Eleven women and two men, between 30 and 40 years of age, who had a child (4-9 years old) with a DD diagnosis based on Diagnostic and Statistical Manual of Mental Disorders criteria, participated in semistructured interviews. RESULTS Two central themes emerged: parental needs and parental strategies used to enable their child's participation. Parental needs were the following: increasing awareness, ameliorating parental burden, providing tailored interventions and supporting parents in finding suitable leisure activities. Parental strategies aimed at increasing their child's resiliency, attaining maximal fit between activity requirements and child capacity, and creating inclusive opportunities and awareness. CONCLUSIONS Understanding what families' needs are and how families use and integrate strategies within the context of their daily lives provides practitioners with insights needed to support families' resiliency in promoting their children's participation. The results have implications for professionals as this information can be used to inform, refine, or tailor participation-based and family-centred services.
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Affiliation(s)
- Marieke Coussens
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Floris Vitse
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Annemie Desoete
- Faculty of Psychology and Educational Sciences, Ghent University, Gent, Belgium
| | - Guy Vanderstraeten
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Hilde Van Waelvelde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
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Kaelin VC, Bosak DL, Villegas VC, Imms C, Khetani MA. Participation-Focused Strategy Use Among Caregivers of Children Receiving Early Intervention. Am J Occup Ther 2021; 75:7501205090p1-7501205090p11. [PMID: 33399057 PMCID: PMC7784037 DOI: 10.5014/ajot.2021.041962] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Evidence on common types of participation-focused caregiver strategies can help occupational therapy practitioners to take an evidence-based approach to designing participation-focused practice. OBJECTIVE To identify and explore types of caregiver strategies to support young children's participation in valued occupations in the home and community. DESIGN Qualitative study using a subset of data collected online with the Young Children's Participation and Environment Measure (YC-PEM). Narrative responses about strategy use were content coded to the family of Participation-Related Constructs (fPRC) framework using a deductive analytic approach to identify relevant types of participation-focused strategies used in the home and community. Responses were further analyzed within each relevant fPRC construct using an inductive analytic approach to identify the scope of strategies used for each construct. SETTING Early intervention. PARTICIPANTS Caregivers (N = 106) of young children receiving early intervention. OUTCOMES AND MEASURES Caregivers' strategies to support their child's home and community participation, provided by the YC-PEM. RESULTS Caregivers most commonly adapted the child's environment or context to support their child's home and community participation (45.06%). The least common focus of caregiver strategies was the child's activity competencies (11.16%). Three or more types of caregiver strategies were identified for each participation-related construct. CONCLUSION AND RELEVANCE Results indicated that caregivers used a range of strategies related to each of the participation-related constructs to support their child's participation in home and community occupations, most commonly targeting the environment. Occupational therapy practitioners can select from this range of strategies when planning participation-focused early intervention with families. WHAT THIS ARTICLE ADDS This study yields new evidence on the scope of caregiver strategy use to support young children's participation in home and community occupations. Occupational therapy practitioners can apply this evidence to anticipate common areas of caregiver strategy use in participation-focused practice with families in early intervention.
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Affiliation(s)
- Vera C Kaelin
- Vera C. Kaelin, MScOT, is PhD Student and Graduate Research Assistant, Program in Rehabilitation Sciences, University of Illinois at Chicago
| | - Dianna L Bosak
- Dianna L. Bosak, BA, is OTD Student, Department of Occupational Therapy, Boston University, Boston, MA. At the time of this study, Bosak was Undergraduate Research Assistant, Children's Participation in Environment Research Lab, University of Illinois at Chicago
| | - Vivian C Villegas
- Vivian C. Villegas, MS, OTR/L, is OTD Student and Graduate Research Assistant, Department of Occupational Therapy, University of Illinois at Chicago
| | - Christine Imms
- Christine Imms, PhD, is Professor, Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia. At the time of this study, Imms was Professor of Occupational Therapy, Department of Occupational Therapy, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mary A Khetani
- Mary A. Khetani, ScD, OTR/L, is Associate Professor, Department of Occupational Therapy, University of Illinois at Chicago;
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Balton S, Arvidsson P, Granlund M, Huus K, Dada S. Test-retest reliability of Picture My Participation in children with intellectual disability in South Africa. Scand J Occup Ther 2020; 29:315-324. [PMID: 33307940 DOI: 10.1080/11038128.2020.1856922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Picture My Participation (PmP) is a promising instrument for measuring the participation in everyday situations of children with intellectual disability (ID), particularly in low- and middle-income countries. AIM To explore test-retest reliability of PmP by comparing two repeated measurements of children with ID in an urban context in South Africa. METHODS A picture-supported interview with 31 children with ID, aged 7-17 years, was conducted twice, two weeks apart. The children rated their participation, operationalised as attendance and involvement, in 20 everyday activities. Analyses were completed for total scores, for the four subcomponents and at item level. RESULTS Test-retest agreement at an item level for both attendance and involvement showed slight/fair agreement for most activities (Kappa = 0.01-0.40), and moderate agreement for some activities (Kappa = 0.41-0.60). Moderate agreement was shown for the total scale and at component level (ICC = 0.5-0.75), except for (firstly) attendance of and involvement in 'Family Activities' (ICC = 0.26 for attendance, 0.33 for involvement), and (secondly) involvement in 'Personal Activities' (ICC = 0.33). CONCLUSION The result indicates that PmP can reliably be used at component level and as a screening tool for intervention planning to identify participation and participation restrictions in children with ID.
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Affiliation(s)
- Sadna Balton
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Patrik Arvidsson
- CHILD, Swedish Institute for Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Mats Granlund
- Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Karina Huus
- Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
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Coussens M, Van Driessen E, De Baets S, Van Regenmortel J, Desoete A, Oostra A, Vanderstraeten G, Waelvelde HV, Van de Velde D. Parents' perspectives on participation of young children with attention deficit hyperactivity disorder, developmental coordination disorder, and/ or autism spectrum disorder: A systematic scoping review. Child Care Health Dev 2020; 46:232-243. [PMID: 31867727 DOI: 10.1111/cch.12735] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 12/12/2019] [Accepted: 12/14/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND During the early years of a child's life, participation is essential for learning and development. Children with disabilities are at risk for decreased participation. The interplay between environment and participation is identified as one of the most important factors influencing successful participation. The objective of this scoping review was to synthesize peer-reviewed literature about barriers and facilitators of participation according to the perspective of parents of children younger than 6 years with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and/ or Developmental Coordination Disorder (DCD). METHODS The scoping review followed Arksey and O'Malley's framework. Relevant studies were identified by a comprehensive search of scientific databases (PubMed and Web of Science). Studies describing perspectives of parents regarding their child's participation, written in English, and published between 2001 and September 2017 were included. RESULTS A total of 854 articles were retrieved, with 13 meeting the criteria. Elements contributing to perceived barriers and facilitators were identified and organized according to the International Classification of Functioning, Child-Youth framework. Concepts contained in these studies were linked to "activities and participation" (general tasks and demands, such as bedtime and dinner routines, and social, civic life, such as play and leisure). Environment-focused factors identified were situated on "support and relationships, " "attitudes, " and "services, systems, and policies." CONCLUSION The review revealed guidelines focusing on family-centred care, communication with, and providing information to parents with young children with developmental disabilities (ADHD, DCD, and/ or ASD).
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Affiliation(s)
- Marieke Coussens
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Evy Van Driessen
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Stijn De Baets
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Jasmine Van Regenmortel
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Annemie Desoete
- Department of Experimental Clinical and Health Psychology, University of Ghent, Ghent, Belgium
| | - Ann Oostra
- Department of Paediatrics and Medical Genetics, University of Ghent, Ghent, Belgium
| | - Guy Vanderstraeten
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Hilde Van Waelvelde
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences, Occupational Therapy Program, University of Ghent, Ghent, Belgium
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Chien CW, Leung C, Schoeb V, Au A. A Chinese version of the young children's participation and environment measure: psychometric evaluation in a Hong Kong sample. Disabil Rehabil 2020; 43:3061-3069. [PMID: 32096426 DOI: 10.1080/09638288.2020.1727032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate the psychometric properties of a Chinese-translated version of the Young Children's Participation and Environment Measure. MATERIALS AND METHODS The Young Children's Participation and Environment Measure was translated into Chinese using cultural adaptation by adding/replacing with activities relevant to Chinese culture. Parents of 53 children aged 2-5 years with developmental disabilities and of 50 typical developing children completed the questionnaires. Internal consistency, test-retest reliability, known-group validity, and discriminant validity were examined using Cronbach's alpha, intraclass correlation coefficient, Mann-Whitney U tests, and Spearman's rank correlation coefficients respectively. RESULTS Internal consistency was acceptable for most scales (α = 0.42-0.89). Test-retest reliability of the summary scores was moderate to high for all scales (intraclass correlation coefficient = 0.65-0.90). Known-group validity was supported by demonstrating significant differences by disability status in all community participation scales, two daycare/preschool participation scales, and one home participation scale. Low or negative correlations between the scores of some scales and children's cognition (ρ = 0.27-0.32; -0.36-to-0.35) and parental stress (ρ = -0.42-to-0.31) supported discriminant validity. CONCLUSION This study provided psychometric evidence supporting the use of the Young Children's Participation and Environment Measure to assess Chinese children's participation and environmental support.IMPLICATIONS FOR REHABILITATIONThe Young Children's Participation and Environment Measure is translated into Chinese using a cultural adaptation process.The Chinese version of the Young Children's Participation and Environment Measure demonstrates evidence for internal consistency, test-retest reliability (including the minimal detectable change).The Chinese version of the Young Children's Participation and Environment Measure demonstrates evidence for known-group validity and discriminant validity.The Chinese version of the Young Children's Participation and Environment Measure holds promise for use in children aged 2-5 years to assess their participation and identify environmental barriers warranting intervention.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Cynthia Leung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Veronika Schoeb
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont, Switzerland
| | - Alma Au
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
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Schmengler H, El-Khoury Lesueur F, Yermachenko A, Taine M, Cohen D, Peyre H, Saint-Georges C, Thierry X, Melchior M. Maternal immigrant status and signs of neurodevelopmental problems in early childhood: The French representative ELFE birth cohort. Autism Res 2019; 12:1845-1859. [PMID: 31373761 DOI: 10.1002/aur.2181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/15/2019] [Indexed: 12/24/2022]
Abstract
A growing body of evidence suggests that children of immigrants may have increased risks of neurodevelopmental disorders. However, evidence based on parent report and on very young children is lacking. We therefore investigated the association between maternal immigrant status and early signs of neurodevelopmental problems in a population-based sample of 2-year-old children using standardized parent-report instruments. We used data from the French representative Étude Longitudinale Française depuis l'Enfance birth cohort, initiated in 2011. The study sample included 9,900 children of nonimmigrant French, 1,403 children of second, and 1,171 children of first generation immigrant women followed-up to age 2 years. Neurodevelopment was assessed using the Modified Checklist for Autism in Toddlers (M-CHAT) and an adaptation of the MacArthur-Bates Communicative Development Inventories (MB-CDI). In fully adjusted linear regression models, maternal immigrant status was associated with M-CHAT scores, with stronger associations in children of first (β-coefficient: 0.19; 95% CI 0.08-0.29) than second generation immigrants (0.09; 0.01-0.17). This association was especially strong among children of first generation immigrant mothers native of North Africa (vs. nonimmigrant French: 0.33; 0.16-0.49) and French-speaking Sub-Saharan Africa (0.26; 0.07-0.45). MB-CDI scores were lowest among children of first generation immigrant mothers, particularly from mostly non-francophone regions. Children of first generation immigrant mothers were most likely to have simultaneously low MB-CDI and high M-CHAT scores. Our findings suggest that maternal immigrant status is associated with early signs of neurodevelopmental difficulties, with strong variations according to maternal region of origin. Further research is necessary to test whether these associations persist and to determine the underlying mechanisms. Autism Res 2019, 12: 1845-1859. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We asked immigrant and nonimmigrant mothers in France about early signs of neurodevelopmental problems in their 2-year-old children. Overall, we found that children of immigrants may be at higher risk of showing these early warning signs, as compared to children of nonimmigrants. This is in line with previous studies, which were based on doctors' diagnoses at later ages. However, our results differed depending on the mothers' regions of origin. We found the highest risks in children of first generation immigrants from North and French-speaking Sub-Saharan Africa, who also seemed especially at risk of neurodevelopmental problems combined with low language development.
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Affiliation(s)
- Heiko Schmengler
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, (IPLESP, Department of Social Epidemiology), F75012, Paris, France.,École des Hautes Études en Santé Publique (EHESP), Paris, France.,Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
| | - Fabienne El-Khoury Lesueur
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, (IPLESP, Department of Social Epidemiology), F75012, Paris, France
| | - Anna Yermachenko
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, (IPLESP, Department of Social Epidemiology), F75012, Paris, France
| | - Marion Taine
- Early Determinants of Children's Health and Development Team (ORCHAD), INSERM UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Villejuif, France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France.,Institute for Intelligent Systems and Robotics, CNRS UMR 7222, Sorbonne Université, Paris, France
| | - Hugo Peyre
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Cognitive Sciences and Psycholinguistics Laboratory, École Normale Supérieure, Paris, France.,INSERM UMR 1141, Paris Diderot University, Paris, France
| | - Catherine Saint-Georges
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Paris, France.,Institute for Intelligent Systems and Robotics, CNRS UMR 7222, Sorbonne Université, Paris, France
| | - Xavier Thierry
- Institut National d'Études Démographiques, Paris, France
| | - Maria Melchior
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, (IPLESP, Department of Social Epidemiology), F75012, Paris, France
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Caregiver Strategy Use to Promote Children's Home Participation After Pediatric Critical Illness. Arch Phys Med Rehabil 2019; 100:2144-2150. [PMID: 31278925 DOI: 10.1016/j.apmr.2019.05.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/28/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The primary objectives are to assess the most common type of caregiver strategy (remedial vs compensatory) reported for supporting their child's home participation after critical illness and identify themes in compensatory strategies described, with a secondary objective to describe themes in strategy use as reported by caregivers of children who did and did not receive pediatric intensive care unit (PICU) rehabilitation services. DESIGN Qualitative substudy of the Wee-Cover prospective cohort study. SETTING Two PICU sites. PARTICIPANTS Wee-Cover enrolled caregivers (N=180) of children 1-17 years of age, who were admitted to a PICU for ≥48 hours. This study excluded participants missing relevant data (n=12). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Qualitative data were gathered from open-ended questions on strategies within the Participation and Environment Measure at PICU discharge and 3 and 6 months post-PICU discharge. Strategies were classified as remedial or compensatory pending their content fit with 1 of 5 environmental chapters in the International Classification of Functioning, Disability, and Health-Children and Youth Version. Data on PICU-based rehabilitation services were obtained prospectively from electronic medical records and dichotomized (yes or no). RESULTS Most caregiver strategies were compensatory, with more than half (60%) of the strategies pertaining to fostering supportive relationships. In contrast, strategies addressing the child's natural environment (12%), services (3%), and attitudes of others in the home (1%) were least commonly described. Similar themes were identified for caregivers whose children did and did not receive PICU rehabilitation services. CONCLUSIONS Caregivers identify a range of strategies to facilitate their child's participation in home activities post-PICU discharge, but primarily report on strategies for addressing supports and relationships in the child's home environment. Results highlight areas warranting caregiver education to support the child's participation after critical illness.
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Arakelyan S, Maciver D, Rush R, O'hare A, Forsyth K. Family factors associated with participation of children with disabilities: a systematic review. Dev Med Child Neurol 2019; 61:514-522. [PMID: 30613957 PMCID: PMC6850164 DOI: 10.1111/dmcn.14133] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2018] [Indexed: 12/02/2022]
Abstract
AIM The aim of this review was to synthesize empirical evidence of family factors associated with participation of children with disabilities aged 5 to 12 years to inform the development of family-centred participation-fostering interventions. METHOD A systematic search was performed for articles published in English between 2001 and 2017 in MEDLINE, PsycINFO, CINAHL, Scopus, and ASSIA following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Quality of evidence was appraised using the Research Triangle Institute Item Bank. Family factors associated with participation were identified and assessed using a multistage 'semi-quantitative' approach. RESULTS Thirty studies were included in the review. Four non-modifiable 'status' factors consistently associated with participation were parental ethnicity, parental education, family type, and family socio-economic status. Six modifiable 'process' factors with consistent associations with participation were parental mental and physical health functioning, parental self-efficacy beliefs, parental support, parental time, family preferences, and activity orientation. INTERPRETATION Rehabilitation professionals should direct their focus towards modifiable family factors as primary targets for family-centred interventions. Strategies that can improve families' access to information, counselling, and community support services are likely to support children's participation by empowering families and optimizing their health and well-being. WHAT THIS PAPER ADDS Non-modifiable 'status' and modifiable 'process' factors are important in participation of children with disabilities. Disadvantaged family circumstances shaped by status factors are associated with reduced participation. Key process factors for intervention are parental mental and physical health and parental self-efficacy beliefs. Other important process factors for intervention are parental support and time, family preferences, and activity orientation.
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Affiliation(s)
| | - Donald Maciver
- School of Health SciencesQueen Margaret UniversityEdinburghUK
| | - Robert Rush
- School of Health SciencesQueen Margaret UniversityEdinburghUK
| | - Anne O'hare
- Centre for Clinical Brain SciencesThe University of EdinburghEdinburghUK
| | - Kirsty Forsyth
- School of Health SciencesQueen Margaret UniversityEdinburghUK
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Jeong Y. Participation, supports, and barriers of Korean children and youth with and without disabilities in the school environment. Disabil Rehabil 2019; 42:1667-1674. [PMID: 30714425 DOI: 10.1080/09638288.2019.1567836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: This study compared participation patterns of Korean children with and without disabilities at school and examined perceived environmental supports and barriers to their school participation.Methods: One hundred eighty four parents of Korean children, aged 5 to 13 years, with and without disabilities completed the Korean Participation and Environment Measure for Children and Youth. The item-level scores of Korean Participation and Environment Measure for Children and Youth were compared between children with and without disabilities using Analysis of covariance and Pearson chi-square tests.Results: In comparison with typically developing children, children with disabilities were less frequently participated and involved and their parents were more likely to desire the change of children's participation in all school activities. Parents of children with disabilities reported that child's physical, cognitive, and social demands, relationship with peers, programs and services, policies and procedures, and money are environmental barriers and personal and public transportation are environmental supports to school participation.Conclusions: Findings help to better understand school participation patterns of Korean children with disabilities and environmental supports and barriers to their participation. The knowledge can be used to support collaboration among school-related professionals for successful participation of children with disabilities at school.Implications for rehabilitationParents of children with disabilities need to focus on both how many times their children participate in school activities and how they get involved in those activities.Educators and therapists should consider in which types of change in school participation parents of children with disabilities are interested to select target activities and to modify them for successful school participation.Educators, therapists, and parents of children with disabilities should analyze the poor fits between functional limitation of children with disabilities and the physical, cognitive, and social demands of school activities for successful school participation.Using information about school participation patterns and environmental supports/barriers can support to better understand children with disabilities and strengthen partnerships among educators, therapists, and parents of children with disabilities for successful inclusion into school contexts.
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Affiliation(s)
- Yunwha Jeong
- Department of Occupational Therapy, Jeonju University, Jeonju, South Korea
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Killeen H, Shiel A, Law M, O'Donovan DJ, Segurado R, Anaby D. Relationships between Adaptive Behaviours, Personal Factors, and Participation of Young Children. Phys Occup Ther Pediatr 2018; 38:343-354. [PMID: 29257920 DOI: 10.1080/01942638.2017.1406428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM To examine the extent to which personal factors (age, socioeconomic grouping, and preterm birth) and adaptive behaviour explain the participation patterns of young children. METHODS 65 Children 2-5 years old with and without a history of preterm birth and no physical or intellectual disability were selected by convenience sampling from Galway University Hospital, Ireland. Interviews with parents were conducted using the Adaptive Behaviour Assessment System, Second Edition (ABAS-II) and the Assessment of Preschool Children's Participation (APCP). Linear regression models were used to identify associations between the ABAS-II scores, personal factors, and APCP scores for intensity and diversity of participation. RESULTS Adaptive behaviour explained 21% of variance in intensity of play, 18% in intensity of Skill Development, 7% in intensity of Active Physical Recreation, and 6% in intensity of Social Activities controlling for age, preterm birth, and socioeconomic grouping. Age explained between 1% and 11% of variance in intensity of participation scores. Adapted behaviour (13%), Age (17%), and socioeconomic grouping (5%) explained a significant percentage of variance in diversity of participation controlling for the other variables. CONCLUSIONS Adaptive behaviour had a unique contribution to children's intensity and diversity of participation, suggesting its importance.
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Affiliation(s)
- Hazel Killeen
- a Occupational Therapy, Aras Moyola , National University of Ireland , Galway , Ireland
| | - Agnes Shiel
- b Occupational Therapy, College of Medicine, Nursing and Health Sciences , National University of Ireland , Galway , Ireland
| | - Mary Law
- c School of Rehabilitation Science, CanChild Centre for Childhood Disability Research , McMaster University , Ontario , Canada
| | - Donough J O'Donovan
- d Neonatal Intensive Care Unit , University College Hospital Galway , Ireland
| | - Ricardo Segurado
- e Public Health (Biostatistics), CSTAR and School of Public Health, Physiotherapy and Sports Science , University College Dublin , Ireland
| | - Dana Anaby
- f School of Physical and Occupational Therapy , McGill University . Montreal , Canada
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Åström FM, Khetani M, Axelsson AK. Young Children's Participation and Environment Measure: Swedish Cultural Adaptation. Phys Occup Ther Pediatr 2018; 38:329-342. [PMID: 28467126 DOI: 10.1080/01942638.2017.1318430] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM To culturally adapt and evaluate the psychometric properties of the Young Children's Participation and Environment Measure (YC-PEM) for use by caregivers of Swedish children with and without disabilities, aged 2-5 years. METHODS Thirteen cognitive interviews and two focus groups with caregivers of children with and without disabilities were conducted to evaluate the cultural relevance of YC-PEM content for use in Sweden. Per participant feedback, a revised version of the Swedish YC-PEM was created and pilot tested with caregivers of children with disabilities (n = 11) and children with typical development (n = 22). RESULTS User feedback informed content revisions to 7% of items. Internal consistency estimates of the Swedish YC-PEM pilot version were acceptable and ranged from .70 to .92 for all but two of the YC-PEM scales. Mean percentage agreement between raters ranged from 47% to 93% across YC-PEM scales for inter-rater, and 44% to 86% for test-retest. One of twelve YC-PEM scales revealed significant group differences between young children with and without disabilities. CONCLUSIONS This study contributes preliminary evidence for the use of some scales within a culturally adapted YC-PEM in Sweden. Further validation with larger samples will allow for parametric testing to evaluate its psychometric properties.
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Affiliation(s)
- Frida Marie Åström
- a Swedish Institute for Disability Research, CHILD Research Group , Jönköping University , Jönköping , Sweden
| | - Mary Khetani
- b Department of Occupational Therapy , Colorado State University , Fort Collins , Colorado , USA.,c Department of Disability and Human Development , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Anna Karin Axelsson
- a Swedish Institute for Disability Research, CHILD Research Group , Jönköping University , Jönköping , Sweden
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Gilboa Y, Fuchs R. Participation Patterns of Preschool Children With Intellectual Developmental Disabilities. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2018; 38:261-268. [PMID: 29649939 DOI: 10.1177/1539449218766888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We aim to examine the pattern of participation of children with intellectual developmental disabilities (IDD) or global developmental delay (GDD) in comparison with typically developing preschoolers. In addition, to identify environmental and personal factors associated with their participation, 20 children with mild to moderate GDD or IDD, and 24 age- and gender-matched controls, aged 3 to 6 years, were assessed using the Assessment of Preschool Children's Participation and the Environmental Restriction Questionnaire. Significant differences were found between the groups, both for general scales of participation and for each activity area. For the IDD/GDD group, participation was significantly negatively correlated with environmental restrictions at home. For the control group, participation was correlated with demographic variables. Typically developing children participate at a higher frequency and in a more diverse range of activities compared with children with IDD/GDD. Associations between participation and contextual factors varied depending on the child's health condition.
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Technology-based functional assessment in early childhood intervention: a pilot study. Pilot Feasibility Stud 2018; 4:65. [PMID: 29588860 PMCID: PMC5863479 DOI: 10.1186/s40814-018-0260-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 03/13/2018] [Indexed: 11/10/2022] Open
Abstract
Background Electronic patient-reported outcomes (e-PROs) may provide valid and feasible options for obtaining family input on their child’s functioning for care planning and outcome monitoring, but they have not been adopted into early intervention (EI). The purpose of this pilot study was to evaluate the feasibility of implementing technology-based functional assessment into EI practice and to examine child, family, service, and environmental correlates of caregiver-reported child functioning in the home. Methods In a cross-sectional design, eight individual EI providers participated in a 90-min technology-based functional assessment training to recruit participants and a 60-min semi-structured focus group post data collection. Participants completed the Young Children’s Participation and Environment Measure (YC-PEM) home section online and Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) via iPad. Participants’ EI service use data were obtained from administrative records. Results A total of 37 caregivers of children between 6 and 35 months old (mean age = 19.4, SD = 7.7) enrolled, a rate of 44% (37/84) in 2.5 months. Providers suggested expanding staff training, gathering data during scheduled evaluations, and providing caregivers and providers with access to assessment summaries. Caregivers wanted their child’s participation to change in 56% of home activities. Lower caregiver education and higher EI intensity were related to less child involvement in home activities. Conclusions Implementing technology-based functional assessment is feasible with modifications, and these data can be useful for highlighting child, family, and EI service correlates of caregiver-reported child functioning that merit further study. Feasibility results informed protocol modifications related to EI provider training, timing of data collection, and management of EI service use data extraction, as preparation for a subsequent scale-up study that is underway.
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Khetani MA, Lim HK, Corden ME. Caregiver Input to Optimize the Design of a Pediatric Care Planning Guide for Rehabilitation: Descriptive Study. JMIR Rehabil Assist Technol 2017; 4:e10. [PMID: 29066421 PMCID: PMC5676028 DOI: 10.2196/rehab.7566] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/21/2017] [Accepted: 08/25/2017] [Indexed: 11/25/2022] Open
Abstract
Background Caregiver input has informed the design of a valid electronic patient-reported outcome (PRO) measure for use in pediatric rehabilitation. This proxy assessment may be further developed to expedite and enhance patient-centered care planning processes, but user input is first needed to finalize the core requirements that will guide its design. Objective The objective of this study was to examine the feasibility of a stepwise process for building on a baseline assessment of young children's participation in activities to develop a care plan relevant to pediatric rehabilitation. Methods A cross-sectional descriptive study design was employed using qualitative methods. Data were collected via Web-based technology and by telephone. Twenty-five caregivers of young children (9 with developmental delays, 16 without delays) and between 1 and 7 years were recruited from a subsample of parents who had previously enrolled in a Web-based validation of a PRO on children’s participation and provided consent for future contact. Each caregiver completed a demographic questionnaire and Young Children’s Participation and Environment Measure (YC-PEM) online, followed by a 20- to 60-min semistructured and audiotaped phone interview to review and build upon PRO results as summarized in an electronic report. Interview data were content coded to the interview guide and reviewed by multiple research staff to estimate feasibility according to stepwise completion rates, perceptions of difficulty in step completion, and perceptions of overall utility. Results Half of the participants in the final study sample (N=25) fully completed a stepwise process of building on their baseline PRO assessment to develop an initial care plan for their child. In most cases, similar stepwise completion rates and trends in the approaches taken for step completion were found regardless of the child’s disability status. However, more parents of children with disabilities reported difficulties in rank ordering their priorities for change and identified child-focused strategies for goal attainment. Nearly 77% (19/25) of users were willing to use the process to develop and communicate intervention priorities and strategies with professionals, family, and friends. Conclusions Results informed revisions to the care planning guide before usability and feasibility testing of an initial Web-based prototype that is now underway.
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Affiliation(s)
- Mary A Khetani
- Children's Participation in Environment Research Lab, Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Heather K Lim
- Children's Participation in Environment Research Lab, Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Marya E Corden
- Children's Participation in Environment Research Lab, Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States
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Arestad KE, MacPhee D, Lim CY, Khetani MA. Cultural adaptation of a pediatric functional assessment for rehabilitation outcomes research. BMC Health Serv Res 2017; 17:658. [PMID: 28915817 PMCID: PMC5603009 DOI: 10.1186/s12913-017-2592-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 09/04/2017] [Indexed: 11/18/2022] Open
Abstract
Background Significant racial and ethnic health care disparities experienced by Hispanic children with special health care needs (CSHCN) create barriers to enacting culturally competent rehabilitation services. One way to minimize the impact of disparities in rehabilitation is to equip practitioners with culturally relevant functional assessments to accurately determine service needs. Current approaches to culturally adapting assessments have three major limitations: use of inconsistent translation processes; current processes assess for some, but not all, elements of cultural equivalence; and limited evidence to guide decision making about whether to undertake cultural adaptation with and without language translation. The aims of this observational study are (a) to examine similarities and differences of culturally adapting a pediatric functional assessment with and without language translation, and (b) to examine the feasibility of cultural adaptation processes. Methods The Young Children’s Participation and Environment Measure (YC-PEM), a pediatric functional assessment, underwent cultural adaptation (i.e., language translation and cognitive testing) to establish Spanish and English pilot versions for use by caregivers of young CSHCN of Mexican descent. Following language translation to develop a Spanish YC-PEM pilot version, 7 caregivers (4 Spanish-speaking; 3 English-speaking) completed cognitive testing to inform decisions regarding content revisions to English and Spanish YC-PEM versions. Participant responses were content coded to established cultural equivalencies. Coded data were summed to draw comparisons on the number of revisions needed to achieve cultural equivalence between the two versions. Feasibility was assessed according to process data and data quality. Results Results suggest more revisions are required to achieve cultural equivalence for the translated (Spanish) version of the YC-PEM. However, issues around how the participation outcome is conceptualized were identified in both versions. Feasibility results indicate that language translation processes require high resource investment, but may increase translation quality. However, use of questionnaires versus interview methods for cognitive testing may have limited data saturation. Conclusions Results lend preliminary support to the need for and feasibility of cultural adaptation with and without language translation. Results inform decisions surrounding cultural adaptations with and without language translation and thereby enhance cultural competence and quality assessment of healthcare need within pediatric rehabilitation.
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Affiliation(s)
- Kristen E Arestad
- Department of Occupational Therapy, Colorado State University, Occupational Therapy Building, Fort Collins, CO, 80523-1573, USA
| | - David MacPhee
- Department of Human Development and Family Studies, Colorado State University, Behavioral Sciences Building 319, Fort Collins, CO, 80523-1570, USA
| | - Chun Y Lim
- Department of Child Development, KK Women's and Children's Hospital, Rd, #05-06 Boon Siew Building, 75 Bukit Timah, 229833, Singapore
| | - Mary A Khetani
- Department of Occupational Therapy, University of Illinois at Chicago, 1919 West Taylor Street, Room 316A, Chicago, IL, 60612-7250, USA.
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Di Marino E, Tremblay S, Khetani M, Anaby D. The effect of child, family and environmental factors on the participation of young children with disabilities. Disabil Health J 2017. [PMID: 28624289 DOI: 10.1016/j.dhjo.2017.05.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND While participation is essential to a child's health and well-being, little is known about participation patterns of young children with disabilities. OBJECTIVE This study described the participation of children with disabilities under age 6, and examined the extent to which the child's factors (i.e., age, complexity of child's condition), family factors (i.e., general family functioning, income) and environmental factors (i.e., environmental helpfulness) affect participation dimensions (frequency, involvement, desire for change) in three different settings: home, daycare/preschool and community. METHODS Cross-sectional design was employed. Parents (n = 90) of children aged 1.4-6 years old (mean = 4.15, SD = 1.03) with disabilities completed the French Young Children's Participation and Environment Measure (YC-PEM) and Family Assessment Device. Descriptive statistics and multiple linear regressions were performed to describe participation patterns and identify the significant explanatory factors in each setting. RESULTS Participation restriction, based on frequency of activities, was primarily observed in the community setting. Environmental helpfulness (resources, supports) consistently explained participation levels for at least one of the dimensions across all settings, whereas contribution of the child's factors was less evident. Family functioning had a significant effect when examining participation involvement in the community and desire for change in the home setting and, in combination with environmental helpfulness, explained 18% and 21% of the variance respectively. CONCLUSION This study emphasizes the role of the environment in supporting participation of young children with disabilities. Findings can re-direct practitioners' attention towards modifying the environment as a primary target of intervention aimed at promoting health through participation.
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Environmental Barriers to Participation of Preschool Children with and without Physical Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050518. [PMID: 28492518 PMCID: PMC5451969 DOI: 10.3390/ijerph14050518] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/28/2017] [Accepted: 05/06/2017] [Indexed: 11/16/2022]
Abstract
Environment plays a vital role in affecting participation of young children in home, school, and community. Knowledge of environmental barriers helps to develop solutions or strategies that enable participation. The study compared the environmental barriers perceived by parents of preschool children with physical disabilities (PD, n = 142) and with typical development (TD, n = 192) in Taiwan. Parents identified environmental barriers by structured interview using the Chinese version of the Child and Adolescent Scale of Environment (CASE-C). The CASE-C is an 18-item measure of the impact of problems with physical, social, and attitudinal environmental features. Differences between the PD and TD groups in the summary scores for the CASE-C and the percentages of parents who perceived a problem for each item were examined by the analysis of covariance (ANCOVA) and Chi-square test. Parents of children with PD more often identified barriers related to family resources and community programs or services, social attitudes, assistance and supports outside of home, physical design of home and community, transportation, and assistive devices or equipment. Greater impacts of barriers were also reported by parents of preschool children with PD. Our findings provide evidence of environmental barriers that inform practice and policies to modify the barriers and provide an accessible and inclusive environment for families with young children.
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Albrecht EC, Khetani MA. Environmental impact on young children's participation in home-based activities. Dev Med Child Neurol 2017; 59:388-394. [PMID: 27988938 PMCID: PMC5334138 DOI: 10.1111/dmcn.13360] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/03/2022]
Abstract
AIM To test the effect of child, family, and environmental factors on young children's participation in home-based activities. METHOD Caregivers of young children were recruited using convenience and snowball sampling. Participants were 395 caregivers of children (222 males, 173 females) aged from 1 month to 5 years and 11 months. Demographic items and the home section of the Young Children's Participation and Environment Measure were administered online, followed by completion of the daily activities, mobility, and social/cognitive domains of the Pediatric Evaluation of Disability Inventory Computer Adaptive Test by telephone interview. RESULTS A structural equation model fitted the data well (comparative fit index=0.91) and explained 31.2% of the variance in perceived environmental support and 42.5% of the variance in home involvement. Functional limitations and performance had an indirect effect on young children's participation through their effect on perceived environmental support. Specifically, fewer functional limitations and higher task performance were associated with greater environmental support, which in turn predicted higher levels of home involvement. INTERPRETATION Results suggest the importance of a young child's functional abilities and task performance on caregiver perceptions of environmental support at home, and the impact of environmental support on a child's participation in home-based activities during the early childhood period. Results warrant replication with more diverse samples to evaluate model generalizability.
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Affiliation(s)
- Erin C Albrecht
- Department of Human Development and Family StudiesColorado State UniversityFort CollinsCOUSA
| | - Mary A Khetani
- Department of Occupational TherapyUniversity of Illinois at ChicagoChicagoILUSA
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Khetani MA. Capturing change: participation trajectories in cerebral palsy during life transitions. Dev Med Child Neurol 2017; 59:118-119. [PMID: 27591047 DOI: 10.1111/dmcn.13260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mary A Khetani
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
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