Is autonomy related to the quality of performance of everyday activities in children with spina bifida?

Occupational patterns of families living with a health condition: A scoping review

BACKGROUND

A family's health is sustained by its occupational patterns. While it is commonly accepted that a health condition places extra demands on a family's time or can limit daily occupations, few studies have reported on the occupational patterns of these families.

AIMS/OBJECTIVES

This scoping review provides an overview of the current state of research exploring occupational patterns of families living with a health condition.

MATERIAL AND METHOD

Publications between 2000 and 2018 indexed in CINAHL, PsycInfo, Medline and Scopus databases were searched.

RESULTS

Seventy-seven studies were included in the final content analysis. Findings suggest that families' occupational patterns are more complex than simply the sum of individual and shared occupational patterns, but consist of interconnected relational aspects of occupations, rarely highlighted in studies. Moreover, testimonies tend to be predominantly from the mother's perspectives, thereby limiting the scope of understanding of the interdependent nature of families' occupational patterns.

CONCLUSION

To better understand the complexity and interdependence of families' occupational patterns, future studies should examine multiple perspectives (parents and children) when studying occupations in a family setting. This can be enabled by the use of a variety of data collection methodologies.

Daily time management in children with spina bifida

PURPOSE

Spina bifida (SB) often results in a complex disability and can also cause cognitive dysfunction. No previous study has investigated the ability to adapt to time in children with SB. This ability is crucial for an individual's possibility to develop autonomy in life. The purpose of this study was to investigate whether children aged 10-17 with SB have lower time-processing abilities than typically-developing children, and to describe the profile of time-processing in children with SB.

METHOD

Participants comprised a consecutive sample of 21 children (drawn from a geographical cohort of 45) aged 10-17 years (mean: 14 years, SD: 2 years); 13 were boys. The instruments used were KaTid-Y, Time-S, and Time-P.

RESULTS

The children with SB had lower time-processing abilities than typically-developing children (52.4% under -2SD), particularly difficulties to orient to and to estimate objective time, to understand time perspectives and with time planning. They also self-rated low use of strategies to adapt to time. The parents rated their children as having extensive difficulties in daily time management.

CONCLUSIONS

The low time-processing ability found in children with SB is likely to be an important contributing factor to low autonomy and independence.

Agreements and disagreements between children and their parents in health-related assessments

PURPOSE

To systematically review research concerning parent-child agreement in health-related assessments to reveal overall agreement, directions of agreement, and the factors that affect agreement in ratings.

METHOD

The Uni-Search and five additional databases were searched. Children's health issues were grouped into psychosocial issues including autism and ADHD, and physical and performance issues including pain. Measures used for comparison were those addressing (a) psychosocial functioning, (b) physical and performance functioning, and (c) health-related quality of life.

RESULTS

Totally, 39 studies met the inclusion criteria, comprising 44 analyses in all since four studies contained more than one analyses. Moderate child-parent agreement was demonstrated in 23 analyses and poor agreement in 20 analyses. Several analyses found more agreement on observable/external than on non-observable/internal domains. Overall, parents considered their children had more difficulties than did the children themselves, although there were indications that for children with physical performance issues, parents may underreport their children's difficulties in emotional functioning and pain. There were no consistencies in differences between children's and parent's ratings on levels of agreement with respect to the children's health issue, age or gender.

CONCLUSIONS

Discrepancies between child and parent reports seem to reflect their different perspectives and not merely inaccuracy or bias. Implications for Rehabilitation In general, parents consider their children to have more difficulties - or more extensive difficulties - than the children themselves think they have. The perspectives of the child and his or her parents should be sought whenever possible since both constitute important information concerning the child´s health and well-being. Children with physical and performance issues reported more difficulties than their parents concerning the children's emotional functioning and pain. Clinicians should prioritize obtaining children's views on subjective aspects such as emotional issues as well as on pain.

Patterns of participation in school-related activities and settings in children with spina bifida

PURPOSE

To evaluate how children with spina bifida (SB) participate in school-related activities and to explore if their motor and process skills in task performance were related to their level of active participation in school.

METHOD

Fifty children from a geographical cohort of children with SB (aged 6-14 years) and their teachers rated the children's frequency of participation in school-related activities using a Swedish adaptation of the Availability and Participation Scale. The teachers also rated each child's level of active participation with the School Function Assessment, part one. Each child's motor and process skills were evaluated with the Assessment of Motor and Process Skills. The relation between levels of active participation and motor and process skills was subjected to binary logistic regression analysis.

RESULTS

The children participated very frequently in school activities, but their level of active participation was restricted, particularly in the recess/playground setting. There was a highly significant relation between full active participation in most school settings and the children's motor and process skills.

CONCLUSION

Children with SB need support to become more actively involved, particularly in unstructured peer activities. The school staff need to be informed that not only the motor skills but also the process skills have an impact on the children's active participation.

IMPLICATIONS FOR REHABILITATION

The children with spina bifida (SB) showed a low level of active participation and involvement in school settings even though their frequency of participation was high. It is of highest importance to enable children with SB to be actively involved in peer-related and unstructured activities and to encourage them to participate in both academic and societal learning. To achieve active participation, it is important to inform the school staff about how this issue is affected not only by the level of the child's motor skills but also, and probably even more so, by the level of his/her process skills. From this knowledge, individual strategies can be worked out.