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Alimohamadi A, Ghasemzadeh M, Fooladi F, Abdolmohamadi K, Killikelly C, Janghorbanian Z. Living-loss: A narrative synthesis review of the grief process in parents of children with autism spectrum disorder. J Pediatr Nurs 2024:S0882-5963(24)00113-1. [PMID: 38570227 DOI: 10.1016/j.pedn.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
PROBLEM Realizing that a child has a lifelong developmental condition like Autism Spectrum Disorder (ASD) can create feelings of sadness and grief for the parents. It remains unclear, however, how parents deal with and understand these emotions. The purpose of this narrative review was to explore the grief process of parents of children with ASD. ELIGIBILITY CRITERIA An analysis of the literature was conducted using the databases Psychinfo, Scopus, Web of Science, and PubMed. As part of our research, we also searched the grey literature (Google Scholar) and the thesis database (ProQuest) manually. Among the study criteria were (1) targeting direct informants as parents of children with ASD, (2) original and empirical research published in different English-language sources, (3) outcomes pertaining to grief experiences among parents, and/or processes involved in raising children with ASD, and (4) studies with qualitative data collection methods. SAMPLE Seven articles met the inclusion criteria and were included in this narrative analysis. RESULTS Our study's deductive content analysis revealed three primary themes: (i) manifestations of ambiguous loss, (ii) dealing with disenfranchised grief, and (iii) oscillation. CONCLUSIONS The results showed that ASD in children can cause parents to feel ambiguity and uncertainty, experience grief, and may result in the modification of expectations, emergent affective responses, and self-blame attributions. When confronted with difficulties arising from their child's condition, parents of children with ASD may undergo significant life changes and oscillate between various coping strategies. IMPLICATIONS The findings are expected to provide healthcare professionals, including nurses and front-line clinicians, with valuable information about the burden of grief experienced by parents of children with ASD so they can provide and validate the necessary support for them. Moreover, rigorous qualitative and quantitative studies are also required to support the claims made.
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Affiliation(s)
- Asgar Alimohamadi
- Assistant Professor, Department of Psychology and Education of Exceptional Children, Allameh Tabataba'i University, Tehran, Iran.
| | - Mahdi Ghasemzadeh
- Department of Clinical and General Psychology, Allameh Tabataba'i University, Tehran, Iran
| | - Fatemeh Fooladi
- Department of Educational Psychology, Alzahra University, Tehran, Iran
| | - Karim Abdolmohamadi
- Assistant Professor, Department of Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
| | - Clare Killikelly
- Assistant Professor, Department of Psychology, University of Zurich, Binzmuhlestrasse 14-70, 8050 Zurich, Switzerland; Visiting Research Fellow, Department of Psychiatry, University of British Columbia, 5950 University Blvd, Vancouver, BC V6T 1Z3, Canada
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Heydenrijk-Kikkert MA, Schmidt AKK, Pangalila R, De Wit MCY, van Haren NEM, Van Veelen MLC, Roebroeck ME. Meaningful outcomes for children and their caregivers attending a paediatric brain centre. Dev Med Child Neurol 2023; 65:1493-1500. [PMID: 37072934 DOI: 10.1111/dmcn.15610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/23/2023] [Accepted: 03/14/2023] [Indexed: 04/20/2023]
Abstract
AIM To identify meaningful outcomes of children and their caregivers attending a paediatric brain centre. METHOD We compiled a long list of outcomes of health and functioning of children with brain-related disorders such as cerebral palsy, spina bifida, (genetic) neurodevelopmental disorders, and acquired brain injury. We incorporated three perspectives: patients, health care professionals, and published outcome sets. An aggregated list was categorized using the International Classification of Functioning, Disability, and Health: Children and Youth version in a patient validation survey for children and parent-caregivers to prioritize outcomes. Outcomes were considered meaningful when ranked 'very important' by 70% or more of the participants. RESULTS We identified 104 outcomes from the three perspectives. After categorizing, 59 outcomes were included in the survey. Thirty-three surveys were completed by children (n = 4), caregivers (n = 24), and parent-caregivers together with their child (n = 5). Respondents prioritized 27 meaningful outcomes covering various aspects of health and functioning: emotional well-being, quality of life, mental and sensory functions, pain, physical health, and activities (communication, mobility, self-care, interpersonal relationships). Parent-caregiver concerns and environmental factors were newly identified outcomes. INTERPRETATION Children and parent-caregivers identified meaningful outcomes covering various aspects of health and functioning, including caregiver concerns and environmental factors. We propose including those in future outcome sets for children with neurodisability. WHAT THIS PAPER ADDS Outcomes that children with brain-related disorders and their parent-caregivers consider to be the most meaningful cover a wide range of aspects of functioning. Involving these children and their parent-caregivers resulted in the identification of important outcomes that were not covered by professionals and the literature. Parent-caregiver-related factors (coping, burden of care) and environmental factors (support, attitudes, and [health care] services) were identified as meaningful.
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Affiliation(s)
- Myrna A Heydenrijk-Kikkert
- Erasmus MC, University Medical Center Rotterdam, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Pediatric Brain Center, Rotterdam, the Netherlands
- Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Ann Katrin K Schmidt
- Erasmus MC, University Medical Center Rotterdam, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
| | - Robert Pangalila
- Erasmus MC, University Medical Center Rotterdam, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Pediatric Brain Center, Rotterdam, the Netherlands
- Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Marie-Claire Y De Wit
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Pediatric Brain Center, Rotterdam, the Netherlands
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatric Neurology and The ENCORE Expertise Center for Neurodevelopmental Disorders, Rotterdam, the Netherlands
| | - Neeltje E M van Haren
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Pediatric Brain Center, Rotterdam, the Netherlands
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Department of Child and Adolescent Psychiatry, Rotterdam, the Netherlands
| | - Marie-Lise C Van Veelen
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Pediatric Brain Center, Rotterdam, the Netherlands
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Department of Neurosurgery, Rotterdam, the Netherlands
| | - Marij E Roebroeck
- Erasmus MC, University Medical Center Rotterdam, Department of Rehabilitation Medicine, Rotterdam, the Netherlands
- Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Pediatric Brain Center, Rotterdam, the Netherlands
- Rijndam Rehabilitation, Rotterdam, the Netherlands
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Roldán-Pérez P, San Miguel-Pagola M, Doménech-García V, Bellosta-López P, Buesa-Estéllez A. Identification of the needs of children with neurodisability and their families at different stages of development: A qualitative study protocol. PLoS One 2023; 18:e0291148. [PMID: 37682853 PMCID: PMC10490905 DOI: 10.1371/journal.pone.0291148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Within the field of childhood neurodisability, the tendency in the study of needs has been to categorize them based on ability (motor, verbal, cognitive). However, current perspectives such as F-words, family-centered practices, or the principles of family empowerment, lead the researcher to ask: What are these needs according to the stage of development? METHODS AND ANALYSIS A descriptive qualitative study will be carried out. Several methods will be followed to ensure the reliability and validity of the results, and the Standards for Reporting Qualitative Research and the Consolidated criteria for reporting qualitative research checklists will also be used to guide the project. Data collection is sought from three main sources: Focus groups (detection of needs), a survey to collect sociodemographic and clinical data necessary to obtain an overview of the context of the participants, and a survey to find out the level of satisfaction with this initiative. DISCUSSION The results expected to be obtained after this study will respond to the main needs of families with childhood neurodisability, based on age groups and covering the whole territory of the Spanish population. Thanks to these detected needs, it will be possible to design future lines of work to improve the design of family-centered practices and increase the empowerment of families. The intention is to detect needs by stage of development, which can be categorized within the F-words framework, showing families and professionals a clear picture of the needs of this population.
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Affiliation(s)
| | | | | | - Pablo Bellosta-López
- Universidad San Jorge, Campus Universitario, Villanueva de Gállego, Zaragoza, Spain
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Dong SY, Nguyen L, Cross A, Doherty-Kirby A, Geboers J, McCauley D, Soper AK, St Dennis A, Steeves D, Trehan N, Gorter JW. Youth engagement in research: exploring training needs of youth with neurodevelopmental disabilities. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:50. [PMID: 37430378 DOI: 10.1186/s40900-023-00452-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/26/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Authentic researcher-youth partnerships in patient-oriented research (POR) where the research responds to the needs expressed by youth themselves are essential to make research meaningful. While patient-oriented research (POR) is increasingly practiced, few training programs exist in Canada and none, to our knowledge, are tailored for youth with neurodevelopmental disabilities (NDD). Our primary objective was to explore the training needs of youth (ages 18-25) with NDD to enhance their knowledge, confidence, and skills as research partners. Our secondary objective was to identify the benefits and challenges of engaging youth with NDD in a POR approach. METHODS Our team of four youth and one parent with lived experience [Youth Engagement in Research (YER) partners] and six researchers engaged in POR to investigate the primary objective via two phases: (1) individual interviews with youth living with NDD and (2) a two-day virtual symposium with focus groups with youth and researchers. Collaborative qualitative content analysis was employed to synthesize the data. Our secondary objective was assessed by asking our YER partners to complete the Public and Patient Engagement Evaluation Tool (PPEET) survey and participate in reflective discussions. RESULTS Phase 1 participants (n = 7) identified various barriers and facilitators to their engagement in research and offered suggestions to meet their needs through minimizing barriers and integrating facilitators, which would subsequently enhance their knowledge, confidence, and skills as research partners. Informed by phase 1, phase 2 participants (n = 17) prioritized the following POR training needs: researcher-youth communication, research roles and responsibilities, and finding partnership opportunities. For delivery methods, participants stated the importance of youth representation, using Universal Design for Learning, and co-learning between youth and researchers. Based on the PPEET data and subsequent discussions, YER partners agreed that they were able to express views freely, feel that their views were heard, and that their participation made a meaningful difference. Challenges included scheduling difficulties, ensuring multiple methods for engagement, and working under short timelines. CONCLUSION This study identified important training needs for youth with NDD and for researchers to engage in meaningful POR, which can subsequently inform the co-production of accessible training opportunities with and for youth.
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Affiliation(s)
- Samantha Yimeng Dong
- Bachelor of Health Sciences Program, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Linda Nguyen
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | | | - Jessica Geboers
- Youth Engagement in Research (YER) Partners/Patient Authors, Hamilton, Canada
- Childhood Cerebral Palsy Integrated Neuroscience Discovery Network (CP-NET), McMaster University, Hamilton, ON, Canada
| | - Dayle McCauley
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Childhood Cerebral Palsy Integrated Neuroscience Discovery Network (CP-NET), McMaster University, Hamilton, ON, Canada
| | - Alice Kelen Soper
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Amanda St Dennis
- Youth Engagement in Research (YER) Partners/Patient Authors, Hamilton, Canada
- Childhood Cerebral Palsy Integrated Neuroscience Discovery Network (CP-NET), McMaster University, Hamilton, ON, Canada
| | - Danny Steeves
- Youth Engagement in Research (YER) Partners/Patient Authors, Hamilton, Canada
- Childhood Cerebral Palsy Integrated Neuroscience Discovery Network (CP-NET), McMaster University, Hamilton, ON, Canada
| | - Natasha Trehan
- Youth Engagement in Research (YER) Partners/Patient Authors, Hamilton, Canada
- Biomedical Science Program, Ottawa University, Ottawa, ON, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada.
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht, The Netherlands.
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Programs to Prepare Siblings for Future Roles to Support Their Brother or Sister with a Neurodevelopmental Disability: a Scoping Review. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2023; 10:47-79. [PMID: 36845576 PMCID: PMC9942034 DOI: 10.1007/s40474-023-00272-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2023] [Indexed: 02/23/2023]
Abstract
Purpose of Review To identify and map the characteristics and outcomes of programs designed to prepare siblings for their future roles with their sibling with a neurodevelopmental disability. Recent Findings Existing programs to support siblings of individuals with a neurodevelopmental disability often focus on providing information about neurodevelopmental disabilities, creating a community for siblings to connect with each other, and connecting siblings to resources and services to support them in their roles. Some programs are offered to the whole family with specific sessions for siblings. While these program descriptions are provided in the literature, there is limited understanding about the impacts and outcomes of these programs on siblings of an individual with a neurodevelopmental disability. Summary Fifty-eight articles (published between 1975 and 2020, with > 50% published since 2010) met the inclusion criteria, representing 54 sibling programs from 11 countries. Extracted data represented 1033 (553 females) sibling participants, between 4 and 67 years old. Twenty-seven programs focused on the outcome of knowledge acquisition for the siblings and thirty-one programs focused on the outcome of empowerment for the siblings to teach skills to their sibling with a neurodevelopmental disability. While there is an increasing number of programs for siblings of individuals with a neurodevelopmental disability in the past decade, there is a lack of siblings as co-developers or facilitators. Future research should consider the various roles that siblings can have in programs to address their needs. Supplementary Information The online version contains supplementary material available at 10.1007/s40474-023-00272-w.
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Wang L, Micsinszki SK, Goulet-Barteaux M, Gilman C, Phoenix M. Youth and family engagement in childhood disability evidence syntheses: A scoping review. Child Care Health Dev 2023; 49:20-35. [PMID: 35708523 DOI: 10.1111/cch.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 04/12/2022] [Accepted: 06/13/2022] [Indexed: 12/15/2022]
Abstract
Within the last decade, stakeholder engagement in research has become increasingly popular in childhood disability research; however, literature on the engagement of youth with neurodisabilities and their families in evidence syntheses is underdeveloped. Involving patients as partners in research has the potential to improve applicability and relevance of the research and benefit patient partners (e.g. enhanced self-esteem, increased research knowledge and skills); however, the methods, challenges, outcomes and recommendations of engaging youth with neurodisabilities and their families in evidence syntheses are unknown. Two parents of youth with complex disability needs were engaged as partners throughout this review. Following methods outlined by Arksey and O'Malley (2005), the primary research question in this scoping review is twofold: (i) what activities have youth with neurodisabilities and their families been engaged in as part of evidence syntheses and (ii) what were the outcomes of that engagement? After full text review of 369 articles, nine articles were included. Youth and families were engaged prior to the evidence synthesis and at every stage in the project, most often during data analysis where they contextualized the findings. Youth and family engagement were not formally evaluated; however, positive outcomes were reported by parents and researchers. Challenges such as increased time, sustaining engagement, and parents' dissatisfaction with their level of involvement were reported. Recommendations centred around providing partners with information, building relationships via social media, and openly communicating about roles, feedback and logistics. Childhood disability researchers should be aware of how they can increase engagement opportunities at all stages of evidence syntheses and how they might improve accessibility for youth with neurodisabilities and their families. Further research is needed to solidify a unified framework for conduct and reporting of youth and family engagement in evidence syntheses.
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Affiliation(s)
- Lucy Wang
- McMaster University, Hamilton, Ontario, Canada
| | - Samantha K Micsinszki
- McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | | | - Christina Gilman
- Parents Partnering in Research, CanChild, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Phoenix
- McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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Cross A, Soper AK, Tomas V, Grahovac D, Brocklehurst J, Kay D, Baptiste S, Gorter JW, Rosenbaum P. Exploring 10 years of dissemination of the F-words for Child Development: A multifaceted case study. Child Care Health Dev 2022; 48:751-762. [PMID: 35128716 DOI: 10.1111/cch.12983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is growing interest in exploring how to move research findings into practice. Since 2014, a team of families and researchers has been working to promote and study the dissemination of the "F-words for Child Development" (Function, Family, Fitness, Fun, Friends, and Future). This case study describes our dissemination strategies and uses the Diffusion of Innovation theory to understand the factors contributing to the uptake of the F-words-a function-promoting, strengths-based, and family-centred innovation in child health and development. METHODS Between November 2011 and November 2021, we collected data from multiple sources: our dissemination strategies, including affiliated documents/artefacts (e.g., videos and presentations) and evaluation data (e.g., surveys and Google/video analytics). We used a two-step analysis: (1) a chronological time series to describe the processes involved along with indicators of dissemination over time (e.g., increase knowledge and awareness); and (2) Diffusion of Innovation theory to explore the factors that contributed to the uptake of the F-words. RESULTS Multifaceted dissemination strategies were essential to raise awareness and increase families' and service providers' knowledge of the F-words. These included three primary strategies: (i) development and distribution of educational materials; (ii) presentations at educational meetings; and (iii) educational outreach visits. Additional strategies, such as the use of mass media, collaboration with early adopters/champions, and the involvement of family members further supported dissemination efforts. Diffusion of Innovation factors (innovation characteristics, time, social systems, and communication channels) all contributed to the uptake of this innovation. CONCLUSIONS Purposeful planned dissemination practice, to increase knowledge and awareness of an innovation, is an important step in the knowledge translation process. Over a period of 10 years, through the use of multiple dissemination strategies conducted in partnership with families and service providers, the F-words have spread globally. Diffusion of Innovation theory has served to help understand how and why the F-words are being shared and adopted around the world.
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Affiliation(s)
- Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Alice Kelen Soper
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Vanessa Tomas
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada
| | - Danijela Grahovac
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Julie Brocklehurst
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Diane Kay
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Sue Baptiste
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Family members' experience of well‐being as racial/ethnic minorities raising a child with a neurodevelopmental disorder: A qualitative meta‐synthesis. Res Nurs Health 2022; 45:314-326. [DOI: 10.1002/nur.22217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/07/2022]
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Gardiner E, Wong V, Lin G, Miller AR. Terminology and descriptions of navigation and related practices for children with neurodisability and their families: a scoping review. BMC Health Serv Res 2022; 22:214. [PMID: 35177039 PMCID: PMC8851781 DOI: 10.1186/s12913-022-07617-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with neurodisability (ND) represent a significant population with a demonstrated need for coordinated support. Patient navigation has a primary focus on: facilitating access to and connection amongst fragmented systems; as well as the provision of educational and emotional support. Given the distinct needs of children with ND and their families, programs built upon such core concepts could be of great benefit. The diversity of terminology encompassing navigation-related concepts and activities (e.g., care coordination, case management, family support), however, presents challenges to both practice and research. This scoping review examined the terminology and descriptions provided within published articles on navigation-type models for children with ND and their families. METHODS The scoping review was conducted according to the Joanna Briggs Institute methodology. A preliminary search was completed on PubMed (NCBI), MEDLINE (Ovid) and CINAHL (EBSCO) to identify initial search terms, upon which a full search strategy was developed and executed in MEDLINE (Ovid) and CINAHL (EBSCO). After screening records according to our inclusion and exclusion criteria, a full-text review of relevant articles was conducted and data extracted using a researcher-developed tool. Under close supervision by the research team, study selection was primarily performed by one author. RESULTS Of the 2597 papers identified, 33 were included in the final review. From the included papers, a total of 49 terms were extracted, 20 of which were unique. Across the diversity of terminology observed, articles provided detailed and rich descriptions characterized by four central domains, namely: (i) what navigation-related resources, supports and services aim to facilitate and (ii) provide; (iii) descriptions of their intended outcomes; as well as (iv) guiding principles. CONCLUSIONS This scoping review addresses a gap in our knowledge related to the specification of patient navigation and related supports as applied to the specific context of children with ND and their families. Given the particular needs of this population, we propose an empirically-informed integrative model that synthesizes the findings from this scoping review. We suggest that this framework can be used as a guide to the mindful characterization of how supports aiming to connect children and families to needed service are termed and described within future research and in practice.
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Affiliation(s)
- Emily Gardiner
- BC Children's Hospital Research Institute, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada. .,Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Vivian Wong
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.,Sunny Hill Health Centre at BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Grace Lin
- School of Medicine, Queen's University, 15 Arch Street, Kingston, ON, K7L 3N6, Canada
| | - Anton R Miller
- BC Children's Hospital Research Institute, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.,Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
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Rosenbaum PL. The F-words for child development: functioning, family, fitness, fun, friends, and future. Dev Med Child Neurol 2022; 64:141-142. [PMID: 35005779 DOI: 10.1111/dmcn.15021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Salvino C, Spencer C, Filipe AM, Lach LM. Mapping of Financial Support Programs for Children With Neurodisabilities Across Canada: Barriers and Discrepancies Within a Patchwork System. JOURNAL OF DISABILITY POLICY STUDIES 2022. [DOI: 10.1177/10442073211066776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A cross-jurisdictional pan-Canadian environmental scan was conducted to identify provincial, territorial, and federal financial supports available to families with children living with neurodisabilities. In partnership with the organization Childhood Disability LINK, flowchart-styled pathway documents were developed for each financial support identified, mapping out the processes required to access each support. A critical analysis was completed as it relates to structural barriers, accessibility of program information and geographic discrepancies. The results revealed that, despite almost universal availability of programs to support families of children living with neurodisabilities, significant barriers and inequity remain. This included considerable variation in access to financial support based on geographic and jurisdictional discrepancies, absence of adequate and accurate information about programs, and minimal support provided to families in the application process. We argue that the barriers and discrepancies identified were an inherent result of the Canadian federalist fragmentation of the delivery of social care and financial support programs for children living with neurodisabilities. A more unified response by Canadian provincial, territorial, and federal governments is clearly needed to take positive steps to address the consequences of federalist fragmentation and respond to the structural barriers and geographic discrepancies identified by this study.
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Shanmugarajah K, Rosenbaum P, Zubairi M, Di Rezze B. A Narrative Review of Function-Focused Measures for Children With Neurodevelopmental Disorders. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:709978. [PMID: 36188829 PMCID: PMC9397797 DOI: 10.3389/fresc.2021.709978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/02/2021] [Indexed: 12/03/2022]
Abstract
Clinical measures in health and rehabilitation settings are often used to examine child functioning to better support the diverse needs of children with neurodevelopmental disorders (NDD) and their families. The WHO's International Classification of Functioning, Disability, and Health (ICF) framework reflects a focus of health beyond biomedical deficits, using the concept of functioning to create opportunities for measurement development involving this construct. In the measures developed in the field of childhood NDD, it is unclear whether and how these tools measure and incorporate the ICF framework and its domains within health care contexts. Understanding how these measures utilize the ICF will enable researchers and clinicians to operationalize function-focused concepts in studies and clinical practice more effectively. This narrative review aims to identify and describe function-focused measures that are based on the ICF for children with NDD, as described in the peer-reviewed literature. This review used a systematic search strategy with multiple health-focused databases (Medline, PsycInfo, EMBASE, EMCARE), and identified 14 clinical measures that provide direct support for children (aged 0-21) with NDD in pediatric health (and other) settings. Results described the measures that were primarily developed for three main diagnostic populations [cerebral palsy, autism spectrum disorder, and communication disorders]; had varying contextual use (clinical-only or multiple settings); and for which authors had conducted psychometric tests in the measure's initial development studies, with the most common being content validity, interrater reliability, test-retest reliability. Participation (79%, n = 11) & Activities (71%, n = 10) were the most common ICF domains captured by the set of measurement tools. Overall (71%, n = 10) of the identified measures utilized multiple ICF domains, indicating that the “dynamic nature” of the interactions of the ICF domains was generally evident, and that this result differentiated from “linking rules,” commonly used in research and clinical practice. The implications of these findings suggest that clinical measures can be an effective application of the ICF's defined concepts of functioning for children with NDD.
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Affiliation(s)
- Kajaani Shanmugarajah
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
- *Correspondence: Kajaani Shanmugarajah
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- McMaster Autism Research Team, Hamilton, ON, Canada
| | - Mohammad Zubairi
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- McMaster Autism Research Team, Hamilton, ON, Canada
| | - Briano Di Rezze
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
- McMaster Autism Research Team, Hamilton, ON, Canada
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Russell MJ, Michael Scott CW, Murias K, Ben Gibbard W, Cui X, Tough S, Zwicker JD. Cross-ministry data on service use and limitations faced by children in special education. Disabil Health J 2021; 14:101118. [PMID: 34074619 DOI: 10.1016/j.dhjo.2021.101118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Children with disabilities often face limitations that cross support sectors. OBJECTIVE Our aim was to measure cross-ministry service use, outcomes, and functional limitations faced by children who qualified for special education. METHODS We used longitudinal British Columbia ministry data linked to children (0-18y) registered in K-12 education. Children were grouped by special education funding (most to least; Level 1, Level 2, Level 3, Unfunded, and no special education), and related to 1) service use patterns, 2) the age they first used disability services, and 3) functional limitations reported in health visits. We also reported how length of special education use related to disability service use. RESULTS Of 111,274 children, 154(0.1%) were Level 1, 4427(4.0%) Level 2, 2897(2.6%) Level 3, 13472(12.1%) Unfunded, and 90324(81.2%) not in special education. Children with higher funding levels, compared to lower levels of funding, generally were more likely to experience poorer outcomes, have functional limitations, have service needs, and receive early support. One exception was children with serious behavioural/mental health special education coding, which had poorer outcomes for their level of funding. Children received child disability supports early (about half of users started by 4y), but use was mostly limited to those with many years (9+years) of funded special education (70.7% of the all users) and biased to certain special education codes (i.e., Level 1, severe intellectual disability, and autism). CONCLUSIONS This study provides evidence of the long-term, diverse needs of children in special education and may be used to inform decisions surrounding their support.
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Affiliation(s)
- Matthew Joseph Russell
- School of Public Policy, University of Calgary, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; PolicyWise for Children & Families, 1000-9925 109 St NW, Edmonton, AB T5K 2J8, Canada.
| | - Craig William Michael Scott
- School of Public Policy, University of Calgary, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada
| | - Kara Murias
- Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - W Ben Gibbard
- Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - Xinjie Cui
- PolicyWise for Children & Families, 1000-9925 109 St NW, Edmonton, AB T5K 2J8, Canada
| | - Suzanne Tough
- Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - Jennifer D Zwicker
- School of Public Policy, University of Calgary, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta, T2P 1H9, Canada; Faculty of Kinesiology, University of Calgary, 376 Collegiate Blvd NW, Calgary, Alberta, T2N 1N4, Canada
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Assenza C, Cacciatore D, Manica M, Iosa M, Foti C, Gobbetti T, Paolucci S, Morelli D. Assistive products and childhood neurodisability: a retrospective study on factors associated with aids/orthoses prescription. Eur J Phys Rehabil Med 2020; 56:412-420. [PMID: 32406225 DOI: 10.23736/s1973-9087.20.06224-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Children affected by pathologies causing neurodisability go through motor, cognitive, sensory and other limitations. The selection of assistive products can influence their level of independence and quality of life. AIM The present study investigated the possibility to assess the equipment needs of children with neurodisabilities, based on their clinical characteristics. DESIGN A retrospective observational study. SETTING Outpatients. POPULATION Inclusion criteria: diagnosis of cerebral palsy or genetic/chromosomal/syndromic disorders, age range 0-18 years, intelligence quotient evaluation, medical history of positive or negative presence of epilepsy and of communication disorders, admission at our neurorehabilitation service between 2007 and 2017, and registration of all equipment prescribed to each child. METHODS In 192 children (111 males, 57.81%) we evaluated the relationship between several independent variables (diagnosis, sex, Gross Motor Function Classification System level, intelligence quotient, history of epilepsy and communication disorders) and equipment prescription by means of logistic regression models. RESULTS Our data showed significant correlation between the Gross Motor Function Classification System level and the equipment prescribed. A history of seizures was negatively correlated with walker prescriptions (the log odds of prescription decreases by -2.156; CI: -4.16 to -0.65) and positively with those of stroller (the log odds increases by 1.427; CI: 0.22 to 2.69). Stroller and knee-ankle-foot orthoses and hip-knee-ankle-foot orthoses prescriptions were negatively correlated with the cerebral palsy diagnosis. The prescription of foot orthoses was positively correlated with mental retardation (the log odds increases by 0.358; CI: 0.12 to 0.61). A negative correlation between communication disorders and the prescription of ankle-foot orthoses and communication/learning devices was also found (the log odds decreases by -0.833; CI -1.66 to -0.01). CONCLUSIONS Several clinical characteristics correlate with specific equipment needs. CLINICAL REHABILITATION IMPACT The definition of the clinical characteristics with a potential predicting value, may facilitate the task of physician on choosing what is more appropriate to prescribe, as well as the authorizing office responsible for evaluating the appropriateness of prescriptions. Furthermore, it could be possible to foresee the care needs in terms of type and number of aids/orthoses and to guarantee every disabled child the possibility to take advantage of the same opportunities.
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Affiliation(s)
- Carla Assenza
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy - .,Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy -
| | - Denise Cacciatore
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | | | - Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy
| | - Tiziana Gobbetti
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | - Stefano Paolucci
- Clinical Laboratory of Experimental Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
| | - Daniela Morelli
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research and Health Care Santa Lucia Foundation, Rome, Italy
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Filipe AM, Bogossian A, Zulla R, Nicholas D, Lach LM. Developing a Canadian framework for social determinants of health and well-being among children with neurodisabilities and their families: an ecosocial perspective. Disabil Rehabil 2020; 43:3856-3867. [DOI: 10.1080/09638288.2020.1754926] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Angela M. Filipe
- Department of Sociology, McGill University, Montréal, Canada
- Centre for Research on Children and Families, McGill University, Montréal, Canada
| | - Aline Bogossian
- École de Travail Social, Université de Montréal, Montréal, Canada
| | - Rosslynn Zulla
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - David Nicholas
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Lucyna M. Lach
- Centre for Research on Children and Families, McGill University, Montréal, Canada
- School of Social Work, Faculty of Arts, McGill University, Montréal, Canada
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16
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Xavier DM, Gomes GC, Cezar-Vaz MR. Meanings assigned by families about children's chronic disease diagnosis. Rev Bras Enferm 2020; 73:e20180742. [PMID: 32236375 DOI: 10.1590/0034-7167-2018-0742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/18/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to understand the meanings assigned by family caregivers about children's chronic disease diagnosis. METHODS qualitative study, which used as theoretical framework the Symbolic Interactionism, and methodological, the Grounded Theory. It was held in a pediatric unit in Southern Brazil, in 2016, through interviews submitted to open and axial analysis, with the participation of 20 family caregivers of hospitalized children. RESULTS relatives, interacting with the nursing/health staff, perceive children's disease at birth. They are diagnosed with chronic disease by the physician and deny it. Subsequently, they accept and seek information on care. CONCLUSIONS the results pointed out the stages that relatives experience by assigning meanings to about children's chronic disease diagnosis. These meanings provide subsidies for nurses' actions, which need to be aware of children's and family's needs in order to offer comprehensive and humanized care.
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Akobirshoev I, Mitra M, Parish SL, Valentine A, Simas TAM. Racial and Ethnic Disparities in Birth Outcomes and Labor and Delivery Charges Among Massachusetts Women With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:126-138. [PMID: 32240049 DOI: 10.1352/1934-9556-58.2.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Understanding the pregnancy experiences of racial and ethnic minority women with intellectual and developmental disabilities (IDD) is critical to ensuring that policies can effectively support these women. This research analyzed data from the 1998-2013 Massachusetts Pregnancy to Early Life Longitudinal (PELL) data system to examine the racial and ethnic disparities in birth outcomes and labor and delivery charges of U.S. women with IDD. There was significant preterm birth disparity among non-Hispanic Black women with IDD compared to their non-Hispanic White peers. There were also significant racial and ethnic differences in associated labor and delivery-related charges. Further research, examining potential mechanisms behind the observed racial and ethnic differences in labor and delivery-related charges in Massachusetts' women with IDD is needed.
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Affiliation(s)
- Ilhom Akobirshoev
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Monika Mitra
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Susan L Parish
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Anne Valentine
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
| | - Tiffany A Moore Simas
- Ilhom Akobirshoev and Monika Mitra, Brandeis University; Susan L. Parish, Virginia Commonwealth University; Anne Valentine, Brandeis University; and Tiffany A. Moore Simas, University of Massachusetts Medical School
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18
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Cameron KL, Albesher RA, McGinley JL, Allison K, Cheong JLY, Spittle AJ. Movement-based interventions for preschool-age children with, or at risk of, motor impairment: a systematic review. Dev Med Child Neurol 2020; 62:290-296. [PMID: 31713851 DOI: 10.1111/dmcn.14394] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/11/2022]
Abstract
AIM To explore the efficacy of movement-based interventions to improve motor skills in preschool-age children with, or at risk of, motor impairment, including those with a diagnosis of cerebral palsy, autism spectrum disorder, and developmental coordination disorder. METHOD Relevant electronic databases were searched for randomized or quasi-randomized controlled trials. Outcomes were classified using domains of the International Classification of Functioning, Disability and Health: Children & Youth version. Quality was assessed using the Physiotherapy Evidence Database scale. Risk of bias was assessed using the Cochrane Risk of Bias tool. Effect sizes were calculated using Cohen's d. RESULTS Seventeen articles exploring a heterogeneity of intervention types, population groups, and outcome measures met the inclusion criteria. Movement-based interventions did not significantly improve outcomes in either the body structure and function or activity domains in most studies. No studies used a participation outcome measure. INTERPRETATION There is a paucity of evidence exploring movement-based interventions in the preschool-age group. Although movement-based interventions showed potential for improving body structure and function and activity outcomes for children with motor impairment, results were mostly not significant. Small sample sizes, variable study quality, and risk of bias limit confidence in the results. WHAT THIS PAPER ADDS The evidence is inconclusive to support movement-based interventions in this group. No studies used outcome measures assessing participation. Variability in intervention type and study quality limit confidence in results.
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Affiliation(s)
- Kate L Cameron
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Reem A Albesher
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jennifer L McGinley
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Kim Allison
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Neonatal Research, Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
| | - Alicia J Spittle
- Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Neonatal Research, Royal Women's Hospital, Melbourne, VIC, Australia
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Imms C. Participation in diverse life situations for people with disability: a vision for the future. Dev Med Child Neurol 2020; 62:5. [PMID: 31797359 DOI: 10.1111/dmcn.14399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
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20
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Gardiner E, Miller AR, Lach LM. Topography of behavior problems among children with neurodevelopmental conditions: Profile differences and overlaps. Child Care Health Dev 2020; 46:149-153. [PMID: 31714607 DOI: 10.1111/cch.12720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 11/05/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND This exploratory proof of principle study examined the extent to which behavior problems represent a functional characteristic that crosses diagnostic boundaries. METHODS This cross-sectional study pertains to 179 caregivers of children, aged 4-13 years (M = 8.27) with cerebral palsy (n = 77), autism spectrum disorder (n = 58), and global developmental delay/intellectual disability (n = 44). Caregivers completed the Strengths and Difficulties Questionnaire, which provides a measure of conduct problems, emotional symptoms, hyperactivity-inattention, peer problems, as well as total difficulties. RESULTS Behavior problem severity differed across diagnostic groups (p < .001). Visual examination of box plots indicated substantial overlap within Strengths and Difficulties Questionnaire subscales across children with autism spectrum disorder, cerebral palsy, and global developmental delay/intellectual disability. Children within each condition demonstrated matching profile topographies, such that hyperactivity-inattention difficulties were most severe. Repeated measures analysis of variances confirmed that children within each group received significantly higher ratings on the hyperactivity-inattention subscale (all p < .001). CONCLUSIONS The approach adopted to examine the data and findings have the potential to inform how we conceptualize and study behavior problems among children with neurodevelopmental conditions. Importantly, children with particular conditions did not demonstrate unique constellations of difficulties. Clinicians must therefore be attuned to the possibility of commonality in behavior problems across children with disparate diagnoses, irrespective of syndrome-specific expectations.
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Affiliation(s)
- Emily Gardiner
- BC Children's Hospital Research Institute, Vancouver, Canada
| | - Anton R Miller
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Lucyna M Lach
- School of Social Work, McGill University, Montreal, Canada
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21
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Richardson ZS, Scully EA, Dooling-Litfin JK, Murphy NJ, Rigau B, Khetani MA, McManus BM. Early Intervention Service Intensity and Change in Children's Functional Capabilities. Arch Phys Med Rehabil 2019; 101:815-821. [PMID: 31778660 DOI: 10.1016/j.apmr.2019.10.188] [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: 06/28/2019] [Revised: 10/08/2019] [Accepted: 10/13/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To estimate correlates of early intervention (EI) service dosage and gains in children's functional capabilities from EI entry and discharge. DESIGN Retrospective cohort study. SETTING Secondary analyses of a subset of data (N=1005) collected from an EI administrative database on children discharged from a large, urban EI program between October 1, 2014 and September 30, 2016. PARTICIPANTS Children who were EI eligible due to developmental delay, had received an EI care plan and at least 1 billable EI service, and had outcomes data at EI entry and exit (N=1005). Measured child characteristics included age (49.0% 12-24mo; n=492), sex (36.0% female; n=362), number of developmental delays (76.1% had 1 developmental delay; n=765), and number of EI services received (78.5% received multiple; n=789). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Outcomes were EI service intensity (hours per month) and change in functional capabilities as measured via the state-mandated Child Outcomes Summary (COS). Adjusted quantile median regression estimated EI intensity. Adjusted linear regression estimated change in function for social-emotional, cognitive, and adaptive domains of the COS. Measures of children's developmental delay severity, age at EI entry, race and ethnicity, sex, and language. RESULTS Children older than 24 months old experienced significantly higher EI service intensity (b=0.40; 95% confidence interval, 0.18-0.63). Child age and EI service intensity were significantly linked to gains in social and cognitive COS score changes from EI entry to exit. CONCLUSIONS Older children receive a higher intensity of EI services. EI service intensity and age were linked with positive changes in functional gains.
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Affiliation(s)
- Zachary S Richardson
- Department of Health Systems, Management and Policy, University of Colorado at Denver, Denver, Colorado
| | | | | | - Natalie J Murphy
- Department of Physical Medicine and Rehabilitation, University of Colorado at Denver, Denver, Colorado
| | - Briana Rigau
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, Illinois
| | - Mary A Khetani
- Departments of Occupational Therapy and Disability and Human Development, University of Illinois at Chicago, Chicago, Illinois.
| | - Beth M McManus
- Department of Health Systems, Management and Policy, University of Colorado at Denver, Denver, Colorado
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Wertlieb D. Nurturing care framework for inclusive early childhood development: opportunities and challenges. Dev Med Child Neurol 2019; 61:1275-1280. [PMID: 30977124 DOI: 10.1111/dmcn.14234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2019] [Indexed: 11/28/2022]
Abstract
The nurturing care framework (NCF) for early childhood development (ECD) launched at the 2018 World Health Assembly opens a range of opportunities and challenges for child neurodisability professionals. The United Nations Convention on the Rights of the Child and Convention on the Rights of People with Disabilities frame these pathways for collaboration and progress. This overview of the NCF and its contexts in inclusive ECD identifies avenues for innovation and collaboration in harmony with the field's clinical, scientific, and advocacy agendas. One avenue involves enhancing the alignment between health systems and human rights. A second avenue involves neurodisability professionals engaging with nurturing care as leaders, partners, and implementers. WHAT THIS PAPER ADDS: Participation and leadership by neurodisability professionals can enhance quality and impact. A rights-based framework that includes young children with disabilities and their families is widely encouraged.
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Affiliation(s)
- Donald Wertlieb
- Partnership for Early Childhood Development & Disability Rights, Eliot-Pearson Department of Child Study & Human Development, Tufts University, Medford, MA, USA
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Soper AK, Cross A, Rosenbaum P, Gorter JW. Exploring the international uptake of the "F-words in childhood disability": A citation analysis. Child Care Health Dev 2019; 45:473-490. [PMID: 31041806 DOI: 10.1111/cch.12680] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The "F-words in childhood disability" (function, family, fitness, fun, friends, and future) were introduced in a concept paper in 2012 entitled, "The F-words in childhood disability: I swear this is how we should think!". The "F-words" are grounded in, and aim to operationalize, the World Health Organization's (World Health Organization, 2001) International Classification of Functioning, Disability and Health (ICF) framework. A citation analysis was conducted to explore the extent of research uptake of the "F-words" concepts. METHODS Three databases-Google Scholar, Wiley Online, and Web of Science-were searched from July 2012 to December 2018 for sources that cited the original F-words paper. Dates of publication and countries of first authors were extracted from all cited articles, and a taxonomy was developed to categorize the type of usage. RESULTS The search yielded 157 sources from 26 countries, and the number of citations has continued to increase since the paper's publication. Sources were placed into three categories: cited/referenced (n = 109; i.e., the paper was simply cited), integrated/informed (n = 36; i.e., the F-words were stated within the text), and non-English (n = 12). Of the 36 integrated/informed sources, 34 (94.4%) applied the F-words to the ICF framework and five themes emerged with respect to the use of the F-words: (a) support of a holistic approach to childhood disability, (b) association of the F-words to physical activity and rehabilitation, (c) application and measurement of quality of life, (d) F-words research team-related papers, and (e) "other" category. CONCLUSION This citation analysis shows that the F-words are mainly being used to operationalize the ICF, support a holistic approach to childhood disability, and inform physical activity and rehabilitation-based interventions. These perspectives will play an important role in informing the next steps with respect to moving the F-words into research and practice.
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Affiliation(s)
- Alice Kelen Soper
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Silveira AD, Neves ET. Cotidiano de cuidado de adolescentes com necessidades especiais de atenção à saúde. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Compreender o cotidiano de cuidado de adolescentes com necessidades especiais de atenção à saúde. Métodos Pesquisa qualitativa, pautada no referencial crítico-libertador Freireano, realizada no ambulatório pediátrico de um hospital de ensino, no segundo semestre de 2016. Realizou-se a análise de prontuários, entrevista semiestruturada e a construção do genograma e ecomapa de 35 adolescentes com algum tipo de demanda de saúde. Após a dupla transcrição, as entrevistas foram submetidas à análise de discurso Pechetiana. Resultados O cotidiano de cuidado desses adolescentes é traduzido por meio da higiene pessoal, aparência física, uso de medicamentos, nutrição e habituais modificados. O discurso dos adolescentes apresentou diferentes níveis emancipatórios: em alguns momentos a partir da adaptação e alienação, pelo costume e necessidade de ter que desenvolver o cuidado por meio de uma reprodução técnica, o que contribui para a opressão; e em outros momentos pela possibilidade de emancipação, a partir da reflexão sobre sua realidade e posicionar-se sobre ela. Conclusão O cotidiano de cuidado do adolescente é permeado pelas possibilidades e habilidades em diferentes níveis emancipatórios. A ausência de dialogicidade, troca de saberes e reflexão podem contribuir para o processo de opressão. A Enfermagem necessita possibilitar a troca de saberes e a reflexão, para que o adolescente transite de uma consciência ingênua para crítica.
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Rosenbaum P. Diagnosis in developmental disability: a perennial challenge, and a proposed middle ground. Dev Med Child Neurol 2019; 61:620. [PMID: 31049943 DOI: 10.1111/dmcn.14216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Arim RG, Miller AR, Kohen DE, Guèvremont A, Lach LM, Brehaut JC. Changes in the health of mothers of children with neurodevelopmental disabilities: An administrative data study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 86:76-86. [PMID: 30684833 DOI: 10.1016/j.ridd.2018.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/14/2018] [Accepted: 12/18/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Using linked administrative health data, this study compared the health and healthcare service utilization between mothers of children with and without neurodevelopmental disabilities (NDD), before, during, and after the birth of a child. METHODS The population (N = 25,388) was based on a cohort of children born in 2000 and who were, along with their mothers, continuously registered with the British Columbia's universal health insurance program between 2000 and 2007. RESULTS Compared to mothers of children without NDD, mothers of children with NDD were more likely to have chronic conditions and higher service utilization before child birth. Mothers of children with NDD showed a smaller increase in physician visits in the year before birth but a greater increase in different prescription drugs in the year after birth. There was no further divergence (or convergence) in health and service utilization between the groups in the 7-year period post-birth. CONCLUSIONS Differences in health and healthcare service utilization between mothers of children with and without NDD existed before the birth of the child and did not diverge in the 7 years post-birth. Replication of these findings is warranted as well as follow-up analyses examining longer term outcomes for mothers beyond 7 years post-birth.
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Affiliation(s)
- Rubab G Arim
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Anton R Miller
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, 4480 Oak Street, Room 2D19, BC Children's Hospital, Vancouver, British Columbia, V6H 3V4, Canada
| | - Dafna E Kohen
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada
| | - Anne Guèvremont
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada
| | - Lucy M Lach
- School of Social Work, McGill University, 3506 University Street, #300, Montreal, Québec, H3A 2A7, Canada
| | - Jamie C Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 511, Ottawa, Ontario, K1H 8L6, Canada
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Miller AR, Gardiner E, Harding L. Behavioural and emotional concerns reported by parents of children attending a neurodevelopmental diagnostic centre. Child Care Health Dev 2018; 44:711-720. [PMID: 30043480 DOI: 10.1111/cch.12594] [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] [Received: 11/02/2017] [Revised: 06/07/2018] [Accepted: 06/24/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Behavioural and emotional problems are a salient concern for parents of children with neurodisability, but little is known about the nature of such concerns in this population, nor about the distribution of concern types across ostensibly different subpopulations. METHODS Information about behavioural and emotional concerns was extracted from clinical reports of developmental paediatricians (N = 12) who had assessed children aged 3 to 8 years (N = 129) through three clinics at a major developmental and rehabilitation service centre. All concerns were captured at a granular level. A two-stage, consensus-based interdisciplinary concept-sorting technique was used to identify and group thematically related behavioural and emotional concerns into First Stage Groupings, intended to preserve detail and specificity, and a reduced number of Second Stage Clusters. RESULTS A total of 669 discrete concerns were encountered, aggregated to 58 First Stage Concern Groupings and 28 Second Stage Concern Clusters. Findings of the salience of Groupings related to Attention, Concentration and Distractibility, and Anxiousness, Shyness, and Emotional Sensitivity reflect existing literature for children with neurodevelopmental concerns. "Social Isolation/Peer Engagement," "Tantrums/Outbursts/Meltdowns" and "Volatility/Self-regulation Difficulties," and "Sensory Issues" emerged as areas of significant concern and salience as well. Across clinics, three Clusters recurred among the top five observed for each clinic: "Tantrums/Outbursts/Meltdowns," "Inflexibility/Gets Stuck or Fixated," and "Social Behaviours." CONCLUSIONS This rich descriptive dataset affords insight into the phenomenology of behaviour and emotional concerns in the daily lives of parents whose children have known or suspected neurodisability. Study findings can inform and sensitize clinicians working with this population. Usefulness is enhanced by inclusion of behavioural material that is subthreshold for a formal psychopathologic diagnosis. Certain concern types are encountered commonly across different clinical subpopulations, supporting a noncategorical view of behavioural and emotional problems as functional attributes that cross neurodisability diagnostic categories.
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Affiliation(s)
- Anton R Miller
- BC Children's Hospital Research Institute, Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Emily Gardiner
- BC Children's Hospital Research Institute, Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Louise Harding
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
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Arim RG, Miller AR, Guèvremont A, Lach LM, Brehaut JC, Kohen DE. Children with neurodevelopmental disorders and disabilities: a population-based study of healthcare service utilization using administrative data. Dev Med Child Neurol 2017; 59:1284-1290. [PMID: 28905997 DOI: 10.1111/dmcn.13557] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to identify children with neurodevelopmental disorders and disabilities (NDD/D) and compare their healthcare service utilization to children without NDD/D using provincial linked administrative data. METHOD The sample included children aged 6 to 10 years (n=183 041), who were registered with the British Columbia Medical Services Plan. Diagnostic information was used for the identification and classification of NDD/D in six functional domains. Healthcare service utilization included outcomes based on physician claims, prescription medication use, and hospitalization. RESULTS Overall, 8.3% of children were identified with NDD/D. Children with NDD/D had higher healthcare service utilization rates than those without NDD/D. Effect sizes were: very large for the number of days a prescription medication was dispensed; large for the number of prescriptions; medium for the number of physician visits, different specialists visited, number of different prescription medications, and ever hospitalized; and small for the number of laboratory visits, X-ray visits, and number of days hospitalized. INTERPRETATION The findings have policy implications for service and resource planning. Given the high use of psychostimulants, specialized services for both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D. Future studies may examine patterns of physician behaviours and costs attributable to healthcare service utilization for children with NDD/D. WHAT THIS PAPER ADDS Children with neurodevelopmental disorders and disabilities (NDD/D) have higher healthcare service utilization than those without. Based on provincial population-based linked administrative health data, a sizeable number of children are living with NDD/D. Given the high use of psychostimulants, specialized services for children with both NDD/D and psychiatric conditions may be the most needed services for children with NDD/D.
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Affiliation(s)
- Rubab G Arim
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | - Anton R Miller
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anne Guèvremont
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | - Lucyna M Lach
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Jamie C Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Dafna E Kohen
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
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Bogossian A, King G, Lach LM, Currie M, Nicholas D, McNeill T, Saini M. (Unpacking) father involvement in the context of childhood neurodisability research: a scoping review. Disabil Rehabil 2017; 41:110-124. [DOI: 10.1080/09638288.2017.1370497] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Aline Bogossian
- Centre for Research on Children and Families, School of Social Work, McGill University, Montreal, Canada
| | - Gillian King
- Department of Occupational Science and Occupational Therapy, Bloorview Research Institute, University of Toronto, Toronto, Canada
| | - Lucyna M. Lach
- Centre for Research on Children and Families, School of Social Work, McGill University, Montreal, Canada
| | | | - David Nicholas
- Faculty of Social Work, University of Calgary, Edmonton, Canada
| | - Ted McNeill
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Michael Saini
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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