Decisional Support Algorithm for Collaborative Care Planning using the Participation and Environment Measure for Children and Youth (PEM-CY): A Mixed Methods Study

ABSTRACT Aims: The purpose of this study was to explore the utility of the Participation and Environment Measure for Children and Youth (PEM-CY) for collaborative care planning with parents of children with disabilities. Methods: An explanatory sequential mixed methods approach was employed to examine how community-based service providers interpret and apply PEM-CY case results to set goals and formulate care plans with parents. We used two distinct, interactive phases that included collection and summary of PEM-CY data in Phase One (quantitative) and sequential collection and analysis of interview data during Phase Two (qualitative). Twenty-three parents of children with disabilities (mean age = 10.7 years) completed the PEM-CY community section during Phase One (quan). Four PEM-CY case reports were used with seven providers who were interviewed during Phase Two (QUAL). Results: Providers identified a four-step decisional support algorithm for leveraging PEM-CY case results in care planning: (1) parent rank orders activities in which change is desired, (2) child preferences are incorporated, (3) provider clarifies parent and child goals, and (4) activity-specific supports, barriers, and strategies are identified. Conclusions: Further validation and refinement of the decisional support algorithm with parents and children when applied to PEM-CY home and school reports is discussed.

The Americans With Disabilities Act of 1990 expands employment opportunities for persons with developmental disabilities

The primary purpose of the ADA is the full inclusion of persons with disabilities within their communities. The ADA prohibits discrimination on the basis of disability in the areas of employment, transportation, public accommodations, telecommunications, and state and local government agencies. The person described in this report encountered some of this discrimination. He successfully obtained paid community-integrated employment only after overcoming major obstacles and barriers, the greatest being transportation. In our highly mobile society, reliable transportation is essential for the acquisition and maintenance of community-integrated employment. The participant was repeatedly denied access to public transportation on the basis of his disability. To help overcome this barrier, Transition Services had to provide needed transportation at great expense, which delayed opportunities for the participant to gain control of this aspect of his life. Enactment of the ADA makes it more difficult for public transportation agencies to deny services to persons with disabilities by claiming inconvenience or lack of accessible vehicles. When publicly funded transportation programs assume their full responsibility for transportation to the public, agencies like Transition Services can focus on individualized employment and training issues rather than on providing transportation. In the workplace, the employer's willingness to work cooperatively with the participant and the staff of Transition Services resulted in several low-cost and reasonable accommodations based on the participant's needs and abilities. A simple rearrangement of work space allowed the participant to perform his job while benefiting the other workers in the crowded restaurant kitchen.(ABSTRACT TRUNCATED AT 250 WORDS)