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Ullenhag A, Imms C, Anaby D, Kramer JM, Girdler S, Gorter JW, Ketelaar M, Jahnsen RB, Elliott C, Granlund M. How can we reach long-lasting inclusive participation for all? A vision for the future. Child Care Health Dev 2024; 50:e13249. [PMID: 38523460 DOI: 10.1111/cch.13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/12/2024] [Accepted: 02/27/2024] [Indexed: 03/26/2024]
Abstract
In 2022, an international conference was held focusing on 'participation'. We shared current evidence, identified knowledge gaps and worked together to understand what new knowledge and community and practice changes were needed. This brief communication is a summary of the conference delegates' discussions. We present the key assumptions we make about participation and propose what is needed to create change for societies, communities, families and individuals. While we have some robust evidence to support participation approaches, more is needed, and it is everyone's responsibility to build an inclusive society where participation for all is the reality.
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Affiliation(s)
- Anna Ullenhag
- Department of Physiotherapy, Academy of Health, Care and Welfare, Mälardalens University, Västerås, Sweden
- Beitostølen Healthsports Center, Beitostølen, Norway
| | - Christine Imms
- Department of Paediatrics, The University of Melbourne, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Dana Anaby
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Jessica M Kramer
- Department of Occupational Therapy, University of Florida, Gainesville, Florida, USA
| | - Sonya Girdler
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Jan Willem Gorter
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Utrecht, Brain Center and De Hoogstraat Rehabilitation, Center of Excellence for Rehabilitation Medicine, University Medical Center, Utrecht, The Netherlands
| | | | - Catherine Elliott
- Telethon Kids Institute, Perth Children's Hospital, School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Mats Granlund
- Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Wang Z, Golos A, Weiss JA, Anaby D. Participation of Children With Autism During COVID-19: The Role of Maternal Participation. OTJR (Thorofare N J) 2024; 44:13-24. [PMID: 37089012 PMCID: PMC10125891 DOI: 10.1177/15394492231164939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Little is known about participation during adverse times. OBJECTIVES This study described participation of children with autism aged 6 to 13 during COVID-19 pandemic and examined the extent to which child factors, mother's own participation, and environmental barriers/supports explain child participation in home and community. METHOD A total of 130 mothers completed the Participation and Environment Measure for Children and Youth, the Health Promoting Activities Scale, functional issues checklist, and sociodemographic questionnaire. RESULTS Children's participation frequency and involvement were significantly higher at home than in the community. In both settings, mothers desired change in 71% of activities. Multiple regression models indicated that child's age and mother's participation frequency significantly explained child's home involvement (R2 = 21%), where mother's participation (frequency) had a unique contribution (ΔR2 = 10.4%) at home but not in the community. CONCLUSION Findings imply the importance of maternal participation to child's participation at home and suggest redirecting attention for enhancing family participation as a whole.
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Affiliation(s)
- Ziru Wang
- McGill University, Montreal, Quebec, Canada
| | - Anat Golos
- The Hebrew University, Jerusalem, Israel
| | | | - Dana Anaby
- McGill University, Montreal, Quebec, Canada
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Waisman-Nitzan M, Ivzori Y, Anaby D. Promoting Participation-Focused Practices in Inclusive Educational Settings: Stakeholders' Perspectives Following a Knowledge Translation Initiative. Am J Occup Ther 2023; 77:7706205050. [PMID: 37922537 DOI: 10.5014/ajot.2023.050262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
IMPORTANCE Available participation-focused interventions (e.g., the Pathways and Resources for Engagement and Participation intervention [PREP]), are not well integrated into practice, indicating a knowledge-to-practice gap. OBJECTIVE To explore the perspectives of school-based (SB) occupational therapists and occupational therapy managers following knowledge translation (KT) programs for facilitating participation-based practices in inclusive education. DESIGN This was an implementation qualitative study. After taking part in KT programs for implementing PREP, which were tailored to the needs and contexts of each stakeholder group, occupational therapists participated in focus groups, and occupational therapy managers responded to open-ended survey questions. A content analysis was done separately for each group, then integrated and organized according to the Participation-focused KT (P-KT) framework. SETTING Inclusive educational setting. PARTICIPANTS Seven occupational therapists working in inclusive schools and 39 occupational therapy managers. RESULTS We identified 10 themes addressing the micro, meso, and macro levels of the P-KT framework across the two groups. Five themes, common to all participants, addressed micro (e.g., setting participation-focused goals) and meso (e.g., school-PREP fit) levels. Macro-level themes were addressed by managers only (e.g., anchoring PREP to existing policy of the Israeli Ministry of Education). CONCLUSIONS AND RELEVANCE Targeting different stakeholders at the micro and meso levels of the educational system can initiate a shift in practice toward a focus on participation. KT intersectoral initiatives at the macro level (e.g., targeting community services and local policies), and engaging other stakeholders (e.g., students, families, and educators), are required to ensure the sustainability of participation-based practices. What This Article Adds: The authors present two knowledge translation programs that target both occupational therapists and managers in the educational system. The programs promote a shift in school-based occupational therapy services toward a focus on participation and environment.
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Affiliation(s)
- Michal Waisman-Nitzan
- Michal Waisman-Nitzan, PhD, BOT, is Research and Teaching Fellow, Occupational Therapy Department, University of Haifa, Haifa, Israel;
| | - Yonat Ivzori
- Yonat Ivzori, PhD, BOT, is Researcher and Lecturer, Occupational Therapy Department, Zefat Academic College, Zefat, Israel, and Researcher and Lecturer, Special Education Department, Oranim College of Education, Kiryat Tiv'on, Israel
| | - Dana Anaby
- Dana Anaby, PhD, BOT, is Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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Kaya Kara O, Kara K, Dogan M, Tascioglu EN, Kose B, Cetin SY, Sahin S, Anaby D. How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports? Res Dev Disabil 2023; 141:104592. [PMID: 37639883 DOI: 10.1016/j.ridd.2023.104592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Children with chronic conditions face participation restrictions and exclusions. AIMS To investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). METHODS AND PROCEDURES The study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners' Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. OUTCOME AND RESULTS In home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). CONCLUSIONS AND IMPLICATIONS When seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges.
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Affiliation(s)
- Ozgun Kaya Kara
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey.
| | - Koray Kara
- University of Health Sciences Turkey, Antalya Training and Research Hospital, Department of Child and Adolescent Psychiatry, Antalya, Turkey
| | - Mert Dogan
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey
| | - Elif Nur Tascioglu
- Pamukkale University, Faculty of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Barkin Kose
- University of Health Sciences Turkey, Faculty of Gülhane Health Sciences, Department of Occupational Therapy, Turkey
| | - Sebahat Yaprak Cetin
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey
| | - Sedef Sahin
- Hacettepe University, Faculty of Health Sciences, Department of Occupational Therapy, Ankara, Turkey
| | - Dana Anaby
- McGill University, Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, Montreal, Canada
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Shahin S, Ahmed S, DiRezze B, Anaby D. Reliability and Validity of the Youth and Young-Adult Participation and Environment Measure (Y-PEM): An Initial Evaluation. Phys Occup Ther Pediatr 2023; 44:232-247. [PMID: 37415271 DOI: 10.1080/01942638.2023.2232030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
AIM To examine psychometric properties and aspects of utility of the Youth and young-adult Participation and Environment Measure (Y-PEM). METHODS Young people with and without physical disabilities (n = 113) aged 12 to 31 (x¯ = 23; SD = 4.3) completed an online survey containing the Y-PEM and QQ-10 questionnaire. To examine construct validity, differences in participation levels and environmental barriers/facilitators were examined between those with (n = 56) and without disabilities (n = 57) via t-test. Internal consistency was computed using Cronbach's alpha. To examine test-retest reliability, a sub-sample of 70 participants completed the Y-PEM a second time, 2-4 weeks apart. The Intraclass correlation coefficient (ICC) was calculated. RESULTS Descriptively, participants with disabilities had lower levels of frequency and involvement across all four settings: home, school/educational, community, workplace. Internal consistency were 0.71 and above (up to 0.82) across all scales with the exception of home (0.52) and workplace frequency (0.61). Test-retest reliability were 0.70 and above (up to 0.85) across all settings except for environmental supports at school (0.66) and workplace frequency (0.43). Y-PEM was perceived as a valuable tool with relatively low burden. CONCLUSIONS Initial psychometric properties are promising. Findings support Y-PEM's use as a feasible self-reported questionnaire for individuals aged 12-30 years old.
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Affiliation(s)
- Saeideh Shahin
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), CIUSSS Central-West Montreal, Montreal, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), CIUSSS Central-West Montreal, Montreal, Canada
| | - Briano DiRezze
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), CIUSSS Central-West Montreal, Montreal, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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Golos A, Vidislavski S, Anaby D. Participation Patterns of Israeli Children with and without Autism, and the Impact of Environment. Phys Occup Ther Pediatr 2023; 44:143-160. [PMID: 37415267 DOI: 10.1080/01942638.2023.2230269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Abstract
AIMS Participation is vital to children's quality of life, yet it is often limited for those with autism spectrum disorder (ASD). An improved understanding of the factors that may support or hinder their participation is important. This study aims to explore the participation patterns of children with and without ASD in the home, school, and community settings, as well as to explore the impact of environmental factors on the participation of children with ASD. METHODS 78 parents of children aged 6-12, attending mainstream educational settings (30 with ASD; 48 without ASD) completed the Participation and Environment Measure for Children and Youth and a demographic questionnaire. RESULTS Children with ASD were rated significantly lower than children without ASD in participation, and their parents expressed a greater desire to change their participation while reporting lower overall environmental support. Among the ASD group, significant differences in participation were found across the three settings, with the highest participation scores at home. Environmental factors that support or limit children's participation were identified. CONCLUSIONS The results highlight the importance of environmental factors in children's participation. It is essential to evaluate different environmental settings; identifying the supportive and limiting environmental factors will enhance interventions for children with ASD.
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Affiliation(s)
- Anat Golos
- Head of Environment and Participation in Community Laboratory; School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
- Ministry of Education, School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Shira Vidislavski
- Ministry of Education, School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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Amalfi A, Li JY, Théberge-Lamoureux V, Tang C, Rinaldi E, Khayargoli P, Anaby D. Mental health problems among transition-aged youth with physical disabilities: an initial evaluation. Front Rehabil Sci 2023; 4:1069464. [PMID: 37214127 PMCID: PMC10196478 DOI: 10.3389/fresc.2023.1069464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/14/2023] [Indexed: 05/24/2023]
Abstract
Aim Decreased participation and complex transitions into adulthood among youth with disabilities may impede their well-being. To advance knowledge on the co-occurrence of mental health problems and physical disability, this brief report describes the frequency of mental health problems, measured by the Behavior Assessment System of Children (BASC-3), among transition-aged youth (14-25 years) with physical disabilities and examines the association between mental health problems and sex, age, and number of functional issues. Methods Thirty-three participants completed a demographic questionnaire and the BASC-3. Frequency of BASC-3 scales falling within 3 categories: "within norms", "at risk", and "clinically significant" were described. Crosstabs and Chi-square tests were used to examine the association between BASC-3 scales and sex, age (< and ≥ 20), and number of functional issues (< and ≥ 6). Results Overall, "somatization", "self-esteem", "depression" and "sense of inadequacy" were the most common subscales being at risk. Participants with a higher number of functional issues (≥6) were more likely to fall within "at risk" or "clinically significant" categories across 20 (out of 22) BASC-3 scales, and female participants tended to fall more within "at risk" or "clinically significant" categories for 8 of BASC-3 scales. Younger participants (<20) were ranked in the "at risk" or "clinically significant" categories for 7 scales. Conclusions Findings lend further support for the occurrence of mental health problems emerging in youth with physical disabilities and highlight initial trends especially across functional levels. Further investigation of such co-occurrences and the factors that affect their development is needed.
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Affiliation(s)
- Amanda Amalfi
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Jia Yin Li
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | - Carmen Tang
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Emilie Rinaldi
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Pranamika Khayargoli
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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Kaelin VC, Anaby D, Werler MM, Khetani MA. School participation among young people with craniofacial microsomia and other childhood-onset disabilities. Dev Med Child Neurol 2023:10.1111/dmcn.15628. [PMID: 37138446 PMCID: PMC10622330 DOI: 10.1111/dmcn.15628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 05/05/2023]
Abstract
AIM To examine how school environment, physical functioning problems, and behavioral problems explain levels of school participation (i.e. attendance and involvement) among young people with craniofacial microsomia (CFM) and other childhood-onset disabilities, and whether participation-focused caregiver strategies play a role in these relationships. METHOD We conducted secondary analyses of a subset of data (n = 260 families: 120 with CFM and 140 with other childhood-onset disabilities) from the second follow-up phase of a longitudinal cohort study. We applied structural equation modeling with data collected from the Participation and Environment Measure - Children and Youth version, the Child Behavior Checklist, and the Pediatric Quality of Life Inventory physical functioning scale. RESULTS Model fit was acceptable to close (comparative fit index = 0.973; root mean square error of approximation = 0.055; standardized root mean squared residual = 0.043; Tucker-Lewis index = 0.958). School environmental support had a positive effect on young people's participation attendance and involvement, and physical functioning problems had a negative effect on participation involvement. The number of disclosed caregiver strategies had a significant positive effect on the relationship between school environmental support and school participation attendance. INTERPRETATION Findings confirm the effect of school environmental support and physical functioning problems on school participation and highlight the role of participation-focused caregiver strategies to intensify the positive effect of school environmental support on school participation attendance.
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Affiliation(s)
- Vera C Kaelin
- Occupational Therapy, University of Illinois Chicago, Chicago, USA
- Computer Science, University of Illinois Chicago, Chicago, USA
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | | | - Mary A Khetani
- Occupational Therapy, University of Illinois Chicago, Chicago, USA
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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Kaelin V, Anaby D, Werler M, Khetani M. Caregiver Strategies Explaining School Participation Among Children and Youth with Craniofacial Microsomia and Childhood-Onset Disabilities. Arch Phys Med Rehabil 2023. [DOI: 10.1016/j.apmr.2022.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Golos A, Zyger C, Lavie-Pitaro Y, Anaby D. Improving Participation among Youth with Disabilities within Their Unique Socio-Cultural Context during COVID-19 Pandemic: Initial Evaluation. Int J Environ Res Public Health 2023; 20:3913. [PMID: 36900924 PMCID: PMC10002320 DOI: 10.3390/ijerph20053913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Participation in meaningful activities is important for quality of life among youth with disabilities; yet participation is often restricted during adverse times. This study aimed to explore the effectiveness of the Pathways and Resources for Engagement and Participation (PREP) intervention among ultra-Orthodox Jewish Israeli youth with disabilities during the COVID-19 pandemic. METHODS A 20-week single-subject research design with multiple baselines measuring participation goals/activities was employed with two youths (15 and 19 years old) combining quantitative and qualitative descriptive data. Changes in participation levels were measured biweekly using the Canadian Occupational Performance Measure; COPM; participation patterns were measured using the Participation and Environment Measure-Children and Youth; PEM-CY pre- and post-intervention; parents' satisfaction was measured using the Client Satisfaction Questionnaire, CSQ-8. Semi-structured interviews were conducted post-intervention. RESULTS Both participants significantly improved participation in all selected goals and participation patterns, and were highly satisfied with the intervention. The interviews revealed additional information on personal and environmental barriers, factors supporting intervention, and intervention effects. CONCLUSIONS The results indicated that an environment-centered and family-centered approach can potentially improve the participation of youths with disabilities within their unique socio-cultural context, during adverse times. Flexibility, creativity, and collaboration with others also contributed to intervention success.
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Affiliation(s)
- Anat Golos
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel
| | - Chani Zyger
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel
| | - Yael Lavie-Pitaro
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
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Abstract
PURPOSE To develop and evaluate the content of a self-reported measure of participation and environment, named Youth, Young-adult Participation and Environment Measure (Y-PEM), capturing participation at home, school, community, and the workplace among individuals with physical disabilities aged 12-30. MATERIALS AND METHODS A multi-phase sequential design based on elements of COnsensus for Standard Measurements INstrument was employed. Five consecutive rounds of cognitive interviews with 24 participants aged 12-33 years (X̅ = 20.9; n = 19 with a physical disability) and consultation with experts (n = 15) were conducted for item development and validation. Relevancy and clarity of items in each setting were assessed using the 10-cm Visual Analogue Scales (VASs). RESULTS Participants recommended adding activities specific to this age group (i.e., dating, caregiving, preparing meals, employment). On a 4-point Likert scale, work-related items were perceived important by experts (X̅ = 3.4) and young adults (X̅ = 3.1) with average clarity of 8.8 and relevancy of 8.4 out of 10, on the VASs. Similarly, the average clarity of items across settings (home, school, community) ranged from 6.9 to 8.7 and relevancy from 7.4 to 8.1. No modifications were required in environmental items. CONCLUSIONS Results suggest that Y-PEM is clear, relevant, comprehensive, and can be completed by individuals aged 12-30 with physical disabilities.IMPLICATIONS FOR REHABILITATIONThe Y-PEM can provide a standardized and systematic method to assess the first-hand subjective experience of youth and young adults with disabilities aged 12-30 in their participation at home, school, community, and the workplace.The Y-PEM can provide information regarding participation in activities that prepare youth or young adults for the job market as well as their perspective on the environmental barriers or supports that they may face in their employment.Clinicians can use the Y-PEM to identify environmental barriers and facilitators that impact participation across different settings and address them to further promote participation in meaningful and age-related activities.
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Affiliation(s)
- Saeideh Shahin
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, CIUSS du Centre-Sud-de-l'Île-de-Montreal, Montreal, Canada
| | - Briano DiRezze
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, CIUSS du Centre-Sud-de-l'Île-de-Montreal, Montreal, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, CIUSS du Centre-Sud-de-l'Île-de-Montreal, Montreal, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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Souto DO, da Silva LC, de Sousa Junior RR, Clutterbuck G, Anaby D, Longo E, Magalhães RC, Camargos ACR, Leite HR. Practitioner-led, peer-group sports intervention combined with a context-focused intervention for children with cerebral palsy: a protocol of a feasibility randomised clinical trial. BMJ Open 2023; 13:e068486. [PMID: 36720567 PMCID: PMC9890811 DOI: 10.1136/bmjopen-2022-068486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND There is a need to investigate relevant, acceptable and feasible approaches that promote participation in leisure-time physical activity for children with cerebral palsy (CP). The aim of this study is to assess the feasibility of a randomised controlled trial comparing a peer-group intervention focused on improving physical literacy (Sports Stars) with the combination of Sports Stars and a context-focused intervention (Pathways and Resources for Engagement and Participation, PREP) for ambulant children with CP in Brazil. METHODS In this feasibility trial, 18 ambulant children (aged 6-12 years) with CP will be randomised into two groups (nine per group): (1) Sports Stars and (2) Sports Stars plus PREP. The Sports Stars group will receive 8 weekly group sessions, focusing on developing the physical, social, cognitive and psychological skills required to participate in popular Brazilian sports. The combined Sports Stars and PREP group will receive Sports Stars in addition to eight individual PREP sessions focused on overcoming environmental barriers to participation. The primary outcome will include feasibility measures: willingness to participate in an RCT, eligibility and recruitment rates, maintenance of evaluator blinding, acceptability of screening procedures and random allocation, feasibility of evaluating outcomes, contamination between the groups, intervention adherence, treatment satisfaction, understanding of the intervention and implementation resources. Additional instruments will be applied to obtain data related to leisure-time physical activity participation goals, overall participation (home, school and community), physical literacy, level of physical activity and family empowerment. Outcomes will be assessed before, after and 12 weeks after intervention. ETHICS AND DISSEMINATION This feasibility trial has been approved by ethical Federal University of Minas Gerais' Ethics Review Committee (CAAE: 33238520.5.0000.5149). All potential subjects will provide written informed consent. The results of this study will be published in peer-reviewed journals and be presented at academic conferences. TRIAL REGISTRATION NUMBERS RBR-4m3b4b6, U1111-1256-4998.
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Affiliation(s)
- Deisiane Oliveira Souto
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Luana Cristina da Silva
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Ricardo Rodrigues de Sousa Junior
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Georgina Clutterbuck
- Western Sydney University, School of Health Sciences, Parramatta, New South Wales, Australia
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University Researcher, Montreal, Quebec, Canada
| | - Egmar Longo
- Graduate Program in Rehabilitation Sciences and in Collective Health, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte (UFRN-FACISA), Santa Cruz, Rio Grande do Norte, Brazil
| | - Rafael Coelho Magalhães
- Graduate Program in Occupational Studies, Occupational Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Ana Cristina Resende Camargos
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Hércules Ribeiro Leite
- Graduate Program in Rehabilitation Sciences, Physical Therapy Department, School of Physical Education, Physical Therapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
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14
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Tremblay S, Lal S, Xiang L, Ferro MA, Anaby D. Organization of rehabilitation services for youth with physical disabilities and mental health problems: A scoping review. Front Rehabil Sci 2023; 4:1085827. [PMID: 36891032 PMCID: PMC9986938 DOI: 10.3389/fresc.2023.1085827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023]
Abstract
Introduction Youth with childhood-onset physical disabilities receiving rehabilitation services often present with many complex needs. Emerging evidence confirms co-occurrence of mental health problems in this population is common, and mental health is often overlooked during rehabilitation for chronic physical conditions. For example, symptoms of depression and anxiety are frequently present in adolescents with physical disability such as spina bifida or Duchenne muscular dystrophy, and access to mental health services is often limited. Addressing mental health concerns for this age group is particularly critical as it encompasses a challenging transition to adulthood. Objectives Building upon findings from a recent scoping review on the co-occurrence of physical disabilities and mental health problems, this paper synthesizes scientific literature related to the organization and delivery of services for youth with co-occurring childhood-onset physical disabilities (e.g., cerebral palsy, spina bifida) and mental health problems (e.g., depression, anxiety). Methods A scoping review protocol stemming from Arksey & O'Malley's framework and updated guidelines from the Joanna Briggs Institute was developed. Four databases (Medline, PsycINFO, CINAHL, Embase) were searched. The search was limited to French or English peer-reviewed articles published between 2000 and 2021. Articles included were primary papers addressing: 1) youth aged 15 to 24 with a childhood-onset physical disability, 2) mental health problems, and 3) healthcare service organization or delivery. They were screened by two reviewers and discussed with a third to establish consensus on the inclusion criteria and resolve disagreements. Results Sixteen articles were retained from the 1,010 screened. Many (9/16) were from the United States. Two models were found: the Biopsychosocial, Collaborative, Agency-Based Service Integration Approach (including psychiatry in a pediatric rehabilitation hospital) and the Client Network Consultation (an interagency collaboration in mental health care for children with complex healthcare needs). Twelve key principles for service organization and delivery were identified and categorized into: collaboration and coordination, training and support, and delivery of care. Conclusion Identified principles can guide improved service delivery for this population. Highlighted research gaps include the need for developing models of collaborative healthcare delivery and subsequently evaluating their effectiveness.
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Affiliation(s)
- Stephanie Tremblay
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,PEPP Montreal and ACCESS Open Minds, Douglas Mental Health University Institute, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Shalini Lal
- PEPP Montreal and ACCESS Open Minds, Douglas Mental Health University Institute, Montreal, QC, Canada.,School of Rehabilitation, University of Montreal, Montreal, QC, Canada.,Health Innovation and Evaluation Hub, University of Montreal Hospital Research Center, Montreal, QC, Canada
| | - Lucille Xiang
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,School of Public Health, Brown University, Providence, RI, United States
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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15
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Bonnard M, Hui C, Manganaro M, Anaby D. Toward Participation-Focused School-Based Occupational Therapy: Current Profile and Possible Directions. Journal of Occupational Therapy, Schools, & Early Intervention 2022. [DOI: 10.1080/19411243.2022.2156427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Lal S, Tremblay S, Starcevic D, Mauger-Lavigne M, Anaby D. Mental health problems among adolescents and young adults with childhood-onset physical disabilities: A scoping review. Front Rehabilit Sci 2022; 3:904586. [PMID: 36189015 PMCID: PMC9485587 DOI: 10.3389/fresc.2022.904586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022]
Abstract
Aim This scoping review aims to better understand the extent and nature of research activity on the topic of mental health problems in young people with childhood-onset physical disabilities. Specifically, we document what has been investigated in terms of the occurrence and experience of mental health problems among young people with childhood-onset physical disabilities, and their access to mental health services. Methods We searched four databases (Medline, PsycINFO, CINAHL, Embase) for articles published between 2007 and 2019. Studies were included if they addressed: (1) young people between the ages of 13 and 24 with a childhood-onset physical disability, and (2) mental health assessment, treatment, or service access and use. Results We identified 33 peer-reviewed studies that focused mainly on young people with cerebral palsy, juvenile arthritis, and spina bifida. The most common mental health problems investigated were depression and mood related difficulties (73%), anxiety (39%), and social/behavioural issues (33%) and the most common age range was 13 to 17. Ten studies explored access, use, and experiences of mental health services; stigma; caregiver mental health; and value for comprehensive care, using qualitative, quantitative, or mixed methods. Conclusions Findings suggest the importance of developing integrated models of service delivery to identify and address the mental health needs of this population, and consensus on best practices for assessment and reporting rates of subclinical symptoms and psychiatric conditions.
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Affiliation(s)
- Shalini Lal
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
- PEPP Montreal and ACCESS Open Minds, Douglas Mental Health University Institute, Montreal, QC, Canada
- Correspondence: Shalini Lal
| | - Stephanie Tremblay
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Danielle Starcevic
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
| | - Melina Mauger-Lavigne
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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17
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Kaelin VC, Valizadeh M, Salgado Z, Sim JG, Anaby D, Boyd AD, Parde N, Khetani MA. Capturing and Operationalizing Participation in Pediatric Re/Habilitation Research Using Artificial Intelligence: A Scoping Review. Front Rehabilit Sci 2022; 3. [PMID: 35919375 PMCID: PMC9340801 DOI: 10.3389/fresc.2022.855240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background There is increased interest in using artificial intelligence (AI) to provide participation-focused pediatric re/habilitation. Existing reviews on the use of AI in participation-focused pediatric re/habilitation focus on interventions and do not screen articles based on their definition of participation. AI-based assessments may help reduce provider burden and can support operationalization of the construct under investigation. To extend knowledge of the landscape on AI use in participation-focused pediatric re/habilitation, a scoping review on AI-based participation-focused assessments is needed. Objective To understand how the construct of participation is captured and operationalized in pediatric re/habilitation using AI. Methods We conducted a scoping review of literature published in Pubmed, PsycInfo, ERIC, CINAHL, IEEE Xplore, ACM Digital Library, ProQuest Dissertation and Theses, ACL Anthology, AAAI Digital Library, and Google Scholar. Documents were screened by 2–3 independent researchers following a systematic procedure and using the following inclusion criteria: (1) focuses on capturing participation using AI; (2) includes data on children and/or youth with a congenital or acquired disability; and (3) published in English. Data from included studies were extracted [e.g., demographics, type(s) of AI used], summarized, and sorted into categories of participation-related constructs. Results Twenty one out of 3,406 documents were included. Included assessment approaches mainly captured participation through annotated observations (n = 20; 95%), were administered in person (n = 17; 81%), and applied machine learning (n = 20; 95%) and computer vision (n = 13; 62%). None integrated the child or youth perspective and only one included the caregiver perspective. All assessment approaches captured behavioral involvement, and none captured emotional or cognitive involvement or attendance. Additionally, 24% (n = 5) of the assessment approaches captured participation-related constructs like activity competencies and 57% (n = 12) captured aspects not included in contemporary frameworks of participation. Conclusions Main gaps for future research include lack of: (1) research reporting on common demographic factors and including samples representing the population of children and youth with a congenital or acquired disability; (2) AI-based participation assessment approaches integrating the child or youth perspective; (3) remotely administered AI-based assessment approaches capturing both child or youth attendance and involvement; and (4) AI-based assessment approaches aligning with contemporary definitions of participation.
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Affiliation(s)
- Vera C. Kaelin
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Mina Valizadeh
- Computer Science, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
| | - Zurisadai Salgado
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Julia G. Sim
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Andrew D. Boyd
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Physical Therapy, University of Illinois at Chicago, Chicago, IL, United States
| | - Natalie Parde
- Computer Science, University of Illinois at Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois at Chicago, Chicago, IL, United States
- Natalie Parde
| | - Mary A. Khetani
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Children's Participation in Environment Research Lab, University of Illinois at Chicago, Chicago, IL, United States
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Occupational Therapy, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Mary A. Khetani
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18
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Ianni L, Camden C, Anaby D. How can we evaluate collaborative practices in inclusive schools? Challenges and proposed solutions. Journal of Occupational Therapy, Schools, & Early Intervention 2022. [DOI: 10.1080/19411243.2022.2054486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Lina Ianni
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Chantal Camden
- École de réadapation, Université de Sherbrooke Sherbrooke, Quebec, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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19
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Cinar E, Anaby D, Dostie R, Camden C. Perspectives of International Experts on Collaborative Tiered School-Based Physiotherapy Service Delivery. Phys Occup Ther Pediatr 2022; 42:595-614. [PMID: 35535646 DOI: 10.1080/01942638.2022.2073799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS The purpose of this Phase II study is to identify the perceived strengths and weaknesses of a collaborative tiered school-based physiotherapy (PT) service delivery model, considering its core attributes and tiered interventions identified in the first phase of the study (Phase I), and explore the potential facilitators and barriers to implementing the model internationally. METHODS Three focus group discussions were conducted with international experts (n = 16) Discussions focused on the core attributes and tiered interventions of the model in Phase I. Data were analyzed using a framework approach and SWOT (strengths, weaknesses, opportunities, and threats) analysis. RESULTS Themes surrounding the perceived characteristics of the model included comprehensiveness, guiding document, collaborative approach, and inclusiveness. Additional themes were related to the implementation that included governance, professional roles, workload, implementation in different countries, advocacy, and available opportunities. A framework table was tabulated to present the strengths and weaknesses of the service delivery model and available opportunities, and potential barriers to implementation. CONCLUSIONS This study revealed international perspectives regarding a proposed collaborative tiered school-based PT service delivery model and presented a framework to guide clinicians, researchers, and policymakers for the implementation of tiered approaches.Relationships between health and education have been more pronounced in recent years, and interactions between healthcare and the education system have evolved (Zajacova & Lawrence, 2018). Recent recommendations of the World Health Organization (WHO) and UNESCO suggest that "every school should be a health-promoting school", and provided intervention guidelines for the global standards for health-promoting schools (WHO., 2021a). In the meantime, education sectors in different countries have shifted inclusive education policy, with a focus not only on students with disabilities, but all students (Whitley & Hollweck, 2020). In conjunction with the changes in both education and school health services (WHO., 2021b), researchers in the field of speech-language therapy (SLT), occupational therapy (OT) (Camden et al., 2021), and physiotherapy (PT) (Cinar et al., 2021), have been exploring tiered approaches to delivering services in schools, and searching for collaborative strategies to encourage interaction between stakeholders in health and education sectors.
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Affiliation(s)
- Eda Cinar
- Research Centre of the Sherbrooke, University Hospital Centre, Sherbrooke, Quebec, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Rosalie Dostie
- Sherbrooke University and Research Centre of the Sherbrooke University Hospital Centre, Quebec, Canada
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- The Members of PRISE (Physiotherapists-inteRnatIonal School-basEd) PT Network
| | - Chantal Camden
- School of Rehabilitation, Sherbrooke University and Research Centre, Sherbrooke University Hospital Centre, Sherbrooke, Quebec, Canada
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20
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Waisman-Nitzan M, Ivzori Y, Anaby D. Implementing Pathways and Resources for Engagement and Participation (PREP) for Children with Disabilities in Inclusive Schools: A Knowledge Translation Strategy. Phys Occup Ther Pediatr 2022; 42:526-541. [PMID: 35189769 DOI: 10.1080/01942638.2022.2037809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Aims: To examine the effectiveness of PREP (Pathways and Resources for Engagement and Participation) knowledge translation (KT)-program on (a) change in practice behaviors and improved knowledge of school-based occupational therapists, and (b) participation of children with disabilities in inclusive education.Methods: A mixed-methods design was employed. Therapists (n = 39) completed a 30-hour program. Each therapist applied PREP intervention to one child (n = 39) aged 4-15 (Mean = 9.31, SD = 2.4). Therapists' outcomes included: (a) knowledge of PREP evaluated using a clinical vignette, analyzed descriptively, (b) change in practice behavior measured by the Professional Evaluation and Reflection on Change Tool (PERFECT), analyzed thematically. Change in children' participation pre- and post-KT-program and during follow-up was measured by the Canadian Occupational Performance Measure (COPM), analyzed using ANOVA.Results: Therapists acquired knowledge of PREP (vignette mean score 17.7/20). PERFECT revealed therapists' self-perceived changes in practice: incorporating an environmental perspective, expanding partnerships, and redirecting focus on participation. Completing the KT-program was a primary enabler and reason for change. Children's participation significantly improved post KT-program and during follow-up in both performance (p < 0.001) and satisfaction (p < 0.001).Conclusions. KT strategies, as illustrated in this study, accelerated the uptake of evidence-based interventions, minimizing existing 'know-do' gaps and promoting children's health through participation.
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Affiliation(s)
| | - Yonat Ivzori
- Special education, Oranim Academic College of Education, Tivon, Israel
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC
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21
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Shakya S, Parsekar SS, Ramachandran S, Madapura S. S, Balakrishna Shetty H, Anaby D, Gopalakrishna S, Venkatesan VS, Rao BK. Physiotherapy interventions for head and trunk control in children with developmental disabilities: A scoping review protocol. F1000Res 2022; 11:1074. [PMID: 36875989 PMCID: PMC9975404.2 DOI: 10.12688/f1000research.123955.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Background: Head and trunk control is prerequisite skill that maximizes engagement and participation in one's environment by integrating vision, oromotor skill, arm control and respiration. Various physiotherapy and technology-based interventions have been utilized to facilitate head and trunk control in children with developmental disabilities. This scoping review is planned to map and summarize existing studies from the scientific literature on physiotherapy and technology-based interventions for head and trunk control in children with developmental disabilities. Methods: The scoping review will utilize the Joanna Briggs Institute scoping review methodology. The review will cover studies including children and adolescents aged between six months and 17 years 11 months 29 days, with developmental disabilities where in child finds difficulty in lifting its head and aligning head and trunk. We will include randomized controlled trial (RCT), non-RCT, quasi-experimental trial, and systematic reviews that have employed physiotherapy and technology-based interventions. Database-specific search strategy will be used to search records in Medline (PubMed and Web of Science), Embase, Scopus, CINAHL, PEDro, and Cochrane Library. Additionally, various grey literatures and clinical-trial registries will be searched. Two reviewers, independently, will screen and extract the data. Tables and visual representations will be utilized to present the extracted data. Registration details: The protocol has been registered in Open Science Framework, DOI: 10.17605/OSF.IO/B3RSU (22 nd August 2022).
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Affiliation(s)
- Shristi Shakya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shradha S. Parsekar
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Selvam Ramachandran
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shamantha Madapura S.
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Harikishan Balakrishna Shetty
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Sivakumar Gopalakrishna
- Department of Physiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - V. S. Venkatesan
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bhamini Krishna Rao
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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22
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Tomas V, Srinivasan R, Kulkarni V, Teplicky R, Anaby D, Khetani M. A guiding process to culturally adapt assessments for participation-focused pediatric practice: the case of the Participation and Environment Measures (PEM). Disabil Rehabil 2021; 44:6497-6509. [PMID: 34410207 DOI: 10.1080/09638288.2021.1960645] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE There is unprecedented opportunity to evaluate children's participation in diverse cultural contexts, to enhance cross-cultural research, advance the delivery of culturally responsive pediatric rehabilitation, and translate new knowledge on a global scale. The participation concept is complex and heavily influenced by a child's context. Therefore, effectively capturing the participation concept requires valid, reliable, and culturally sensitive participation-focused measures. This perspective paper proposes a structured process for culturally adapting measures of participation for children and youth with disabilities. METHODS Elements of the Applied Cultural Equivalence Framework and Beaton and colleagues' six-step process were used to create a guiding process for culturally adapting a Participation and Environment Measure (PEM) while drawing on two distinct cultural contexts. This process included forward and back language translations, and semi-structured cognitive interviews, to develop adapted versions of the PEM that are ready for psychometric validation. RESULTS Common challenges to culturally adapting PEM content and administration are identified and methodological strategies to mitigate these challenges are proposed. CONCLUSIONS The proposed process can guide rehabilitation specialists and researchers in adapting participation measures that are suitable for their culture. Such a process can facilitate scalable implementation of evidence-based tools to support participation-based practice in the rehabilitation field.Implications for RehabilitationThe use of a systematic process can harmonize efforts by rehabilitation researchers and service providers to effectively culturally adapt pediatric participation measures to optimize its impact for culturally sensitive research and practice targeting participation.Two distinct, yet complementary, illustrative exemplars showcase the range of considerations and strategies, such as by conducting consecutive rounds of cognitive interviews, when teams use this systematic process to cultural adapt a pediatric participation measure.The systematic process outlined in this paper promotes rigor in achieving all elements of cultural equivalency, when feasible, to best ensure that the participation measure is suitable for use in the target cultural context.
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Affiliation(s)
- Vanessa Tomas
- Rehabilitation Science Institute, University of Toronto, Toronto, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | | | | | - Rachel Teplicky
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Dana Anaby
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Mary Khetani
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada.,Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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23
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Camden C, Campbell W, Missiuna C, Berbari J, Héguy L, Gauvin C, Dostie R, Ianni L, Rivard L, Anaby D. Implementing Partnering for Change in Québec: Occupational Therapy Activities and Stakeholders' Perceptions. Can J Occup Ther 2021; 88:71-82. [PMID: 33834889 PMCID: PMC8041449 DOI: 10.1177/0008417421994368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background. The occupational therapy school-based Partnering for Change (P4C) model has mostly been documented in Ontario. Purpose. This implementation study describes the implementation of P4C in two Québec elementary schools (P4C-Q), as well as therapy practices, their impacts, factors perceived to influence implementation, and recommendations. Method. A sequential mixed-methods design was applied. Therapists (n=2) completed daily journals, describing activities by P4C-Q level. Therapists and other school-stakeholders (n=11) participated in semi-structured interviews, analyzed through a content analysis framework. Findings. Daily journals illustrated that the majority of therapy time was spent on activities targeting the entire classroom, and on collaboration with educators. Interviews illustrated how coaching was used across different practices and the impact of these practices for schools (e.g., capacity-building) and children (e.g., increased functioning), and highlighted how relationship-building is key to facilitating the implementation of this model. Implications. Lessons learned may be helpful for others implementing P4C in their own contexts.
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Affiliation(s)
| | | | | | | | | | | | - Rosalie Dostie
- Rosalie Dostie, Université de Sherbrooke, 2500 Boulevard de l’Université, Sherbrooke, Québec J1K 2R1, Canada. Lina Ianni, School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, Québec H3G 1Y5, Canada.
| | - Lina Ianni
- Rosalie Dostie, Université de Sherbrooke, 2500 Boulevard de l’Université, Sherbrooke, Québec J1K 2R1, Canada. Lina Ianni, School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montréal, Québec H3G 1Y5, Canada.
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Anaby D, Khetani M, Piskur B, van der Holst M, Bedell G, Schakel F, de Kloet A, Simeonsson R, Imms C. Towards a paradigm shift in pediatric rehabilitation: Accelerating the uptake of evidence on participation into routine clinical practice. Disabil Rehabil 2021; 44:1746-1757. [PMID: 33832391 DOI: 10.1080/09638288.2021.1903102] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Evidence for the importance of focusing on participation to promote health and wellbeing in childhood-onset disability exists, but practice is slow to change. This paper provides a knowledge translation roadmap to accelerate uptake of participation evidence into day-to-day practice. MATERIALS AND METHODS A structured roadmap to guide knowledge translation initiatives for implementing participation-based practices in co-creation with service users was developed based on elements from: the Five-factorframework for predicting implementation outcomes, the Cultural Cone framework, and the Knowledge-to-Action model. RESULTS Guiding principles paired with examples of multi-component knowledge implementation strategies to facilitate readiness for change by stakeholders at the micro (e.g., client/family, service providers), meso (e.g., administrators within organisations such as rehabilitation centres, hospitals, schools) and macro (e.g., local and governmental policy, regulatory bodies) levels are introduced. Solution-based strategies are provided to facilitate "readiness to change" for each stakeholder group. The strategies are examples for successful implementation of evidence-based interventions/approaches that can be contextualized across settings. CONCLUSIONS The knowledge translation roadmap can assist children and families, service providers, administrators, and policymakers to bridge existing knowledge-to-practice gaps surrounding participation. Partnering and collaborating through a "family-clinician-manager-community leader-policymaker" synergy is key for achieving strategic practice change focussed on participation.Implications for RehabilitationSound evidence surrounding the topic of participation, including effective assessments and interventions, is available and ready for use.Shifting towards participation-focused practices for children and youth with disabilities requires a systemic multi-level KT approach.Our Participation-KT roadmap, comprised of a framework and a list of principles and strategies for implementation, can be used to guide all stakeholders to foster a shift in practice.Forming partnerships and working collaboratively with all stakeholders is key for successful implementation.
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Affiliation(s)
- D Anaby
- School of Physical and Occupation Therapy, McGill University, Quebec, Canada
| | - M Khetani
- University of Illinois at Chicago, Chicago, IL, USA
| | - B Piskur
- Research Center Autonomy and Participation, Faculty of Health Care, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - M van der Holst
- Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands.,Basalt Rehabilitation Center, The Hague, Netherlands
| | - G Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
| | - F Schakel
- Basalt Rehabilitation Center, The Hague, Netherlands
| | - A de Kloet
- Basalt Rehabilitation Center, The Hague, Netherlands.,The Hague University of Applied Sciences, The Haag, Netherlands
| | - R Simeonsson
- University of North Carolina, Chapel hill, NC, USA
| | - C Imms
- Faculty of Medicine Dentistry and Health Sciences Melbourne, University of Melbourne, Parkville, Australia
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25
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Srinivasan R, Kulkarni V, Smriti S, Teplicky R, Anaby D. Cross-Cultural Adaptation and Evaluation of the Participation and Environment Measure for Children and Youth to the Indian Context-A Mixed-Methods Study. Int J Environ Res Public Health 2021; 18:1514. [PMID: 33562602 PMCID: PMC7915983 DOI: 10.3390/ijerph18041514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/19/2022]
Abstract
Culturally appropriate measures enable knowledge transfer and quality improvement of rehabilitation services in diverse contexts. The Applied Cultural Equivalence Framework (ACEF) was used in a two-phased mixed methods study to adapt and evaluate the Participation and Environment Measure-Children and Youth (PEM-CY) in India. Cognitive interviews with caregivers of children with disabilities (n = 15) aged 5-17 years established conceptual, item, semantic, and operational equivalence of the Indian PEM-CY. Construct validity was assessed by comparing PEM-CY scores of children with and without disabilities (n = 130) using a case-control design. Cognitive interviews resulted in operational (60.3%), semantic (26.4%), and item-level (13.2%) modifications in the PEM-CY with no changes at the conceptual level. Internal consistency (n = 130) was acceptable to excellent (0.61-0.87) on most scales. Test-retest reliability (n = 30) was good to excellent (ICC ≥ 0.75, Kappa 0.6-1.0) for most scales. Significant differences in all PEM-CY summary scores were found between children with and without disabilities, except for environmental supports. Children with disabilities had lower scores on frequency and involvement in activities across all settings; their caregivers desired greater change in participation and reported experiencing more environmental barriers across settings. Findings suggest the adapted PEM-CY is a valid and reliable measure for assessing the participation of Indian children.
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Affiliation(s)
- Roopa Srinivasan
- Ummeed Child Development Center, Department of Developmental Pediatrics and Occupational Therapy, Mumbai 400011, Maharashtra, India;
| | - Vrushali Kulkarni
- Ummeed Child Development Center, Department of Developmental Pediatrics and Occupational Therapy, Mumbai 400011, Maharashtra, India;
| | - Sana Smriti
- Butterflies Child Development Centre, Hyderabad 500081, Telangana, India;
| | - Rachel Teplicky
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada;
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26
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Shabat T, Fogel-Grinvald H, Anaby D, Golos A. Participation Profile of Children and Youth, Aged 6-14, with and without ADHD, and the Impact of Environmental Factors. Int J Environ Res Public Health 2021; 18:E537. [PMID: 33440680 PMCID: PMC7828023 DOI: 10.3390/ijerph18020537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Children and youth with attention deficit hyperactivity disorder (ADHD) may experience difficulties in participation, but few studies examine their participation and the environmental factors affecting participation. This study explored the participation and the environmental factors of children and youth, with and without attention deficit hyperactivity disorder (ADHD), in the following three settings: home, school, and community. MATERIALS AND METHODS Parents of 65 participants aged 6-14 (M = 9.91, SD = 1.87) with and without ADHD completed the Participation and Environment Measure for Children and Youth (PEM-CY) questionnaire, which evaluates participation and environmental factors, along with demographic and screening questionnaires. RESULTS The ADHD group (n = 31) scored significantly lower than the non-ADHD group (n = 34) in "frequency" at home, "involvement", and overall environmental support in all settings, with parents expressing a greater desire to change their child's home and community participation. For the ADHD group, a relationship was found between environmental support and involvement in all three settings. CONCLUSIONS The findings demonstrated differences in the participation of children and youth with ADHD across different settings, compared to those without ADHD, and confirmed the effect of environmental factors on participation, especially involvement. It is essential to consider participation measures and environmental factors when designing interventions for children and youth with ADHD.
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Affiliation(s)
- Tair Shabat
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel; (T.S.); (H.F.-G.)
| | - Haya Fogel-Grinvald
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel; (T.S.); (H.F.-G.)
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada;
| | - Anat Golos
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel; (T.S.); (H.F.-G.)
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27
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Anaby D, Ryan M, Palisano RJ, Levin MF, Gorter JW, Avery L, Cormier I, Teplicky R, Coulter J, Hanes J. Participation during a Pandemic: Forging New Pathways. Phys Occup Ther Pediatr 2021; 41:115-119. [PMID: 33508997 DOI: 10.1080/01942638.2021.1875739] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Mallory Ryan
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Robert J Palisano
- Department of Physical Therapy and Rehabilitation Sciences, Drexel Univeristy, Philadelphia, Pennsylvania, USA
| | - Mindy F Levin
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Lisa Avery
- Avery Information Services Ltd, Orilla, ON, Canada
| | - Isabelle Cormier
- CRIR - Lethbridge-Layton-Mackay Rehabilitation Centre of the CIUSSS West-Central, Montreal, QC
| | - Rachel Teplicky
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | | | - Julia Hanes
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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Montpetit-Tourangeau K, Kairy D, Ahmed S, Anaby D, Bussières A, Lamontagne MÈ, Rochette A, Shikako-Thomas K, Thomas A. A strategic initiative to facilitate knowledge translation research in rehabilitation. BMC Health Serv Res 2020; 20:973. [PMID: 33097043 PMCID: PMC7585309 DOI: 10.1186/s12913-020-05772-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While there is a growing body of literature supporting clinical decision-making for rehabilitation professionals, suboptimal use of evidence-based practices in that field persists. A strategic initiative that ensures the relevance of the research and its implementation in the context of rehabilitation could 1) help improve the coordination of knowledge translation (KT) research and 2) enhance the delivery of evidence-based rehabilitation services offered to patients with physical disabilities. This paper describes the process and methods used to develop a KT strategic initiative aimed at building capacity and coordinating KT research in physical rehabilitation and its strategic plan; it also reports the initial applications of the strategic plan implementation. METHODS We used a 3-phase process consisting of an online environmental scan to identify the extent of KT research activities in physical rehabilitation in Quebec, Canada. Data from the environmental scan was used to develop a strategic plan that structures KT research in physical rehabilitation. Seven external KT experts in health science reviewed the strategic plan for consistency and applicability. RESULTS Sixty-four KT researchers were identified and classified according to the extent of their level of involvement in KT. Ninety-six research projects meeting eligibility criteria were funded by eight of the fourteen agencies and organizations searched. To address the identified gaps, a 5-year strategic plan was developed, containing a mission, a vision, four main goals, nine strategies and forty-two actions. CONCLUSION Such initiatives can help guide researchers and relevant key stakeholders, to structure, organize and advance KT research in the field of rehabilitation. The strategies are being implemented progressively to meet the strategic initiative's mission and ultimately enhance users' rehabilitation services.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada. .,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada
| | - Dana Anaby
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Département Chiropratique, Université du Québec à Trois-Rivières, 3351, boul. Des Forges, C. P. 500, Trois-Rivières, Quebec, G9A 5H, Canada
| | - Marie-Ève Lamontagne
- Département de réadaptation, Université Laval, Quebec, Quebec, G1V 0A6, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de Réadaptation en Déficience Physique de Québec, 525 Boul Wilfrid-Hamel, Quebec, Quebec, G1M 2S8, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, P.O. Box 6128, Station Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
| | - Keiko Shikako-Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3654 Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.,Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, 1110 Pine Avenue West, Montreal, Quebec, H3G 1A3, Canada
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29
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Villegas V, Bosak D, Kaelin V, Jarvis J, Anaby D, Teplicky R, Khetani M. Leveraging Technology for Family-Centered and Participation-Focused Care Planning: A Feasibility and Pilot Study of Participation and Environment Measure-Plus (PEM+). Am J Occup Ther 2020. [DOI: 10.5014/ajot.2020.74s1-po3119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 03/26/20
This study evaluated the feasibility, acceptability, and preliminary effects of PEM+, a web-based care-planning application that was designed with and for caregivers to help OTs enact family-centered and participation-focused care with children and families. Results indicate that PEM+ has potential as an innovative option for improving caregiver confidence when creating participation-focused care plans in OT.
Primary Author and Speaker: Vivian Villegas
Contributing Authors: Vera Kaelin, Jessica Jarvis, Dana Anaby, Rachel Teplicky, Mary Khetani
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Affiliation(s)
| | - Dianna Bosak
- University of Illinois at Chicago, Chicago, IL, USA
| | - Vera Kaelin
- University of Illinois at Chicago, Chicago, IL, USA
| | | | | | | | - Mary Khetani
- University of Illinois at Chicago, Chicago, IL, USA
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30
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Jarvis JM, Kaelin VC, Anaby D, Teplicky R, Khetani MA. Electronic participation-focused care planning support for families: a pilot study. Dev Med Child Neurol 2020; 62:954-961. [PMID: 32259292 PMCID: PMC7332406 DOI: 10.1111/dmcn.14535] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the feasibility, acceptability, and preliminary effects of Participation and Environment Measure-Plus (PEM+) 2.0, an optimized version of a web-based, participation-focused, care-planning tool. METHOD Twenty-two caregivers of children aged 0 to 5 years receiving rehabilitation services, who reported dissatisfaction with their child's participation, had internet access, and could read and write English, were recruited for this 2-week, single-arm pilot trial. Feasibility was assessed through retention rates, completion time, percentage of care plans developed relative to caregiver reported need, and independent completion of PEM+ 2.0. Acceptability was assessed by the Usefulness, Satisfaction, and Ease of Use Questionnaire. Preliminary effects were assessed by two items on caregiver reported impact of PEM+ 2.0 on confidence for addressing their child's participation. RESULTS Eighteen caregivers completed at least one iteration of PEM+ 2.0; of those, 17 were female and 15 were 30 to 39 years old. The median completion time was 12.99 minutes (quartile 1, 6.30; quartile 3, 17.33), mean care plan creation relative to need was 50% (standard deviation [SD] 31), and 17 completed PEM+ 2.0 independently. Mean acceptability scores were 3.80 to 4.97 (SD 1.25-1.97) and mean preliminary effect scores were 4.61 to 4.72 (SD 1.85-2.24), out of 7.0. There were strong and significant positive associations between two of the three estimates of PEM+ 2.0 acceptability and caregiver confidence (r=0.577-0.793, p<0.01). INTERPRETATION Electronic health tools have the potential for facilitating family-centered care in pediatric rehabilitation. PEM+ 2.0 is a feasible tool within pediatric rehabilitation and has potential to be an acceptable tool for improving caregiver confidence for promoting their child's participation in valued activities. WHAT THIS PAPER ADDS Participation and Environment Measure-Plus (PEM+) 2.0 is feasible for collaboratively engaging caregivers in the care-planning process. Caregivers perceived PEM+ 2.0 as helpful for thinking about their child's participation and what can be done to improve it. Feasibility and acceptability results will inform PEM+ 2.0 optimizations.
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Affiliation(s)
- Jessica M Jarvis
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vera C Kaelin
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Rachel Teplicky
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Mary A Khetani
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
- Rehabilitation Sciences, University of Illinois at Chicago, Chicago, IL, USA
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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31
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Hoehne C, Baranski B, Benmohammed L, Bienstock L, Menezes N, Margolese N, Anaby D. Changes in Overall Participation Profile of Youth with Physical Disabilities Following the PREP Intervention. Int J Environ Res Public Health 2020; 17:ijerph17113990. [PMID: 32512815 PMCID: PMC7312643 DOI: 10.3390/ijerph17113990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 11/16/2022]
Abstract
The Pathways and Resources for Engagement and Participation (PREP), an environmental-based intervention, is effective in improving the participation of youth with disabilities in specific targeted activities; however, its potential impact on overall participation beyond these activities is unknown. This study examined the differences in participation levels and environmental barriers and supports following the 12-week PREP intervention. Existing data on participation patterns and environmental barriers and supports, measured by the Participation and Environment Measure for Children and Youth, pre-and post-PREP intervention, were statistically analyzed across 20 youth aged 12 to 18 (mean = 14.4, standard deviation (SD) = 1.82) with physical disabilities in three settings: home, school and community. Effect sizes were calculated using Cohen’s d. Following PREP, youth participated significantly less often at home (d = 2.21; 95% Confidence Interval (CI) [1.79, 2.96]), more often (d = 0.57; 95% CI [−0.79, −0.14]) and in more diverse activities (d = 0.51; 95% CI [−1.99, −0.51]) in the community. At school, significantly greater participation was observed in special school roles (t = −2.46. p = 0.024). Involvement and desire for change remained relatively stable across all settings. A substantial increase in community environmental supports was observed (d = 0.67), with significantly more parents reporting availability of, and access to information as a support (χ2 = 4.28, p = 0.038). Findings lend further support to the effectiveness of environmental-based interventions, involving real-life experiences.
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Affiliation(s)
- Colin Hoehne
- Health Sciences Centre, Winnipeg, MB R3A 1R9, Canada;
| | - Brittany Baranski
- School of Physical & Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (B.B.); (L.B.); (N.M.); (N.M.)
| | | | - Liam Bienstock
- School of Physical & Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (B.B.); (L.B.); (N.M.); (N.M.)
| | - Nathan Menezes
- School of Physical & Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (B.B.); (L.B.); (N.M.); (N.M.)
| | - Noah Margolese
- School of Physical & Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (B.B.); (L.B.); (N.M.); (N.M.)
| | - Dana Anaby
- School of Physical & Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada; (B.B.); (L.B.); (N.M.); (N.M.)
- Centre de Recherche Interdisciplinaire en Réadaptation de Montréal Métropolitain (CRIR), Montreal, QC H3S1M9, Canada
- Correspondence:
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32
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Anaby D, Avery L, Gorter JW, Levin MF, Teplicky R, Turner L, Cormier I, Hanes J. Improving body functions through participation in community activities among young people with physical disabilities. Dev Med Child Neurol 2020; 62:640-646. [PMID: 31670397 DOI: 10.1111/dmcn.14382] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2019] [Indexed: 12/14/2022]
Abstract
AIM To examine the impact of engagement in a self-chosen community-based activity on three relevant body functions (motor, cognitive, and affective) as well as on the performance of the selected activity. METHOD An individual-based interrupted time series design with multiple baselines was used. Seven young people (four males, three females) aged 15 to 25 years (median 18y; interquartile range 17-20y) with physical disabilities participated in an 8-week community activity of choice (e.g. swimming, playing piano). Change in three relevant body functions, underpinning the specific chosen activity, including motor (e.g. Functional Reach Test, Trunk Impairment Scale, dynamometers), cognitive and affective (Behavior Assessment System for Children), as well as activity performance (Canadian Occupational Performance Measure) were measured repeatedly, providing individual outcome trajectories. Linear and mixed-effects models were used. RESULTS Significant improvements in at least one aspect of motor function (6 out of 6), cognition (3 out of 3), affect (5 out of 7), and performance (7 out of 7) were observed. Specifically, the intervention had a moderate to large effect on hyperactivity (1.45, 95% confidence interval [CI] 1.0-1.9) with a smaller effect on anxiety (0.21, 95% CI 0.10-0.32) and inadequacy (0.21, 95% CI 0.02-0.39). Concurrently, a notable effect size for activity performance (4.61, 95% CI 0.76-8.46) was observed. Average change across motor outcomes was substantial (3.7 SDs from baseline), yet non-significant. INTERPERTATION Findings provide initial evidence of the benefits resulting from participation-based interventions, emphasizing the merit of meaningful 'real-life' young people-engaging therapy. WHAT THIS PAPER ADDS Participation-based interventions can impact body-function level outcomes. Significant improvements in the performance of chosen activities were observed. Significant improvements were also seen in cognitive and affective body functions. Improvements in motor-related outcomes were substantial but not statistically significant.
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Affiliation(s)
- Dana Anaby
- School of Physical and Occupation Therapy, McGill University, Montreal, QC, Canada.,CRIR - Lethbridge-Layton-Mackay Rehabilitation Centre of the CIUSSS West-Central Montreal, QC, Canada
| | - Lisa Avery
- Avery Information Services Ltd, Orilla, ON, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Mindy F Levin
- School of Physical and Occupation Therapy, McGill University, Montreal, QC, Canada
| | - Rachel Teplicky
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Laura Turner
- Conestoga College of Applied Arts and Technology, Kitchener, ON, Canada
| | - Isabelle Cormier
- CRIR - Lethbridge-Layton-Mackay Rehabilitation Centre of the CIUSSS West-Central Montreal, QC, Canada
| | - Julia Hanes
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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33
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Chan-Viquez D, Hasanbarani F, Zhang L, Anaby D, Turpin NA, Lamontagne A, Feldman AG, Levin MF. Development of vertical and forward jumping skills in typically developing children in the context of referent control of motor actions. Dev Psychobiol 2020; 62:711-722. [PMID: 31957019 DOI: 10.1002/dev.21949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/14/2019] [Accepted: 12/23/2019] [Indexed: 12/20/2022]
Abstract
The empirically based referent control theory of motor actions provides a new framework for understanding locomotor maturation. Mature movement patterns of referent control are characterized by periods of minimization of activity across multiple muscles (global electromyographic [EMG] minima) resulting from transient matching between actual and referent body configurations. We identified whether locomotor maturation in young children was associated with (a) development of referent control and (b) children's frequency of participation in everyday activities evaluated by parents. Kinematics and EMG activity were recorded from typically developing children (n = 15, 3-5 years) and young adults (n = 10, 18-25 years) while walking, vertical or forward jumping. Presence and location of global EMG minima in movement cycles, slopes of ankle vertical/sagittal displacements, and shoulder displacement ratios were evaluated. Children had fewer global EMG minima compared to adults during specific phases of vertical and forward jumps. Ankle displacement profiles for walking and jumping forward were related to each other in adults, whereas those for walking and vertical jumping were related in children. Higher frequency of participation was significantly correlated with more mature jumping patterns in children. A decrease in the number of global EMG minima and changes in ankle movement patterns could be indicators of locomotor immaturity in typically developing children.
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Affiliation(s)
- Daniela Chan-Viquez
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Fariba Hasanbarani
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Lei Zhang
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,Department of Neuroscience, University of Montreal, Montreal, QC, Canada
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Nicolas A Turpin
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,Department of Neuroscience, University of Montreal, Montreal, QC, Canada
| | - Anouk Lamontagne
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
| | - Anatol G Feldman
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.,Department of Neuroscience, University of Montreal, Montreal, QC, Canada
| | - Mindy F Levin
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
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Anaby D, Teplicky R, Turner L, Law M, Avery L, Majnemer A, Feldman D. Pathways and Resources for Engagement and Participation (PREP): Improving the Participation of Youth With Disabilities in Community-Based Occupations. Am J Occup Ther 2019. [DOI: 10.5014/ajot.2019.73s1-rp101b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 04/04/19
This study demonstrates the effectiveness of a novel, client-centered OT intervention, named PREP, for improving the participation of youth with disabilities. By removing environmental barriers, OTs enabled 28 youth to successfully take part in the activities they identified, such as shopping with friends, riding a bike, and joining a glee club. These findings support a shift toward community-based ecological practices that occur in real-life situations.
Primary Author and Speaker: Dana Anaby
Additional Authors and Speakers: Rachel Teplicky, Laura Turner
Contributing Authors: Mary Law, Lisa Avery, Annette Majnemer, Debbie Feldman
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Affiliation(s)
| | | | | | - Mary Law
- McMaster University, Hamilton, ON, Canada
| | - Lisa Avery
- Avery Information Services, Ltd, Orillia, ON, Canada
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Jarvis JM, Gurga A, Greif A, Lim H, Anaby D, Teplicky R, Khetani MA. Usability of the Participation and Environment Measure Plus (PEM+) for Client-Centered and Participation-Focused Care Planning. Am J Occup Ther 2019; 73:7304205130p1-7304205130p8. [PMID: 31318677 PMCID: PMC9563087 DOI: 10.5014/ajot.2019.032235] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Importance: The Participation and Environment Measure Plus (PEM+) is a new electronic health application to help caregivers contribute to client-centered and participation-focused care planning for their young child. The PEM+ is designed to help caregivers build on their participation assessment by determining priority activities, setting specific goals, and identifying strategies for goal attainment. Objective: To examine the usability of the PEM+. Design: A single-arm usability trial. Setting: Two early intervention and early childhood educational programs. Participants: Six caregivers of children ages 0–3 yr with developmental delay and receiving rehabilitation services. Intervention: Caregivers who were eligible and enrolled were given access to the PEM+ for 1 wk and instructed to complete one iteration. Outcomes and Measures: Usability was assessed according to caregivers’ report of PEM+’s technical effectiveness and ease of use, ease of learning, and user satisfaction via the Usefulness, Satisfaction, and Ease of Use questionnaire. Results: All caregivers completed the PEM+ online once and in its entirety (mean completion time = 13.6 min). Mean technical effectiveness ratings ranged from 5.7 to 6.3 out of 7.0, and mean ease of use, ease of learning, and user satisfaction ratings were 4.4, 5.4, and 4.2 out of 6.0, respectively. Conclusions and Relevance: Caregivers of young children can navigate the PEM+. Trends in survey feedback informed optimizations for the PEM+ before further feasibility testing. What This Article Adds: This study provides preliminary evidence for a promising tool that can help to customize the way practitioners partner with families to create a plan for occupational therapy services.
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Affiliation(s)
- Jessica M Jarvis
- Jessica M. Jarvis, PhD, is Postdoctoral Associate, Department of Occupational Therapy, University of Illinois at Chicago
| | - Andrea Gurga
- Andrea Gurga, MS, is Graduate Research Assistant, Department of Occupational Therapy, University of Illinois at Chicago
| | - Alexa Greif
- Alexa Greif, MS, is Graduate Research Assistant, Department of Occupational Therapy, University of Illinois at Chicago
| | - Heather Lim
- Heather Lim, BS, is Graduate Research Assistant, Department of Occupational Therapy, University of Illinois at Chicago
| | - Dana Anaby
- Dana Anaby, PhD, is Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Rachel Teplicky
- Rachel Teplicky, MS, is Business and Engagement Officer, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Mary A Khetani
- Mary A. Khetani, ScD, is Associate Professor, Department of Occupational Therapy, University of Illinois at Chicago;
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Affiliation(s)
- Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Kinga Pozniak
- CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada
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Anaby D, Vrotsou K, Kroksmark U, Ellegård K. Changes in participation patterns of youth with physical disabilities following the Pathways and Resources for Engagement and Participation intervention: A time-geography approach. Scand J Occup Ther 2019; 27:364-372. [DOI: 10.1080/11038128.2018.1554088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Katerina Vrotsou
- Division of Media and Information Technology, Department of Science and Technology, Linköping Universtiy, Sweden
| | - Ulla Kroksmark
- Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Göteburg, Sweden
| | - Kajsa Ellegård
- Division of Technology and Social Change, Department of Thematic Studies, Linköping University, Linköping, Sweden
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Anaby D. Towards a new generation of participation-based interventions for adolescents with disabilities: the impact of the environment and the need for individual-based designs. Dev Med Child Neurol 2018; 60:735-736. [PMID: 29573401 DOI: 10.1111/dmcn.13749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Yee T, Magill-Evans J, Zwaigenbaum L, Sacrey LAR, Askari S, Anaby D. Participation Measures for Preschool Children with Autism Spectrum Disorder: a Scoping Review. Rev J Autism Dev Disord 2017. [DOI: 10.1007/s40489-017-0102-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Anaby D, Korner-Bitensky N, Steven E, Tremblay S, Snider L, Avery L, Law M. Current Rehabilitation Practices for Children with Cerebral Palsy: Focus and Gaps. Phys Occup Ther Pediatr 2017; 37:1-15. [PMID: 26865220 DOI: 10.3109/01942638.2015.1126880] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To describe the focus of therapy practices in occupational and physical therapy for school-aged children with cerebral palsy, and better understand whether it is congruent with recommended practices. METHODS A Canada-wide Web-based survey was completed by 62 occupational and 61 physical therapists to identify problems, assessments, and treatment interventions for two case-based scenarios. Data were coded using the International Classification of Functioning, Disability and Health (ICF) definitions for "body functions and structure," "activity and participation," and "environment." RESULTS Physical therapists, in comparison to occupational therapists, were more likely to select interventions classed in the "body functions and structure" category (34-42% and 18-20%, respectively). Both professions focused on "activity and participation" (34-61%) when identifying problems, assessing, and intervening; attention, however, was mainly directed towards task-oriented activities such as activities of daily living and mobility. Participation in leisure or community-based activities received less attention (2-15%). The environment received limited attention for problems and assessments (4-25%), though it was an important focus of intervention (19-37%). CONCLUSIONS While body functions and structure are well-addressed, other ICF elements, specifically participation, are poorly integrated into practice. The emerging focus on the environment in therapy intervention, by modifying the context rather than changing aspects of the child, is consistent with current approaches and evidence. Knowledge translation implementation initiatives are recommended to bridge identified gaps.
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Affiliation(s)
- Dana Anaby
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Nicol Korner-Bitensky
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Emma Steven
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Stephanie Tremblay
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Laurie Snider
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Lisa Avery
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Mary Law
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
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Abstract
Both students with disabilities and their typically-developing peers exhibit alarming participation deficits that involve many occupational areas of their school experience. Enabling participation in school-related occupations as the goal of school-based occupational therapy services invokes practice breadth. However, the documented focus of practice appears narrow, and there is an apparent paucity of evidence to describe how school participation is enabled. This paper discusses the complex concept of participation and how it can be applied in the school setting, while drawing upon occupational therapy elements. Redirecting attention towards participation can expand the scope of school-based occupational therapy to its intended broad perspective.
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Affiliation(s)
- Madeleine Bonnard
- Research Associate, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Dana Anaby
- Assistant Professor, McGill University, Canada and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Canada
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Anaby D, Law M, Coster W, Bedell G, Khetani M, Avery L, Teplicky R. ISDN2014_0182: The role of the environment in explaining participation in the home, school and community: Results of a structural equation modelling. Int J Dev Neurosci 2015. [DOI: 10.1016/j.ijdevneu.2015.04.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - M. Law
- McMaster UniversityCanada
| | - W. Coster
- Sargent College of Rehabilitation SciencesCanada
| | | | | | - L. Avery
- Avery Information Services LtdCanada
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Anaby D, Korner-Bitensky N, Law M, Cormier I. Focus on participation for children and youth with disabilities: Supporting therapy practice through a guided knowledge translation process. Br J Occup Ther 2015. [DOI: 10.1177/0308022614563942] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction Participation in community leisure occupations of children with disabilities is important, yet poorly integrated into practice. This knowledge translation strategy tested an intervention to increase clinicians' awareness and to bring about change in practice toward a focus on participation. Method During this qualitative study, 14 clinicians participated in six learning sessions facilitated by a knowledge broker. Three months post-intervention, clinicians were individually interviewed, by drawing on the Professional Evaluation and Reflection on Change Tool, to evaluate potential change in practice. Two researchers independently performed thematic data analysis. Results Impact on practice emerged in both the personal and professional levels (for example, empowerment, validation of clinical wisdom, change in thinking and behavior). Clinicians suggested strategies for integrating participation in their day-to-day practice, illustrating a substantial intention for change, while describing barriers and facilitators for implementation (for example, organizational mandate). Two additional themes described the overall experience of the intervention: motivation to learn (for example, desire to link research to practice) and elements of the learning environment (for example, meeting informational needs). Conclusion This strategy was effective in redirecting clinicians' focus toward the notion of participation and establishing readiness for change. This shift can potentially facilitate new programs in occupational therapy that are participation-based and community-focused.
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Affiliation(s)
- Dana Anaby
- Assistant Professor, McGill University, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Canada
| | | | - Mary Law
- Professor, McMaster University, Canada
| | - Isabelle Cormier
- Occupational Therapist, MAB-Mackay Rehabilitation Centre, Canada
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Law M, Anaby D, Imms C, Teplicky R, Turner L. Improving the participation of youth with physical disabilities in community activities: An interrupted time series design. Aust Occup Ther J 2015; 62:105-15. [PMID: 25678151 DOI: 10.1111/1440-1630.12177] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM Youth with physical disabilities experience restrictions to participation in community-based leisure activities; however, there is little evidence about how to improve their involvement. This study examined whether an intervention to remove environmental barriers and develop strategies using a coaching approach improved youth participation in leisure activities. METHODS An Interrupted Time Series design was employed, where replication of the intervention effect was examined across individualised participation goals and across participants. Six adolescents with a physical disability participated in a 12-week intervention. An occupational therapist worked with each youth and his/her family to set three leisure goals based on problems identified using the Canadian Occupational Performance Measure (COPM). A coaching approach was used to collaboratively identify and implement strategies to remove environmental barriers. Interventions for each goal were introduced at different time points. Outcomes were evaluated using the COPM. RESULTS Improvements in COPM performance scores were clinically significant for 83% of the identified activities; an average change of 4.5 points in the performance scale (SD = 1.95) was observed. Statistical analysis using the celeration line demonstrated that the proportion of data points falling above the line increased in the intervention phase for 94% of the activities, indicating a significant treatment effect. CONCLUSIONS This study is the first to examine an intervention aimed at increasing leisure participation by changing only the environment. The results indicate that environment-focussed interventions are feasible and effective in promoting youth participation. Such findings can inform the design of a larger study and guide occupational therapy practice.
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Affiliation(s)
- Mary Law
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
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Anaby D, Lal S, Huszczynski J, Maich J, Rogers J, Law M. Interrupted time series design: a useful approach for studying interventions targeting participation. Phys Occup Ther Pediatr 2014; 34:457-70. [PMID: 24328671 DOI: 10.3109/01942638.2013.866612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Comparative effectiveness research (CER) strives for evidence to inform clinical decisions for specific clients in typical health care settings. While the randomized controlled trial (RCT) is well-aligned with the objectives of CER, this design may not be feasible or applicable to all research questions, particularly those pertaining to clinical decision making and individually based change. It is important, therefore, to consider alternative approaches, especially when studying complex and subjective outcomes such as children's participation. We propose the use of interrupted time series (ITS) quasi-experimental design for its potential application in determining the effectiveness of participation-focused interventions. In this perspective, ITS design is described, ascertaining its advantages and limitations, and suggestions are provided to overcome challenges to implementation. Results of a case study using the ITS approach to evaluate changes in participation of an adolescent with physical disabilities are described. Finally, strategies to implement this design in practice are suggested.
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Affiliation(s)
- Dana Anaby
- 1School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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Khetani MA, Cliff AB, Schelly C, Daunhauer L, Anaby D. Decisional Support Algorithm for Collaborative Care Planning using the Participation and Environment Measure for Children and Youth (PEM-CY): A Mixed Methods Study. Phys Occup Ther Pediatr 2014; 35:231-252. [PMID: 24670061 DOI: 10.3109/01942638.2014.899288] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Mary A Khetani
- 1Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA
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Law M, Hanna S, Anaby D, Kertoy M, King G, Xu L. Health-related quality of life of children with physical disabilities: a longitudinal study. BMC Pediatr 2014; 14:26. [PMID: 24476085 PMCID: PMC3911963 DOI: 10.1186/1471-2431-14-26] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 01/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent's perceptions of child's HRQoL across 18 months and 3) explore factors that predict these changes. METHODS Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child's factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors. RESULTS CHQ scores of the study's participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children's behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time. CONCLUSIONS Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ.
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Affiliation(s)
- Mary Law
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.
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Law M, Anaby D, Teplicky R, Khetani MA, Coster W, Bedell G. Participation in the Home Environment among Children and Youth with and without Disabilities. Br J Occup Ther 2013. [DOI: 10.4276/030802213x13603244419112] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: This study examines participation patterns and environmental supports and barriers for children with and without disabilities within their home setting. Method: The Participation and Environment Measure for Children and Youth (PEM-CY) is a newly developed, reliable parent/caregiver-report tool, which combines assessment of children's participation and the environment. The PEM-CY was completed online by 576 parents of children or youth (5 to 17 years old) with and without disabilities from Canada and the United States. ANOVA analyses were performed to examine group differences in PEM-CY summary scores. Item-level differences are presented descriptively using radar plots. Results: After controlling for age and income, significant differences between children with and without disabilities were observed for all home-based PEM-CY participation and environment summary scores. Differences between the two groups were also evident at the item level, particularly when comparing the percentage of children and youth who never participate in specific home-based activities and when comparing perceived barriers to participation. Conclusion: Although all children and youth participate frequently in home-based activities, those with disabilities tend to participate in less complex and quieter/sedentary activities. This, in addition to parental report of environmental barriers to participation, highlights the potential importance of home-based occupational therapy intervention to optimise participation in this setting.
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Affiliation(s)
- Mary Law
- Professor, CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Dana Anaby
- Assistant Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Rachel Teplicky
- Research Coordinator, CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Mary Alunkal Khetani
- Assistant Professor, Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, United States
| | - Wendy Coster
- Professor, Department of Occupational Therapy, Boston University, Sargent College of Health and Rehabilitation Sciences, Boston, Massachusetts, United States
| | - Gary Bedell
- Associate Professor, Department of Occupational Therapy, Tufts University, Medford, Massachusetts, United States
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