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Quartermaine JR, Rose TA, Auld ML, Johnston LM. Participation measures that evaluate attendance and involvement for young people aged 15 to 25 years with cerebral palsy: a systematic review. Disabil Rehabil 2024; 46:1734-1750. [PMID: 37195908 DOI: 10.1080/09638288.2023.2207042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE To identify participation-focused measures used for young people with cerebral palsy (CP), evaluate their psychometric evidence, and map item content to the International Classification of Functioning, Disability, and Health (ICF), and family of Participation-Related Constructs (fPRC) frameworks. METHODS Four databases (PubMed, Embase, Web of Science, CINAHL) were searched for papers that involved young people with CP aged 15 to 25 years and reported original data from a participation measure. Each measure was examined for validity, reliability, responsiveness (using the COSMIN checklist), clinical utility, the inclusion of accessible design features, self- and/or proxy-report from people with communication support needs, and item content according to ICF and fPRC. RESULTS Of 895 papers, 80 were included for review. From these, 26 measures were identified. Seven measures (27 papers/resources) were participation-focused, capable of producing a score for participation Attendance and/or Involvement. Of these, all measured Attendance (n = 7) but fewer than half measured Involvement (n = 3). Few included studies (37%) reported including some self-report of people with communication support needs. CONCLUSIONS Participation measures for young people with CP are evolving but require more: (i) emphasis on measurement of involvement; (ii) investigation of psychometric properties; and (iii) adaptation to enable self-report by young people with communication support needs.
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Affiliation(s)
- Jacinta R Quartermaine
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
- Choice, Passion, Life, Brisbane, Australia
- Queensland Cerebral Palsy Register, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
| | - Megan L Auld
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
- Choice, Passion, Life, Brisbane, Australia
- Queensland Cerebral Palsy Register, Brisbane, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Motor Control Research Collaboration, Brisbane, Australia
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2
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Hwang CK, Harris KT, Wood D. Barriers to Transitional Care in Spina Bifida. Urol Clin North Am 2024; 51:187-196. [PMID: 38609191 DOI: 10.1016/j.ucl.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
The health care needs children with spina bifida evolve over their lifetime; continued, regular contact with appropraitely trained, multidisciplinary providers is crucial to a patient's health and quality of life. Substantial research has been conducted to improve the transition process starting at an early age; however, there continue to be strong barriers to successful transition. This article reviews key aspects of the care of patients with spina bifida, the impact of inadequate transition to adult care, barriers to transition, and offers a potential vision for the future.
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Affiliation(s)
- Catalina K Hwang
- Division of Urology, Children's Hospital Colorado, 13123 East 16th Avenue, Box 323, Aurora, CO 80045, USA
| | - Kelly T Harris
- Division of Urology, Children's Hospital Colorado, 13123 East 16th Avenue, Box 323, Aurora, CO 80045, USA
| | - Dan Wood
- Division of Urology, Children's Hospital Colorado, 13123 East 16th Avenue, Box 323, Aurora, CO 80045, USA.
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Lennon N, Kalisperis F, Church C, Niiler T, Miller F, Biermann I, Davey J, Sees JP, Shrader MW. Self-reported Health-related Quality of Life in Adolescents With Cerebral Palsy. J Pediatr Orthop 2024; 44:e46-e50. [PMID: 37728111 DOI: 10.1097/bpo.0000000000002519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Happiness, comfort, and motor function contribute to satisfaction with life for individuals with cerebral palsy (CP). Evidence-based medical care can improve motor function and physical health of youth with CP. Less is known about medical care and its relationship to health-related quality of life (HRQOL) in adolescents and young adults with CP. This study aimed to describe HRQOL among adolescents with CP to examine differences between adolescent (self) and parent (proxy) reports of HRQOL and to explore associations of pain, age, and gross motor function with HRQOL. METHODS This is a retrospective study including adolescents with CP classified as Gross Motor Function Classification System levels I to V, ages 11 to 20 years, reading ≥ a fourth-grade level, and who completed the self-reported Pediatric Outcomes Data Collection Instrument (PODCI). Parents completed the PODCI concurrently or within 12 months and scores were compared. In addition, self-reported scores were compared between age bands, across Gross Motor Function Classification System levels, with typically developing youth (TDY), and between youth with/without pain. RESULTS PODCI scores from 102 adolescents [59 males; 15.0 (SD: 2.6) years old] were examined. Scores from 50 adolescents and parents were matched. Mean self-reported scores were significantly higher than mean parent-reported scores in 4 domains: upper extremity and physical function ( P =0.018), sports and physical function ( P =0.005), happiness ( P =0.023), and global functioning ( P =0.018). All domains, except Happiness, were significantly < TDY ( P <0.01). The presence of pain was associated with lower scores in all domains ( P <0.05). CONCLUSION Examining HRQOL with the PODCI revealed significant limitations in physical function and higher pain in adolescents with CP compared with TDY. Self- and parent-reported PODCI results should be considered separately. Adolescents report higher HRQOL compared with parent proxy. Recognizing and validating the perspectives of youth and their parents presents an opportunity for providers to discuss different points of view with families. Such engagement can help promote self-efficacy in youth with CP as they transition to the responsibility of guiding their own care in adulthood. LEVEL OF EVIDENCE III, Retrospective comparative study.
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Affiliation(s)
- Nancy Lennon
- Department of Orthopaedics, Nemours Children's Health, Wilmington, DE
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Zheng H, Bornman J, Granlund M, Zhao Y, Huus K. Agreement between children with long-term health conditions and their primary caregivers on reports of perceived participation. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1123651. [PMID: 37350849 PMCID: PMC10282543 DOI: 10.3389/fresc.2023.1123651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/15/2023] [Indexed: 06/24/2023]
Abstract
Background There is limited knowledge regarding the perceived participation of children with long-term health conditions in everyday activities. Children may have perceptions that differ from those of their primary caregivers. It is unclear whether children and caregivers rate their participation in everyday situations in the same way. Objectives We aimed to explore the level of agreement pertaining to perceived participation (attendance and involvement) and examine whether differences exist in the rank order of activities selected as the three most important between reports from children with long-term health conditions and their primary caregivers. Methods The simplified Chinese version of the Picture My Participation (PMP-C; Simplified) was used in an interview with children with long-term health conditions; meanwhile, their primary caregivers finished the questionnaire independently. Data were analyzed using Wilcoxon tests, weighted kappa values, and Spearman's rank order correlation. Results Children with long-term health conditions reported significantly lower attendance scores for six activity items (p < 0.05) and higher involvement scores for two activity items (p < 0.05) than their primary caregivers did. An overall slight to fair agreement in perceived participation was found at the child-caregiver dyad level, though differences in dyads were observed. A strong correlation was identified between the rank order of the most important activities for both groups (r = 0.81). Conclusions Differences may exist between the perceived participation of children with long-term health conditions, as reported by primary caregivers and the children themselves. The findings highlight that children with long-term health conditions exhibit unique views with respect to their perceived participation and have to be asked regarding their perceptions themselves.
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Affiliation(s)
- Hong Zheng
- CHILD Research Group, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Juan Bornman
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Mats Granlund
- CHILD Research Group, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Karina Huus
- CHILD Research Group, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Noritz G, Davidson L, Steingass K. Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy. Pediatrics 2022; 150:e2022060055. [PMID: 36404756 DOI: 10.1542/peds.2022-060055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cerebral palsy (CP) is the most common motor disorder of childhood, with prevalence estimates ranging from 1.5 to 4 in 1000 live births. This clinical report seeks to provide primary care physicians with guidance to detect children with CP; collaborate with specialists in treating the patient; manage associated medical, developmental, and behavioral problems; and provide general medical care to their patients with CP.
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Affiliation(s)
- Garey Noritz
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
| | - Lynn Davidson
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Katherine Steingass
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
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Connaghan KP, Baylor C, Romanczyk M, Rickwood J, Bedell G. Communication and Social Interaction Experiences of Youths With Congenital Motor Speech Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2609-2627. [PMID: 36215658 PMCID: PMC9911099 DOI: 10.1044/2022_ajslp-22-00034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE The purpose of this study was to explore the communication and social interaction experiences of adolescents with congenital motor speech disorders due to cerebral palsy or Down syndrome, with the aim of identifying clinical and research needs to support the development and implementation of speech-language interventions. METHOD Five male youths (ages 14-18 years) with congenital motor speech disorders and one of their parents participated in face-to-face, semistructured interviews designed to understand communication and social experiences in daily life. Interviews were audio-recorded and orthographically transcribed offline. Content was coded according to topic areas emerging in the data. Themes were developed to illustrate the most salient and representative aspects of participants' experiences according to the phenomenological tradition that recognizes that participants are experts in their "lived experience." RESULTS Participants described the youths' day-to-day communication experiences, including facilitators and barriers to successful social interactions. Thematic analysis revealed three main themes: (a) strong core relationships amidst sparse, superficial interactions in daily life; (b) the complicated picture of why; and (c) how speech-language pathologists can help. CONCLUSIONS Participants reported that the impact of congenital motor speech disorders on social interactions and experiences became more apparent in adolescence than in earlier childhood. Addressing communication challenges to meet the unique social demands of this period requires tailored interventions that target multiple contributing factors beyond speech impairment, such as social communication skills, negative communication partner attitudes, and participation opportunities. Shifting practice toward a life participation approach to communication intervention stands to substantially improve the long-term social outcomes of adolescents with motor speech disorders.
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Affiliation(s)
- Kathryn P. Connaghan
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
| | - Carolyn Baylor
- Department of Rehabilitation Sciences, University of Washington, Seattle
| | - Megan Romanczyk
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Jessica Rickwood
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA
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Ferreira MC, Garcia NR, Prudente COM, Ribeiro MFM. Quality of life of adolescents with cerebral palsy: agreement between self-report and caregiver's report. Rev Lat Am Enfermagem 2020; 28:e3300. [PMID: 32609264 PMCID: PMC7332252 DOI: 10.1590/1518-8345.3928.3300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 03/14/2020] [Indexed: 11/28/2022] Open
Abstract
to assess the quality of life (QOL) of adolescents with cerebral palsy (CP) by
self-report and by the caregiver’s report, and to analyze the agreement between
these reports.
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Affiliation(s)
- Mariana Ceravolo Ferreira
- Universidade Federal de Goiás, Faculdade de Medicina, Goiânia, GO, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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8
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Ozipek M, Arikan H, Calik-Kutukcu E, Kerem-Gunel M, Saglam M, Inal-Ince D, Vardar-Yagli N, Livanelioglu A, Bozdemir-Ozel C, Cakmak A, Sonbahar-Ulu H, Emiralioglu N, Ozcelik U. Deviations of body functions and structure, activity limitations, and participation restrictions of the International Classification of Functioning, Disability, and Health model in children with cystic fibrosis and non-cystic fibrosis bronchiectasis. Pediatr Pulmonol 2020; 55:1207-1216. [PMID: 32109001 DOI: 10.1002/ppul.24708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 02/18/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND To the best of our knowledge, there is no study in the literature investigating the extrapulmonary outcomes of children with non-cystic fibrosis (CF) bronchiectasis and CF under the framework of the International Classification of Functioning, Disability, and Health (ICF) model. The purpose of the present study is to evaluate the children with CF and non-CF bronchiectasis using the ICF model. MATERIALS AND METHODS Children with CF, non-CF bronchiectasis, and healthy counterparts were evaluated (20 participants in each group) according to the ICF items in domain b (body functions), domain s (body structures), and domain d (activities and participation). The pulmonary functions, respiratory and peripheral muscle strength tests, and posture analysis were carried out for domain b. For domain d, however, the Glittre-activities of daily living test and Pediatric Outcome Data Collection were used. RESULTS Muscle strength of shoulder abductors and hip extensors in children with CF was significantly lower than healthy children and adolescents (P < .05). The severity of lateral and posterior postural abnormalities in children with CF and non-CF bronchiectasis was higher than those of healthy children (P < .05). Among the patient groups, global function, sports/physical function, expectations, transfers/basic mobility, and pain/comfort were the most affected participation dimensions (P < .05). CONCLUSIONS This study highlights the need for comprehensive up-to-date evaluation methods according to the ICF model for understanding rehabilitation requirements in CF and non-CF bronchiectasis in different age groups.
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Affiliation(s)
- Melike Ozipek
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hulya Arikan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Atilim University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Mintaze Kerem-Gunel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ayse Livanelioglu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cemile Bozdemir-Ozel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Aslihan Cakmak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hazal Sonbahar-Ulu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Nagehan Emiralioglu
- Department of Child Health and Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ugur Ozcelik
- Department of Child Health and Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Flanigan M, Gaebler-Spira D, Kocherginsky M, Garrett A, Marciniak C. Spasticity and pain in adults with cerebral palsy. Dev Med Child Neurol 2020; 62:379-385. [PMID: 31602643 DOI: 10.1111/dmcn.14368] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
AIM To evaluate whether spasticity measures are related to pain in adults with cerebral palsy (CP). METHOD This cross-sectional study recruited individuals aged 16 to 89 years with a diagnosis of CP. Participants completed the Penn Spasm Frequency Scale (PSFS), Brief Pain Inventory (BPI), and PROMIS Pain Interference measures. The Modified Ashworth Scale (MAS) and Tardieu spasticity angles of six joints were rated and summed to composite MAS and Tardieu scores for each participant. Associations between spasticity and pain measures were evaluated. RESULTS Forty-seven participants (27 females, 20 males) with a mean age of 35 years 7 months (range 18-77y) spanning all Gross Motor Function Classification System (GMFCS) levels were included. Twenty-six participants reported their average pain level on BPI as greater than 0 over the past week (median pain level 4.0). Median PSFS was 1.0 (range 0.0-1.0) and this correlated with average BPI and Pain Interference T scores (median 40.7; ρ=0.33 and ρ=0.31 respectively [both p=0.01]). When adjusted for pain medication use and age, MAS correlated with BPI (ρ=0.30; p=0.04). Other pain and spasticity measures, or GMFCS level, were not significantly related with pain interference or BPI rating. Age was weakly associated with BPI (slope=0.10; p<0.01). INTERPRETATION PROMIS Pain Interference was lower than population-based norms. Patient-rated spasm frequency demonstrated better association with pain levels and interference than physician-rated MAS and Tardieu. WHAT THIS PAPER ADDS Pain was not associated with Gross Motor Function Classification System level. Pain increased with age, as anticipated. Self-reported spasm scores were associated with increased pain in contrast to clinical examination scales. Adjusted, summed spasticity on the Modified Ashworth Scale was associated with pain scores on the Brief Pain Inventory. Although pain is experienced by adults with cerebral palsy, pain did not interfere with activities.
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Affiliation(s)
- Megan Flanigan
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Pediatric Rehabilitation, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Masha Kocherginsky
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Christina Marciniak
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Shirley Ryan AbilityLab, Chicago, IL, USA
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10
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Liao YT, Hwang AW, Liao HF, Granlund M, Kang LJ. Understanding the Participation in Home, School, and Community Activities Reported by Children with Disabilities and Their Parents: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2217. [PMID: 31238490 PMCID: PMC6616950 DOI: 10.3390/ijerph16122217] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/01/2019] [Accepted: 06/19/2019] [Indexed: 11/16/2022]
Abstract
Participation has significant impact on children's health and well-being. Knowledge is limited on how children with disabilities perceive their participation and whether their perceptions differ from their parents. This pilot study aimed to explore whether self-reported frequency of participation and prioritized activities differ between children with disabilities and their parents. Thirty children with disabilities eligible for special education in elementary school and their parents were included. Each of them were interviewed with the Chinese version of Picture My Participation (PMP), separately, to identify the child's participation frequency in 21 activities at home, school, and community, desire-to-change activities, and the level of involvement in these activities. The results indicated that children's ratings of participation frequency were significantly lower than parents' ratings in home activities but not in school and community activities, as analyzed by the Wilcoxon Signed Ranked test. Nineteen (63%) child-parent pairs had selected entirely different items as their desire-to-change activities. Children selected the activities that they were somewhat to very involved in; while parents selected the activities they thought their children were less involved in. Our findings suggest that children with disabilities had unique views on life and this should be supported in their health care and individualized education plans.
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Affiliation(s)
- Ya-Tzu Liao
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan City 333, Taiwan.
| | - Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan City 333, Taiwan.
- The Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 5 Fu-Xing St., Kwei-Shan, Tao-Yuan City 333, Taiwan.
| | - Hua-Fang Liao
- The School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 17 Xuzhou Rd., Taipei City 100, Taiwan.
| | - Mats Granlund
- CHILD, Swedish Institute of Disability Research, Jönköping University, Gjuterigatan 5, 553 18 Jönköping, Sweden.
| | - Lin-Ju Kang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan City 333, Taiwan.
- The Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 5 Fu-Xing St., Kwei-Shan, Tao-Yuan City 333, Taiwan.
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11
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Chan DV, Thorpe DE, Trost SG, Boyd RN, Faldowski RA, Barber L, Levin I, Carroll A, Bagatell N. Novel approaches to measuring community integration in adults with cerebral palsy. Disabil Rehabil 2019; 42:2653-2664. [PMID: 30994013 DOI: 10.1080/09638288.2019.1577500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Rehabilitation goals often focus on increasing community integration for adults with disabilities and are measured by objective assessments. Research methods have lagged behind in capturing current conceptualizations of community integration as a multidimensional construct that incorporates participation, social supports, and feelings of belonging in the community. This paper addresses this challenge by describing a multi-method approach to assessing community integration for adults with cerebral palsy.Methods: Measures include standardized questionnaires, qualitative methods, measures of function and physical activity, and geospatial measures using Geographic Information System mapping and Global Positioning System tracking. These objective and subjective data are used to determine where adults spend time and are most active, and which activities and social connections are associated with feeling integrated into the community.Results: Two case examples highlight the importance of using a multi-method approach to assess community integration for adults with cerebral palsy. Results of objective clinical measures were comparable among case examples; however, actual experiences of feeling connected to the community were vastly different.Conclusions: Multiple measures are required to capture the complexity of community integration. Relying solely on objective measures may not provide a complete picture of community integration.IMPLICATIONS FOR REHABILITATIONCommunity integration is a complex construct that incorporates participation, socialization, and feelings of belonging in the community.New methods and measures are needed to assess the many aspects of community integration in adults with disabilities.A multi-method approach is recommended to provide a richer characterization of community integration in individuals with disabilities.A combination of quantitative and qualitative measures addressing the physical, social and psychological aspects of community integration should be used.
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Affiliation(s)
- Dara V Chan
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah E Thorpe
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, South Brisbane, Australia
| | - Richard A Faldowski
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lee Barber
- Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, South Brisbane, Australia
| | - Ilana Levin
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amanda Carroll
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nancy Bagatell
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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