Measuring Participation of Children and Environmental Factors at Home, School, and in Community: Construct Validation of the Korean PEM-CY

Child and adolescent participation measurement tools and their translations: A systematic review

BACKGROUND

Numerous participation measurement tools targeting children and youth have been developed. Despite the translation of these tools into specific languages and cultures, the reliability and validity of the translated versions remain uncertain. To address this gap in knowledge, this study aims to identify tools for assessing the participation of children aged 5-18 years and to appraise the psychometric properties of their translated versions.

METHODS

Four electronic databases were searched for peer-reviewed studies published in English. Preferred Reporting Items for Systematic Reviews guidelines was followed. Study titles and abstracts were screened by four independent reviewers. Data were extracted for both original and translated versions of eligible tools. Instrument quality assessments were performed using the Outcome Measures Rating Form Guidelines. Any discrepancies were resolved by consensus.

RESULTS

Out of the 31 measurement tools examined, 18 tools had at least one translated version available, and among those original measurement tools, a total of 58 translated versions were identified. The most widely translated tool was the Physical Activity Questionnaire for Children (12 languages), and the most frequently translated language was Chinese (7 tools). Most translated versions verified internal consistency and content validity. Only three translated versions were verified inter-rater reliability, and seven translated versions were tested criterion validity with the gold standard tools assessing participation of children (e.g., accelerometer, Pediatric Evaluation of Disability Inventory and four 24-h recalls). None of the translated versions were tested for intra-rater reliability and responsiveness.

CONCLUSIONS

These findings can support the selection of psychometrically sound tools for children with disabilities, given their culture and language, and tool quality.

Occupational performance and participation in children with developmental coordination disorders before and during Covid-19

INTRODUCTION

Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children's occupational performance and participation. It is known that the Covid pandemic has adversely affected the whole world in many areas. We aim to investigate the occupational performance and participation of children with DCD before and during the COVID-19.

METHODS

Sixty-five children aged 5-12 years included in the study were assessed by the Canadian Measure of Occupational Performance and the Participation and Environment Measure for Children and Youth.

RESULTS

Statistically significant differences were detected in occupational performance and satisfaction scores (p < 0.01). Additionally, except for 'involvement in the home environment' (p > 0.05), there were statistically significant differences in all other areas of participation (p < 0.01).

CONCLUSION

The occupational performance and participation of children with DCD are impacted during COVID-19. In addition, it is seen that the desire of families to change regarding participation has increased due to COVID-19. It would be beneficial to include strategies to improve these areas in the rehabilitation processes.

Inside the Functional Individualized Therapy for Teenagers with Executive Deficits (FITTED): Insights from the Adolescents and Their Parents

This study explores Functional Individualized Therapy for Teenagers with Executive Deficits (FITTED) factors facilitating adolescents' improvement. At each of eight therapy sessions, 41 adolescents with executive function deficits and their parents wrote the primary concept they "took away." Experts categorized their answers by the FITTED model's main factors-goals, strengths, and strategies-adding child's difficulties for the parents' answers. Results describe answer frequencies by factor in each session. Across time, strengths and strategies dominated among adolescents, and strategies and difficulties among parents. Cognitive strategies are integral to the FITTED process for improving the daily functioning of adolescents with executive function deficits.

Difference in home participation patterns and environmental factors between Korean children with and without disabilities

PURPOSE

To identify the participation patterns of Korean children with and without disabilities at home, and the environmental factors affecting their participation.

MATERIALS AND METHODS

The Korean Participation and Environment Measure for Children and Youth were applied to 184 caregivers of children aged 5 to 13 years in South Korea. To explore home participation patterns and environmental factors at the item level, analysis of covariance, Pearson's chi-square tests, and radar plots were used.

RESULTS

The largest group differences in participation frequency were in "school preparation" and "homework" and those at involvement level were in "indoor play and games," "getting together with other people," "school preparation," and "homework." More caregivers of children with disabilities desired changes in their children's participation in all activities. They also perceived that "physical, cognitive, and social demands of typical home activities," "supplies," and "money" hindered children's home participation.

CONCLUSIONS

The findings provide information about how Korean children participated in home-based activities, whether their caregivers desired changes in their participation, and what environmental factors impede their home participation. These can help service providers understand the interaction between participation and environmental factors and offer insight into where their service goals should be focused for the successful participation of children with disabilities at home.Implications for RehabilitationAs children with disabilities spend much time at home, their parents need to consider both how many times their children participate and how much they get involved in home-based activities.Rehabilitation service providers need to focus on whether parents are satisfied with their children's participation in home activities to decide where much effort is needed for meaningfully occupying children's time at home.The goal of rehabilitation services can be to mitigate a poor fit between children's abilities and the demands of activities for successful participation in home activities.Measuring not only the quantity of participation but also the quality of participation is helpful for setting a collaborative goal with parents to improve the participation of children with disabilities at home.

Factors influencing the participation of children with disabilities in the community

[Purpose] To promote community involvement in children, the factors that influence and limit their participation must be well understood. The purpose of this study was to clarify the factors that limit the community participation of children with disabilities. [Participants and Methods] In total, 235 questionnaires were distributed to parents at special support schools, pediatric hospitals, home-visit nursing stations, and after-school daycare services in Tokyo, Gunma, Hiroshima, and Saga prefectures in Japan. Data related to the Participation and Environment Measure for Children and Youth, age, height, weight, gross motor function, presence of medical care, diagnosis, and parental age were recorded for school-aged children. [Results] Multiple regression analysis using the 100 valid questionnaire responses revealed that the number of community activities that the children participated in depended on the children's need for medical care (standardized partial regression coefficient: -0.20). The frequency was affected by gross motor function (standardized partial regression coefficient: -0.24). When respiratory, feeding, and excretion-related medical care were required, the children tended to participate in fewer community activities. [Conclusion] Community participation is influenced by the different factors in each aspect analyzed (number of activities, frequency, and degree of involvement). The factors that should be considered when promoting children's participation in rehabilitation must be identified.

Participation Profile of Children and Youth, Aged 6-14, with and without ADHD, and the Impact of Environmental Factors

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.

Psychometric properties of the Turkish version of Participation and Environment Measure for Children and Youth

BACKGROUND

Participation in daily activities provides many opportunities for children with and without disabilities to improve cognitive, physical and communication abilities; to develop social relationships and to promote adaptive behaviours. The aim of this study is to examine the psychometric properties of the Participation Environment Measure for Children and Youth (PEM-CY) in Turkish children and youth with and without a disability.

METHODS

A total of 410 parents of children with (n = 232) and without (n = 178) disabilities, aged 5-17 years, were included in this study. Cronbach's alpha (α) and intraclass correlation coefficients (ICCs) were evaluated for internal consistency and test-retest reliability, respectively. Discriminant validity was determined by comparing the differences in participation and environment scores for disability groups and age intervals with the two-way analysis of variance (ANOVA) followed by post-hoc analyses when results were statistically significant.

RESULTS

Internal consistency (0.67-0.80) and test-retest reliability (0.67-0.93, p < 0.0001) ranged from moderate to very strong for different summary scores. Discriminant validity of the Turkish version of PEM-CY was supported by significant differences between children with and without disabilities on participation and environment scales (p < 0.05). We identified some significant age differences, but they did not follow consistently.

CONCLUSIONS

The Turkish version of the PEM-CY is a valid and reliable tool to determine the participation and environmental factors in the home, at school and in community settings in Turkish children and youth aged 5-17 years, with and without disabilities.

Exploring the Participation Patterns and Impact of Environment in Preschool Children with ASD

Participation in everyday activities at home and in the community is essential for children's development and well-being. Limited information exists about participation patterns of preschool children with autism spectrum disorder (ASD). This study examines these participation patterns in both the home and community, and the extent to which environmental factors and social communication abilities are associated with participation. Fifty-four parents of preschool-aged children with ASD completed the Participation and Environment Measure for Young Children and the Autism Classification System of Functioning: Social Communication. The children had a mean age of 48.9 (8.4) months. Patterns of participation were studied using descriptive statistics, radar graphs, and Spearman correlations. Children with ASD participated in a variety of activities at home and in the community, but showed a higher participation frequency at home. Parents identified different barriers (e.g., social demands) and supports (e.g., attitudes) in both settings. There was a moderate positive association between children's social communication abilities and their levels of involvement during participation and the diversity of activities. This study highlights the importance of social communication abilities in the participation of preschool children with ASD, and the need to support parents while they work to improve their child's participation, especially within their communities.

Investigation on participation, supports and barriers of children with specific learning disabilities

BACKGROUND

Children with specific learning disabilities (SLD) have been observed to face participation restrictions in their daily life.

AIMS

This study aims to examine the participation and environmental features of children with SLD compared to non-disabled children.

METHODS AND PROCEDURES

This study was designed as a case-controlled study. Parents of children between 5 and 17 years of age with SLD (n = 90) and those who are non-disabled (n = 88) were included in this study to do the Participation and Environment Measure for Children and Youth (PEM-CY).

RESULTS

Differences between groups were found statistically significant in home, school, and community settings between both participation and environmental features (p < 0.05). Children with SLD participated less frequently in school settings and were less involved in activities in home and school settings. Parents of children with SLD desired more change in their child's participation in all settings. Environmental factors were significantly more likely to be identified as barriers in the participation of children with SLD.

CONCLUSION AND IMPLICATIONS

This study provides information about participation patterns and environmental factors for many children with SLD. The results provide insights into a rehabilitation program that may improve the participation of children with SLD, and on where greater efforts are needed to support participation and environmental features for children with SLD.

Development and psychometric evaluation of the Chinese version of the Participation and Environment Measure for Children and Youth

Purpose: To adapt the Participation and Environment Measure for Children and Youth for use with Chinese children and youths, and to investigate its psychometric properties.Materials and methods: The Participation and Environment Measure for Children and Youth was translated into Chinese using a cultural adaptation process. Parents of 69 children aged 5-12 years with disabilities and 319 children without disabilities completed the questionnaires. Internal consistency, test-retest reliability, factorial structure, and known-group validity were examined using Cronbach's alpha, intraclass correlation coefficient, confirmatory factor analysis and t-test, respectively.Results: We added and/or replaced activities with culturally-relevant activities in the Chinese version. Internal consistency was acceptable for most of the scales (0.55-0.86). Test-retest reliability of the summary scores was moderate to high (0.70-0.84). Data-model fit was confirmed in a one-factor structure for the participation scales and a two-factor structure for the environment scales. There were also significant differences in the summary scores between 65 gender- and age-matched pairs of children with and without disabilities on the school participation scales and all the environment scales.Conclusion: This study provides psychometric evidence supporting the use of the Participation and Environment Measure for Children and Youth to assess Chinese children's participation and environmental supports/barriers.Implications for rehabilitationThe Chinese version of the Participation and Environment Measure for Children and Youth was developed through a rigorous translation and cultural adaptation process.There is evidence for the reliability (internal consistency and test-retest reliability) and construct validity (factorial structure and known-group validity) of the Chinese version of the Participation and Environment Measure for Children and Youth.The Chinese version of the Participation and Environment Measure for Children and Youth can be used to assess children's participation in home, school and community settings and to identify environmental barriers that require further intervention.

Participation, supports, and barriers of Korean children and youth with and without disabilities in the school environment

Background: This study compared participation patterns of Korean children with and without disabilities at school and examined perceived environmental supports and barriers to their school participation.Methods: One hundred eighty four parents of Korean children, aged 5 to 13 years, with and without disabilities completed the Korean Participation and Environment Measure for Children and Youth. The item-level scores of Korean Participation and Environment Measure for Children and Youth were compared between children with and without disabilities using Analysis of covariance and Pearson chi-square tests.Results: In comparison with typically developing children, children with disabilities were less frequently participated and involved and their parents were more likely to desire the change of children's participation in all school activities. Parents of children with disabilities reported that child's physical, cognitive, and social demands, relationship with peers, programs and services, policies and procedures, and money are environmental barriers and personal and public transportation are environmental supports to school participation.Conclusions: Findings help to better understand school participation patterns of Korean children with disabilities and environmental supports and barriers to their participation. The knowledge can be used to support collaboration among school-related professionals for successful participation of children with disabilities at school.Implications for rehabilitationParents of children with disabilities need to focus on both how many times their children participate in school activities and how they get involved in those activities.Educators and therapists should consider in which types of change in school participation parents of children with disabilities are interested to select target activities and to modify them for successful school participation.Educators, therapists, and parents of children with disabilities should analyze the poor fits between functional limitation of children with disabilities and the physical, cognitive, and social demands of school activities for successful school participation.Using information about school participation patterns and environmental supports/barriers can support to better understand children with disabilities and strengthen partnerships among educators, therapists, and parents of children with disabilities for successful inclusion into school contexts.