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Kang LJ, Huang HH, Wu YT, Chen CL. Initial evaluation of an environment-based intervention for participation of autistic children: a randomized controlled trial. Disabil Rehabil 2024; 46:1851-1861. [PMID: 37183406 DOI: 10.1080/09638288.2023.2209743] [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] [Received: 09/23/2022] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE To evaluate the efficacy of environment-based intervention on participation outcomes and parent efficacy in autistic children. MATERIALS AND METHODS Twenty-one autistic children 6-10 years old and their parents were randomized to environment-based intervention (n = 11) or usual care (n = 10). The environment-based intervention targets individualized participation goals in leisure and community activities through changing environment and activity demands. The study outcomes were Canadian Occupational Performance Measure (COPM), Goal attainment scaling (GAS), and Parent Empowerment and Efficacy Measure (PEEM). Assessments included baseline, 12 weeks (post-test), and 24 weeks (follow-up). Mixed ANOVAs were used to examine within-group and between-group effects in outcome variables. RESULTS The COPM performance and satisfaction scores and GAS T-scores increased after environment-based intervention from baseline to 12 weeks and 24 weeks (p < 0.001) but did not significantly differ from usual care. The medium to large effect sizes of COPM performance and GAS T-scores favored the environment-based intervention. For the PEEM scores, no significant differences were found. CONCLUSIONS Environment-based intervention may support school-age autistic children to participate in self-chosen activities over time. The intervention effects on participation goals and parent efficacy, however, were inconclusive and need further research.
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Affiliation(s)
- Lin-Ju Kang
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsiang-Han Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Ling Chen
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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2
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Lo OYH, Wong YM, Kwok NT, Ma PS, Chien CW. Relationship Between Change in Participation and Later Mental Health Problems in Children. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492231216663. [PMID: 38164901 DOI: 10.1177/15394492231216663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Participation in everyday activities is beneficial for mental health. However, little is known about the extent to which changes in children's participation are associated with later mental health. OBJECTIVES To investigate the association between changes in the frequency and involvement in home, school, and community activities and subsequent mental health problems in children. Methodology: We recruited 242 school-aged children. Their parents completed the Participation and Environment Measure for Children and Youth twice, and after 2 years, they completed the Strengths and Difficulties Questionnaire. RESULTS After controlling for demographic factors, hierarchical regression analysis revealed that reductions in children's involvement in home and community activities were significantly associated with elevated levels of externalizing and internalizing problems. Furthermore, an increase in children's involvement in school activities showed significant relationships with better mental health outcomes. CONCLUSION These findings inform participation-based interventions for occupational therapists aimed at mitigating children's future mental health problems.
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Affiliation(s)
- Oi Ying Heidi Lo
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Yi Man Wong
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Nga Ting Kwok
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Pui-Sze Ma
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Chi-Wen Chien
- The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
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3
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Coussens M, Bulckmans N, Desoete A, Vanderstraeten G, Van Waelvelde H, Van de Velde D. Translation, Cross-Cultural Adaptation and Pilot Testing of the Young Children’s Participation and Environment Measure (YC-PEM) in the Dutch Culture. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2023. [DOI: 10.1080/19411243.2023.2179156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Marieke Coussens
- Occupational Therapy program, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Niki Bulckmans
- Occupational Therapy program, AP Hogeschool Antwerpen, Belgium
| | - Annemie Desoete
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Guy Vanderstraeten
- Occupational Therapy program, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hilde Van Waelvelde
- Occupational Therapy program, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Occupational Therapy program, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Rosenberg L, Cohen Erez A. Differences in Meaning of Occupations Between Children With and Without Neurodevelopmental Disorders. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:35-42. [PMID: 35549767 DOI: 10.1177/15394492221094314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Engaging children in meaningful occupations is a means of improving their participation. The objective of this study is to assess differences in dimensions of meaning of occupations-challenge, value, felt time, and autonomy-between children with and without neurodevelopmental disorders and their associations with the participation of each group. Thirty children with neurodevelopmental disorders (autism spectrum disorder [ASD]/attention deficit hyperactive disorder [ADHD]) and 30 typically developing children (M age = 9.37 ± 1.41 years) reported regarding dimensions of meaning of occupations. Their parents reported regarding children's participation. Children with neurodevelopmental disorders attach different meanings to their everyday activities than their typically developing peers, with a large effect size (ηp2 = .07-.12). For children with neurodevelopmental disorders, the value and autonomy dimensions of meaning were correlated with participation. The findings expand knowledge of occupational meaning and participation among children. To optimize the participation of children, occupational therapists should facilitate autonomy and engage children in activities that they value.
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"I never really thought that a virtual ride would be that good!": Experiences of participants with disabilities in online leisure-time physical activity during COVID-19. Disabil Health J 2023; 16:101395. [PMID: 36396586 PMCID: PMC9556957 DOI: 10.1016/j.dhjo.2022.101395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The COVID-19 pandemic has exacerbated the sedentary behavior and inactivity of people, including individuals with disability, who were already less active than their able-bodied counterparts. Therefore, it is particularly important to think about how to maintain and increase their leisure-time physical activity (LTPA). Online adaptive programs may represent a useful tool to do so. However, there is a little research focused on the health impacts of online LTPA. OBJECTIVE This mixed-methods study aimed to explore the experiences of people with disabilities who participated in online adaptive LTPA along with the factors contributing to or limiting participation. METHOD First, semi-structured interviews were conducted with 10 individuals participating in online adaptive LTPA offered by a community organization. Based on these interviews, a survey was developed and completed by 104 participants. RESULTS The results of the study suggested that people with disabilities can get a variety of physical and emotional health benefits when participating in adaptive online LTPA, including a strong social benefit. Staff attitude and knowledge as well as the staff's ability to adapt to participant needs played important roles in facilitating participation. Greater access to equipment was needed. CONCLUSION This study offers insights into how online LTPA could support the health-promoting behavior of people with disabilities during the pandemic and beyond.
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Hill J, Vogler J, Gullo H. Occupational therapists' understanding of supporting physical activity participation when working with children and adolescents: A national survey. Aust Occup Ther J 2022. [DOI: 10.1111/1440-1630.12854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/28/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Jessica Hill
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Australia
| | - Jessica Vogler
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Australia
| | - Hannah Gullo
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Australia
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Milićević M. Exploring participation in family activities among Serbian children with cerebral palsy and children with typical development: diversity, frequency, children's presence, and engagement. Disabil Rehabil 2021; 44:1583-1594. [PMID: 34342549 DOI: 10.1080/09638288.2021.1958931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to characterize the participation in family activities in two groups of children: children with cerebral palsy (CP group) and children with typical development (TD group), with regard to diversity, frequency, children's presence, and engagement. METHOD The convenience sample of this descriptive and comparative cross-sectional study conducted in Serbia included 48 children with CP and 74 children with TD, aged 7-12 years. Parents completed the Child Participation in Family Activities (Child-PFA) questionnaire. Mann-Whitney U test was used for data analysing. RESULTS Children with CP experienced less diverse and less frequent family activities compared to children with TD, with more pronounced differences in the diversity of family activities than in their frequency. In the occurring family activities, children with CP were present in a comparable proportion as children with TD. Once in an activity, children with CP were less engaged. CONCLUSIONS Our results confirmed that children with CP do not have the same opportunities to participate and be engaged in everyday family life activities as children with TD. Greater efforts are needed to address these differences and facilitate access to and engagement of children with CP in a variety of family activities.IMPLICATIONS FOR REHABILITATIONIn comparison to children with typical development, family activities are less diverse and less frequent in families of children with cerebral palsy, and children are less engaged, specifically when activities include family's or children's social network.In line with current practice, this study confirms the importance of addressing opportunities for children with cerebral palsy to be often and more engaged in everyday family life activities.Professionals should support a family context that optimizes the engagement of children with cerebral palsy in activities with other family members, thus providing them everyday natural learning opportunities.
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Affiliation(s)
- Milena Milićević
- Institute of Criminological and Sociological Research, Belgrade, Serbia
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8
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Axelsson AK, Ullenhag A, Ödman P. A Swedish cultural adaptation of the participation questionnaire Functional Scale of the Disability Evaluation System - Child version. Disabil Rehabil 2021; 44:1720-1727. [PMID: 33941022 DOI: 10.1080/09638288.2021.1917704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim was to culturally validate a questionnaire about children's/youth's participation to be used in a Swedish context. METHODS FUNDES-Child, based on the well-established CASP, was chosen. Questions about engagement and hindering factors were added to the existing questions about frequency and independence in 20 activity areas. Using a qualitative, explorative design, 16 interviews with children/youths/caregivers were made to explore opinions about the questionnaire. Follow-up interviews confirmed the result of the revised questionnaire. Qualitative content analysis was performed. RESULTS The interviews provided support for the questionnaire's relevance by being a tool to assess important aspects of participation, to gain insights into one's own/the child's participation, and to promote ideas about what causes the degree of participation. To achieve comprehensiveness, no activity area was found to be missing nor superfluous. However, some examples were needed to be modified where "parades" are unusual in Sweden and therefore removed, while "singing in choir" was added. In search for comprehensibility, opinions about the layout of the first version were raised and a varying degree of understanding of wording and concepts were found and thus taken into account. CONCLUSIONS The questionnaire can be used for establishing meaningful goals and to potentially increase children's participation.Implications for rehabilitationParticipation is of great importance for children's functioning, well-being, and development.Cultural validation of well-established participation questionnaires is a priority and questions about important aspects of participation need to be included.Interviews with children/youth and caregivers guided revisions to reach relevance, comprehensiveness, and comprehensibility of the Swedish FUNDES-Child (FUNDES II-SE).Children/youths, caregivers, and others may increase their awareness concerning the child's/youth's participation by responding to the questionnaire.
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Affiliation(s)
| | - Anna Ullenhag
- Academy of Health, Care and Welfare, Mälardalens University, Västerås, Sweden
| | - Pia Ödman
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University Hospital, Linköping, Sweden
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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] [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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Willis C, Elliott C, Reid S, Nyquist A, Jahnsen R, Bölte S, Rosenberg M, Girdler S. "Capturing the magic": identifying the active ingredients of a physical activity participation intervention for children and youth with disabilities. Disabil Rehabil 2021; 44:1650-1659. [PMID: 33820452 DOI: 10.1080/09638288.2021.1907458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to define the active ingredients of a participation-focused physical activity intervention for children and youth with disabilities. MATERIALS AND METHODS An ethnographic approach was employed, triangulating participant observation, interviews and focus groups. Participant recruitment occurred through purposive sampling of staff employed at Beitostolen Healthsports Centre (BHC), and paediatric service providers visiting the centre. Interviews were transcribed verbatim and coded together with observation data. Secondary coding linked data to corresponding categories of the International Classification of Functioning, Disability and Health: Child and Youth version. RESULTS Thirteen staff from BHC and 7 paediatric service providers participated in the study. Fourteen active ingredients were identified and were characterised at the level of the intervention (k = 8), the organisation (k = 4), and the individual (k = 2). Within the ingredients, 53 unique ICF-CY categories were identified. Twenty-six categories belonged to the ICF-CY component of "environment," and 26 categories to "activities and participation." No categories related to "body functions" or "body structures." CONCLUSIONS The role of the environment, and specifically support and relationships, may be an essential consideration for enabling physical activity participation. Outcomes may guide program design and implementation to promote and sustain physical activity behaviours for children and youth with disabilities.Implications for rehabilitationThe active ingredients identified in this study may guide the design and implementation of programs to promote and sustain physical activity behaviours of children and youth with disabilities.Leadership qualities and strength-based attitudes may be key characteristics of organisational practice that optimise outcomes for children and families.A "relationship-centred" approach, i.e., a network of children, families, health professionals, peers, mentors, and services in the community, may support children and young people with disabilities to achieve their physical activity participation goals.
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Affiliation(s)
- Claire Willis
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,School of Human Sciences (Exercise Science), The University of Western Australia, Perth, Australia
| | - Catherine Elliott
- School of Occupational Therapy and Social Work, Curtin University, Perth, Australia
| | - Siobhan Reid
- School of Human Sciences (Exercise Science), The University of Western Australia, Perth, Australia
| | | | - Reidun Jahnsen
- Beitostolen Healthsports Centre, Beitostolen, Norway.,Research Centre for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Michael Rosenberg
- School of Human Sciences (Exercise Science), The University of Western Australia, Perth, Australia
| | - Sonya Girdler
- School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.,Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Coussens M, Vitse F, Desoete A, Vanderstraeten G, Van Waelvelde H, Van de Velde D. Participation of young children with developmental disabilities: parental needs and strategies, a qualitative thematic analysis. BMJ Open 2021; 11:e042732. [PMID: 33795296 PMCID: PMC8021744 DOI: 10.1136/bmjopen-2020-042732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/17/2021] [Accepted: 03/09/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Participation refers to a person's involvement in activities and roles that provide interaction with others as well as engagement in family and community activities. Young children with developmental disabilities (DD) such as attention deficit hyperactive disorder, autism spectrum disorder and developmental coordination disorder are limited in their participation compared with their typically developing peers. This study aimed to obtain information regarding parental needs and strategies used to enable their child's participation. DESIGN A thematic inductive approach with in-depth interviews was used to explore parental experiences. Eleven women and two men, between 30 and 40 years of age, who had a child (4-9 years old) with a DD diagnosis based on Diagnostic and Statistical Manual of Mental Disorders criteria, participated in semistructured interviews. RESULTS Two central themes emerged: parental needs and parental strategies used to enable their child's participation. Parental needs were the following: increasing awareness, ameliorating parental burden, providing tailored interventions and supporting parents in finding suitable leisure activities. Parental strategies aimed at increasing their child's resiliency, attaining maximal fit between activity requirements and child capacity, and creating inclusive opportunities and awareness. CONCLUSIONS Understanding what families' needs are and how families use and integrate strategies within the context of their daily lives provides practitioners with insights needed to support families' resiliency in promoting their children's participation. The results have implications for professionals as this information can be used to inform, refine, or tailor participation-based and family-centred services.
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Affiliation(s)
- Marieke Coussens
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Floris Vitse
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Annemie Desoete
- Faculty of Psychology and Educational Sciences, Ghent University, Gent, Belgium
| | - Guy Vanderstraeten
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Hilde Van Waelvelde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Science, Ghent University, Ghent, Belgium
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Allonsius F, de Kloet A, Bedell G, van Markus-Doornbosch F, Rosema S, Meesters J, Vliet Vlieland T, van der Holst M. Participation Restrictions among Children and Young Adults with Acquired Brain Injury in a Pediatric Outpatient Rehabilitation Cohort: The Patients' and Parents' Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041625. [PMID: 33567741 PMCID: PMC7914578 DOI: 10.3390/ijerph18041625] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022]
Abstract
Improving participation is an important aim in outpatient rehabilitation treatment. Knowledge regarding participation restrictions in children and young adults with acquired brain injury (ABI) is scarce and little is known regarding the differences in perspectives between patients and parents in the outpatient rehabilitation setting. The aims are to describe participation restrictions among children/young adults (5–24 years) with ABI and investigating differences between patients’ and parents’ perspectives. At admission in 10 rehabilitation centers, patients and parents were asked to complete the Child and Adolescent Scale of Participation (CASP; score 0–100; lower score = more restrictions) and injury/patient/family-related questions. CASP scores were categorized (full/somewhat-limited/limited/very-limited participation). Patient/parent-reported outcomes were compared using the Wilcoxon signed-rank test. 223 patients and 245 parents participated (209 paired-samples). Median patients’ age was 14 years (IQR; 11–16), 135 were female (52%), 195 had traumatic brain injury (75%). The median CASP score reported by patients was 82.5 (IQR: 67.5–90) and by parents 91.3 (IQR: 80.0–97.5) (difference = p < 0.05). The score of 58 patients (26%) and 25 parents (10%) was classified as ‘very-limited’. Twenty-six percent of children and young adults referred for rehabilitation after ABI had “very-limited” participation. Overall, parents rated their child’s participation better than patients themselves. Quantifying participation restrictions after ABI and considering both perspectives is important for outpatient rehabilitation treatment.
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Affiliation(s)
- Florian Allonsius
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Correspondence: (F.A.); (M.v.d.H.)
| | - Arend de Kloet
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA 02155, USA;
| | - Frederike van Markus-Doornbosch
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
| | - Stefanie Rosema
- National Department Level, Specialists in Youth and Families, 1105 AZ Amsterdam, The Netherlands;
| | - Jorit Meesters
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Centre of Expertsie in Health Innovations, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands
| | - Thea Vliet Vlieland
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Menno van der Holst
- Basalt Rehabilitation Center, Department of Innovation, Quality and Research, 2543 SW The Hague, The Netherlands; (A.d.K.); (F.v.M.-D.); (J.M.); (T.V.V.)
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence: (F.A.); (M.v.d.H.)
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13
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Beneitez I, Nieto R, Hernández E, Boixadós M. Adolescents’ social needs living with juvenile idiopathic arthritis and their views about digital resources. Adv Rheumatol 2020; 60:36. [DOI: 10.1186/s42358-020-00138-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/29/2020] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Juvenile Idiopathic Arthritis (JIA) and its related symptoms (e.g. pain) have been associated with interference in the daily life of adolescents with JIA including their friendships. There is little research in that sense and in consequence, interventions designed to improve this area. The objectives of this study are 1) to gain knowledge about the needs of adolescents with JIA, particularly focused on their friendships; 2) to explore the potential of the Internet to help them, and 3) to determine what kind of online resource would be the best and what elements it should include.
Methods
To achieve the proposed objectives we designed a qualitative study including two phases: the first one exploratory (semi-structured interviews) and the following, confirmatory (online focus group).
Results
14 adolescents were interviewed and 7 participated in the focus group. They reported some social challenges related to their illness: feeling different, criticized by peers, or not believed. Additionally, they specified some of the coping strategies they used, such as disclosing to others that they have JIA, using communication skills, maintaining activities with friends, trying to minimize pain, and ignoring negative comments. Adolescents considered an online resource useful and mentioned that they would like to find general information and to have the possibility to interact with others. They considered Instagram and WhatsApp as good platforms to implement the online resource.
Conclusions
According to their perceptions, adolescents with JIA can benefit from an online resource which delivers information, strategies and facilitates interaction with others.
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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND 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] [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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15
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A Strength-Based Intervention to Increase Participation in Leisure Activities in Children with Neuropsychiatric Disabilities: A Pilot Study. Occup Ther Int 2020; 2020:1358707. [PMID: 32454804 PMCID: PMC7154983 DOI: 10.1155/2020/1358707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 03/10/2020] [Indexed: 11/18/2022] Open
Abstract
The aim is to evaluate the feasibility of an intervention model with a client-centered goal-directed approach with the aim to enhance the child's participation in leisure activities, self-efficacy, and activity performance. A pilot intervention using a client-centered goal-directed approach and a single-subject design was performed. Two Swedish boys with neuropsychiatric diagnosis aged 12 and 14 years old were included, and 3 leisure activity goals were identified. The intervention was carried out over 8 weeks and took place in the adolescent's everyday environment and at the pediatric rehabilitation center. The goal attainment of participation goals (GAS), the perceived performance ability according to the Canadian Occupational Performance Measure (COPM), the self-efficacy, and the participants' satisfaction were used to study the effect. The participants succeeded in attaining their leisure goals as specified by the GAS by achieving +2 on one goal and +1 on the other two goals. They estimated higher performance ability and self-efficacy in their goal performance. Participants, parents, and therapists were overall satisfied and found the intervention to be applicable and helpful in optimizing leisure participation. The intervention model with a client-centered goal-directed approach in which participants define their own leisure activity goals appears to be effective in increasing participation in leisure activities.
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Jindal P, Macdermid JC, Rosenbaum P, Direzze B, Narayan A, Nayak SL. Treatment and re/habilitation of children with cerebral palsy in India: a scoping review. Dev Med Child Neurol 2019; 61:1050-1060. [PMID: 30883735 DOI: 10.1111/dmcn.14211] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2019] [Indexed: 11/27/2022]
Abstract
AIM To describe the nature and extent of the literature addressing the medical and its re/habilitative management of cerebral palsy (CP) in India. METHOD Online worldwide scholarly databases, research hosting directories, Indian publishing houses, and grey literature were used to identify papers published between 2005 and 2016. We retrieved 144 English language papers that described the medical and rehabilitative management of Indian children with CP. RESULTS Quantitative, qualitative, and mixed research designs are published by a variety of health care professionals in India. Intervention (45%) and observational studies (30%) predominate. Outcomes were categorized using the World Health Organization's International Classification of Functioning, Disability and Health framework, with body structure and function most reported and activity/participation least reported; 57% described its re/habilitation interventions and 43% were medical interventions. INTERPRETATION There is a substantial body of CP research in India that focuses on interventions to reduce impairments, with minimal attention given to activities and participation, environmental, and personal factors. Twenty-six per cent of studies are published in what appear to be 'predatory journals'. This paper serves as an alert about the presence of 'predatory journals' in medicine that may introduce publication bias, which can distort results reported in those studies individually, or from conclusions drawn in reviews that contain those studies. WHAT THIS PAPER ADDS Cerebral palsy research in India focuses on interventions to reduce impairment. Activities, participation, and environmental factors are minimally addressed. Quantitative studies are more common than qualitative studies. Many Indian studies are published in journals that are not indexed in worldwide databases of scholarly journals.
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Affiliation(s)
- Pranay Jindal
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Joy C Macdermid
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,School of Physical Therapy, University of Western Ontario, London, Ontario, Canada.,Clinical Research Laboratory, St. Joseph's Health Centre, London, Ontario, Canada
| | - Peter Rosenbaum
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Briano Direzze
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Amitesh Narayan
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, India
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Nguyen L, Cross A, Rosenbaum P, Gorter JW. Use of the International Classification of Functioning, Disability and Health to support goal-setting practices in pediatric rehabilitation: a rapid review of the literature. Disabil Rehabil 2019; 43:884-894. [PMID: 31345067 DOI: 10.1080/09638288.2019.1643419] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The International Classification of Functioning, Disability and Health (referred to as the ICF) is the World Health Organization's framework for health. It can be used to identify goals that capture all aspects of a person's life and to inform clinical goal-setting processes. This review aims to report how healthcare providers are using the ICF framework to support goal-setting practices in pediatric rehabilitation services. METHODS A rapid review was conducted using scoping review principles in the following databases: CINAHL, Medline and PsycINFO. Key terms included: "ICF", "goal-setting" and "pediatrics". RESULTS Sixteen studies met the inclusion criteria. Three main themes emerged about the use of the ICF in pediatric rehabilitation: 1) match the content of goals to the ICF domains; 2) implement with existing tools for goal-setting; and 3) inform the development of new tools for goal-setting. Healthcare providers often use a combination of goal-setting tools. The SMART approach is used to frame goals, while the Canadian Occupational Performance Measure and Goal Attainment Scale have been used to document and evaluate goals. CONCLUSION The ICF framework can be used with current goal-setting practices and offers a common lens and language with which to facilitate collaborative goal-setting with families and healthcare providers.Implications for RehabilitationThe International Classification of Functioning, Disability and Health (ICF) provides a common framework and language to support collaborative goal-setting between families and healthcare providersDespite the opportunity for the ICF to be used as a framework with goal-setting approaches, to date the ICF has mainly been used to match the content of goals to ICF domains for documentation purposesThe ICF should be incorporated into the established clinical routines in order to promote its use among healthcare providersThe ICF can be used with existing goal-setting tools in clinical practice and to inform the ongoing development of new tools to support the goal-setting process in family-centred services.
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Affiliation(s)
- Linda Nguyen
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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18
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Chien CW, Li-Tsang CWP, Cheung PPP, Leung KY, Lin CY. Development and psychometric evaluation of the Chinese version of the Participation and Environment Measure for Children and Youth. Disabil Rehabil 2019; 42:2204-2214. [PMID: 31081396 DOI: 10.1080/09638288.2018.1553210] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
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.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Cecilia W P Li-Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Phoebe Pui Pui Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Ka-Yan Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
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19
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Nyquist A, Jahnsen RB, Moser T, Ullenhag A. The coolest I know – a qualitative study exploring the participation experiences of children with disabilities in an adapted physical activities program. Disabil Rehabil 2019; 42:2501-2509. [DOI: 10.1080/09638288.2019.1573937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Astrid Nyquist
- Beitostølen Healthsports Center, Beitostølen, Oppland, Norway
| | - Reidun Birgitta Jahnsen
- Beitostølen Healthsports Center, Beitostølen, Oppland, Norway
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Research Center for Habilitation and Rehabilitation Models and Services, University of Oslo, Institute of Health and Society, CHARM, Oslo, Norway
| | - Thomas Moser
- Department of Educational Science, University of South-Eastern Norway, Tønsberg, Norway
| | - Anna Ullenhag
- Beitostølen Healthsports Center, Beitostølen, Oppland, Norway
- Department of Physiotherapy, School of Health Care and Social Welfare, Mälardalens University, Västerås, Sweden
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20
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Labbé D, Miller WC, Ng R. Participating more, participating better: Health benefits of adaptive leisure for people with disabilities. Disabil Health J 2019; 12:287-295. [DOI: 10.1016/j.dhjo.2018.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/28/2018] [Accepted: 11/03/2018] [Indexed: 10/27/2022]
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Harpster K, Sheehan A, Foster EA, Leffler E, Schwab SM, Angeli JM. The methodological application of goal attainment scaling in pediatric rehabilitation research: a systematic review. Disabil Rehabil 2018; 41:2855-2864. [PMID: 29954232 DOI: 10.1080/09638288.2018.1474952] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: The objectives of this review article were to (1) describe the populations and interventions to which Goal Attainment Scaling (GAS) has been applied in pediatric rehabilitation, (2) summarize the scientific rigor of published studies utilizing GAS as an outcome measure in pediatric rehabilitation, and (3) illustrate the responsiveness of GAS following intervention.Materials and methods: Four electronic databases were searched for English language, human subject studies. Two reviewers independently extracted data, graded evidence, and rated study quality.Results: Fifty-two studies utilizing GAS as an outcome measure within pediatric rehabilitation were included. A majority of studies were characterized as low-level evidence in the Sackett hierarchy (Sackett levels IV-V; 33 of 52). Quality appraisal scores for all reviewed studies ranged from 1-13 points (17 possible points) and averaged 4.71 points. GAS appeared to detect meaningful change in more than 60% of studies.Conclusions: GAS is a clinically useful tool for measuring progress toward goals, but has not been utilized with a high level of methodological rigor in research. Emphasis on reduced variation in administration and interpretation will strengthen the utility of GAS for efficacy and program evaluation in future research.Implications for rehabilitationGoal Attainment Scaling (GAS) can be used across a diversity of interventions and diagnoses as an outcome measure in pediatric rehabilitation.Careful consideration should be used in the study design to standardize administration and scoring of GAS to strengthen the study.Goal Attainment Scaling is responsive to change, and the tool appears to detect meaningful change the majority of the time in pediatric rehabilitation.
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Affiliation(s)
- Karen Harpster
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Amber Sheehan
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ellen A Foster
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Eryn Leffler
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah M Schwab
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer M Angeli
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
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22
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Willis C, Nyquist A, Jahnsen R, Elliott C, Ullenhag A. Enabling physical activity participation for children and youth with disabilities following a goal-directed, family-centred intervention. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 77:30-39. [PMID: 29635224 DOI: 10.1016/j.ridd.2018.03.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/15/2018] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND There is a paucity of research demonstrating the optimisation and maintenance of participation outcomes following physical activity interventions for children and youth with disabilities. AIM To evaluate changes in physical activity participation in children with disabilities following a goal-directed, family-centred intervention at a healthsports centre, and to identify factors influencing participation following the intervention. METHODS AND PROCEDURES A mixed methods pre-test post-test cohort design was applied. Recruitment occurred over a 12 month period during standard clinical service provision. The Canadian Occupational Performance Measure (COPM) was administered to children and parents pre (T1) and post-intervention (T2), and at 12 weeks follow-up (T3). Goal Attainment Scaling (GAS) was applied to assess outcomes at 12 weeks follow-up (T2-T3). Qualitative inquiry described barriers to goal attainment at T3. OUTCOMES AND RESULTS Ninety two children with a range of disabilities (mean age 11.1yr; 49 males) were included in the study. Statistically significant and clinically meaningful improvements in parent ratings of COPM performance and satisfaction of participation goals were observed following intervention. Ratings at 12 weeks follow-up remained significantly higher than baseline, and 32% of children attained their COPM-derived GAS goal. Environmental factors were the most frequent barrier to goal attainment following intervention. CONCLUSION AND IMPLICATIONS These results provide preliminary evidence for goal-directed, family-centred interventions to optimise physical activity participation outcomes for children with disabilities.
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Affiliation(s)
- Claire Willis
- School of Sport Science, Exercise and Health, The University of Western Australia, 35 Stirling Hwy, Crawley, Perth, 6008, WA, Australia.
| | - Astrid Nyquist
- Beitostolen Healthsports Centre, Sentervegen 4, Beitostolen, 2953, Norway.
| | - Reidun Jahnsen
- Beitostolen Healthsports Centre, Sentervegen 4, Beitostolen, 2953, Norway; Department of Clinical Neurosciences for Children, Oslo University Hospital, Kirkeveien 166, Oslo, 0450, Norway.
| | - Catherine Elliott
- School of Occupational Therapy and Social Work, Curtin University, Kent St, Bentley, Perth, 6102, WA, Australia.
| | - Anna Ullenhag
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, 721 23, Västeraas, Sweden.
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23
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Anaby DR, Law M, Feldman D, Majnemer A, Avery L. The effectiveness of the Pathways and Resources for Engagement and Participation (PREP) intervention: improving participation of adolescents with physical disabilities. Dev Med Child Neurol 2018; 60:513-519. [PMID: 29405282 DOI: 10.1111/dmcn.13682] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 11/30/2022]
Abstract
AIM This study examined the effectiveness of the Pathways and Resources for Engagement and Participation (PREP) intervention in improving the participation of adolescents in community-based activities. METHOD Twenty-eight adolescents (14 males, 14 females), aged 12 to 18 years (mean 14y 6mo, SD 21.6mo) with moderate physical disabilities participated in a 12-week PREP intervention. An interrupted time series design with multiple baselines was employed, replicating the intervention effect across three chosen activities and all participants. An occupational therapist worked individually with adolescents and parents to identify and implement strategies to remove environmental barriers that impede participation in selected activities. Activity performance was repeatedly measured using the Canadian Occupational Performance Measure (COPM) at baseline, intervention, and follow-up (20wks). For each activity, the trajectory representing change in performance was analyzed descriptively. Segmented regression combined with a mixed-effects modeling approach was used to statistically estimate the overall effectiveness of the intervention within and across 79 activities. RESULTS A statistically significant improvement (B=2.08, p<0.001) was observed across all activities, 59 per cent of which also indicated a clinically significant change of more than 2 points on the COPM scale. Levels of performance were maintained during follow-up with an additional increase of 0.66 points on the COPM scale (t=3.04, p=0.004). Intervention was most effective for males and those with a higher number of functional issues. INTERPRETATION Findings illustrate that participation can be improved by changing the environment only. Such evidence further supports emerging therapeutic approaches that are activity-based, goal-oriented, and ecological in nature. WHAT THIS PAPER ADDS Environment-based intervention strategies, guided by the Pathways and Resources for Engagement and Participation, are effective in improving and maintaining adolescent participation. Intervention was most effective for males and those with a higher number of functional issues. The study design serves as an example for future pragmatic studies accounting for individual-based changes and contexts.
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Affiliation(s)
- Dana R Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Mary Law
- School of Rehabilitation, Science and CanChild Research Centre, McMaster University, Hamilton, ON, Canada
| | - Debbie Feldman
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Lisa Avery
- Avery Information Services Ltd., Orilla, ON, Canada
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Reedman S, Boyd RN, Sakzewski L. The efficacy of interventions to increase physical activity participation of children with cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol 2017; 59:1011-1018. [PMID: 28318009 DOI: 10.1111/dmcn.13413] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2017] [Indexed: 11/30/2022]
Abstract
AIM To determine efficacy of therapy and behaviour change interventions to increase the level of participation in leisure-time physical activities (LTPAs) and habitual physical activity in children and young people with cerebral palsy. METHOD Five databases were systematically searched. Included studies were randomized or comparison designs. Methodological quality was assessed with a modified Downs and Black Scale. Quantitative analysis was performed using RevMan 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Intervention components and behaviour change constructs were mapped against (1) the International Classification of Functioning, Disability and Health (ICF) and (2) the Theoretical Domains Framework. RESULTS Searches yielded 2487 unique articles. Eight studies (nine articles) were included. Interventions included physical training, activity level training, combined physical training and behaviour change therapy, online behaviour change modules, and context-focused therapy. Study quality varied from moderate to high. There was a small, significant effect of physical activity intervention compared with passive usual care on level of habitual physical activity, of approximately 1000 additional steps per day (standardized mean difference 0.34, 95% confidence interval 0.03-0.66, p=0.030). There was no significant effect on LTPA participation (standardized mean difference 0.40, 95% confidence interval -0.40 to 1.19, p=0.330). INTERPRETATION Therapy and behaviour change interventions have the potential to increase LTPA participation of children and young people with cerebral palsy, although there is a need to depart from impairment-focused approaches. Inappropriate selection of outcomes and inadequate reporting of complex interventions are barriers to progress in this field.
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Affiliation(s)
- Sarah Reedman
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Roslyn N Boyd
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Leanne Sakzewski
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, Qld, Australia
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25
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Willis CE, Reid S, Elliott C, Nyquist A, Jahnsen R, Rosenberg M, Girdler S. 'It's important that we learn too': Empowering parents to facilitate participation in physical activity for children and youth with disabilities. Scand J Occup Ther 2017; 26:135-148. [PMID: 28927322 DOI: 10.1080/11038128.2017.1378367] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM The actions and behaviors of parents have been identified as key factors that influence a child's participation in physical activity. However, there is limited knowledge of how parents can be supported to embody facilitative roles. This study aimed to explore how an ecological intervention encourages parents of children with disabilities to develop as facilitators, to enable ongoing physical activity participation in a child's local environment. METHODS A qualitative design using grounded theory was employed. Forty four parents (26 mothers, 18 fathers) of 31 children with a range of disabilities (mean age 12y 6m (SD 2y 2m); 18 males) partaking in the Local Environment Model intervention at Beitostolen Healthsports Centre in Norway participated in the study. Data were derived from the triangulation of semi-structured interviews and participant observation. Data analysis was an iterative approach of constant comparison, where data collection, memo writing, open, axial and selective coding analysis, were undertaken simultaneously. Findings were consolidated into a model describing the central phenomenon and its relationship to other categories. RESULTS Thematic concepts uncovered in this study describe a social process of parent learning and empowerment, comprising three primary components; (i) active ingredients of the intervention that enabled learning and empowerment to transpire, (ii) parent learning and empowerment as a process, and (iii) related outcomes. CONCLUSION A family-centered approach, encompassing family-to-family support, may enhance physical activity participation outcomes for children and youth with disabilities.
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Affiliation(s)
- Claire E Willis
- a School of Sport Science, Exercise and Health , The University of Western Australia , Perth , Australia
| | - Siobhan Reid
- a School of Sport Science, Exercise and Health , The University of Western Australia , Perth , Australia
| | - Catherine Elliott
- b School of Occupational Therapy and Social Work , Curtin University , Perth , Australia.,c Paediatric Rehabilitation and Research , Child and Adolescent Health Service , Perth , Australia
| | - Astrid Nyquist
- d Department of Research , Beitostolen Healthsports Centre , Beitostolen , Norway
| | - Reidun Jahnsen
- d Department of Research , Beitostolen Healthsports Centre , Beitostolen , Norway
| | - Michael Rosenberg
- a School of Sport Science, Exercise and Health , The University of Western Australia , Perth , Australia
| | - Sonya Girdler
- b School of Occupational Therapy and Social Work , Curtin University , Perth , Australia
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26
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Tveten KM, Arnevik K, Jahnsen R. Goal-directed physical activities in group rehabilitation and impact on health-related quality of life and participation among young adults with physical disabilities – a qualitative study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1304573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kine Melfald Tveten
- Children’s Physical Therapy Centre and Turbo, Bergen, Norway
- Department of Global Public Health and Primary Care, Bergen University, Bergen, Norway
| | - Kamilla Arnevik
- Children’s Physical Therapy Centre and Turbo, Bergen, Norway
| | - Reidun Jahnsen
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway
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King G. The Role of the Therapist in Therapeutic Change: How Knowledge From Mental Health Can Inform Pediatric Rehabilitation. Phys Occup Ther Pediatr 2017; 37:121-138. [PMID: 27384880 DOI: 10.1080/01942638.2016.1185508] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The therapist is a neglected and poorly understood variable in pediatric rehabilitation. Much more attention has been paid to the role of intervention on client change than the role of therapist-related variables. This article synthesizes what is known in the adult and child mental health literature about the role of the therapist, and integrates this with work in pediatric rehabilitation. The article reviews the mental health literature on the therapist as a random variable associated with client outcomes (role of the therapist alone) and the role of three other therapist-related constructs: the therapist-client relationship (therapist and client), treatment implementation (therapist and intervention), and therapy process (therapist, client, and intervention considered holistically). Implications for clinical practice in pediatric rehabilitation include recognition of change as a multi-determined phenomenon involving common therapist-related factors, the therapist's role in creating facilitative conditions for change (through supportive relationships, positive expectancies, and mastery and learning experiences), and the importance of training in collaborative partnership skills. A contextual approach to therapeutic change is advocated, in which psychosocial factors and mechanisms are acknowledged, the therapist is seen as crucial, and the intervention process is seen as the context or vehicle through which changes occur.
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Affiliation(s)
- Gillian King
- a Bloorview Research Institute and Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada
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King G, Imms C, Stewart D, Freeman M, Nguyen T. A transactional framework for pediatric rehabilitation: shifting the focus to situated contexts, transactional processes, and adaptive developmental outcomes. Disabil Rehabil 2017; 40:1829-1841. [DOI: 10.1080/09638288.2017.1309583] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- CanChild Centre for Childhood Disability Research, Master University, Hamilton, Canada
| | - Christine Imms
- CanChild Centre for Childhood Disability Research, Master University, Hamilton, Canada
- Centre for Disability and Development Research, Australian Catholic University, and Murdoch Childrens Research Institute, Melbourne, Australia
| | - Debra Stewart
- CanChild Centre for Childhood Disability Research, Master University, Hamilton, Canada
| | - Matt Freeman
- CanChild Centre for Childhood Disability Research, Master University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Tram Nguyen
- CanChild Centre for Childhood Disability Research, Master University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
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Hoare B, Greaves S. Unimanual versus bimanual therapy in children with unilateral cerebral palsy: Same, same, but different. J Pediatr Rehabil Med 2017; 10:47-59. [PMID: 28339410 DOI: 10.3233/prm-170410] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There is high-level evidence supporting constraint-induced movement therapy (CIMT) and bimanual therapy for children with unilateral cerebral palsy. Evidence-based intervention includes time-limited, goal-directed, skills-based, intensive blocks of practice based on motor learning theory. AIM AND METHODS Using supporting literature and clinical insight, we provide a theoretical rationale to highlight previously unreported differences between CIMT and bimanual therapy. DISCUSSION The current emphasis on total dosage of practice for achieving positive outcomes fails to recognise the influence of other critical concepts within motor learning. Limitations exist in the application of motor learning principles using CIMT due to its unimanual nature. CIMT is effective for development of unimanual actions brought about by implicit learning, however it is difficult to target explicit learning that is required for learning how to use two hands together. Using bimanual therapy, object properties can be adapted to trigger goal-related perceptual and cognitive processes required for children to learn to recognise when two hands are required for task completion. CONCLUSION CIMT and bimanual should be viewed as complementary. CIMT could be used to target unimanual actions. Once these actions are established, bimanual therapy could be used for children to learn how to use these actions for bimanual skill development.
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Affiliation(s)
- Brian Hoare
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia.,CPtherapy, Australian Catholic University, Victoria, Australia
| | - Susan Greaves
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia.,Occupational Therapy Department, The Royal Children's Hospital, Victoria, Australia
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