Voices of children with intellectual disabilities on participation in daily activities

Construct validity of the simplified Chinese version of the instrument 'Picture My Participation'

BACKGROUND

Preliminary evidence of the content validity of the simplified Chinese version of 'Picture My Participation' (PMP-C; Simplified) items and reliability of the subscale attendance for the effectiveness of the use with children and youth in mainland China has been collected. However, evidence of construct validity for the instrument is not yet available.

AIM

To explore the construct validity of the attendance scale in PMP-C (Simplified).

METHODS

A cross-sectional study using convenience sampling was conducted using PMP-C (Simplified) with a picture-supported interview for 290 children and youths aged 5-21 with and without ID in urban and rural areas of mainland China. Exploratory factor analysis (EFA) was performed using the principal component analysis (PCA) to analyse the resulting data.

RESULTS

The EFA extracted five factors with eigenvalues greater than one and the cumulative contribution rate of factors accounted for 51.62% of the variance. All items had factor loadings above 0.50. The five subcomponents included: organised activities, social activities, taking care of others, family life activities and personal care and development activities.

CONCLUSION

The results of the factor analysis support the construct validity of the PMP-C (Simplified) attendance scale. It provides further psychometric evidence that PMP-C (Simplified) is a sound measure to assess participation for children and youths in mainland China.

Enhanced Milieu Teaching in resource-constrained settings: Stakeholder-informed adaptation guidelines

BACKGROUND

 Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic developmental behavioural intervention (NDBI) for children with developmental disabilities. Little is known about the EMT's fit or what adaptations might be needed to improve its applicability within a resource-constrained setting.

OBJECTIVES

 To explore stakeholders' perceptions of the contextual fit of EMT for young children with developmental disabilities in a resource-constrained context and to identify adaptations to improve EMT's contextual fit.

METHOD

 We conducted a descriptive qualitative study using semi-structured interviews and focus groups. Participants included 5 speech and language therapists and 11 caregivers of children with developmental disabilities who speak English and Afrikaans or isiXhosa. Using thematic analysis, data were coded into 10 subthemes and grouped according to the Adaptome framework components.

RESULTS

 Overall, stakeholders view EMT as an appropriate intervention in the South African context. They indicated that certain intervention components may need to be modified. Specifically, clinicians may need to adapt intervention materials and activities to be sensitive to families' available resources, preferred activity routines and priorities. From these data, we provide guidelines to improve the fit of EMT in South Africa.

CONCLUSION

 Enhanced Milieu Teaching is an appropriate intervention in the South African context, although some adaptations can enhance its fit.Contribution: This article highlights the importance of engaging with stakeholders to determine the fit of NDBIs, like EMT, as they are implemented in new contexts. Based on these insights, stakeholder-informed adaptation guidelines are provided for improving the contextual fit of EMT in resource-constrained settings.

Barriers and facilitators to participation in everyday activities for children with intellectual disabilities in China

BACKGROUND

Children with intellectual disabilities (IDs) are vulnerable and participate less in everyday activities compared to their peers with typical development. This study aimed to identify barriers and facilitators related to the participation in everyday activities of children with IDs in China.

METHODS

Twenty semi-structured interviews were conducted with primary caregivers of children with IDs from special schools in Tianjin, China. The data were transcribed and analysed using inductive qualitative content analysis.

RESULTS

Four categories of barriers to participation in everyday activities for children with IDs were identified: insufficient knowledge, attitudes and skills in primary caregivers; ID-related characteristics of children; stigma and Chinese culture; and lack of support from society. Four categories describing facilitators of participation in everyday activities for children with IDs were also identified: the optimistic attitude of the primary caregiver; adequate family support; active environment in school and policy; and attractive characteristics of children with IDs.

CONCLUSIONS

The findings in this study add knowledge on important barriers and facilitators affecting the participation of children with IDs in everyday activities in China. The primary caregivers' voices need to be heard by government and society. Appropriate and effective changes in family-oriented services and the legal, social, political and economic context of the child welfare management system for the scale-up of improving participation should be implemented for children with IDs.

Participation restriction of children with cerebral palsy living in Thailand and influential factors: A cross-sectional study

OBJECTIVE

To explore participation in daily activities of children with cerebral palsy(CP) in Thailand and influential factors.

METHODS

A convenience sample of family-caregivers of 80 children with CP, 6-18 year-old, completed self-administered questionnaires (i.e., frequency of participation, Gross Motor Function Classification System-Family Report) during clinic visits at a university hospital.

RESULTS

Family-caregivers reported that more than one-third of the children never participated in outdoor activities. The gap in the frequency of participation between groups with high versus low motor function was very high. Better gross motor and communication were strong predictors of participation. Caregiver's education and family income were associated with participation in art/cultural, leisure and tourist activities.

CONCLUSIONS

Family-caregiver-report suggests that Thai-children with CP, especially those with severe impairments, have limited participation in daily activities. Increasing mobility and communication may promote the participation. Comprehensive intervention is needed to narrow the participation gap found between high and low functioning children.

Voices of children with intellectual disabilities on participation in daily activities

Background

Participation in daily activities is expressed as a human right. Full participation of children with disabilities in daily activities creates optimal opportunities for learning and development. Previous studies have focused primarily on proxy ratings of participation of children with intellectual disabilities in daily activities. However, little is known about how the children rate barriers and facilitators to their participation in everyday activities.

Objectives

To identify barriers to and facilitators for everyday activities as experienced by children with intellectual disabilities from low- and middle-income countries and high-income countries. The research questions were as follows: 'what barriers to participation do children with disabilities experience in everyday activities?' and 'what facilitators to participation do children with disabilities experience in everyday activities?'

Method

A qualitative content analyses was used in this study, and individual interviews were conducted with 49 children with intellectual disabilities. The interviews were performed using pictures. The children also selected the most important activities and described in their own words the facilitators and barriers relevant to being able to perform the activities.

Results

The most important activities were organised leisure activities, formal learning at school, taking care of other family members and family mealtimes. Self-reported barriers identified were personal functioning, social exclusion and lack of resources. The identified facilitators included satisfaction, personal capability, being included and having access to resources.

Conclusion

These findings provide important knowledge about the factors to consider in the development of interventions, aimed at improving the participation of children with intellectual disabilities.