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Krieger B, Moser A, Morgenthaler T, Beurskens AJHM, Piškur B. Parents' Perceptions: Environments and the Contextual Strategies of Parents to Support the Participation of Children and Adolescents with Autism Spectrum Disorder-A Descriptive Population-Based Study from Switzerland. J Autism Dev Disord 2024; 54:871-893. [PMID: 36538129 PMCID: PMC9765345 DOI: 10.1007/s10803-022-05826-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2022] [Indexed: 12/24/2022]
Abstract
Environments have a modifying effect on the participation of children and adolescents with autism spectrum disorder (ASD) in all areas of life. This cross-sectional study investigated parental perspectives on supportive or hindering environments and the daily contextual strategies parents used to enhance their children's participation. Qualitative and quantitative data gathered from 115 parents from German-speaking Switzerland using the participation and environment measure-child and youth (PEM-CY) were analyzed. Results revealed 45 environmental supports and barriers at home, at school, and in the community. Contextual strategies were identified in combination with people, activities, time, objects, and places. Parental perspectives on participation and their contextual strategies should be considered in environmental-based interventions to support the participation of children and adolescents with ASD.
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Affiliation(s)
- Beate Krieger
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland.
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands.
| | - Albine Moser
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Thomas Morgenthaler
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8401, Winterthur, Switzerland
| | - Anna J H M Beurskens
- Department of Family Medicine, School Caphri, Maastricht University, Maastricht, The Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People With Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Krieger B, Piškur B, Beurskens AJHM, Moser A. Parents' perceptions: Participation patterns and desires for change for children and adolescents with autism spectrum disorder-A descriptive population-based study from Switzerland. Child Care Health Dev 2024; 50:e13155. [PMID: 37487595 DOI: 10.1111/cch.13155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/21/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Low participation in youth with autism spectrum disorder (ASD) has been reported, but age-related and contextual information is rare. OBJECTIVE This study aimed to describe, from parental perspectives, two patterns of participation and parental desires for change of children (age: 5-11) and adolescents (age: 12-17) with ASD in Switzerland. METHOD A cross-sectional design used the German version of the Participation and Environment Measure-Child and Youth to describe and juxtapose the participation results of 60 children and 55 adolescents with ASD in 45 activities at home, school and in the community and parental desires for change. RESULTS Participation patterns differed between settings and age groups. Both groups were found to participate most at home, followed by school, whereas community participation was either low or nonexistent. Children were more involved at home than adolescents, while school involvement was higher than participation frequency in both age groups. Community participation frequency was generally low but higher in children than in adolescents, while involvement was similarly low in both groups. Half the parents expressed desire for change with three tendencies: (1) widespread desire for change at home due to high support needs, (2) parents of adolescents expressed more desire for change in all settings than those of children and (3) all parents mainly desired to increase participation frequency and involvement. CONCLUSIONS This study informs research and social, health and community service providers to further reshape their programmes to meet parental needs and increase the participation of youth with ASD.
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Affiliation(s)
- Beate Krieger
- School of Health Professions, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Barbara Piškur
- Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Hasselt University, Faculty of Rehabilitation Sciences, Hasselt, Belgium
| | - Anna J H M Beurskens
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Albine Moser
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
- Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Kaya Kara O, Kara K, Dogan M, Tascioglu EN, Kose B, Cetin SY, Sahin S, Anaby D. How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports? Res Dev Disabil 2023; 141:104592. [PMID: 37639883 DOI: 10.1016/j.ridd.2023.104592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Children with chronic conditions face participation restrictions and exclusions. AIMS To investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). METHODS AND PROCEDURES The study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners' Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. OUTCOME AND RESULTS In home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). CONCLUSIONS AND IMPLICATIONS When seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges.
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Affiliation(s)
- Ozgun Kaya Kara
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey.
| | - Koray Kara
- University of Health Sciences Turkey, Antalya Training and Research Hospital, Department of Child and Adolescent Psychiatry, Antalya, Turkey
| | - Mert Dogan
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey
| | - Elif Nur Tascioglu
- Pamukkale University, Faculty of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Barkin Kose
- University of Health Sciences Turkey, Faculty of Gülhane Health Sciences, Department of Occupational Therapy, Turkey
| | - Sebahat Yaprak Cetin
- Akdeniz University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Antalya, Turkey
| | - Sedef Sahin
- Hacettepe University, Faculty of Health Sciences, Department of Occupational Therapy, Ankara, Turkey
| | - Dana Anaby
- McGill University, Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, Montreal, Canada
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Srinivasan R, Kulkarni V, Smriti S, Teplicky R, Anaby D. Cross-Cultural Adaptation and Evaluation of the Participation and Environment Measure for Children and Youth to the Indian Context-A Mixed-Methods Study. Int J Environ Res Public Health 2021; 18:1514. [PMID: 33562602 PMCID: PMC7915983 DOI: 10.3390/ijerph18041514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/19/2022]
Abstract
Culturally appropriate measures enable knowledge transfer and quality improvement of rehabilitation services in diverse contexts. The Applied Cultural Equivalence Framework (ACEF) was used in a two-phased mixed methods study to adapt and evaluate the Participation and Environment Measure-Children and Youth (PEM-CY) in India. Cognitive interviews with caregivers of children with disabilities (n = 15) aged 5-17 years established conceptual, item, semantic, and operational equivalence of the Indian PEM-CY. Construct validity was assessed by comparing PEM-CY scores of children with and without disabilities (n = 130) using a case-control design. Cognitive interviews resulted in operational (60.3%), semantic (26.4%), and item-level (13.2%) modifications in the PEM-CY with no changes at the conceptual level. Internal consistency (n = 130) was acceptable to excellent (0.61-0.87) on most scales. Test-retest reliability (n = 30) was good to excellent (ICC ≥ 0.75, Kappa 0.6-1.0) for most scales. Significant differences in all PEM-CY summary scores were found between children with and without disabilities, except for environmental supports. Children with disabilities had lower scores on frequency and involvement in activities across all settings; their caregivers desired greater change in participation and reported experiencing more environmental barriers across settings. Findings suggest the adapted PEM-CY is a valid and reliable measure for assessing the participation of Indian children.
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Affiliation(s)
- Roopa Srinivasan
- Ummeed Child Development Center, Department of Developmental Pediatrics and Occupational Therapy, Mumbai 400011, Maharashtra, India;
| | - Vrushali Kulkarni
- Ummeed Child Development Center, Department of Developmental Pediatrics and Occupational Therapy, Mumbai 400011, Maharashtra, India;
| | - Sana Smriti
- Butterflies Child Development Centre, Hyderabad 500081, Telangana, India;
| | - Rachel Teplicky
- CanChild Center for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada;
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Krieger B, Schulze C, Boyd J, Amann R, Piškur B, Beurskens A, Teplicky R, Moser A. Cross-cultural adaptation of the Participation and Environment Measure for Children and Youth ( PEM-CY) into German: a qualitative study in three countries. BMC Pediatr 2020; 20:492. [PMID: 33099320 PMCID: PMC7585231 DOI: 10.1186/s12887-020-02343-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/13/2020] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland. METHODS Fifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence. RESULTS Results show adaptations mainly focused on experiential and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect those typical in German speaking countries. Conceptual equivalence mainly addressed aspects of "involvement" and "environment" of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions. CONCLUSIONS This study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. Using a modified cultural adaptation process, a culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.
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Affiliation(s)
- Beate Krieger
- School of Health Professionals, Zurich University of Applied Sciences, Winterthur, Switzerland. .,Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.
| | - Christina Schulze
- School of Health Professionals, Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | | | - Barbara Piškur
- Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Anna Beurskens
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | | | - Albine Moser
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.,Research Centre for Autonomy and Participation for People with Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Chien CW, Cheung P, Chen CY. The Relationship Between Sleep Duration and Participation in Home, School, and Community Activities Among School-Aged Children. Front Neurosci 2019; 13:860. [PMID: 31474822 PMCID: PMC6702267 DOI: 10.3389/fnins.2019.00860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/31/2019] [Indexed: 12/14/2022] Open
Abstract
Sleep duration has important implications for children’s participation in daily activities; however, past attempts to examine this relationship has been limited to specific types of physical or educational activities. The present study aimed to investigate the relationship between sleep duration and participation in various daily activities among school-aged children. A school-based sample of 391 children aged 5–12 years (boys: 52.4%) participated in this cross-sectional survey. Sleep duration was quantified using parental reports of their children’s bedtime and wake-up time on weekdays and weekends. The parent-reported Participation and Environment Measure for Children and Youth was used to measure their children’s participation frequency and involvement in 25 home, school, and community activities. The results of hierarchical regression analyses showed that, when the demographic variables were controlled for, weekday sleep duration was positively related to homework involvement and negatively related to the frequency of TV viewing; however, it was unrelated to participation in school and community activities. Conversely, weekend sleep duration was positively related to overall participation in school activities, and participation frequency and involvement in some home and community activities. Furthermore, sleep duration was approximately an hour shorter on weekdays than on weekends. These results suggest that weekend sleep duration has stronger positive implications for children’s participation in daily activities than does weekday sleep duration. Interventions aiming to promote children’s activity participation may either prolong children’s weekend sleep duration or address their shorter weekday sleep duration.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Pauline Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chao-Ying Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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