Perceived Environmental Barriers to Recreational, Community, and School Participation for Children and Youth With Physical Disabilities (original) (raw)
Related papers
Community Participation, Supports, and Barriers of School-Age Children With and Without Disabilities
Archives of Physical Medicine and Rehabilitation, 2013
Objective: To examine patterns of community participation and environmental factors that affect community participation for school-age children with and without disabilities. Design: Cross-sectional, descriptive, and exploratory study. Setting: Parents from the United States and Canada completed the main outcome measure online in their homes or communities. Participants: Parents (NZ576) reported on their children aged 5 to 17 years with disabilities (nZ282) and without disabilities (nZ294). Interventions: Not applicable. Main Outcome Measure: Participation and Environment Measure for Children and Youth. Results: Group differences in summary scores and many items were significant (P<.001). Children with disabilities participated less frequently, were less involved, and had less environmental support in the community than children without disabilities. Parents of children with disabilities desired more change in their child's participation than parents of children without disabilities. Effect sizes for summary scores were moderate to very large (n 2 p from .11e.40), with the largest group difference found in environment scores. Overall, the largest group differences in participation were in "unstructured physical activities" and "getting together with other children"dalso the 2 areas where parents of children with disabilities most frequently desired change. The largest differences in environmental impact were in physical, social, and cognitive activity demands and availability/adequacy of programs and services. Conclusions: Results provide insights about where greater efforts are needed to support community participation of school-age children with disabilities. Further study with a more diverse sample in terms of race/ethnicity, family income/education levels, and geographic region is needed to determine the extent to which results may be generalized. Archives of Physical Medicine and Rehabilitation 2013;94:315-23 ª 2013 by the American Congress of Rehabilitation Medicine Participation in activities that provide a sense of accomplishment and enjoyment during childhood and youth helps to foster positive development into adulthood. 1-5 Participation has been shown to be an indicator of overall health and well-being across the lifespan and has been described as a key rehabilitation outcome. 5-8
Disability and Rehabilitation, 2013
Objective: The study's purpose was to identify and synthesize research evidence regarding the effect of the environment on community participation of children with disabilities. Methods: A scoping review of peer-reviewed studies published from 1990 to 2011 was performed. Two independent reviewers selected studies based on a systematic procedure. Inclusion criteria for studies were: participants with a disability, aged 5-21 years, whose environment was examined in relation to participation in out-of-school activities. Data were organized and synthesized based on environmental domains within the International Classification of Functioning, Disability and Health (ICF): Natural Environment/Products and Technology; Support and Relationships; Attitudes; and Services, Systems and Policies. Results: Searching identified 1232 articles and 31 met the inclusion criteria. Each domain of the environment within the ICF influenced participation as a facilitator and/or barrier. The most common facilitators involved social support of family and friends and geographic location. The most common barriers included attitudes, physical environment, transportation, policies and the lack of support from staff and service providers. Conclusions: Knowledge derived from this review can assist practitioners in addressing the specific environmental domains that influence children's participation. Such awareness can also foster new research questions and assist policy makers in identifying the factors influencing participation. ä Implications for Rehabilitation All domains of the environment, suggested by the ICF, have an influence on children's participation. Evidence regarding the effect of the environment on participation is focused primarily on children with physical disabilities; more studies are needed involving various health conditions and age groups. Practitioners and decision-makers can focus attention on specific aspects of the environment, e.g. attitudinal challenges and social support, in order to foster inclusion and participationbased communities.
Archives of Physical Medicine and Rehabilitation, 2014
Objective: To test the effect of personal and environmental factors on children's participation across 3 different settings (home, school, community); to ascertain the interrelations between these factors; and to propose and test 3 models, 1 for each setting, using structural equation modeling. Design: Survey, cross-sectional study, and model testing. Setting: Web-based measures were completed by parents residing in North America in their home/community. Participants: Parents (NZ576) of children and youth with and without disabilities, (nZ282 and nZ294, respectively), ages 5 to 17 years (mean age, 11y 2mo), completed the Participation and Environment Measure for Children and Youth (PEM-CY). Interventions: Not applicable. Main Outcome Measures: The PEM-CY measured levels of participation frequency and involvement, as well as environmental barriers and supports of participation, in each of the following 3 settings: home, school, and community. Information about the child's health condition and functional issues was also collected. Results: All 3 models fit the data well (comparative fit index, .89e.97) and explained 50% to 64% of the variance of participation frequency and involvement. Environmental barriers and supports served as significant mediators between child/personal factors (income, health condition, functional issues) and participation outcomes, across all models. The effect of the environment was most pronounced, however, in the community setting. Conclusions: Our findings highlight the unique role of the environment in explaining children's participation across different settings and, therefore, support the development of interventions targeting modifiable environmental factors.
Journal of Intellectual Disability Research, 2017
Background Despite the benefits of social participation, children and adolescents with developmental disabilities (DD) are often excluded from taking part in social activities. There is a gap in the literature about the factors that contribute to adequate participation of children with severe DD in particular and the barriers to their participation. Taking an ecological perspective, the purpose of this study was to examine child, family and community variables that may impact the activity participation of children and adolescents with severe DD. Methods A total of 197 parents of children with severe DD (4-19 years) completed a survey, addressing a wide range of child, family and community related variables, as well as a measure of activity participation. Results Overall, the final model significantly accounted for 30% of the variance in activity participation. Higher adaptive behaviour, greater parental socialisation and placement in an integrated school programme were significant predictors of greater activity participation. Conclusion Child, family and community factors were all important in understanding the activity participation of children with severe DD, thus supporting the value of an ecological approach. Suggestions for future research and clinical implications are discussed.
Child: Care, Health and Development, 2012
Aim In light of the International Classification of Functioning, and Health (ICF) model, to assess whether parents of children with mild developmental disabilities perceived various environmental factors as barriers to their child's participation, and whether these factors have a unique contribution to the total explained variance of participation, beyond personal factors. Methods Seventy-nine kindergarten children (mean age 5.20 Ϯ 0.52 years old) with mild developmental disabilities and their parents participated in the study. Three questionnaires measuring the child's participation, performance skills and environmental factors were completed by the parents. Results Parents perceived environmental factors as slightly restricting to their child's participation. Associations were found between home and education factors and the dimensions of child participation -independence, enjoyment and parental satisfaction. Although parents perceived human environmental factors as more restricting than physical factors at home, regression analysis revealed that the latter was found to affect the child participation dimension of independence beyond the contribution of personal factors. Interpretation These findings are the first, to our knowledge, to support the contribution of environmental factors to the participation of young children with mild developmental disabilities. The results show that environmental factors have significant slight contribution to child's independence in participation beyond other predictors (i.e. personal factors). Therefore, it is recommended to include environmental restrictions measurement in the child evaluation process to facilitate effective intervention programs.
Journal of Child and Family Studies, 2012
Enhancing participation in age-related activities is a key goal in the education and rehabilitation of children with diverse disabilities. The aim of this study was to explore a multidimensional and ecological model of participation for young children. Seventy eight children with mild developmental disabilities (MDD, such as motor and visual-motor difficulties), and 110 children without disabilities, between the ages 4 and 6 years old, participated in the study together with their parents. Data were collected using standardized assessments for child capacities and newly developed questionnaires for child participation and for human and physical environmental factors. Associations were found between personal and environmental factors and the participation dimensions amongst young children, thus supporting the validity of the proposed model of participation. Moreover, the study results outline different pathways for the participation of children with and without MDD. Child factors (e.g. process skills) were found to be crucial predictors of participation particularly for children with MDD, whereas human environmental factor (e.g. maternal self-efficacy beliefs) was associated with higher participation scores especially for children without disabilities. These findings may facilitate the development of effective intervention programs which focus on environmental factors as well as on child factors.
Disability and Health Journal, 2017
Background: While participation is essential to a child's health and well-being, little is known about participation patterns of young children with disabilities. Objective: This study described the participation of children with disabilities under age 6, and examined the extent to which the child's factors (i.e., age, complexity of child's condition), family factors (i.e., general family functioning, income) and environmental factors (i.e., environmental helpfulness) affect participation dimensions (frequency, involvement, desire for change) in three different settings: home, daycare/preschool and community. Methods: Cross-sectional design was employed. Parents (n=90) of children aged 1.4 to 6 years old (mean= 4.15, SD= 1.03) with disabilities completed the French Young Children's Participation and Environment Measure (YC-PEM) and Family Assessment Device. Descriptive statistics and multiple linear regressions were performed to describe participation patterns and identify the significant explanatory factors in each setting. Results: Participation restriction, based on frequency of activities, was primarily observed in the community setting. Environmental helpfulness (resources, supports) consistently explained participation levels for at least one of the dimensions across all settings, whereas contribution of the child's factors was less evident. Family functioning had a significant effect when examining participation involvement in the community and desire for change in the home setting and, in combination with environmental helpfulness, explained 18% and 21% of the variance respectively. Conclusion: This study emphasizes the role of the environment in supporting participation of young children with disabilities. Findings can redirect practitioners' attention towards modifying the environment as a primary target of intervention aimed at promoting health through participation.
Physical & Occupational Therapy In Pediatrics, 2003
Participation in everyday activities is considered to be a vital part of children's development, which is related to their quality of life and future life outcomes. Research studies indicate that children with disabilities are at risk for lower participation in ordinary activities at home and in the community. This article presents a conceptual model of 11 environmental, family, and child factors that are thought to influence children's participation in recreation and leisure activities. The article outlines the existing evidence for the influence of these factors on one another and on children's participation. The review encompasses four bodies of literature: the participation of children or adults with disabilities, the risk and resilience of children facing adversity, the determinants of leisure and recreation activities, and the factors influencing physical activity and exercise. The proposed model is expected to be a useful tool for guiding future research studies and for developing policies and programs for children with disabilities and their families.
Environmental Barriers to Participation of Preschool Children with and without Physical Disabilities
International Journal of Environmental Research and Public Health
Environment plays a vital role in affecting participation of young children in home, school, and community. Knowledge of environmental barriers helps to develop solutions or strategies that enable participation. The study compared the environmental barriers perceived by parents of preschool children with physical disabilities (PD, n = 142) and with typical development (TD, n = 192) in Taiwan. Parents identified environmental barriers by structured interview using the Chinese version of the Child and Adolescent Scale of Environment (CASE-C). The CASE-C is an 18-item measure of the impact of problems with physical, social, and attitudinal environmental features. Differences between the PD and TD groups in the summary scores for the CASE-C and the percentages of parents who perceived a problem for each item were examined by the analysis of covariance (ANCOVA) and Chi-square test. Parents of children with PD more often identified barriers related to family resources and community programs or services, social attitudes, assistance and supports outside of home, physical design of home and community, transportation, and assistive devices or equipment. Greater impacts of barriers were also reported by parents of preschool children with PD. Our findings provide evidence of environmental barriers that inform practice and policies to modify the barriers and provide an accessible and inclusive environment for families with young children.