Beata Batorowicz

Conceptualizing participation in context for children and youth with disabilities: an activity setting perspective

Abstract This article considers the conceptualization, operationalization and implications of “activity settings” for research on the recreation and leisure participation of children and youth with disabilities. Activity settings are contextualized settings that situate child and youth activities and their participation experiences. We discuss activity settings as an important construct for considering environmental qualities that provide opportunities for beneficial participation experiences for children and youth with disabilities. The article considers existing research using the concept of activity settings, the conceptualization of environment and contemporary issues in the measurement of participation and environment, indicating how these are addressed by an activity settings approach. We then describe the development of two quantitative measures of recreation and leisure activity settings – one assessing environmental qualities and the other assessing youth experiences – that have the potential to inform researchers, managers and clinicians about relationships between environmental qualities and participation experiences. Finally, we consider the implications of an activity settings approach for research, theory building and clinical practice. Implications for Rehabilitation An activity setting perspective can enhance understanding of the recreation and leisure participation of children and youth with disabilities. The Measure of Environmental Qualities of Activity Settings (MEQAS) and Self-reported Experiences of Activity Settings (SEAS) provide unique assessments of environmental qualities and experiences from an activity setting perspective. Clinicians might use the SEAS alone to understand particular youth experiences in certain types of settings, which may be limiting or facilitating development. The combined use of the SEAS and MEQAS can provide experiential profiles linked to activity setting qualities such as structure, type of activity and social partners, providing a valuable source of information about youth programs.

Social Participation of School-aged Children Who Use Communication Aids: The Views of Children and Parents

Abstract Social participation is crucial for childrens development and well-being; however, little is known about the social participation of children who use communication aids. This article presents findings from interviews with eight 5- to 14-year-old children who used communication aids and their parents about social participation, communicative interactions, and peer relationships. Video- and audio-recordings were transcribed and analyzed using thematic content analysis, and five themes were identified. Two themes reflect parents’ views: Communication partners and strategies and Access to aided communication. Three themes reflect perceptions expressed both by children and parents: Participation in society, Interaction opportunities, and Social relationships. The findings provide insights into both the achievements and the challenges experienced by young people who use aided communication.

Development of a Measure to Assess Youth Self-Reported Experiences of Activity Settings (SEAS).

There is a need for psychometrically sound measures of youth experiences of community/home leisure activity settings. The 22-item Self-Reported Experiences of Activity Settings (SEAS) captures the following experiences of youth with a Grade 3 level of language comprehension or more: Personal Growth, Psychological Engagement, Social Belonging, Meaningful Interactions, and Choice & Control. Forty-five youth aged 14–23 years (10 with severe disabilities) completed the SEAS in 160 leisure activity settings. The SEAS has good to excellent internal consistency (Cronbach’s alpha from 0.71 to 0.88) and moderate test–retest reliability (mean scale intra-class correlation coefficient  =  0.68), as expected due to changes in activity settings over time. The SEAS was able to differentiate various types of activity settings and participation partners. The SEAS can be used to gain greater understanding of situation-specific experiences of youth participating in various types of recreation and leisure activity settings, including youth with different types of disabilities and those without disabilities.

AAC and Community Partnerships: The Participation Path to Community Inclusion

The Life Needs Model (LNM) of service delivery emphasizes the importance of community participation in childrens development and quality of life. This article is a case illustration of two community partnership programs based on the LNM. StoryTime and Dress Up and Drama provide participation opportunities in the community for children who use Augmentative and Alternative Communication (AAC). The authors describe the development and implementation of both programs. Regardless of level of functioning, each child who participated in the programs did so by communicating, interacting socially, and controlling the environment. Multiple benefits for children, parents/caregivers, community partners, and AAC clinicians are highlighted. The authors hope that this article will assist others in developing partnerships and implementing inclusive practices within their communities.

Measuring the quality of transdisciplinary teams

The Team Decision Making Questionnaire (TDMQ) demonstrated internal consistency, stability over time, and construct validity. Internal consistencies were excellent and Cronbachs Alphas (N = 102) for the 4 components ranged from 0.83 to 0.91. The internal consistency for the total instrument was 0.96. Test re-test reliability (N = 22) measured with Intraclass Correlation Coefficient was good. Transdisciplinary teamwork is widely practiced in health care. However, specific measures to evaluate transdisciplinary team decision-making are not described in the literature. The purpose of this study was to develop and psychometrically test a scale to measure the quality of transdisciplinary teamwork. A multi-method approach using focus groups, field testing, and quantitative instrument development procedures was used to develop and evaluate TDMQ. Principal component analysis (PCA) with a varimax rotation (N = 102) revealed a four-component solution resulting in a 19-item measure consisting of 4 subscales including Decision Making, Team Support, Learning, and Developing Quality Services. This studys findings support the use of the TDMQ for measuring the benefits of transdisciplinary teamwork. The four subscales of the measure provide insight into the nature of such benefits. To validate the TDMQ research is required with a greater number of health care professionals and in other clinical fields.

Technology Supporting Written Productivity in Children with Learning Disabilities: A Critical Review

Background. Occupational therapists working with school-aged children are often in the position of recommending technology to enhance written productivity. The outcome of using technology on the writing of children with learning disabilities has not been reviewed critically, and this knowledge is necessary for evidence-based practice. Purpose. To review evidence regarding the use of technology to support written productivity in children with learning disabilities. Methods. A systematic search of seven databases, plus a manual search, retrieved 864 papers published between 1985 and March 2012. Twenty-seven papers (28 studies) met inclusion criteria. Findings. The evidence is of a moderately low level and results are inconclusive; however, trends suggest a positive influence of some technology on childrens performance and behaviour. Methodological limitations exist in most studies and the description of specific technology intervention is often combined with teaching instructions. Implications. The available research is encouraging, but high-quality investigations with newer technologies are needed.

An integrated model of social environment and social context for pediatric rehabilitation

Abstract This article considers the conceptualization and operationalization of “social environment” and “social context” with implications for research and practice with children and youth with impairments. We first discuss social environment and social context as constructs important for understanding interaction between external environmental qualities and the individuals experience. The article considers existing conceptualizations within psychological and sociological bodies of literature, research using these concepts, current developmental theories and issues in the understanding of environment and participation within rehabilitation science. We then describe a model that integrates a person-focused perspective with an environment-focused perspective and that outlines the mechanisms through which children/youth and social environment interact and transact. Finally, we consider the implications of the proposed model for research and clinical practice. This conceptual model directs researchers and practitioners toward interventions that will address the mechanisms of child–environment interaction and that will build capacity within both children and their social environments, including families, peers groups and communities. Health is created and lived by people within the settings of their everyday life; where they learn, work, play, and love [p.2]. Implications for Rehabilitation Understanding how social environment and personal factors interact over time to affect the development of children/youth can influence the design of services for children and youth with impairments. The model described integrates the individual-focused and environment-focused perspectives and outlines the mechanisms of the ongoing reciprocal interaction between children/youth and their social environments: provision of opportunities, resources and supports and contextual processes of choice, active engagement and collaboration. Addressing these mechanisms could contribute to creating healthier environments in which all children, including children with impairments, have experiences that lead to positive developmental benefits.

The leisure activity settings and experiences of youth with severe disabilities

Abstract Objective: The objective was to describe the leisure activity settings of youth with severe disabilities, the environmental qualities of these settings, and youths’ experiences. Methods: Fifteen youth using augmentative and alternative communication and 11 with complex continuing care needs took part in 54 leisure activity settings of their own choosing. Following their participation, they completed the Self-Reported Experiences of Activity Settings questionnaire and trained observers completed the Measure of Environmental Qualities of Activity Settings. Results: Youths’ selected activity settings provided relatively high opportunities for choice, interaction with adults, and social activities, and youth experienced relatively high levels of psychological engagement, social belonging, and control and choice. Youth primarily took part in activity settings that provided opportunities for competency/relatedness and involved others. Conclusion: Implications for future research and clinical practice include the importance of valuing passive recreational activities for the opportunities for challenge, choice, and social interaction they provide.

Investigating executive functions in children with severe speech and movement disorders using structured tasks

Executive functions are the basis for goal-directed activity and include planning, monitoring, and inhibition, and language seems to play a role in the development of these functions. There is a tradition of studying executive function in both typical and atypical populations, and the present study investigates executive functions in children with severe speech and motor impairments who are communicating using communication aids with graphic symbols, letters, and/or words. There are few neuropsychological studies of children in this group and little is known about their cognitive functioning, including executive functions. It was hypothesized that aided communication would tax executive functions more than speech. Twenty-nine children using communication aids and 27 naturally speaking children participated. Structured tasks resembling everyday activities, where the action goals had to be reached through communication with a partner, were used to get information about executive functions. The children (a) directed the partner to perform actions like building a Lego tower from a model the partner could not see and (b) gave information about an object without naming it to a person who had to guess what object it was. The executive functions of planning, monitoring, and impulse control were coded from the childrens on-task behavior. Both groups solved most of the tasks correctly, indicating that aided communicators are able to use language to direct another person to do a complex set of actions. Planning and lack of impulsivity was positively related to task success in both groups. The aided group completed significantly fewer tasks, spent longer time and showed more variation in performance than the comparison group. The aided communicators scored lower on planning and showed more impulsivity than the comparison group, while both groups showed an equal degree of monitoring of the work progress. The results are consistent with the hypothesis that aided language tax executive functions more than speech. The results may also indicate that aided communicators have less experience with these kinds of play activities. The findings broaden the perspective on executive functions and have implications for interventions for motor-impaired children developing aided communication.

Expertise in research-informed clinical decision making: Working effectively with families of children with little or no functional speech

In this article, we consider what is known about how to work effectively with families of children with disabilities, including those with little or no functional speech. Existing evidence about what families want from services is considered, along with information about how expert therapists practice. Our review indicates the importance of understanding family needs, preferences, and priorities, and of being sensitive to the demands of interventions on family life. The augmentative and alternative communication (AAC) literature is linked to the broader literature, confirming what is known about how to work effectively with families and illuminating the contribution of AAC research to this area of knowledge. In general, the AAC literature highlights the importance of the parent-practitioner relationship, of parental involvement and engagement in the intervention process, and of considering the demands that interventions place on families. We conclude that AAC intervention will benefit from continuing therapist efforts to strengthen the client–practitioner relationship through greater situational understanding and appreciation of family perspectives and life circumstances. Therapists’ efforts should also focus on customizing intervention strategies in order to optimize clients’ sense of control, meaningfulness, and engagement.