Jodie Copley

Comparative Content Review of Children's Participation Measures Using the International Classification of Functioning, Disability and Health–Children and Youth

OBJECTIVE To evaluate to what extent instruments that intend to measure childrens participation actually do so, and to what extent their items can be classified according to the International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY). DATA SOURCES A systematic search was conducted in MEDLINE, CINAHL, PsycINFO, ERIC, and EMBASE and was limited to the period between January 2000 and May 2011. The search terms of participation, outcome measure, and children were used to identify potential childrens participation measures. DATA SELECTION Instruments were included if they (1) evaluated childrens participation based on assessment purpose; (2) were suitable for use with children aged 2 to 12 years; (3) were generic assessments that could be used with a range of disabilities; and (4) involved self-report, proxy report, or interview administrations. DATA EXTRACTION Instruments were obtained from identified full-text articles and were evaluated for inclusion through group discussion. Two researchers further independently reviewed each included instrument to determine which of the items measured participation based on a contemporary definition. These items were also classified using the ICF-CY linking rules to reflect each instruments content coverage. DATA SYNTHESIS Sixteen instruments were identified with 11 found to have more than half of their items measuring participation, but only the School Function Assessment-Participation section comprised 100% participation items. The participation items in each instrument captured between 3 and 9 ICF-CY Activities and Participation domains. Only the Child and Adolescent Scale of Participation and the Participation and Environment Measure for Children and Youth covered all domains. Among the ICF-CY Activities and Participation domains, the interpersonal interactions and relationships domain was addressed the least. CONCLUSIONS This review revealed differences in the inclusion of participation items in existing childrens participation measures and their classification according to the ICF-CY. These differences need to be considered when selecting an instrument.

Use of a Team-Based Approach to Assistive Technology Assessment and Planning for Children With Multiple Disabilities: A Pilot Study

This pilot study trialed a team-based assistive technology assessment and planning process for children with multiple disabilities and their educational teams, in order to inform a wider study using explanatory case study methodology. Fourteen students and their educational teams participated in the process, which incorporated use of the Lifespace Access Profile and Lifespace Access Profile (Upper Extension), together with a video procedure developed to determine size and number of assistive technology targets that students could use. Data generated included pre- and postpilot questionnaires completed by team members, pre- and postpilot technology goals developed by each team, and field notes. Thematic analysis of the data indicated that the team-based process had a number of benefits for teams, including development of more specific and achievable technology goals; increased knowledge, skills, and confidence of team members; more effective teamwork to assist decision-making; and better coordination of technology use between home and school. Further research is required to objectively measure direct student outcomes and to determine the impact of team dynamics.

Making interprofessional education real: a university clinic model.

Interprofessional education (IPE) is an emerging focus in the professional training of allied health students. To date, IPE has occurred in classroom teaching or case simulations, rather than in the provision of client services. At the University of Queensland, students in occupational therapy, speech pathology and music therapy participate in both on-campus and community-based IPE clinics conducted by university staff. These clinics are planned and implemented to promote interprofessional learning for students, and to provide integrated service provision for children and young people in the community. An adapted version of Bronsteins model of interdisciplinary collaboration is used to guide IPE processes, including team orientation, joint goal-setting and intervention planning, and integrated delivery of therapy sessions. The development and implementation of these IPE clinics is described, together with challenges to clinical IPE in the university context.

The meaning of leisure for children and young people with physical disabilities: a systematic evidence synthesis

Participation in leisure has known health benefits. Children and young people (CYP) with physical disabilities demonstrate reduced participation in leisure. To facilitate their meaningful participation, one must understand what leisure means to CYP. The aim of this study was to systematically synthesize evidence from qualitative studies on the meaning of leisure for CYP with physical disabilities.

Measures of participation outcomes related to hand use for 2- to 12-year-old children with disabilities: a systematic review

Many interventions have been used to improve childrens hand-related impairments or hand skill performance in functional activities so as to promote life participation. There is thus a need to have suitable instruments assessing childrens participation in life situations that specifically require hand use in order to support and evaluate such interventions. This systematic review investigated the availability of potential instruments that can be used to assess childrens participation specifically in life situations requiring hand use. Clinical utility and evidence for psychometric properties were also sourced. Database searches initially identified measures that were used to evaluate participation of children aged 2-12 years, involved self- or proxy report or interview administration and had generic application for a range of disabilities/diagnoses. These measures were further evaluated to determine if they fulfilled the above inclusion criteria and contained at least 60% of the items involving hand use. Further searches for psychometric evidence were undertaken for the eligible measures. Fourteen measures were identified and nine met the inclusion criteria. However, none of these measures, except for the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES), contained all items related to hand use. Most of the included measures had limited psychometric properties. Only the Childrens Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC), the School Function Assessment-Participation section (SFA-P) and the Children Participation Questionnaire (CPQ) revealed sufficient evidence of validity and reliability. The findings suggest a need for adapting existing participation measures or developing new ones that specifically assess participation in life situations requiring hand use to support interventions.

Establishing the Validity and Reliability of the Student Practice Evaluation Form–Revised (SPEF-R) in Occupational Therapy Practice Education: A Rasch Analysis

This study investigated construct validity and internal consistency of the Student Practice Evaluation Form–Revised Edition Package (SPEF-R) which evaluates students’ performance on practice education placements. The SPEF-R has 38 items covering eight domains, and each item is rated on a 5-point rating scale. Data from 125 students’ final placement evaluations in their final year study were analyzed using the Rasch measurement model. The SPEF-R exhibited satisfactory rating scale performance and unidimensionality across the eight domains, providing construct validity evidence. Only 2 items misfit Rasch model’s expectations (both related to students’ performance with client groups, which were often rated as not observed). Additionally, the internal consistency of each SPEF-R domain was found to be excellent (Cronbach’s α = .86 to .91) and all individual items had reasonable to excellent item-total correlation coefficients. The study results indicate that the SPEF-R can be used with confidence to evaluate students’ performance during placements, but continued validation and refinement are required.

Twelve tips for effective clinical supervision based on a narrative literature review and expert opinion

Background: Clinical supervision has gained wide recognition in recent years as an essential component of a practitioners continuing professional development. However, confusion exists in professional literature regarding the most effective models, styles, processes and methods of clinical supervision. Aim: This article outlines the elements required to establish and sustain an effective clinical supervision arrangement for health professionals, based on current evidence and the authors expert opinion. Conclusion: A set of practical strategies are proposed to assist practitioners to establish an ongoing, effective clinical supervision partnership.

Development and psychometric evaluation of a new measure for children's participation in hand-use life situations

OBJECTIVE To describe the development of the Childrens Assessment of Participation with Hands, a parent-report questionnaire that assesses childrens participation in life situations requiring hand use specifically, and to investigate its construct validity (using Rasch analysis and known-group comparison) and reliability (test-retest reliability and internal consistency). DESIGN Cross-sectional, validation, and test-retest studies. SETTING Schools. PARTICIPANTS Parents/caregivers (N=202) reported on their children aged 2 to 12 years with (n=97) and without disabilities (n=105). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The Childrens Assessment of Participation with Hands was developed based on a content review of existing childrens participation measures and literature, expert review, and pilot testing. The Childrens Assessment of Participation with Hands included 37 items measuring participation diversity, frequency, independence, and desire for change in specific hand-use life situations across 4 domains of self-care, recreation, education, and domestic life and community. RESULTS Evidence for construct validity of the Childrens Assessment of Participation with Hands domains was established through Rasch analysis (after removing 2 misfitting items from the recreational domain and 1 item from the domestic life and community domain). Differences in summary scores of each domain between children with and without disabilities were also significant (P<.01). Test-retest reliability of the Childrens Assessment of Participation with Hands was moderate to high (intraclass correlation coefficients, .69-.96), except for the desire for change dimension scale of the recreational domain (.40). Internal consistency was varied across the dimensions/domains. CONCLUSIONS Results provide preliminary evidence for the construct validity and reliability of the Childrens Assessment of Participation with Hands that could be used in clinical and research settings to gain a specific understanding of the impact of childrens hand-use difficulties on their participation in life situations requiring hand use.

Assistive technology assessment and planning for children with multiple disabilities in educational settings

A number of critical elements have been identified in assistive technology assessment and planning to optimise its integration into the educational environments of children and hence address their functional goals. These elements are as follows: adopting a collaborative think-tank team approach to which all educational team members contribute equally and where technology experts are consulted once the need for specific technical support or training is identified; involving the family by establishing mutual expectations and using effective communication strategies; and conducting in-depth assessment that identifies clear goals, includes task analysis within daily environments, examines the child-device interaction closely and investigates the resources available to implement assistive technology use. With this backdrop, this paper reviews existing assessments and proposes that the Lifespace Access Profile (LAP) (Williams et al 1993) and Lifespace Access Profile (Upper Extension) (LAPUE) (Williams et al 1994) satisfy many of the criteria for effective assessment and planning advocated in the literature.

Predicting functional outcome for children on admission after burn injury: do parents hold the key?

In this study, a predictive model about recovery postburn was developed for purposive case selection using explanatory case methodology. Seven cases (each comprising a child, caregiver, and teacher) participated. Children were aged 6 to 13 years with between 2% and 35% TBSA burned. Caregivers completed assessments of premorbid family and child-adaptive functioning, and family, parental, and child functioning during acute and postacute treatment periods. Teachers completed assessment of premorbid and postacute child-adaptive functioning. Children and their respective caregivers were interviewed to obtain further insights into outcomes. Assessments and interviews were completed before skin healing, on skin healing, and at 6 months postburn injury. Descriptive analysis of the quantitative data and content analysis of qualitative data was undertaken for individual cases and across all cases. In keeping with the explanatory case methodology, replication logic was applied to each case to determine the extent to which theoretical propositions based on the predictive model were supported. Findings suggest that children whose parents had high state anxiety in combination with ineffective coping strategies seemed most at risk of a nonadaptive outcome after a burn injury. There was little support for the rival explanations that child and family functioning or injury severity most consistently predicted outcome postburn injury.