Limor Rosenberg

Development and initial validation of the Children Participation Questionnaire (CPQ)

Purpose. To develop and test the psychometric properties of a parent-reported questionnaire measuring participation of preschool children (Children Participation Questionnaire; CPQ) aged 4–6 years in their everyday activities. Methods. Reliability was tested by Cronbachs α and by test–retest. Construct validity was computed by known group differences analysis. Convergent and divergent validities were calculated by correlation with the Vineland Adaptive Behaviour Scale (VABS). Two hundred thirty-one children with mild to moderate developmental disabilities (mean age 5.16 ± 0.66 years old) were compared to 249 children without disability (mean age 5.13 ± 0.72 years old). Results. The CPQ has good internal reliability. Cronbachs α for the participation measures ranged between 0.79 and 0.90, indicating good homogeneity. The temporal stability of the CPQ was supported with intra-class correlations ranging from 0.71 to 1.00. Significant differences were found between children with and without disabilities in all the CPQ measures. The CPQ could also differentiate between age groups and groups of varying socio-economic status. Convergent and divergent validity were supported. Conclusions. The CPQ has demonstrated good psychometric properties and can be used as a reliable and valid measure to assess childrens participation at the age of 4–6 years.

Personal and environmental pathways to participation in young children with and without mild motor disabilities

OBJECTIVE Participation in everyday activities has a positive influence upon health and well-being and is considered as an outcome measure. According to recent models child participation is the product of the dynamic interaction between health states and both individual and environmental factors. Children with mild developmental disabilities often present decreased participation in everyday activities. The purpose of this study was to explore the extent to which individual and environmental factors explain the participation of young children, with and without mild motor disabilities. METHODS The study population included 58 kindergarten children together with their parents (29 children with mild motor disabilities who were referred to occupational therapy and 29 children without motor disabilities). Both groups of children were matched for: age; gender; age of parents; and socio-economic status (SES). We assessed participation using the Child Participation Questionnaire (intensity, diversity, independence, child enjoyment and parental satisfaction) and we assessed childrens self-efficacy and motor abilities for individual factors. Parental self-efficacy and SES were collected by questionnaires. RESULTS Participation diversity (number of activities) was predicted by child and mother self-efficacy and by SES. Child independence and enjoyment as well as parental satisfaction were predicted by child motor ability but mainly by maternal self-efficacy. Results suggest that the total explained variance is more than double when the environmental variables (parental self-efficacy and SES) are inserted to the participation model. CONCLUSIONS Maternal self-efficacy and SES serve as facilitators to increased participation and well-being of children with mild motor disabilities.

Perceived environmental restrictions for the participation of children with mild developmental disabilities

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 childs 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 ± 0.52 years old) with mild developmental disabilities and their parents participated in the study. Three questionnaires measuring the childs participation, performance skills and environmental factors were completed by the parents. RESULTS Parents perceived environmental factors as slightly restricting to their childs 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 childs 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.

Can personal and environmental factors explain dimensions of child participation

OBJECTIVE One of the main goals of paediatric occupational therapists and other health professionals is to enhance child participation in age-related activities within their communities. According to theoretical models, the act of participation has numerous dimensions, affected by personal and environmental factors. However, there have been relatively few studies undertaken to validate this theory. The purpose of this study was to explore the extent to which personal and environmental factors explain each of five distinct dimensions of child participation, which are: diversity, intensity, independence, enjoyment and subsequent parental satisfaction. METHOD A convenient sample of 70 kindergarten children without developmental disabilities together with their parents participated in the study. Data were collected using standardized assessments for personal factors and questionnaires for environmental factors. RESULTS The findings confirmed our hypothesis and revealed that with typical children, motor and cognitive abilities affect participation diversity. Moreover, performance skills and self-perceptions of competence affect their independence levels, while environmental factors contribute to frequency of participation and parental satisfaction. However, these factors on their own do not fully explain the degree of enjoyment experienced by children. CONCLUSIONS The findings highlight the importance of measuring the full range of participation dimensions, and provide empirical evidence about the nature of child participation. Further studies are warranted to validate this approach for children with developmental difficulties.

Development and initial validation of the Performance Skills Questionnaire (PSQ).

The objectives of this study was to develop and test the psychometric properties of the Performance Skills Questionnaire (PSQ), addressed to measure performance skills of preschoolers, as reported by their parents. Participants included 231 children ranging in age from 4 to 6 years old, with mild to moderate developmental disabilities and 240 children without disabilities at same age range. Internal consistency, test-retest, construct validity, and divergent and convergent validity were assessed. The PSQ has shown good internal reliability, and temporal stability. Construct validity was supported by factor analysis which yielded 3 factors that explained almost 52% of the total variance. Significant differences were found between known groups. Convergent and divergent validity were supported by significant correlations with Visual-Motor Integration (VMI) test, and the Children Participation Questionnaire (CPQ). The PSQ is a unique tool that measures performance skills based on preschool childrens everyday function. Results provide evidence in support of the PSQ as a reliable and psychometrically sound instrument.

The Associations Between Executive Functions’ Capacities, Performance Process Skills, and Dimensions of Participation in Activities of Daily Life Among Children of Elementary School Age

Effective executive functions (EFs) are crucial for efficient daily functioning. Daily functioning or involvement in life situations is defined as “participation” (International Classification of Functioning, Disability, and Health [ICF]; World Health Organization, 2001). Yet associations between them have been inadequately studied for children. The present study aimed to explore the associations between EFs and child participation. Participants were 60 typically developing children aged 6 to 9 years old and their parents. The children were individually evaluated using five EF cognitive tests. The parents completed three questionnaires: the Children Participation Questionnaire, the Process Skills (the observed executive performance) Questionnaire, and the Environmental Restrictions Questionnaire. Most of the EF scores were associated with the childs age. A unique contribution of executive capacities was found for the “independence” aspect of child participation, though the quantum of contribution was limited compared with the other predictors’ process skills and environmental restrictions. In the context of child participation, EFs should be studied through multivariate analysis, as otherwise, the unique contribution of executive capacities measured by neuropsychological cognitive tests are likely to be ignored. Process skills are crucial for a childs independence and autonomy in daily functioning. These findings are supported by the capacity–performance distinction suggested by the ICF model.

Development and initial validation of the Environmental Restriction Questionnaire (ERQ).

The purpose of this manuscript was to develop and test the psychometric properties of the Environmental Restriction Questionnaire (ERQ) a parent-reported questionnaire for measuring perceived environmental restrictions for young children participation. Reliability and homogeneity were tested by Cronbachs alpha and inter-item correlations. Construct validity was computed by factor analysis and known group differences analysis. Convergent and divergent validities were calculated by correlation with the Children Participation Questionnaire (CPQ). Participants were 290 children and their parent. Seventy-five children who were referred to occupational therapy evaluation as consequence of moderate developmental disabilities and 215 children without any disability (mean age ± standard deviation for total sample, 5 y, 3 mo ± .65 y; range, 3 y, 11 mo to 6 y, 10 mo). The ERQ has good internal reliability. Cronbachs alpha for the ERQ measures ranged between .75 and .91, indicating adequate homogeneity. Factor analysis yielded three factors that explained almost 48% of the total variance. Significant differences were found between known groups. Convergent and divergent validity were supported by various correlations with the Children Participation Questionnaire (CPQ). The ERQ has demonstrated good psychometric properties and can be used as a reliable and valid measure to assess perceived environmental restriction at the age of 4-6 y.

Development and Validation of the Documentation of Occupational Therapy Session during Intervention (D.O.T.S.I.).

OBJECTIVE To developed and validate a form for Documentation of Occupational Therapy Session during Intervention (D.O.T.S.I) based on the OTPF. This form may fill the need for more consistent and detailed documentation of the intervention process. METHOD Fifty five pediatric OTs documented 2-3 treatment sessions. A total of 120 treatment sessions were recorded. Construct validity was assessed through known-groups differences, once based on age groups and once based on context groups. RESULTS Significant inter-rater reliability in most sub-categories was found with a good Cronbach alpha coefficient. Construct validity was established by significant differences between the two settings (educational and clinic) and the two age groups. CONCLUSION The D.O.T.S.I. form as a reliable and valid measure enables to simply document intervention in a unified and professional method. The documentation method of the D.O.T.S.I. stimulates clinical reasoning by allowing the therapist to reflect on the process of intervention and plan future progress.

Different pathways to children's enjoyment of participation in daily activities.

Abstract Background: The enjoyment arising from participating in an activity is considered to be related to health and well-being. However, only a few studies have focused on children’s enjoyment of participation. Aim: To assess the contribution of various individual factors to the total explained variance of children’s enjoyment of participation from the perspectives of parents and children. Methods: Ninety-eight typically developed children were evaluated using motor and cognitive tests; they completed the Children’s Assessment of Participation and Enjoyment. Their parents completed the Children Participation Questionnaire, the Performance Skills Questionnaire, and the Strengths and Difficulties Questionnaire. Results: Age and gender were found to be significant predictors. Parents perceived enjoyment to be associated with their child’s performance skills and the efficient execution of daily tasks. Children perceived enjoyment to be associated with their psychosocial functioning. Conclusions: The contribution of performance skills exceeds the contribution of motor or cognitive ability to the total explained variance of a child’s enjoyment of participation. A gap exists, however, between the perspectives of children and parents regarding enjoyment of participation. Enhancing participation is a central goal of the occupational therapy domain and process; our findings may provide insights into possible pathways to accomplish this goal.

Differences in muscle activity patterns and graphical product quality in children copying and tracing activities on horizontal or vertical surfaces.

The observation that a given task, e.g. producing a signature, looks similar when created by different motor commands and different muscles groups is known as motor equivalence. Relatively little data exists regarding the characteristics of motor equivalence in children. In this study, we compared the level of performance when performing a tracing task and copying figures in two common postures: while sitting at a desk and while standing in front of a wall, among preschool children. In addition, we compared muscle activity patterns in both postures. Specifically, we compared the movements of 35 five- to six-year old children, recording the same movements of copying figures and path tracing on an electronic tablet in both a horizontal orientation, while sitting, and a vertical orientation, while standing. Different muscle activation patterns were observed between the postures, however no significant difference in the performance level was found, providing evidence of motor equivalence at this young age. The study presents a straightforward method of assessing motor equivalence that can be extended to other stages of development as well as motor disorders.