Susanne King

A Conceptual Model of the Factors Affecting the Recreation and Leisure Participation of Children with Disabilities

Participation in everyday activities is considered to be a vital part of childrens 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 childrens participation in recreation and leisure activities. The article outlines the existing evidence for the influence of these factors on one another and on childrens 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.

Patterns of participation in recreational and leisure activities among children with complex physical disabilities

Children with physical disabilities are at increased risk of limitations to participation in everyday activities. This study describes research examining the participation of children in day‐to‐day formal and informal activities (excluding mandated academic schooling). Using the Childrens Assessment of Participation and Enjoyment (CAPE) measure, data on participation patterns were collected from 427 children (229 males, 198 females; mean age 10y [SD 2y 4mo]; range 6–14y) with physical limitations and from their families. The primary types of physical disability in the sample included cerebral palsy, spina bifida, acquired brain injury, and musculoskeletal limitations. Findings indicate a broad range of diversity and intensity of participation, with proportionately greater involvement in informal rather than formal activities. Significant differences in participation and enjoyment were found between males and females, and for children more than 12 years of age. Childrens participation was less diverse in families reporting lower income, single‐parent status, and lower respondent parent education. These findings provide a foundation for an improved understanding of the participation of children with physical disabilities, which can assist families and service providers in planning activities that fit with their childs preferences and ensure active participation.

Predictors of the Leisure and Recreation Participation of Children With Physical Disabilities: A Structural Equation Modeling Analysis

Structural equation modeling was used to test a theoretically based model of environmental, family, and child factors as determinants of the leisure and recreation participation of children with physical disabilities. Participants were 427 families and children (229 boys and 198 girls) with physical functional limitations, in 3 age groups (6-8, 9-11, and 12-14 years). Data were collected via home interviews and self-administered standardized questionnaires. The significant direct predictors of childrens participation intensity in both formal and informal activities were child functional ability, family participation in social and recreational activities, and child preferences for formal and informal activities. Family cohesion, unsupportive environments, and supportive relationships for the child had significant indirect effects on participation. The findings indicate the vital role played by families and the importance of multifaceted approaches to supporting participation.

Participation of children with physical disabilities: relationships with diagnosis, physical function, and demographic variables

The primary goal of occupational therapy intervention for children with disabilities is enabling participation in the daily activities of childhood. The World Health Organization conceptualizes chronic health conditions and disability as two distinct aspects of health, with the primary concern on the level of health condition being with diagnosis rather than function. Participation, within the International Classification of Functioning, Disability and Health (ICF), is characterized by the interactions between a child, its family, and other personal and environmental factors. Few studies have examined the relationships between diagnosis, function, and participation in children with disabilities. Using the results of a study of the participation of 427 children with physical disabilities in activities outside mandated school, the authors examined the relative influence of diagnostic category on participation. When adjusted for age, sex, and physical function, diagnostic category does not significantly affect the intensity and diversity of participation. The results of this study confirm and highlight the limitations in using diagnostic information in childrens rehabilitation in the absence of other information. Participation is a complex phenomenon so it is important to understand more clearly how personal, environmental, and family factors influence the childs involvement in everyday activities. There is a need to move beyond diagnosis to focus on other personal and environmental factors as major predictors of participation.

A Trajectory of Troubles: Parents' Impressions of the Impact of Developmental Coordination Disorder.

Objective: To explore parent perspectives regarding the early experiences of their children with Developmental Coordination Disorder (DCD). Methods: A phenomenological approach was used to explore the meaning of developmental experiences for children with DCD and their families. Parents of 13 children with DCD, aged 6–14, were recruited through purposeful sampling. Parents completed two indepth interviews, and a set of questionnaires. Transcripts and questionnaires were systematically coded to identify emergent themes. Results: There was an evolution over time in the differences that parents noticed and the concerns that they had for their child. There seemed to be a progression from motor and play concerns in the early years, to self-care, academic and peer problems in middle childhood, to significant challenges with self-esteem and emotional health in later childhood. Conclusions: Defining the developmental trajectory of children with DCD highlights the importance of understanding the impact of this disorder as it relates to developmental age and environmental expectations. Implications for early screening and increased awareness of health care professionals are discussed.

Intellectual and functional status at school entry of children who weighed 1000 grams or less at birth: A regional perspective of births in the 1980s

The intellectual and functional status of a regional cohort of children who weighed 501 to 1000 gm when born between 1980 and 1982 was evaluated at a mean age of 5 1/2 years by standard psychometric tests. Of 90 long-term survivors (survival rate 49%), 78 children (87%) had the full test battery, 5 children (6%) had other tests (4 were blind), and one child was untestable. Most of the mean scores were within 1 SD of the test norms; the lowest scores were in the McCarthy Motor scale and in the Beery Test of Visual-Motor Integration. Children without neurologic impairments and those with an IQ greater than or equal to 68 (n = 60) had higher overall scores but still performed poorly on the Motor subscale and the Beery test. Children who weighed less than 800 gm at birth (n = 28) were similar to those who weighed greater than 800 gm (n = 50), except in the Memory and Motor subscales, in which they performed significantly less well. At a functional level, determined by the Vineland Adaptive Behaviour Scales, two thirds of the children were performing in the adequate range and the remainder in the moderately low to low range. Of the 43 children with no neurosensory impairments and an IQ greater than or equal to 84, 49% were identified (by the Florida Kindergarten Screening Battery) to be at mild to high risk for future learning disabilities. The data from this unselected population provide an unbiased estimate of the prevalence of intellectual and functional problems in children who weighed less than or equal to 1000 gm at birth.

A Measure of Parents' and Service Providers' Beliefs About Participation in Family-Centered Services

This article reports the development and validation of a Measure of Beliefs about Participation in Family-Centered Service that consists of 5 scales measuring beliefs about family-centered philosophy and principles, positive and negative outcomes, personal competencies, and barriers. The measure is applicable to both parents and service providers, displays good internal consistency, and has good preliminary evidence of construct validity. The measure shows promise for use in the university preparation of service providers, professional development, clinical practice, and the evaluation of family-centered training programs and materials. It also can be used in research on the attributes, antecedents, and consequences of family-centered service delivery.

Organizational Characteristics and Issues Affecting the Longevity of Self-Help Groups for Parents of Children with Special Needs

In this article, the organizational characteristics and issues affecting the maintenance of nine self-help groups for parents of children with special needs are discussed. Qualitative data were collected through interviews with 20 parents and observation of six group meetings. For continued existence, groups must deal with the challenges of encouraging new leaders, attracting new members, obtaining funds or assistance to support their activities, and meeting the changing needs of members. Important organizational characteristics associated with longevity are committed and effective leadership, community connections that help provide needed funds or practical assistance, and the willingness of group members to change activities to meet changing needs. This information can be used by parents and service providers to plan new groups, recruit group members, and ensure the effective functioning of groups as they change over time.

Self-perceived social function among disabled children in regular classrooms.

Disabled children represent an important “at-risk‘’ group for emotional and behavioral problems. This study determined how they assess their own social function in regular classrooms and compared them with their able-bodied peers. School principals identified 60 visibly disabled children who were integrated into regular classes for at least 50% of the time. A comparison group of 56 randomly selected, same-gender classmates was identified. Children completed the Perceived Competence Scale and a classroom sociometric scale. Parents and teachers were asked to rate each childs social function. Disabled children rated themselves lower on physical competence (mean = 2.53 vs 2.92, p = .002) but not on social or cognitive competence. However, disabled children had fewer friends and scored lower on the classroom sociometric measure than did their able-bodied classmates (mean = 2.06 vs 2.39, p = .01). There was no difference between disabled and control children when social function was assessed by parents or teachers. For all children two variables were significantly associated with the childs self-perceived social competence: the childs self-perceived physical competence (R2 = .27) and the peer sociometric rating (R2 = .13). Teacher perception (R2 = .35) and self-perception (R2 = .10) of social function were most strongly associated with the perception of peers. In both cases whether the child was disabled contributed little to the observed association. These findings support the importance of peers in the successful social function of children and suggest that teachers can have an impact on how children are perceived by other children. The observation that perceived physical competence is strongly associated with perceived social competence supports initiatives that promote the physical abilities of disabled children. J Dev Behav Pediatr 13:11–16, 1992. Index terms: social function, integration, social skills, disability.

Home or children's treatment centre: where should initial therapy assessments of children with disabilities be done?

Following developmental paediatric consultation at a child development clinic, 50 preschool children newly referred for a developmental rehabilitation programme were assigned randomly for initial therapist assessments at home or at the clinic. It was thought that children would perform more typically at home, that therapists would be able to observe more of the childrens usual functions, and that parents would feel more satisfied. Despite several minor statistically significant differences between the two venues, there was no obvious advantage of home evaluation over clinic assessment. However, the added cost of home assessments was marginal, and there may still be some value in seeing young disabled children for first assessment in their own homes.