Moderating effect of the environment in the relationship between mobility and school participation in children and adolescents with cerebral palsy

Abstract

BACKGROUND: The literature demonstrates that the social participation of children with disabilities is influenced by both their functional skills repertoire and environmental factors. However, it is not yet known whether the effect of functional limitations on social participation is minimized or enhanced by the environmental facilitators and barriers. This study aimed to test this hypothesis. OBJECTIVE: To investigate the moderating effect of environmental factors in the relationship between mobility and school participation of children and adolescents with cerebral palsy (CP). METHOD: Participants were 102 elementary school children and adolescents with CP, aged 6 to 17 years, classified as levels I, II, and III according to the Gross Motor Classification System, along with their parents or caregivers and teachers. School participation and parents' perceptions of barriers were evaluated using the School Function Assessment and the Craig Hospital Inventory of Environmental Factors (CHIEF), respectively. RESULTS: The regression model failed to reveal a moderating effect of environmental factors in the relationship between mobility and school participation. While mobility was a strong predictor of participation, environmental factors demonstrated a weak predictive effect on the latter. The CHIEF subscale school/work showed the factors which were greatest barrier to children's participation, while the subscale attitude/support had the least impact. CONCLUSION: The absence of moderation on the tested relationship suggests that, when investigated under the negative perspective of environmental barriers, the contextual factors do not modify the relationship between mobility and school participation. Factors specific to the school environment might add to the present study's results regarding the effect of school participation in this population.

Family factors associated with participation of children with disabilities: a systematic review

“…Parental self‐efficacy beliefs were studied most often showing consistent positive association with participation . Attitudes of family/greater community and parental perceptions of the child's impact on the family were associated with participation inconsistently (Table ). Parental beliefs about activity and perceptions of activity demands were examined in a single study .…”

“…Supports for the child from parents/greater community was studied most often . The presence of parental support was consistently positively associated with participation, except in a single study where the association was negative .…”

“…Supports for the child from parents/greater community was studied most often. 18,41,57,62,64 The presence of parental support was consistently positively associated with participation, 41,57 except in a single study where the association was negative. 62 Family preferences 18,19 and activity orientation 18,19,43 towards social and recreational activities were positively associated with children's The prevailing direction of an association based on the frequency count.…”

Influência ambiental sobre a incapacidade física: uma revisão sistemática da literatura

“…Gallagher et al 22 Ortopedia Amputações de membros (superior ou inferior). Rosenberg et al 23 Neurologia Pediátrica Incapacidades leves, sem condições clínicas especificadas Bouffioulx et al 24 Neurologia Acidente Vascular Encefálico Furtado et al 25 Neurologia Pediátrica Paralisia Cerebral de barreiras físicas tais como desníveis, aclives e pisos lisos nas rotas de acesso, inadequação da largura de portas de banheiros e redução do espaço de circulação nos cômodos do domicílio. O estudo de Andrade et al 9 12 avaliou o ambiente como variável moderadora e mediadora da funcionalidade.…”

Psychometric Properties of the Persian Version of School Function Assessment (SFA) in 6 to 12-Year-Old Children with Physical Disabilities

“…These functional constraints require medical interventions, rehabilitation, and educational services to promote the active participation and health quality of these students in educational settings (4). Participation of children with physical disabilities will increase remarkably the use of the appropriate facilities of schools and welfare services (5). The activities related to school performance are referred to non-educational functional activities that support children's participation in educational and social aspects (6).…”