Critically Examining the Person–Environment Relationship and Implications of Intersectionality for Participation in Children's Rehabilitation Services

Abstract

Participation of children in rehabilitation services is associated with positive functional and developmental outcomes for children with disabilities. Participation in therapy is at risk when the personal and environmental contexts of a child create barriers to accessing services. The International Classification of Functioning, Disability and Health (ICF) provides a framework for conceptualizing the personal and environmental factors linked to a child. However, it does not facilitate critical examination of the person–environment relationship and its impact on participation in children's rehabilitation. This perspective study proposes the use of intersectionality theory as a critical framework in complement with the ICF to examine the impact of systemic inequities on the participation in therapy for children with disabilities. Clinicians are called to be critical allies working alongside children and families to advocate for inclusive participation in children's rehabilitation by identifying and transforming systemic inequities in service delivery.

Diversified caregiver input to upgrade the Young Children’s Participation and Environment Measure for equitable pediatric re/habilitation practice

“…Caregivers in this study proposed ways to clarify, remove/simplify, or add examples to ensure their comprehension, and they repeatedly shared how they could relate and respond when introduced to select anti-racist terms for evaluating the impact of a discriminatory home or community environment. Results suggest that caregivers can be prompted to comprehend and consider their experiences of inequity that could be grounded in experiences of racism, both interpersonally and institutionally [ 2 , 61 ]. Following YC-PEM content modifications, there is need for subsequent studies to systematically apply these YC-PEM data into the complex clinical task of goal setting, if the data are to consistently demonstrate provider commitment to screening for its impact on participation.…”

“…Practitioner and family experiences of pediatric re/habilitation can be inequitable, thereby creating a barrier to achieving the quadruple aim of services which includes optimizing patient and provider service experiences [ 1 , 2 ]. An early opportunity to promote Justice, Equity, Diversity, and Inclusion (JEDI) in a pediatric re/habilitation service context and workflow is presented when designing an early intervention (EI) service plan.…”

My child is growing and now? Exploring the environmental needs of children with congenital Zika syndrome according to their caregivers' perceptions

“…Disability and poverty are believed to operate in a cycle, each reinforcing the other 33 and our results appear to reinforce these findings. Poverty is a factor that negatively affects the level of empowerment of families and access to rehabilitation treatments 8,30 . Public policies that promote income and equal opportunities can help to minimize this gap between families of children with disabilities when compared to their peers without disabilities.…”

“…Poverty is a factor that negatively affects the level of empowerment of families and access to rehabilitation treatments. 8 , 30 Public policies that promote income and equal opportunities can help to minimize this gap between families of children with disabilities when compared to their peers without disabilities. Our findings reinforce the need for support through public policies, especially for a population of low‐income caregivers.…”

“…Promoting social inclusion of children with CZS is challenging and requires lifelong professional assistance, psychological, social support and family‐centred interventions. 6 , 7 , 8 In this sense, the International Classification of Functioning, Disability and Health (ICF) defines participation as the ‘involvement in a life situation’ and it is influenced by environmental factors, such as physical, social and attitudinal aspects (i.e., physical features of the house and school, relationship to close family, community activities, health services, communication and transportation). 9 , 10 …”