Identifying environmental barriers to participation: Usability of a health‐literacy informed problem‐identification approach for parents of young children with developmental disabilities

Abstract

This study suggests that parents with a range of background characteristics can use a structured, environment-focused problem-identification approach. With the approach, parents are more likely to attribute participation challenges to environmental barriers and adopt a problem-solving orientation focused on changes to the community and policy context.

Participation of children with disabilities across the life course: using socio‐ecological perspectives to guide research and practice

“…Future research and action can combine the International Classification of Functioning, Disability and Health -Children and Youth (https://apps.who.int/iris/handle/10665/43737) and social determinants of health (https://www.who.int/social_dete rminants/sdh_definition/en/) approaches, incorporating life course, racial/ethnic equity, health literacy, intersectional, and family engagement frameworks, among others. 2,3 The authors note that children with disabilities have a lower frequency of participation, except when visiting a library. A socio-ecological approach, as defined above, can highlight how such participation might be differently structured.…”

“…3 Further, trainees and current researchers and professionals should be trained in how to use these approaches to produce practice and research endeavours that can more fully consider participation determinants across the life course. [2][3][4] Certainly, real limitations abound; data sets do not have the variables we desire and there is limited funding and time, among other issues. However, we will perpetuate patterns of lower participation, disengagement, and inequitable opportunities for optimal development and participation among children with disabilities if we fail to frame the solutions from a systems perspective, partnering with families at every stage and level.…”

“…A socio-ecological approach, as defined above, can highlight how such participation might be differently structured. [2][3][4] Is there something about public library operations and policy that drives meaningful participation for all children? Could school-district policies that integrate inclusion opportunities in education, sports, and recreational activities change the extent to which children with disabilities get together with friends?…”

“…To more fully understand how child sex, family income, and parental education (determinants identified by the authors) affect the extent and quality of participation of children with disabilities, a socio‐ecological approach is useful. Future research and action can combine the International Classification of Functioning, Disability and Health – Children and Youth (https://apps.who.int/iris/handle/10665/43737) and social determinants of health (https://www.who.int/social_determinants/sdh_definition/en/) approaches, incorporating life course, racial/ethnic equity, health literacy, intersectional, and family engagement frameworks, among others …”

Untitled

“…Second, therapists should develop trainings focused on ADLs for families of adults with ASD as has been demonstrated with other caregiver populations [57,73]. For example, aging parents can be trained to help adults with ASD gain and/or maintain mastery in ADL skills into adulthood.…”