The effect of interventions aimed at improving participation outcomes for children with disabilities: a systematic review

Adair, Brooke; Ullenhag, Anna; Keen, Deb; Granlund, Mats; Imms, Christine

doi:10.1111/dmcn.12809

Cited by 149 publications

(162 citation statements)

References 35 publications

(171 reference statements)

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“…9 We recently completed a systematic review of the effect of randomized controlled trials (RCTs) that aimed to improve participation for children with disabilities. 10 One of the outcomes of that review was the recognition of the lack of consistency and clarity in the definition and measurement of participation in the included trials. The aim of the current study was to extend the findings of the previous review by investigating the construct of participation as applied to children with disabilities and as defined in published intervention research.…”

mentioning

confidence: 99%

‘Participation’: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities

Imms

Adair

Keen

et al. 2015

Develop Med Child Neuro

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298

350

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ICFInternational Classification of Functioning, Disability and Health QOL Quality of life PODCI Pediatric Outcomes Data Collection Instrument RCT Randomized controlled trial AIM Improving participation of children with disabilities is a priority; however, the participation construct lacks clarity. This systematic review investigated how researchers defined 'participation' and the language used in participation intervention research.METHOD Nine health and education databases were searched for intervention studies of children with disabilities that included a participation outcome. Quantitative data were extracted using a customized form, and participation text data were extracted verbatim. Themes were derived using a thematic coding approach. These participation themes were applied to the outcome measures used in the included studies to compare participation language with the methods used to quantify participation changes. RESULTSOf the 2257 articles retrieved, 25 were included in this review. Five participation themes and nine subthemes were developed. Two themes, attendance and involvement, were directly related to the participation construct. Three additional themes described related concepts: preferences, activity competence, and sense of self.INTERPRETATION Attendance and involvement seem to describe the essence of the participation concept. The related themes may provide important avenues to enhance participation outcomes. This review highlighted the need for researchers to define the construct under investigation clearly and select measures carefully, as measurement choice is the mechanism through which the concept is operationalized in research.The publication of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) has resulted in an intensification of international interest in 'participation' as the ultimate health outcome. 1,2 The ICF defines participation as 'involvement in a life situation' 2 participation restriction is defined as 'problems an individual may experience in involvement in life situations'.2 Because there is no universal acceptance of the definition of participation, a discourse in the literature has developed about how to operationalize the concept. 3,4 This is critical, because without clarity about the concept, defining outcome goals and developing scales and measures to assess participation outcomes will remain open to question as to whether the measures are fit for purpose.One part of the complexity of the conceptual issue is the fact that the World Health Organization did not clearly distinguish between activity and participation within their classification system, offering authors four methods for determining when participation rather than activity was being classified.1,2 This lack of distinction provides ample opportunity for varied interpretations of the concept under investigation and hence varied approaches to measurement, 5 leading to imprecision and confusion in what is found and reported.Several authors describe particip...

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confidence: 99%

‘Participation’: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities

Imms

Adair

Keen

et al. 2015

Develop Med Child Neuro

Self Cite

298

350

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“…A systematic review of participation interventions (Adair et al, 2015) report only a weak relation between activity competence and participation. Furthermore, the results of the scoping review (Willis et al, 2017) demonstrate a relatively limited negative impact of impairments on a child's participation experience.…”

Section: Person-based Activity-and Environmentfocused Elementsmentioning

confidence: 98%

Factors Associated With Participation and Change Over Time in Domestic Life, Peer Relations, and School for Adolescents With and Without Self-Reported Neurodevelopmental Disorders. A Follow-Up Prospective Study

et al. 2018

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Even though participation in everyday events is a vital part in the fulfillment of human rights, adolescents with neurodevelopmental disorders (NDD) often face participation restrictions in every-day activities. Few studies have investigated the predictors for participation in different contexts, over time and in relation to the same outcome variables.Objective: Objective of the current study was therefore to investigate predictors of change in participation operationalized as frequency of attendance and perceived importance in domestic life activities, peer related activities, and school activities as experienced by adolescents with and without self-reported neurodevelopmental disorders.Method: Associations with participation, both in terms of frequency and perceived importance, in domestic life, peer relations, and the school setting were investigated using six independent variables measuring experience of time and self, sex, age, stress, support from siblings, and atmosphere in family at two-time (with ∼2 years in between). The sample consisted of adolescents with and without self-reported NDD (n = 916). Adolescents with self-reported NDD were n = 154 and adolescents without self-reported NDD was n = 762. Data was collected via self-reported questionnaires administered in schools.Results: Three key findings are presented. (1) more factors were associated with participation outcomes at time1 for adolescents without NDD than for adolescents with NDD, but this difference in the number of factors decreases with time; (2) few associations were related to time for both adolescents with and without NDD; and (3) patterns of predicting variables were different for adolescents with and without NDD.Lygnegård et al. Participation in and Outside SchoolConclusion: The findings indicate that the factors related to participation in and outside school differs between groups, when the impairment or disability is not considered as a predictor for participation. This study supports the need for using a multidimensional developmental and contextual perspective in addressing enhanced participation for adolescents with NDD.

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“…The construct of participation in the ICF has been recognized as the ultimate health outcome (Adair et al, 2015), although it has not yet been firmly defined (Imms et al, 2016a). The ICF defines participation restriction as "problems an individual may experience in involvement in life situations" (p. 123) (World Health Organization, 2001).…”

Section: Icf As a Conceptual Framework For A Factmentioning

confidence: 99%

“…There are multitudes of possible supportive measures targeting participation for children with disabilities in school, although the evidence base is still emerging (Adair et al, 2015). Social environments at school such as recess and play can be supported to enhance interactions for children with problems in social skills (Fantuzzo et al, 1996;Harper et al, 2008).…”

Section: Environmentmentioning

confidence: 99%

“…This is expected to yield insights regarding possible points of entry for support to improve participation (Rosenbaum and Gorter, 2012). Individual support planning in education based on participation has emerging support (Adair et al, 2015) and has been carried out successfully in community settings . The FACT encourages a collaborative process between teachers and clinicians, a strategy found to be effective in promoting participation among students with disabilities (Selanikyo et al, 2017).…”

Section: Identification Of Points Of Entry For Support and Goal Settingmentioning

confidence: 99%

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A Proposed Functional Abilities Classification Tool for Developmental Disorders Affecting Learning and Behaviour

Klein

Camargo

2018

Front. Educ.

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Children with developmental disorders affecting learning and behaviour (DDALB) (e.g., attention, social communication, language, and learning disabilities, etc.) require individualized support across multiple environments to promote participation, quality of life, and developmental outcomes. Support to enhance participation is based largely on individual profiles of functioning (e.g., communication, cognitive, social skills, executive functioning, etc.), which are highly heterogeneous within medical diagnoses. Currently educators, clinicians, and parents encounter widespread difficulties in meeting children's needs as there is lack of universal classification of functioning and disability for use in school environments. Objective: a practical tool for functional classification broadly applicable for children with DDALB could facilitate the collaboration, identification of points of entry of support, individual program planning, and reassessment in a transparent, equitable process based on functional need and context. We propose such a tool, the Functional Abilities Classification Tool (FACT) based on the concepts of the ICF (International Classification of Functioning, Disability and Health). FACT is intended to provide ability and participation classification that is complementary to medical diagnosis. For children presenting with difficulties, the proposed tool initially classifies participation over several environments. Then, functional abilities are classified and personal factors and environment are described. Points of entry for support are identified given an analysis of functional ability profile, personal factors, environmental features, and pattern of participation. Conclusion: case examples, use of the tool and implications for children, agencies, and the system are described.

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The effect of interventions aimed at improving participation outcomes for children with disabilities: a systematic review

Cited by 149 publications

References 35 publications

‘Participation’: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities

‘Participation’: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities

Factors Associated With Participation and Change Over Time in Domestic Life, Peer Relations, and School for Adolescents With and Without Self-Reported Neurodevelopmental Disorders. A Follow-Up Prospective Study

A Proposed Functional Abilities Classification Tool for Developmental Disorders Affecting Learning and Behaviour

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