Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy

Abstract

AIM To test a model of child, family, and service determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy (CP).METHOD Participants were 288 children with CP, age range 6 to 12 years (mean 9y 8mo, SD 2y), and their parents from seven children's hospitals. The sample comprised 166 (57.6%) males and 122 (42.4%) females, and between 40 (13.9%) and 74 (25.7%) children in each of the five levels of the Gross Motor Function Classification System. Children completed the Children's Assessment of Participation and Enjoyment by interview. Parents completed the Pediatric Outcomes Data Collection Instrument, Family Environment Scale, Coping Inventory, Measure of Processes of Care, and two questionnaires. Structural equation modeling was used to test the model. RESULTSFit statistics indicated a good model fit. The model explains 32% of the variance in intensity of participation. Path coefficients (p£0.05) indicate that higher gross motor function, higher enjoyment, more effective adaptive behavior, younger age, and higher family activity orientation are associated with higher intensity of participation. The path between services and participation was not significant. INTERPRETATIONIntensity of participation of children with CP is influenced by multiple child and family determinants. Children's gross motor function and behavior in life situations are important for participation; knowledge of activities the child and family enjoy has implications for opportunities for participation. Professionals are encouraged to address priorities for leisure and recreation identified by children with CP and their families.Participation (involvement in home, school, and community life 1 ) is of utmost importance to children with cerebral palsy (CP) and their families. Through participation children form friendships, gain knowledge, learn skills, and express creativity. 2 Enablement models such as the International Classification of Functioning, Disability, and Health 1 have increased awareness of participation as an outcome of health and rehabilitation services. Among individuals with CP, diversity and intensity of participation in leisure and recreation activities is higher in children than young people and those with more gross motor function. 3,4 A systematic review identified age, sex, activity limitations, family preferences and cohesion, and environmental resources and supports as factors that might influence participation in leisure activities of children with CP. 5 Among children with CP, lower ability to communicate and higher activity level were constraints to participation whereas higher intelligence and gross motor function were associated with increased participation. 6 King et al. 7 tested a model of predictors of participation in leisure and recreation activities in children with varied physical conditions including CP, congenital and traumatic spinal cord injury, traumatic brain injury, amputation, juvenile arthritis, muscular disorders, and orthopedic conditions. Child...

Influence of accessibility of services on Quality of Life of school children with Cerebral Palsy in Latvia

“…Children with higher physical ability had fewer activity limitations and participation restrictions than those with lower physical ability (Palisano et al, 2011).…”

An international comparison of patterns of participation in leisure activities for children with and without disabilities in Sweden, Norway and the Netherlands

“…Even though the inclusion criteria were comparable in all three countries, a limitation is that we cannot know if the children's functional levels, were equivalent. Studies of children with CP have reported that a lower level of functioning is correlated with lower participation level [17,20,23,27]. There are studies indicating that type of disability is of less importance for the pattern of participation than severity of impairment [53,54].…”

“…Children with disabilities often meet restrictions in their participation due to both personal and environmental factors [5,[15][16][17][18][19][20]. Pain, mobility problems, communication disorders, and intellectual disabilities are examples that can reduce participation [17,[21][22][23].…”

Fitness, Fun and Friends through Participation in Preferred Physical Activities: Achievable for Children with Disabilities?

“…The CAPE generates knowledge on contextual factors and the experience of participation, The literature appears to agree that if an activity is going to be experienced as meaningful and engaging over time, it has to be enjoyable and self-initiated (Hammel et al, 2008;Heah et al, 2007;King et al, 2009;Palisano et al, 2010b). Children's interests are of great importance for participation in leisure activities in general, and in physical activity specifically, and should be seriously considered in rehabilitation interventions.…”