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Keeping Current Title

The Participation of Children with Physical Disabilities

King, G., Law, M., King, S., Rosenbaum, P., Kertoy, M., & Young, N.,
CanChild Centre for Childhood Disability Research

1999 King, G., Law, M., King, S., Rosenbaum, P., Kertoy, M., & Young, N. Published and distributed by CanChild Centre for Childhood Disability Research

Participation is "the nature and extent of a person's involvement in life situations" (WHO, 1997). It includes the activities of personal maintenance, mobility, social relationships, education, leisure, spirituality, and community life.

The Importance of Participation in People's Lives

Participation has tremendous impact on the quality of people's lives...

  • Participation in activities is the context in which people form friendships, develop skills and competencies, express creativity, achieve mental and physical health, and determine meaning and purpose in life (Kinney & Coyle, 1992; Lyons, 1993).
  • Participation in day-to-day formal activities (e.g., lessons and sports) and informal activities (e.g., playing and reading) is a vital part of children's development. Participation enables children to understand societal expectations and acquire the physical and social competencies needed to function and flourish in their homes and communities (Brown & Gordon, 1987).
  • Satisfaction with activities is an important predictor of life satisfaction among adults with physical disabilities (Kinney & Coyle, 1992) and is associated with adjustment and well-being (Brown & Gordon, 1987). Participation is linked to better social and academic competence in children and to resilience (Werner, 1989).

Participation is a key goal of rehabilitation services...

  • The ultimate goal of rehabilitation interventions is to assist children to participate fully in the life of their family and community.

It is therefore vital that parents, service providers, and policy makers concerned with children with disabilities understand the factors that promote or inhibit children's participation.

We Know...

  • That children with disabilities tend to be more restricted in their participation in daily activities (e.g., active recreation, household tasks, and social engagements) than their peers, and that the scope of their activities is limited (Brown & Gordon, 1987).
  • That the participation of children and youth with disabilities decreases as children grow up so that, by adulthood, their participation is severely restricted; typically, they take part in passive, often home-based, activities (Brown & Gordon, 1987; Crapps et al., 1985; Dempsey, 1991; Pollock & Stewart, 1990).
  • That children with disabilities often feel socially isolated (Anderson & Clarke, 1982; Blum et al., 1991; Cadman et al., 1987; LaGreca, 1990; Law & Dunn, 1993).

What Factors Influence Children's Participation?

The literature indicates that some of the most important factors may be:

Child Factors:

  • their feelings of competence (in athletics, academics, etc.)
  • their physical, cognitive & communicative functioning
  • their emotional, behavioral & social functioning.

Family Factors:

  • the presence of supportive family demographic variables (higher income and education)
  • a supportive home environment (consisting of better parent well-being and good family functioning)
  • fewer daily hassles (so parents have the time and opportunity to support their child's participation)
  • family preferences related to recreation and skill-building activities.

Environmental Factors:

  • the presence of supportive factors in the physical and institutional environments (such as absence of restrictions in environments)
  • the presence of supportive relationships with other people.

Environmental factors and family factors are thought to be more important in promoting children's participation than are characteristics of children themselves (Jackson & Burton, 1989; Sloper et al., 1991). Based on the evidence so far, it is important to counsel parents to encourage and support their children to play with others and to take part in group and skill-building activities (clubs, sports, groups such as Brownies or Cubs, lessons).

What's Next?

We don't yet know...

  • which of the above child, family, and environmental factors have the most influence on participation
  • whether patterns of children's activity change with age.

Longitudinal research is needed to understand the phenomenon of participation. We need to develop and then test comprehensive models of factors affecting participation in order to understand participation in its entirety. This will lead to timely and useful interventions.

At CanChild, we are planning a longitudinal study of children with physical disabilities between 5 and 13 years of age to determine the child, family, and environmental factors that enhance participation in the formal and informal activities of childhood.

Anderson, E. M., & Clarke, L. (Eds.). (1982). Disability and adolescence. New York: Methuen.

Blum, R. W., Resnick, M. D., Nelson, R., & St. Germaine, A. (1991). Family and peer issues among adolescents with spina bifida and cerebral palsy. Pediatrics, 88(22), 280-285.

Brown, M., & Gordon, W. (1987). Impact of impairment on activity patterns of children. Archives of Physical Medicine and Rehabilitation, 68, 828-832.

Cadman, D., Boyle, M., Szatmari, P., & Offord, D. R. (1987). Chronic illness, disability, and mental and social well-being: Findings of the Ontario Child Health Study. Pediatrics, 79, 805-813.

Crapps, J., Langone, J., & Swaim, S. (1985). Quality and quantity of participation in community environments by mentally retarded adults. Mental Retardation, 20, 123-9.

Dempsey, I. (1991). Parental roles in the post-school adjustment of their sons and daughters with a disability. Australia and New Zealand Journal of Developmental Disabilities, 17(3), 313-320.

Jackson, E. L., & Burton, T. L. (1989). Understanding leisure and recreation: Mapping the past, charting the future. State College, PA: Venture Publishing Inc.

Kinney, V. B., & Coyle, C. P. (1992). Predicting life satisfaction among adults with physical disabilities. Archives of Physical Medicine and Rehabilitation, 73, 863-869.

LaGreca, A. M. (1990). Social consequences of pediatric conditions: Fertile area for future investigation and intervention? Journal of Pediatric Psychology, 15, 285-307.

Law, M., & Dunn, W. (1993). Perspectives on understanding and changing the environments of children with disabilities. Physical and Occupational Therapy in Pediatrics, 13(3), 1-17.

Lyons, R. F. (1993). Meaningful activity and disability: Capitalizing upon the potential of outreach recreation networks in Canada. Canadian Journal of Rehabilitation, 6(4), 256-265.

Pollock, N., & Stewart, D. (1990). A survey of activity patterns and vocational readiness of young adults with physical disabilities. Canadian Journal of Rehabilitation, 4(1), 17-26.

Sloper, P., Knussen, C., Turner, S., & Cunningham, C. (1991). Factors related to stress and satisfaction with life in families of children with Down's Syndrome. Journal of Child Psychology and Psychiatry, 32(4), 655-676.

Werner, E. E. (1989). High-risk children in young adulthood: A longitudinal study from birth to 32 years. American Journal of Orthopsychiatry, 59, 72-81.

World Health Organization. (1997). International classification of impairments, activities and participation: ICIDH-2 Beta Draft. Geneva: World Health Organization.