Article

The term self-determination refers to decision-making, goal setting,
and perseverance to achieve those goals. Numerous studies have established the
importance of self-determination to enhance learning and improve postschool
outcomes. However, most studies evaluate students with learning disabilities,
cognitive impairment, or behavioral disabilities. There is an absence of research
on self-determination for adolescents with physical disabilities. OBJECTIVE: To
assess self-determination of adolescents with neonatal brachial plexus palsy
(NBPP) compared with their typically developing peers via self-reported measures
of function. DESIGN: Case-control study. SETTING: Brachial plexus clinic.
PARTICIPANTS: Twenty adolescents with NBPP (aged 10-17 years) and their parents
and 20 age/gender-matched typically developing adolescents and their parents were
recruited. Non-English-speaking participants and those with other physical
impairments were excluded from study. METHODS: Participants completed demographic
and American Institutes for Research (AIR) self-determination surveys. One of two
designated occupational therapists evaluated participant physical function. MAIN
OUTCOME MEASUREMENTS: A demographic survey and AIR self-determination assessment
were administered, and active range of motion measurements in shoulder forward
flexion, elbow flexion, elbow extension, forearm pronation, and supination were
obtained. Grip/pinch strength, MRC muscle strength, 9-Hole Peg Test, and Mallet
scale scores also were evaluated. RESULTS: Despite physical differences,
adolescents with NBPP presented similar self-determination levels as their
typically developing peers. Adolescents with NBPP rated their opportunities to
engage in self-determined behaviors at school significantly lower than at home.
Both adolescents with NBPP and those in the control group rated their
opportunities to engage in self-determined behaviors at school significantly
lower than at home. CONCLUSIONS: Adolescents with NBPP presented similar
self-determination scores as their age/gender-matched typically developing peers.
These results could be a reflection of our program's patient- and family-centered
care approach. Therefore, caregivers and providers should encourage personal
development and fulfillment in adolescents with NBPP. Teachers and schools should
be aware that opportunities for acquiring self-determination skills might be more
limited at school than at home in this age group. LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS