Article

PURPOSE: To test a model of child, family and service determinants of
participation in family and recreational activities for young children with
cerebral palsy (CP). METHODS: Participants were a convenience sample of 429
children (242 males) with CP, aged 18 to 60 months, representing all levels of
the Gross Motor Function Classification System (GMFCS). Children were divided
into two groups by GMFCS levels, levels I to II and levels III to V. Data on
impairments and gross motor function were collected by therapists; parents
provided information about children's health conditions and adaptive behaviour.
Seven months later, parents reported on family life and services received. One
year after the beginning of the study, parents reported their children's
participation. Data from the two groups of children were analysed separately
using structural equation modelling. RESULTS: The model explained 35% and 40% of
the variance of frequency of participation in family and recreation and 28% and
38% of enjoyment in participation, for the two groups of children, respectively.
Children's adaptive behaviour, family ecology, and number of community
recreational programs were associated with the frequency of participation for
both groups. Gross motor function was only associated with the frequency of
participation for children in levels III-V. Adaptive behaviour was associated
with enjoyment for both groups. The extent services met children's needs was
associated with enjoyment for children in levels I to II and family ecology was a
determinant of enjoyment for children in levels III to V. CONCLUSION: Supporting
children's adaptive behaviour, family ecology, and access to community
recreational programmes may foster participation in family and recreational
activities for young children with CP. Implications for Rehabilitation
Participation in family and recreational activities for young children with CP is
complex and influenced by child, family and environmental factors. Practitioners
are encouraged to support children's adaptive behaviour and access to community
programs and family relationships, involvement in community activities and
expectations of their children. Optimizing gross motor function for children who
have limitations in self-mobility may enhance their participation in family and
recreational activities. For children with a good prognosis for walking,
providing services perceived by parents to meet their children's needs may
enhance children's enjoyment of participation.

Langue : ANGLAIS