Predictors of Leisure Participation in 6 -14 Years Old Children with Cerebral Palsy: Structural Equation Modeling
Iranian Journal of Child Neurology,
Vol. 14 No. 2 (2020),
1 April 2020
,
Page 41-57
https://doi.org/10.22037/ijcn.v14i2.23646
Abstract
Abstract
Objective: The aim of this study was to test a model of child,family and environment and identify factors affecting intensity of leisure participation by children with cerebral palsy (CP).
Materials & Methods: in this cross-sectional study,232 children with cerebral palsy (141 boys and 91 girls), age range 6 to 14 years and their parents were selected from 4 schools with special needs and 5 rehabilitation center through available sampling in Shiraz city. To evaluate leisure participation, we used the Persian version of Children’s Assessment of Participation and Enjoyment (CAPE) completed by participants. Demographic questionnaires, Craig Hospital Inventory of Environmental Factors (CHIEF), Strengths and Difficulties Questionnaire (SDQ), Family Environmental Scale (FES), SPARCLE cognitive level and parent's version of Gross Motor Function Classification System, Manual Ability Classification System and Communication Function Classification System were send to parents with some necessary explanations and completed. Structural equation modeling was used to test the model hypothesis. SPSS18 and AMOS16 were used for statistical data analysis.
Results: Comparative fit index indicated a moderate to good fit model. The presented model explains 44% of the variance for intensity of participation. Constructs such as Family Activity Orientation with standardized total effect of (.31) and path coefficients P< .05 has shown most significant direct effect on participation, after that higher gross motor function (-.26), higher manual ability (-.19), communication function (-.17), higher cognitive level (-.16), more brothers and sisters in family (.15) and less emotional- behavioral problems (-.15) have shown direct effect on intensity of participation. Family Structures & Relationships (.17) and unsupportive environment constructs (-.14) have shown indirect but significant effect (P< .05). The relationship between family education level and income with participation were not significant (P>.05).
Conclusion: Intensity of CP children participation is influenced by child, family and environmental factors. Parent's knowledge of recreational activities and their preferences to participation in leisure and recreations give children more opportunities to participate. higher gross motor function, manual ability, and communication function have an important role in participation. Family structure means family cohesion, roles organization, and conflicts between family members and also encountering physical, attitudinal and structural barriers in the home and community change children participation pattern indirectly. This study suggests therapists to support children’s behavior, family relationships and involvement in community activities and optimizing physical function for children who have limitations in self-mobility to enhance their participation.
- Participation
- Leisure
- Cerebral Palsy
- Structural Equation Modeling
How to Cite
References
- Roley SS, DeLany JV, Barrows CJ, Brownrigg S, Honaker D, Sava DI, et al. Occupational therapy practice framework: Domain & process 2nd edition. The American journal of occupational
therapy. 2008;62(6):625-83..
Engel-Yeger B, Jarus T, Law M. Impact of culture on children's community participation in Israel. The American journal of occupational therapy. 2007;61(4):421.428
Pashmdarfard M, Amini M, Mehraban AH. Participation of Iranian Cerebral Palsy Children in Life Areas: A Systematic Review Article. Iranian journal of child neurology. 2017;11(1):1.
Jarus T, Anaby D, Bart O, Engel-Yeger B, Law M. Childhood participation in after-school activities: what is to be expected? British Journal of Occupational Therapy. 2010;73(8):344-50.
Shikako-Thomas K, Dahan-Oliel N, Shevell M, Law M, Birnbaum R, Rosenbaum P, et al. Play and be happy? Leisure participation and quality of life in school-aged children with cerebral palsy. International journal of pediatrics. 2012;2012.
Tonkin BL, Ogilvie BD, Greenwood SA, Law MC, Anaby DR. The participation of children and youth with disabilities in activities outside of school: a scoping review. Canadian Journal of Occupational Therapy. 2014 ;81(4):226-236.
Steultjens EM, Dekker J, Bouter LM, Van De Nes JC, Lambregts BL, Van Den Ende CH. Occupational therapy for children with cerebral palsy: a systematic review. Clinical Rehabilitation. 2004;18(1):1-14.
Mehraban AH, Hasani M, Amini M. The Comparison of Participation in School-Aged Cerebral Palsy Children and Normal Peers: A Preliminary Study. Iranian journal of pediatrics. 2016; 26(3): e5303.
Engel-Yeger B, Jarus T, Anaby D, Law M. Differences in patterns of participation between youths with cerebral palsy and typically developing peers. American Journal of Occupational Therapy. 2009;63(1):96-104.
King G, Law M, Hanna S, King S, Hurley P, Rosenbaum P, et al. Predictors of the leisure and recreation participation of children with physical disabilities: a structural equation modeling analysis. Children's Health Care. 2006;35(3):209-34.
Chiarello LA, Bartlett DJ, Palisano RJ, McCoy SW, Fiss AL, Jeffries L, et al. Determinants of participation in family and recreational activities of young children with cerebral palsy. Disability and rehabilitation. 2016;38(25):2455-68.
Palisano RJ, Orlin M, Chiarello LA, Oeffinger D, Polansky M, Maggs J, et al. Determinants of intensity of participation in leisure and recreational activities by youth with cerebral palsy. Archives of physical medicine and rehabilitation. 2011;92(9):1468-76.
Kolehmainen N, Ramsay C, McKee L, Missiuna C, Owen C, Francis J. Participation in physical play and leisure in children with motor impairments: mixed-methods study to generate evidence for developing an intervention. Physical therapy. 2015;95(10):1374-86.
Byrne BM. Structural equation modeling with AMOS: Basic concepts, applications, and programming: Routledge; 2016.
Majnemer A, Shevell M, Law M, Birnbaum R, Chilingaryan G, Rosenbaum P, et al. Participation and enjoyment of leisure activities in school‐aged children with cerebral palsy. Developmental Medicine & Child Neurology. 2008;50(10):751-8.
Alghamdi MS, Chiarello LA, Palisano RJ, McCoy SW. Understanding participation of children with cerebral palsy in family and recreational activities. Research in developmental disabilities. 2017;69:96-104.
Orlin MN, Palisano RJ, Chiarello LA, Kang LJ, Polansky M, Almasri N, et al. Participation in home, extracurricular, and community activities among children and young people with cerebral palsy. Developmental Medicine & Child Neurology. 2010;52(2):160-6.
Longo E, Badia M, Orgaz BM. Patterns and predictors of participation in leisure activities outside of school in children and adolescents with cerebral palsy. Research in developmental disabilities. 2013;34(1):266-75.
Shikako-Thomas K, Majnemer A, Law M, Lach L. Determinants of participation in leisure activities in children and youth with cerebral palsy: systematic review. Physical & occupational therapy in pediatrics. 2008;28(2):155-69.
Law M, King G, King S, Kertoy M, Hurley P, Rosenbaum P, et al. Patterns of participation in recreational and leisure activities among children with complex physical disabilities. Developmental medicine and child neurology. 2006;48(5):337-42.
Mei C, Reilly S, Reddihough D, Mensah F, Green J, Pennington L, et al. Activities and participation of children with cerebral palsy: parent perspectives. Disability and rehabilitation. 2015;37(23):2164-73.
Kanagasabai PS, Mulligan H, Hale LA, Mirfin-Veitch B. “I do like the activities which I can do…” Leisure participation experiences of children with movement impairments. Disability and rehabilitation. 2018;40(14):1630-8.
Colver A. Study protocol: SPARCLE–a multi-centre Eurpean study of the relationship of environment to participation and quality of life in children with cerebral palsy. BMC Public Health. 2006;6(1):105.
Kang L-J, Hsieh M-C, Liao H-F, Hwang A-W. Environmental barriers to participation of preschool children with and without physical disabilities. International journal of environmental research and public health. 2017;14(5):518.
Mollasharifi S, Vakhshoori H, Salimizadeh M. Standardization of Family Environment Scale for Iraininan family living in Tehran. Journal of Family Research. 2005;1(3):255-67.
Nobakht Z, Rassafiani M. Rezasoltani P. Validity and reliability of Persian version of Craige Hospital Inventory of Environmental Factors (CHIFE) in children with cerebral palsy. Iranian Rehabilitation Journal. 2011; 9 (1) :3-10.
Shahmoradi R. Standardization questionnaire strengths and weaknesses of the child’s emotional and behavioral disorders and the epidemiology of shahrekord schoolchildren.(In Persian)[dissertation]. Teh Psychiatric Institute. 2006.
Soleymani Z, Joveini G, Baghestani AR. The Communication Function Classification System: cultural adaptation, validity, and reliability of the Farsi version for patients with cerebral palsy. Pediatric neurology. 2015;52(3):333-7.
Riyahi A, Rassafiani M, AkbarFahimi N, Sahaf R, Yazdani F. Cross-cultural validation of the Persian version of the Manual Ability Classification System for children with cerebral palsy. International Journal of Therapy and Rehabilitation. 2013;20(1):19-24.
Riahi A, Rassafiani M, Binesh M. The Cross-Cultural Validation and Test-Retest and Inter-Rater Reliability of the Persian Translation of Parent Version of the Gross Motor Function Classification System for Children with Cerebral Palsy. Journal of Rehabilitation. 2013;13(5):25-30.
Hooper D, Coughlan J, Mullen M. Structural equation modelling: Guidelines for determining model fit. The Electronic Journal of Business Research Methods. 2008; 6 (1): 53 - 60.
Hair JF, Anderson RE, Babin BJ, Black WC. Multivariate data analysis: A Global Perspective. 7th Edition, 2010. Upper Saddle River (N.J.): Prentice Hall
Dahan-Oliel N, Mazer B, Maltais DB, Riley P, Nadeau L, Majnemer A. Child and environmental factors associated with leisure participation in adolescents born extremely preterm. Early human development. 2014;90(10):665-72.
Kanagasabai PS, Mulligan H, Mirfin‐Veitch B, Hale LA. Association between motor functioning and leisure participation of children with physical disability: an integrative review. Developmental Medicine & Child Neurology. 2014;56(12):1147-62.
Di Marino E, Tremblay S, Khetani M, Anaby D. The effect of child, family and environmental factors on the participation of young children with disabilities. Disability and health journal. 2018;11(1):36-42.
Gau SS-F, Chang JP-C. Maternal parenting styles and mother-child relationship among adolescents with and without persistent attention-deficit/hyperactivity disorder. Research in Developmental Disabilities. 2013; 34(5):1581-94.
Larivière-Bastien D, Majnemer A, Shevell M, Racine E. Perspectives of adolescents and young adults with cerebral palsy on the ethical and social challenges encountered in healthcare services. Narrative inquiry in bioethics. 2011;1(1):43-54.
Clemente I. Barriers and facilitators to participation in physical activity for children with disabilities.: A systematic literature review. 2017.
Gilboa Y, Fuchs R. Participation Patterns of Preschool Children With Intellectual Developmental Disabilities. OTJR . 2018;38(4):261-268.
Rosenberg L, Bart O, Ratzon NZ, Jarus T. Personal and environmental factors predict participation of children with and without mild developmental disabilities. Journal of child and family tudies. 2013;22(5):658-71.
Eversole M, Collins DM, Karmarkar A, Colton L, Quinn JP, Karsbaek R, et al. Leisure activity enjoyment of children with autism spectrum disorders. Journal of autism and developmental disorders. 2016;46(1):10-20.
Palisano RJ, Chiarello LA, King GA, Novak I, Stoner T, Fiss A. Participation-based therapy for children with physical disabilities. Disability and rehabilitation. 2012;34(12):1041-52.
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