Department of Physical Therapy and Rehabilitation Sciences (MS 502), Drexel University, 245 N. 15th Street, Philadelphia, PA 19102-1192, USA.
Disabil Rehabil. 2012;34(12):1041-52. doi: 10.3109/09638288.2011.628740. Epub 2011 Nov 14.
Optimizing home and community participation of children with physical disabilities is an important outcome of rehabilitation.
A review of literature identified research and theory on participation of children with physical disabilities. The authors' incorporated current knowledge to conceptualize the experience of optimal participation, formulate principles of participation-based physical and occupational therapy, and develop a five-step process for intervention. A case report was completed to illustrate application to practice.
Optimal participation involves the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation. Real-life experiences enable children to learn new activities and develop skills that optimize their participation and self-determination. Interventions are: goal-oriented, family-centered, collaborative, strengths-based, ecological, and self-determined. A distinguishing feature of intervention is that the therapist's primary role is to support the child and family to identify challenges to participation and solutions to challenges. The therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity.
The model may have utility for collaboration with families and community providers, determining goals for participation, and providing evidence-informed interventions.
优化残疾儿童的家庭和社区参与是康复的一个重要结果。
文献回顾确定了残疾儿童参与的研究和理论。作者将当前的知识融入其中，将最佳参与体验概念化，制定基于参与的物理治疗和职业治疗原则，并开发了一个五步干预过程。完成了一个案例报告来说明应用于实践。
最佳参与涉及决定因素（儿童、家庭和环境的属性）和参与的维度（身体、社会和自我参与）的动态相互作用。现实生活经验使儿童能够学习新的活动并发展技能，从而优化他们的参与和自我决定能力。干预措施是：目标导向、以家庭为中心、协作、以优势为基础、生态和自我决定。干预的一个显著特点是治疗师的主要角色是支持儿童和家庭识别参与的挑战和挑战的解决方案。治疗师是顾问，与儿童、家庭和社区提供者合作，分享信息、教育和指导，以建立儿童、家庭和社区的能力。
该模型可能有助于与家庭和社区提供者合作，确定参与目标，并提供循证干预措施。
