McGill University, Canada.
University of Illinois at Chicago, USA.
Disabil Health J. 2018 Jan;11(1):36-42. doi: 10.1016/j.dhjo.2017.05.005. Epub 2017 Jun 1.
While participation is essential to a child's health and well-being, little is known about participation patterns of young children with disabilities.
This study described the participation of children with disabilities under age 6, and examined the extent to which the child's factors (i.e., age, complexity of child's condition), family factors (i.e., general family functioning, income) and environmental factors (i.e., environmental helpfulness) affect participation dimensions (frequency, involvement, desire for change) in three different settings: home, daycare/preschool and community.
Cross-sectional design was employed. Parents (n = 90) of children aged 1.4-6 years old (mean = 4.15, SD = 1.03) with disabilities completed the French Young Children's Participation and Environment Measure (YC-PEM) and Family Assessment Device. Descriptive statistics and multiple linear regressions were performed to describe participation patterns and identify the significant explanatory factors in each setting.
Participation restriction, based on frequency of activities, was primarily observed in the community setting. Environmental helpfulness (resources, supports) consistently explained participation levels for at least one of the dimensions across all settings, whereas contribution of the child's factors was less evident. Family functioning had a significant effect when examining participation involvement in the community and desire for change in the home setting and, in combination with environmental helpfulness, explained 18% and 21% of the variance respectively.
This study emphasizes the role of the environment in supporting participation of young children with disabilities. Findings can re-direct practitioners' attention towards modifying the environment as a primary target of intervention aimed at promoting health through participation.
参与对于儿童的健康和幸福至关重要，但我们对残疾儿童的参与模式知之甚少。
本研究描述了 6 岁以下残疾儿童的参与情况，并探讨了儿童自身因素（即年龄、儿童病情复杂程度）、家庭因素（即一般家庭功能、收入）和环境因素（即环境支持度）对儿童在家庭、日托/学前和社区三种不同环境中的参与维度（参与频率、参与程度、改变意愿）的影响程度。
采用横断面设计。90 名 1.4-6 岁残疾儿童的家长（均龄=4.15，标准差=1.03）填写了法语幼儿参与和环境量表（YC-PEM）和家庭评估工具。采用描述性统计和多元线性回归来描述参与模式，并确定各环境中具有显著解释力的因素。
活动频率受限主要出现在社区环境中。环境支持度（资源、支持）始终能够解释所有环境中至少一个维度的参与水平，而儿童自身因素的贡献则不明显。家庭功能在社区参与程度和家庭改变意愿方面具有显著影响，与环境支持度结合后，分别解释了 18%和 21%的方差。
本研究强调了环境在支持残疾幼儿参与方面的作用。研究结果可以引导从业者将环境改造作为干预的主要目标，通过参与促进健康。
