Date Presented 04/21/2023
Our research revealed that the number of caregiver strategies intensified the impact of environmental support on participation attendance in school occupations among children and youth with craniofacial microsomia and childhood-onset disabilities.
Primary Author and Speaker: Vera C Kaelin
Contributing Authors: Dana Anaby, Martha M Werler, Mary Alunkal Khetani
PURPOSE: To support participation-focused intervention development, our study tested 1) the direct effect of predictors (i.e., environmental support, physical functioning problems and behavior problems) on school participation among children and youth with unmet participation need, including those with childhood-onset disabilities and craniofacial microsomia (CFM); and 2) the indirect effect of predictors on school participation through the use of caregiver strategies.
DESIGN: This study involved secondary analyses of a subset of data (260 families of children and youth with CFM (n = 120) and with childhood-onset disabilities (n = 140)) from the second follow-up of a longitudinal cohort study.
METHOD: Measure selection was informed by the family of Participation-Related Constructs framework and included Participation and Environment Measure Children and Youth, Child Behavior Checklist, and Pediatric Quality of Life Inventory. Structural equation modeling was used to examine 1) the direct effect of predictors on school participation attendance and level of involvement; and 2) the indirect effect of those relationships through caregiver strategy use, while controlling for parental education and child age.
RESULTS: Models explained 22-37% of the variance in school participation attendance and involvement. Environmental support had a positive direct effect on school participation attendance and involvement. Physical functioning problems had a significant negative direct effect on participation involvement. The number of caregiver strategies intensified the impact of environmental support on child and youth school participation attendance.
CONCLUSION: Results of this study indicate that caregiver strategies, together with environmental supports, may present a valuable starting point for participation-focused intervention planning and addressing family needs.
IMPACT STATEMENT: This research includes relevant work for intervention development to support occupational therapy practice.
Kaelin, V. C., Wallace, E. R., Werler, M. M., Collett, B. R., Rosenberg, J., & Khetani, M. A. (2021). Caregiver perspectives on school participation among students with craniofacial microsomia. American Journal of Occupational Therapy, 75(2), 7502205100p1. https://doi.org/10.5014/ajot.2021.041277
Kaelin, V. C., Wallace, E. R., Werler, M. M., Collett, B. R., & Khetani, M. A. (2022). Community participation in youth with craniofacial microsomia. Disability and Rehabilitation, 44(2),253–260. https://doi.org/10.1080/09638288.2020.1765031
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Anaby, D., Law, M., Coster, W., Bedell, G., Khetani, M. A., Avery, L., & Teplicky, R. (2014). The mediating role of the environment in explaining participation of children and youth with and without disabilities across home, school, and community. Archives of Physical Medicine and Rehabilitation, 95(5), 908–917. https://doi.org/10.1016/j.apmr.2014.01.005