Original article
Perceived Environmental Barriers to Recreational, Community, and School Participation for Children and Youth With Physical Disabilities

https://doi.org/10.1016/j.apmr.2007.07.035Get rights and content

Abstract

Law M, Petrenchik T, King G, Hurley P. Perceived environmental barriers to recreational, community, and school participation for children and youth with physical disabilities.

Objective

To comprehensively describe parent perceptions of environmental barriers to recreational, community, and school participation for children with physical disabilities.

Design

Secondary analysis of cross-sectional data gathered in the first wave of a longitudinal study of the child, family, and environmental factors affecting the recreational and leisure participation of school-age children with physical disabilities.

Setting

General community.

Participants

Parent-child pairs (N=427). Child participants included 229 boys and 198 girls with physical disabilities in 3 age cohorts (6–8, 9–11, 12–14y).

Interventions

Not applicable.

Main Outcome Measure

Craig Hospital Inventory of Environmental Factors.

Results

Barriers to participation were encountered in school and work environments (1.54±1.88), physical and built environments (1.36±1.35), within institutional and government policies (1.24±1.71), services and assistance (1.02±1.2), and attitudes and social support (.87±1.17). Age, socioeconomic status, level of physical functioning, and behavioral difficulties were related to the impact of barriers reported in certain areas. No significant differences by the sex of the children or rural versus urban community were found.

Conclusions

Parents report environmental barriers in several areas, providing valuable information about the environmental factors that support or hinder participation while showing the complexity of these issues. Future research is required to further identify potential avenues for intervention.

Section snippets

Methods

The analysis reported here used cross-sectional data gathered in the first wave of a longitudinal study of child, family, and environmental factors affecting the recreational and leisure participation of school-age children with physical disabilities.8, 26 Ethics approval for the study was obtained from McMaster University. Data collection on a sample of 427 children with physical disabilities and a parent respondent occurred in 3 waves at 9-month intervals during 2001 to 2003. The sample was

Results

Descriptive findings characterizing the impact of perceived barriers to participation in 5 environmental contexts are reported first. These are followed by a report of the main and interaction effects tested by using a MANCOVA comprised of 5 dependent variables (CHIEF subscales), 5 independent variables (child age, sex, level of PF, degree of behavioral difficulties, type of community residence), and a control variable (family income).

Discussion

The findings described in this article represent one of few large empirical studies of parent’s perceptions of environmental barriers to the participation of children with physical disabilities in out-of-school activities. The importance of participation as a major influence on child development is well established.3, 5, 7, 38, 39 For children with physical disabilities, participation has been shown to be limited in comparison to children without disabilities.2, 26 King et al26 found parents’

Conclusions

Findings from this study indicate the presence of multiple environmental barriers to recreational, community, and school participation, thus opening up opportunities for multiple points of entry to facilitate change. Intervention can use both upstream, population-based change approaches as well as downstream, individualized approaches to address barriers, build strengths, and enhance participation.44 Although we cannot always change a child’s functional abilities, in most circumstances, we can

Acknowledgments

We extend our appreciation to Jessica Telford, BA, and Dayle McCauley, BSc, for their contributions to this project.

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    Supported by the U.S. National Institutes of Health (grant no. HD38108-02).

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    Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.