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Understanding the impact of physical, social, and attitudinal environments on the participation of children with cerebral palsy in the North East of England

Lookup NU author(s): Dr Katherine Lawlor, Emeritus Professor Stephen Jarvis


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Objectives: Participation is defined as an individual’s involvement in life situations. According to the model described in the International Classification of Functioning, Disability and Health (ICF), participation is related to the social, attitudinal, and physical environments in an individual’s life. This study attempts to understand the impact of these environments on the participation of children with cerebral palsy (CP) in the North East of England and assesses the use of the ICF classification system to describe the environments. Method: Semi-structured interviews were conducted with the parents of 12 children registered on the North of England Collaborative CP Register. Data from the interviews were analyzed qualitatively using a framework approach. Results: The main themes emerging from the interviews were the importance of mobility, accessible transport, and the supporting role of parents. The major environmental barriers to participation were physical access barriers. Other barriers to participation included inadequately adapted facilities such as public toilets, difficulties in obtaining expensive specialist equipment, and the strain on families’ resources as parents left work to become carers. The main environmental facilitator to participation was the supporting role of parents who provided physical support, financial support, supervision, and advocacy for the children. Other facilitators included private transport with good parking facilities, financial benefits, and information about resources. The ICF system was easy to use when coding the environmental factors. Many situations had multiple environmental barriers and facilitators and so were multiply coded. The coding was particularly useful in considering the services, systems, and policies behind many of the barriers and facilitators, for example, in the planning of the built environment. Conclusions: This study confirms the importance of the environment for the participation of children with CP. Physical elements of the environment were particularly prominent, reflecting the nature of this group of children who had moderate to severe CP and significant limitations to mobility. The social environment, in particular the supporting role of parents, was crucial for participation. The attitudinal environment, evident in the actions of services, systems, and policies, also influenced participation. This qualitative work provides a starting point for undertaking a larger quantitative study of these environmental factors, with a view to influencing policy and advancing the participation of children with CP

Publication metadata

Author(s): Lawlor K; Jarvis SN; Mihaylov B; Welsh M

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Developmental Medicine & Child Neurology: European Academy of Childhood Disability Annual Meeting

Year of Conference: 2003

Pages: 27

ISSN: 0012-1622

Publisher: Mac Keith Press


DOI: 10.1017/S0012162203001348

Library holdings: Search Newcastle University Library for this item

ISBN: 14698749