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January 2011



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First Published Monday, 27 April 2009

Article Date: 27 Apr 2009

A study available on bmj.com concludes that in order for disabled children to participate equally in life with others, conditions in some European countries need to be improved.

In the study, “participation” is described as taking part in life situations, and this is hardly known in disabled children. Researchers in the study evaluated at random 818 European children aged 8 to 12, from southeast and southwest France, southwest Ireland, west Sweden, north England, Northern Ireland, east Denmark and central Italy, all with a cerebral palsy condition.

Parents and children were both interviewed about their involvement in ten main fields or domains of daily life such as mealtimes, communication, relationships, school and recreation. They also supplied information about demographics, employment, level of educational qualifications, and whether they resided in rural or urban areas.

Background information about each child’s impairments including movement (motor function), intellectual ability, vision, hearing and communication was collected as well as an assessment in the rate of occurrence and the degree of pain.

Children with pain and those with more harshly impaired walking, fine motor skills, communication and intellectual abilities had considerably less involvement on most domains. Even after controlling for severity of impairment, soreness was strongly connected with lesser levels of participation.

Children that had considerably less involvement on most domains were those resulting in having more pain, or those that had more harshly impaired walking, fine motor skills, or communication and intellectual abilities. Soreness was always strongly connected with lesser levels of involvement even after calculating the seriousness of the disability.

After adjusting for impairment and pain, the difference in regions on the participation on all domains varied substantially. Danish children had much higher participation than children in all the other regions.

The authors mention that the findings on the research demonstrate the significance in evaluating the children´s pain status, and supervise it efficiently. They also add that unfortunately, national guideline principles and legislation in different countries can also have a commanding influence on the daily lives of children with disabilities and their families.

The researchers suggest that both soreness and involvement of disabled children should be evaluated in clinical practice to help guide involvement. They also recommend that using the experience of those countries that best help disabled children, national regulations and legislations should be aimed at guarantying all countries to adjust environments in order to optimize the participation of disabled children.

In a supplementary editorial, Peter Rosenbaun Professor of Pediatrics at Mc Masters University in Canada mentions that this study reflects modern thinking about health and function.

Dr. Rosenbaun later suggests as the current study has discovered, that the hard work in childhood disability should be to support the attainment and improvement of life skills in all dimensions, and to facilitate young disabled people to take part in both the instrumental and discretionary opportunities of their lives, as the present study has examined.

In conclusion he writes:”If we can broaden our clinical thinking beyond the biomedical dimensions of diseases to include participation … we may help improve the quality of life and long term wellbeing of disabled children and young people along with their families.”

“Research: Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study”
BMJ online

“Editorial: Childhood disability and social policies”
BMJ online

Written by Stephanie Brunner (B.A.)


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