Concurrent Free Paper Sessions A

Abstract

Objective: The International Classification of Functioning and Disability (ICF) centres on participation as the ultimate outcome for persons with disabling conditions. In the ICF, participation is defined as involvement within a life situation and encompasses personal maintenance, mobility, information exchange, social relationships, home life, education, work and employment, economic life and community, social, and civic life. Children's participation needs to be considered in the context of school, home, and broader community environments. This study aimed to investigate the validity, reliability, sensitivity to change, feasibility, accessibility, and practicality of use of measurements of participation of primary school children with hemiplegia. Design: A systematic review. Method: Inclusion criteria: assessments that measure primary school aged children (5-13y) with cerebral palsy or physical disabilities AND participation (at least 30% content), but may also include activity and environmental factors. Exclusion criteria: papers not published in English that assess quality of life, impairments, communication, or interpersonal relationships. Three raters independently assessed all papers and reached consensus. Results: Systematic searching identified 17 assessments. Consensus agreement was reached for the Canadian Occupational Performance Measure (COPM); School Function Assessment (SFA);' Assessment of Life Habits (LIFE-H for children 1.0);2 Children's Assessment of Participation and Enjoyment(CAPE);3 Goal Attainment Scaling (GAS); and School Outcomes Assessment. The Children Helping Out: responsibilities, Expectations and Supports (CHORES) was selected by two of the raters. The CAPE, SFA, and LIFE-H were found to have the best clinimetric properties. The LIFE-H covers 13 life habit areas. Content validity is good and test retest reliability for most areas is adequate (ICC=O.314.74).* The SFA is judgement based, with specific assessment of participation in school. It has high internal consistency (coefficient alpha=0.924.98), excellent test retest reliability (ICC=0.824.98),and adequate interrater reliability (ICC=0.624.73).' Four studies have supported content and construct validity. The CAPE measures participation in non-school mandated activities. Test development and standardization indicates sufficient internal consistency (0.42 formal domain, 0.76 informal domain), test retest reliability (ICC=0.64-0.86) and validity3 Conclusion: The most suitable measures of participation for primary school children with hemiplegia are the CAPE and LIFE-H for home and broader community environments and the SFA for the school environment. The results of this review will further inform the outcome measures for the participation domain in a randomized trial of upper limb training in children with hemiplegia.