Children's Rehabilitation Services Research Articles

Critically Examining the Person-Environment Relationship and Implications of Intersectionality for Participation in Children's Rehabilitation Services.

Participation of children in rehabilitation services is associated with positive functional and developmental outcomes for children with disabilities. Participation in therapy is at risk when the personal and environmental contexts of a child create barriers to accessing services. The International Classification of Functioning, Disability and Health (ICF) provides a framework for conceptualizing the personal and environmental factors linked to a child. However, it does not facilitate critical examination of the person–environment relationship and its impact on participation in children's rehabilitation. This perspective study proposes the use of intersectionality theory as a critical framework in complement with the ICF to examine the impact of systemic inequities on the participation in therapy for children with disabilities. Clinicians are called to be critical allies working alongside children and families to advocate for inclusive participation in children's rehabilitation by identifying and transforming systemic inequities in service delivery.

An Environmental Scan of Parent-focused Transition Practices between Neonatal Follow-up and Children's Rehabilitation Services

ABSTRACTPurpose: Identify parent-focused transition practices for parents of children born preterm/acutely ill when transitioning from Neonatal Follow-Up Programs (NFUP) to Children’s Treatment Centers or Networks (CTCN).Methods: NFUP and CTCN health-care providers participated in an online survey and qualitative interviews. Quantitative data were analyzed using descriptive statistics and qualitative data underwent conventional content analysis.Results: 60 participants (17 sites) from diverse health disciplines completed the survey, and 14 (from 11 of 17 sites) participated in a follow-up interview. Enablers to transition included knowledgeable practitioners, shared services, and family engagement; although not present across all sites. Barriers commonly reported were a lack of time, understanding of roles, and parent engagement.Conclusion: Research study findings highlight the need to improve and bridge NFUP to CTCN parent-focused transition practices. Recommendations for next actions steps include improved cross-sector communication, bridging sectors through enhanced service provision, and moving from information provision to family engagement.

PC-FACS

PC-FACS

Mothers' Perceptions of Their Children's Occupational Therapy Processes: A Qualitative Interview Study

This study aimed to explore parents' views of the management of their children's occupational therapy in the United Kingdom (UK). Forty-one parents of children recently seen by occupational therapists were approached. Seven mothers from four different health boards who agreed to participate were interviewed about their experiences and views of their child's occupational therapy. The interviews were transcribed verbatim and analysed thematically.The interview data suggest that achieving a good quality therapy process requires therapists to appreciate mothers' desire actively to ‘do things’ to help their child and to protect their child from harm. Therapists can support mothers in this by facilitating their access to treatment and support for their child, where the treatment and support are in line with the goals of the child, the parents and the school. The mothers emphasised the importance of interactions between them, the therapist and educational staff. Specifically, shared understandings of the child's condition between the parent and the therapist, and therapists' active engagement of parents, appeared to be linked to parents' positive views of therapy.The findings map onto the literature from North America about parents' expectations of children's rehabilitation services. Recommendations for practice and future research are discussed.

Family-centred care in family-specific teams

Objective: To evaluate the perceptions and views of parents and rehabilitation and special education professionals on the family-centredness of care delivered and received. Design: Descriptive study with comparison of ratings in family-specific teams. Setting: Five paediatric facilities in the Netherlands. Subjects: Parents of children with cerebral palsy and professionals providing their children's rehabilitation and educational services. Main measures: The Dutch Measure of Processes of Care for families (MPOC-NL) and the Measure of Processes of Care for service providers (MPOC-SP). Data were collected and analysed per family. Results: In total 38 MPOC-NLs and 204 MPOC-SPs were returned. The family-specific team analysis of importance ratings yielded significant differences (P < 0.05) on all domains between parents, rehabilitation professionals and special education professionals. For Enabling and partnership (P < 0.01) and Specific information about the child (P < 0.01), parents considered the behaviours to be significantly more important than rehabilitation professionals. The problem-score analyses showed that in all domains a considerable number of parents (19—38%) did not receive the care they deemed important. Conclusion: Family-specific analyses of MPOC importance ratings revealed differences in attitudes towards importance of specific care behaviours of team members, which subsequently may have caused the relatively high incidence of parents not receiving the care they deemed important. This underscores the need to explore and attune opinions on what constitutes proper service delivery.

THE CEREBELLUM IN CEREBRAL PALSY: A COMMONLY OVERLOOKED BUT FREQUENTLY INVOLVED STRUCTURE

Objectives: Cerebellar injury in children with cerebral palsy (CP) who were survivors of extreme prematurity (<28 weeks and <1000 grams) has only recently been appreciated. To investigate the frequency and extent of cerebellar involvement in this group, we reviewed the records of patients with cerebral palsy enrolled in the Children's Rehabilitation Services clinic (CRS) (a state operated, multi-specialty program for special needs children in which CP is a qualifying condition) in Phoenix.

Evaluating children's rehabilitation services: an application of a programme logic model.

To apply a programme logic model to evaluate the effectiveness of a new therapy service for children with special needs who were in transition from pre-school to kindergarten. A children's outpatient rehabilitation centre in Ontario, Canada. The short-term outcomes included parents' perceptions of the transition process itself and the information they required, the children's skill development for the transition to kindergarten, and parents' perceptions of services and satisfaction with resources. A combination of quantitative methods [Goal Attainment Scaling (GAS), Measure of Processes of Care (MPOC), Client Satisfaction Questionnaire (CSQ)] and qualitative interviews were used to evaluate both the process ('Outputs') and outcomes ('Short-term objectives') of the new therapy service. The children involved in the evaluation met or exceeded goals that were set by therapists and parents. Parents' perceptions of, and satisfaction with, the new service were higher than the provincial average. Qualitative data from interviews with parents and service providers supported the findings from standardized measures, and provided suggestions for future service delivery. The programme logic model provided researchers and service providers a collaborative and systematic approach to conducting programme evaluation in a relatively short-time frame. It appears to be a useful option for evaluation of other children's services.

Factors affecting family-centred service delivery for children with disabilities.

The provision of family-centred services (FCS) emphasizes a partnership between parents and service providers so that families are involved in every aspect of services for their child. There is evidence that providing FCS is associated with improvements in parents' satisfaction with services, decreased parental stress, and positive child outcomes. The purpose of this study was to examine factors that are most important in determining parent perceptions of the family centredness of care and parent satisfaction with service. A cross-sectional survey was completed by 494 parents, 324 service providers, and 15 CEOs from 16 organizations delivering children's rehabilitation services. Analyses were completed using a structural equation modelling approach. Survey return rates ranged from 77 to 94%. Findings indicate that the principal determinants of parent satisfaction with services are the family-centred culture at the organization and parent perceptions of FCS. Parent satisfaction with services was also influenced by the number of places where services were received and the number of health and development problems experienced by their child. Parent satisfaction with services is strongly influenced by the perception that services are more family centred, fewer places where services were received and fewer health and development problems for their child. Ways in which organizations can improve satisfaction through carrying out family-centred behaviours are discussed.

Parents' and Service Providers' Perceptions of the Family-Centredness of Children's Rehabilitation Services

Little is known about the extent to which children's rehabilitation services are delivered in a family-centred manner. In this article we report the results of two province-wide surveys, one conducted with 436 parents and the other with 309 service providers, in which we examined the level of family-centred service in children's rehabilitation centres in Ontario, Canada. In one survey we employed the Measure of Processes of Care (MPOC), a measure of parents' perceptions of the behaviours of service providers, and in the other we employed the Family-Centered Program Rating Scale (FamPRS), a measure of service providers' perceptions of the importance and occurrence of family-centred service. The results of the two surveys were very similar. The responses of both parents and service providers indicated that centres were doing well with respect to the interpersonal aspects of service delivery, but that the provision of information was a relatively weak area. The implications of the findings and the utility of the two measurement tools are discussed, as are directions for future research.

Parents' and Service Providers' Perceptions of the Family-Centredness of Children's Rehabilitation Services

Little is known about the extent to which children's rehabilitation services are delivered in a family-centred manner. In this article we report the results of two province-wide surveys, one conducted with 436 parents and the other with 309 service providers, in which we examined the level of family-centred service in children's rehabilitation centres in Ontario, Canada. In one survey we employed the Measure of Processes of Care (MPOC), a measure of parents' perceptions of the behaviours of service providers, and in the other we employed the Family-Centered Program Rating Scale (FamPRS), a measure of service providers' perceptions of the importance and occurrence of family-centred service. The results of the two surveys were very similar. The responses of both parents and service providers indicated that centres were doing well with respect to the interpersonal aspects of service delivery, but that the provision of information was a relatively weak area. The implications of the findings and the utility of the two measurement tools are discussed, as are directions for future research.

Organization termination in the nonprofit setting: the dissolution of children's rehabilitation services

Public and business sector organizations are the primary subjects of the existing literature on organization termination. This article considers the applicability of the termination literature to the nonprofit organization context. In particular, the literatures of public administration (public agency termination), organization theory (life cycles of organizations), and business administration (firm failure) are used to examine the termination experience of a specific nonprofit agency, Children's Rehabilitation Services (CRS). After more than thirty years of providing residential treatment services to boys with emotional problems, the agency merged with another nonprofit rather than face bankruptcy. To understand the causes of CRS's termination, financial factors, deleon's (1978) obstacles to termination, life cycle theory and the role of the agency's changing environment are studied. The case of CRS illustrates many of the findings of the organization termination literature and introduces a new point essential to consideration of termination in the nonprofit context: the importance of the selection of decision makers with competencies appropriate for the given life cycle stage of the organization.

Evaluating family-centred service using a measure of parents' perceptions.

This article describes the use of a newly-developed measure of parents' perceptions of health care providers' behaviours (Measure of Processes of Care-MPOC) to evaluate the family centredness of children's rehabilitation services. The measure was developed with the participation of more than 1600 parents of children with chronic neurodevelopmental conditions throughout Ontario. It assesses five domains: enabling and partnership; providing general information; providing specific information about the child; coordinated and comprehensive care; and respectful and supportive care. By comparing the perceptions of parents receiving services from three different types of organizations or programmes, we demonstrated that the MPOC can pick up differences between parents in their experiences of caregiving. We also demonstrated that the MPOC is able to detect differences in how parents view the family-centredness of services provided by individual centres. The data indicate that the MPOC has appreciable utility in providing programmes and services with a description of their current level of family-centred service as perceived by parents. The strengths, limitations and potential uses of the measure in other contexts are discussed.

Weight gain and triceps skinfolds fat mass after gastrostomy placement in children with developmental disabilities J SUGARMAN ISSACS, KE GEORGESON, HH CLOUD, ET AL University of Alabama at Birmingham, Children's Hospital of Alabama and Children's Rehabilitation Services, Birmingham

Nutrition in Clinical PracticeVolume 10, Issue 4 p. 162-162 Article Weight gain and triceps skinfolds fat mass after gastrostomy placement in children with developmental disabilities J SUGARMAN ISSACS, KE GEORGESON, HH CLOUD, ET AL University of Alabama at Birmingham, Children's Hospital of Alabama and Children's Rehabilitation Services, Birmingham Carolyn Viall, Carolyn ViallSearch for more papers by this author Carolyn Viall, Carolyn ViallSearch for more papers by this author First published: 01 August 1995 https://doi.org/10.1177/088453369501000415AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume10, Issue4August 1995Pages 162-162 RelatedInformation