Participation And Environment Measure For Children And Youth Research Articles

Skills on wheels: initial pre-post findings from a pilot study of a pediatric wheelchair skills training program

Skills on Wheels, a 5-week pediatric wheelchair skills training program implemented over 2 years, was developed to address confidence, social participation, and mobility for wheelchair-using children. This study tests the hypothesis that pediatric wheelchair skills training will increase wheelchair skill ability, confidence, and participation of wheelchair-using children. Individualized instruction was delivered by occupational (N = 50) and physical (N = 12) therapy practitioners and doctoral students. The primary program intervention was adapted for pediatric wheelchair users from the adult Wheelchair Skills Training Program, developed by Dalhousie University, consisting of a total of 33 wheelchair skills. An adapted version of the Wheelchair Confidence measure (Wheel-Con-M-P), the Participation and Environment Measure for Children and Youth (PEM-CY), and Wheelchair Skills Test (WST) were used to measure participants confidence and ability to complete wheelchair skills, endurance, and participation and satisfaction in community, school, and home. The study resulted in: increases in confidence in ability to move wheelchair over threshold (+1.00, p < 0.05), ability to carry lunchbox/bookbag (+0.65, p < 0.05), ability to move in wheelchair when worried or scared (+1.3, p < 0.05), ability to ask for help, and ability to say “no” if they don’t need help (+0.58, p < 0.05) were indicated. The WST indicated increased ability (p < 0.05) on several skills. The Fear of Falling Measure found an overall decrease in fear of falling (−2.37, p < 0.01). The Skills on Wheels program demonstrated many successes in this initial 2-year study and data suggest a positive trend for iterations to come.

Participation Strategies of Parents of Children with Neurodevelopmental Disorders: An Exploratory Study.

Strategies are critical to promote child participation in important life activities. This study analyzed the participation strategies of the parents of children with neurodevelopmental disorders. Ninety-two Japanese elementary children with neurodevelopmental disorders and their parents were recruited. The parents completed the Participation and Environment Measure for Children and Youth (PEM-CY) questionnaire. Strategy text data obtained from the PEM-CY were analyzed with the co-occurrence network and correspondence analyses. The co-occurrence network analysis showed that the commonality of strategies to enable participation at home, school, and community settings was able to explain the child's characteristics when involved in each setting. The correspondence analysis also suggested the need for specific strategies in each setting. The importance of strategies to improve the attitudinal environment and promote the participation of children with neurodevelopmental disorders was evident. Reducing stigma is important in all environments, especially in the public sphere. In addition, specific strategies are needed in each setting, suggesting the importance of context-specific approaches.

Go Zika Go: feasibility study with modified motorized ride-on cars for the mobility of children with Congenital Zika Syndrome (CZS)

Purpose To explore the feasibility of an intervention using modified ride-on cars in terms of acceptability and potential changes in goal attainment, mobility, social function, and participation of children with Congenital Zika Syndrome (CZS). Materials and Methods A pre- and post-intervention feasibility study was conducted with children with CZS, levels IV and V of the Gross Motor Function Classification System (GMFCS). The intervention consisted of 12 weeks of training (3 times a week for 40 min per session) and 4 weeks of follow-up. The primary outcomes included adherence, satisfaction, and learning in mobility. Secondary outcomes encompassed goal attainment, mobility, social/cognitive function, and participation. Descriptive statistics were performed. To explore potential individual changes with the intervention, Wilcoxon test was used to analyze Pediatric Evaluation of Disability Inventory – Computer Adaptive Test (PEDI-CAT) data and Young Children’s Participation and Environment Measure (YC-PEM)/Participation and Environment Measure for Children and Youth (PEM-CY), along with standard error measurements of the PEDI-CAT domains Results Four children participated (median age 4.75 years; two females: three at level V on the GMFCS). Adherence was 75% of the total intervention time, and family members reported being satisfied or very satisfied. Children showed gains in learning the use of the modified ride-on cars and an increase in goal attainment after the intervention. Individual changes were observed in the PEDI-CAT domains (mobility and social/cognitive), but there were no significant changes in participation outcomes. Conclusions Children with CZS at GMFCS levels IV and V can learn to use motorized ride-on cars, attainment goals, and experience satisfaction.

Natural Language Processing to Classify Caregiver Strategies Supporting Participation Among Children and Youth with Craniofacial Microsomia and Other Childhood-Onset Disabilities

Customizing participation-focused pediatric rehabilitation interventions is an important but also complex and potentially resource intensive process, which may benefit from automated and simplified steps. This research aimed at applying natural language processing to develop and identify a best performing predictive model that classifies caregiver strategies into participation-related constructs, while filtering out non-strategies. We created a dataset including 1,576 caregiver strategies obtained from 236 families of children and youth (11–17 years) with craniofacial microsomia or other childhood-onset disabilities. These strategies were annotated to four participation-related constructs and a non-strategy class. We experimented with manually created features (i.e., speech and dependency tags, predefined likely sets of words, dense lexicon features (i.e., Unified Medical Language System (UMLS) concepts)) and three classical methods (i.e., logistic regression, naïve Bayes, support vector machines (SVM)). We tested a series of binary and multinomial classification tasks applying 10-fold cross-validation on the training set (80%) to test the best performing model on the held-out test set (20%). SVM using term frequency-inverse document frequency (TF-IDF) was the best performing model for all four classification tasks, with accuracy ranging from 78.10 to 94.92% and a macro-averaged F1-score ranging from 0.58 to 0.83. Manually created features only increased model performance when filtering out non-strategies. Results suggest pipelined classification tasks (i.e., filtering out non-strategies; classification into intrinsic and extrinsic strategies; classification into participation-related constructs) for implementation into participation-focused pediatric rehabilitation interventions like Participation and Environment Measure Plus (PEM+) among caregivers who complete the Participation and Environment Measure for Children and Youth (PEM-CY).

Community Participation, Supports and Barriers of Adolescents with and without Attention Deficit Hyperactivity Disorder

Aim To compare participation patterns, environmental supports, and barriers to community activities in adolescents with and without attention deficit hyperactivity disorder (ADHD) in Turkey. Methods Participants were 94 adolescents with ADHD and 109 adolescents without ADHD ages 13-17 years (mean age 14.6, S.D 1.49 years) Participation frequency, involvement rate, mothers who desired change, and environmental supports and barriers in a community setting were assessed with the Participation and Environment Measure for Children and Youth (PEM-CY). Results Adolescents with ADHD participated 20.3% less frequently in socializing with peers in the community than adolescents without ADHD. With moderate to large effect sizes, the mean involvement rate in four community activities, including neighborhood outings, community events, socializing with peers in the community, and religious activities, was significantly lower for adolescents with ADHD than for adolescents without ADHD. Conclusion Adolescents with ADHD participate less frequently and are less involved in socializing with peers in the community. Almost half of all ADHD adolescents never participate in community events. It was seen that cognitive difficulties, sensory qualities, and safety may prevent adolescents with ADHD from socializing with peers in the community.

How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports?

BackgroundChildren with chronic conditions face participation restrictions and exclusions. AimsTo investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). Methods and proceduresThe study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners’ Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. Outcome and resultsIn home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). Conclusions and implicationsWhen seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges.

The long-term impact of the COVID-19 pandemic on children with ADHD in terms of participation, support, and barriers at home

PurposeThe purpose of this study was to compare the long-term impact of the COVID-19 pandemic on participation, support, and barriers at home in children with attention deficit hyperactivity disorder (ADHD) and without ADHD. Design and methodsThis study included a total of 227 participants with a mean age of 11.93 ± 2.96 years, comprising 116 children and adolescents with ADHD and 111 without ADHD. The parents or primary caregivers of all the children completed the Participation and Environment Measure for Children and Youth (PEM-CY), which was used to assess participation and environmental factors in the home. The Student's t-test was used to compare numeric data and Chi-square test to categorical data between children and adolescents with ADHD and those without ADHD in all three settings. ResultsThe children with ADHD were determined to play computer and video games significantly more than children without ADHD (p < 0.001). The mean frequency of participation in arts, crafts, music, hobbies (p < 0.001), school preparation (<0.0001), and homework (<0.003) was significantly higher in children without ADHD. A moderate effect size (ϕ = 0.42) was determined in respect of cognitive demands making it more difficult for children with ADHD to participate in home activities than children without ADHD. ConclusionsChildren with ADHD were negatively affected in terms of participating in home activities than their typically developing peers. In addition, cognitive demands prevented their participation and involvement in the home environment while cognitive demands were a support for non-ADHD children. Practical implicationsA highlight of this research was the comprehensive investigation of the long-term effect of the COVID-19 pandemic on participation in all activities at home, in addition to the support and barriers in the home environment for children with ADHD compared to typically developing peers.

The Effect of COVID 19 Pandemic on the Participation of Children with Special Needs

ABSTRACT The objective of this study is to investigate the environmental factors such as supports and barriers that have been faced by those children with SLD between the before and after COVID-19 lockdown and their involvement, participation frequency and desire for change. The participation features as well as the environmental factors at home, school and community settings of these children (n: 61; mean age: 9.37 ± 1.50 year)during the COVID-19 pandemic lockdown were assessed by using the Participation and Environment Measure for Children and Youth (PEM-CY) instrument via Internet access. The differences in participation frequency, involvement, desire for change, and environmental factors (supports and barriers) for school and community settings between the pre and post COVID-19 pandemic lockdown were found to be p < 0.01. There were no statistical differences at home settings in terms of participation frequency and supports (p > 0.05). This study provides information about the participation levels of children with special needs during the COVID-19 pandemic and the environmental factors faced by these children. The results are expected to contribute to the rehabilitation program that may improve the participation levels of children with special needs, and determine where greater efforts are needed to support so as to raise their participation levels and improve environmental features after the quarantine process.

Psychometric properties of the School Participation Questionnaire: Testing a measure of participation-related constructs.

To explore concurrent validity, convergent validity, interrater reliability, test-retest reliability, and Rasch model analysis of the School Participation Questionnaire (SPQ), a tool for teachers to assess personal and environmental determinants of school participation. Teachers of children with additional support needs, including intellectual disability, autism, and learning difficulties completed measures. Data were collected using the SPQ and the Participation and Environment Measure for Children and Youth (PEM-CY). Test-retest and interrater reliability were assessed using intraclass correlation coefficients (ICCs). Internal consistency was assessed with Cronbach's alpha. Concurrent and convergent validity were explored via correlations with the PEM-CY. Further psychometrics were examined using a Rasch model. One hundred and eighty-seven children (136 [72.7%] male; mean age 9y [range 5y 6mo-12y 10mo, SD 2y]) were assessed by 67 teachers. Cronbach's alpha, test-retest, and interrater reliability were acceptable-excellent across each SPQ scale (alphas=0.89, 0.9, 0.94, 0.79; test-retest ICCs=0.64, 0.61, 0.78, 0.62; interrater ICCs=0.85, 0.71, 0.90, 0.81). Concurrent and convergent validity were confirmed with significant positive correlations between SPQ and PEM-CY. After Mokken and Rasch model analysis, person and item reliability were good, and unidimensionality was confirmed. Mean administration time was 8.2 minutes. The results suggest that the SPQ is a rapid, reliable, and valid tool for assessment of participation-related indicators in schools.

Home participation, support and barriers among children with attention-deficit/hyperactivity disorder before and during the COVID-19 pandemic

ObjectivesFew studies have focused on the participation of children with attention-deficit/hyperactivity disorder (ADHD) in daily routine and leisure activities. This study aimed to compare the participation, support and barriers for children with ADHD at home pre-COVID-19 and during the COVID-19 outbreak. MethodsThe study included 55 children with ADHD aged 6–11 years. Participation frequency, involvement, desire for change, supports and barriers at home were assessed using the Participation and Environment Measure for Children and Youth (PEM-CY). ResultsDuring the COVID-19 pandemic compared with the pre-COVID-19 period, the mean frequency of participation of children with ADHD in computer and video games (5.8% vs 5%, respectively), socialising with other people (7% vs 6.2%) and household chores (5.5% vs 4.6%) was shown to be significantly higher (p < 0.05). Mothers of children with ADHD reported higher levels of involvement during the COVID-19 pandemic compared with the pre-COVID-19 period across four areas of home participation, including computer and video games (4.1% vs 3.2%, respectively), arts, crafts, music and hobbies (3.7% vs 3%), household chores (3.6% vs 2.8%) and personal care management (4.2% vs 3.5%) p < 0.05). Mothers of children with ADHD reported that during the pandemic the following two features of the environment made participation easier than pre-COVID-19 (p < 0.05): cognitive demands (36.4% vs 60%, respectively) and social demands (5.5% vs 34.5%). More mothers reported that services (92.7%), supplies (87.3%) and information (85.5%) were available and/or adequate in the COVID-19 period than pre-COVID-19 (p < 0.05). ConclusionsMothers of children with ADHD reported that their children were participating more frequently in some of the home-related activities during the COVID-19 pandemic compared to pre-COVID-19. Reduced cognitive and social demands, and more readily available resources in the home environment during the COVID-19 period resulted in increased home participation compared to pre-COVID-19.

Participation Profile of Children and Youth, Aged 6-14, with and without ADHD, and the Impact of Environmental Factors.

Background: Children and youth with attention deficit hyperactivity disorder (ADHD) may experience difficulties in participation, but few studies examine their participation and the environmental factors affecting participation. This study explored the participation and the environmental factors of children and youth, with and without attention deficit hyperactivity disorder (ADHD), in the following three settings: home, school, and community. Materials and Methods: Parents of 65 participants aged 6–14 (M = 9.91, SD = 1.87) with and without ADHD completed the Participation and Environment Measure for Children and Youth (PEM-CY) questionnaire, which evaluates participation and environmental factors, along with demographic and screening questionnaires. Results: The ADHD group (n = 31) scored significantly lower than the non-ADHD group (n = 34) in “frequency” at home, “involvement”, and overall environmental support in all settings, with parents expressing a greater desire to change their child’s home and community participation. For the ADHD group, a relationship was found between environmental support and involvement in all three settings. Conclusions: The findings demonstrated differences in the participation of children and youth with ADHD across different settings, compared to those without ADHD, and confirmed the effect of environmental factors on participation, especially involvement. It is essential to consider participation measures and environmental factors when designing interventions for children and youth with ADHD.

Participation Patterns of Adolescents with and without Executive Function Deficits: Parents’ Perspectives

ABSTRACT This study examines parents’ perspectives of the participation patterns (frequency, involvement, and parental desire for change) in their adolescent children’s everyday functioning with and without executive function deficit profiles. Parents of 81 adolescents (10–14) years) with executive function deficits (n = 41) and a matched group of parents of adolescents with typical development (n = 40) completed the Participation and Environment Measure for Children and Youth (PEM-CY) questionnaire. The questionnaire includes the adolescents’ participation frequency and involvement in common everyday functions in three environments (home, school, and community) and parental desire for change. Parents of adolescents with executive function deficits reported that their children participated significantly less (in frequency and involvement) in many activities within each environment than parents of typically developing adolescents reported. Additional significant group differences were evident, particularly when comparing parental desires to change their adolescent children’s participation. Each environment’s characteristics regarding the structure level and different activity demands are discussed as a possible reason for these differences in participation. The challenges and complexity of raising a child with everyday functioning difficulties might be one reason for the differences in parents’ desire for change.

Cross-cultural adaptation of the Participation and Environment Measure for Children and Youth (PEM-CY) into German: a qualitative study in three countries

BackgroundConcepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland.MethodsFifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence.ResultsResults show adaptations mainly focused on experiential and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect those typical in German speaking countries. Conceptual equivalence mainly addressed aspects of “involvement” and “environment” of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions.ConclusionsThis study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. Using a modified cultural adaptation process, a culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.

Investigation on participation, supports and barriers of children with specific learning disabilities

BackgroundChildren with specific learning disabilities (SLD) have been observed to face participation restrictions in their daily life. AimsThis study aims to examine the participation and environmental features of children with SLD compared to non-disabled children. Methods and proceduresThis study was designed as a case-controlled study. Parents of children between 5 and 17 years of age with SLD (n = 90) and those who are non-disabled (n = 88) were included in this study to do the Participation and Environment Measure for Children and Youth (PEM-CY). ResultsDifferences between groups were found statistically significant in home, school, and community settings between both participation and environmental features (p < 0.05). Children with SLD participated less frequently in school settings and were less involved in activities in home and school settings. Parents of children with SLD desired more change in their child's participation in all settings. Environmental factors were significantly more likely to be identified as barriers in the participation of children with SLD. Conclusion and implicationsThis study provides information about participation patterns and environmental factors for many children with SLD. The results provide insights into a rehabilitation program that may improve the participation of children with SLD, and on where greater efforts are needed to support participation and environmental features for children with SLD.

Povezanost pristupa usmerenog na porodicu i zadovoljstva roditelja participacijom dece sa cerebralnom paralizom u kućnom okruženju i u okruženju zajednice

This descriptive and exploratory study aimed to examine the relationship between family-centeredness of service delivery and home and community participation of children with cerebral palsy. It was hypothesized that there would be a significant association between family-centeredness of service delivery and parental satisfaction with home and community participation in the group of school-aged children with cerebral palsy. A convenience sample included 110 children with cerebral palsy, aged 7-18 years (55% males; M age = 12.7 years, SD = 3.41). The Measure of Processes of Care (MPOC-20) was used to assess the extent to which parents of children with cerebral palsy perceived health and rehabilitation services they had been receiving as being family-centered. Overall parental satisfaction with their child's home and community participation was evaluated by the Participation and Environment Measure for Children and Youth (PEM-CY). Analyses were performed using Spearman's rank correlation test. Only two out of 10 tested correlations reached the level of statistical significance, both in home environment. Parents who had higher overall satisfaction with their child's current home and community participation perceived certain aspects of health and rehabilitation services as being family-centered to a greater extent (general and specific information). The fulfilment of parents' needs by presenting them general and child-related information could have a positive effect on their satisfaction with their child's home participation. The findings suggest insufficient representation of the concept of participation and family-centered work principles in service planning and the evaluation of outcomes of the applied programs.

Environmental factors and daily functioning levels among adolescents with executive function deficits

Introduction This study examines parents’ perceptions of environmental factors in home, school and community settings on daily functioning of adolescents with executive function deficits. The aim was to map environmental supports and barriers and identify factors that predict functioning. Method Parents of 81 adolescents (10–14 years) completed the Behavior Rating Inventory of Executive Function, Participation and Environment Measure for Children and Youth (PEM-CY) part B and Child Evaluation Checklist (CHECK). We used the BRIEF scores to form a group of adolescents with executive function deficits ( n = 41) and a matched group with typical development ( n = 40). Correlation and discriminate analyses compared environmental factors across groups (PEM-CY) and identified those that predict daily functioning (CHECK). Results Compared to parents of adolescents with typical development, parents of adolescents with executive function deficits reported significantly more environmental barriers than supports (PEM-CY). School and community social demands of activity predicted the adolescents’ current daily functioning (CHECK). Conclusion Cognitive and social demands of activities appear to be common factors that limit functioning of adolescents with executive function deficits in home, school and community environments. The PEM-CY part B can promote awareness of the main support and barrier factors and help focus goals for efficient intervention programmes for these adolescents.

Investigating the participation of children on the autism spectrum across home, school, and community: A longitudinal study.

The World Health Organization recognizes that meaningful participation in one's community empowers individuals. Children and adolescents on the autism spectrum consistently report lower participation than their typical peers in activities, and this appears to continue into adulthood. The aim of this study was to investigate the participation of children on the autism spectrum over a 3-year period across home, school, and community. Caregivers of 84 participants aged 9-10years at Year 1 completed the Participation and Environment Measure for Children and Youth (PEM-CY) at three annual data collection points. The PEM-CY is a 25-question measure of the child's level of involvement in home, school, and community activities. Distribution frequencies were calculated for each time point. Although participation in the majority of items across home, school, and community remained stable, the longitudinal data suggest that children change the types of socializing activities across time. Over the 3years, there was a decline in physical activity (both organized and unstructured) and in participation in school activities. This decline in participation as children move into adolescence is concerning. Further, reduced participation at this phase of development may potentially limit future participation opportunities throughout adolescence and into adulthood. Further exploration of the participation trajectories of children on the autism spectrum is needed.

Comparative study of home and community participation among children with and without cerebral palsy

BackgroundChildren with cerebral palsy (CP) are at increased risk of reduced participation. Parental evaluation of child’s participation is often the decision-making factor in the process of special education and/or rehabilitation. AimsExamine and compare home and community participation of children with CP and typical development (TD) and the associations between their parents’ desire for change and participation dimensions in both settings. Methods and proceduresThis cross-sectional study included a convenience sample of 110 children with CP (55% males; mean age 12.7 years) and 134 children with TD (49% males; mean age 12.1 years). The Participation and Environment Measure for Children and Youth (PEM-CY) was used. Outcomes and resultsHome and community participation and environmental supportiveness of children with CP were lower compared to children with TD (p < .001, family income controlled). The effect sizes indicated that there may be no clinically important difference in participation frequency. Parents of children with CP desired change if participation was less diverse at home, less frequent in the community, or if involvement was lower in both settings (environmental supportiveness and income controlled). Conclusions and implicationsAt home, parents expressed a desire for change more intensely through the range of activities, while parents of children with TD emphasized participation frequency. In the community, parents of children with CP equally perceived participation diversity and focused more on frequency and involvement.

Parent perspectives on home participation of high-functioning children with autism spectrum disorder compared with a matched group of children without autism spectrum disorder

Few studies have focused on home participation of high-functioning children with autism spectrum disorder. We employed a mixed-methods design to explore and compare parent perspectives on (1) participation of children with and without autism spectrum disorder in activities at home, (2) the environmental features and resources that affect these children's home participation and (3) the strategies parents use to help their children participate at home. The Participation and Environment Measure for Children and Youth (PEM-CY) was used to gather online survey and qualitative data from parents of 99 high-functioning children with autism spectrum disorder and 241 children without autism spectrum disorder. Independent sample t-tests and χ2 tests were used to explore differences between groups, and Cohen's d was calculated to examine effect sizes. Differences were obtained on all Participation and Environment Measure for Children and Youth dimensions but particularly when comparing parents' satisfaction and perceived environmental barriers to their children's participation. The qualitative analyses revealed that parents in both groups used similar strategies to facilitate their children's participation at home, although parents of children with autism spectrum disorder made use of more distinct modifications. Our results highlight the importance of environmental aspects and point to how practitioners can support families in their efforts to promote their child's participation at home.

Exploring suitable participation tools for children who need or use power mobility: A modified Delphi survey

Objectives: To identify suitable tools for measuring important elements of participation for children, aged 18 months to 12 years, who need or use power mobility, and to indicate which tools should be considered for inclusion in a measurement toolkit. Methods: Parents, therapists and researchers with expertise in paediatric power mobility and participation (n = 70) completed an online modified Delphi survey, with consensus set a priori >80% agreement. Existing tools were matched against participation elements ranked most important for those in early childhood (18 months–5 years) and of school-age (6–12 years) by the panel. Results: Six out of 13 tools demonstrated potential, meeting at least three elements each, although none addressed all elements deemed important to measure by the panel. Only the Participation and Environment Measure for Children and Youth (PEM-CY) reached consensus for inclusion in a participation measure toolkit. Conclusion: Further evaluation of these tools with this population is warranted.