Children's Activity Preferences Research Articles

Participation in Daily Activities of Children with Atopic Diseases and Its Relation to Their Sensory Modulation Difficulties

(1) Background: Participation in daily activities is critical for a child’s health, development and wellbeing and is considered a main outcome measure of intervention efficiency. Atopic diseases affect children’s daily life and routines but the knowledge about impacts on participation is limited. (2) Objectives: a. to profile the preference to participate in daily activities of children with atopic diseases as compared to healthy controls; b. to profile sensory modulation difficulties (SMD) in each atopic group; c. to examine whether SMD correlate with activity preference. (3) Methods: This cross-section and correlative study included 253 children aged 4–11: 37 with Asthma, 37 with atopic dermatitis (AD), and 31 with Rhinitis. The controls were 148 healthy children. All children completed the Preference for Activities of Children (PAC) while their parents completed a socio-demographic questionnaire and the Short Sensory Profile (SSP). (4) Results: Children with atopic diseases showed significantly lower preference to participate in activities than healthy controls and preferred quiet activities that can be performed alone. Within the atopic groups, children with AD, and specifically girls, had the highest activity preference while boys with Asthma had the lowest preference. SMD was significantly more prevalent in children with atopic diseases and correlated with their reduced preference to participate in activities. (5) Conclusions: Atopic diseases may restrict children’s participation. Clinicians should evaluate participation of children with atopic diseases and examine whether comorbidities as SMD affect participation. Understanding the implications on children’s daily life may improve intervention efficiency and elevate development and wellbeing.

The Relationship Between School-Age Children’s Physical Activity and Their Leisure Activity Interests: An Exploratory Study

ABSTRACT Physical activities and leisure engagement are important occupations that children partake in. However, the association between physical activities and leisure engagement preferences in children remains largely unexplored in Australian contexts. As such, this study investigated the relationship between children’s physical activities and their leisure activity engagement preferences. A study was conducted involving 27 pairs of school-aged children and their parents/caregivers. Children completed the Preferences for Activities of Children and Children’s Leisure Assessment. Parents/caregivers completed the Children’s Physical Activity Questionnaire. Spearman rho correlations and linear regression analyses with bootstrapping were completed. Children’s games and sports activity variety was significantly correlated with active school activity duration (rho = .452, p = .018). In addition, children’s preferences for instrumental indoor activities predicted sports frequency on weekdays (R2 = .446, p = .003). Similarly, self-enrichment activities variety was predictive of sports activities frequency on weekdays (R2 = .446, p = .006) and weekends (R2 = .151, p = .026). Finally, children’s sociability in instrumental indoor activities predicted active leisure activity duration on weekends (R2 = .120, p = 043). Findings suggest that children’s leisure engagement preferences are predictive of their participation in physical activities. Specific aspects of leisure participation, such as variety and sociability, can also predict children’s physical activity levels. When promoting physical activities, it is important to understand children’s leisure engagement preferences so that clinicians can develop individualized plans by incorporating children’s interests. This will inform child-centered goal setting and intervention planning. Further research in this area is recommended.

The relationship between typically developing school-age children’s screen time, participation and physical activity: An exploratory study

Introduction: In recent years, screen-based activities have become increasingly popular amongst children and adolescents. Several studies have found increased screen time to be associated with sleep disturbances, poorer academic performance and reduced physical activity. However, not much is known about children’s activity preferences and participation in relation to their screen time. This study investigated the association between school-aged children’s screen time use and their activity participation and physical activity. Method: A sample of 25 parents/caregivers with typically developing children aged 8–12 years in Australia participated. Parents/caregivers completed the Children Screen Time Use Report (CSTUR) and Children Participation Questionnaire-School (CPQ-S). Child participants completed the CSTUR, Preferences for Activities of Children (PAC), Perceived Meaning of Occupations Questionnaire (PMOQ) and Physical Activity Questionnaire-Children (PAQ-C). Data were analyzed using Spearman Rho correlations. Results: Findings from this study found no statistically significant associations between the CSTUR and PAQ-C subscales in children aged 8–12 years. However, there were several significant correlations found between CSTUR and the PAC, PMOQ and CPQ-S scale scores. Conclusion: Occupational therapists need to consider screen-based activities in school age children and the impact it can have on their daily participation.

Participation patterns in elementary school-aged children with autism spectrum disorders and their typically developing peers

PurposeThis study aims to investigate the differences in participation patterns between children with autism spectrum disorders (ASD) and children with typical development (TD) in Jordan.Design/methodology/approachThe study used a cross-sectional comparative design and convenient and snowball sampling. The sample consisted of 60 children (30 ASD and 30 TD), mean age (nine years), who completed the Children’s Assessment of Participation and Enjoyment and the Preferences for Activities of Children (CAPE/PAC) via interview. Analyses consisted of descriptive statistics and Mann-Whitney U tests.FindingsChildren with ASD had significantly lower participation Diversity (U = 24.00, p < 0.000) and Intensity (U = 110.00, p < 0.000) than children with TD. In addition, children with ASD had significantly lower participation preference in Physical (U = 145.50, p < 0.000), Self-Improvement (U = 163.50, p < 0.000), Skill-Based (U = 281.00, p = 0.01), Social activities (U = 307.50, p = 0.03) and total PAC scale score (U = 246.50, p = 0.003). However, children with ASD had significantly higher Enjoyment (U = 274, p < 0.000) than children with TD.Originality/valueChildren with ASD have restricted participation patterns due to certain ASD features like extreme sensory processing patterns. However, limited research compared participation patterns between school-aged children with ASD and children with TD. This study concluded that participation patterns in children with ASD are different from children with TD.

Translation, Adaptation and Validation of the Portuguese Version of Children’s Assessment of Participation and Enjoyment / Preferences for Activities of Children (CAPE / PAC)

ABSTRACT This study aimed to translate, adapt linguistically and culturally, and validate the Portuguese version of the Children’s Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC). CAPE/PAC is a tool that measures the participation of children and youth with and without disabilities in leisure activities, considering behavioral, contextual and affective aspects. The Portuguese version resulted from a process of translation, back-translation, analysis by experts and pilot application to obtain evidence of content validity. The instrument was administered with 361 children − 306 without disabilities and 55 with disabilities – from five school clusters in the district of Porto, aged 6 to 18 years old. Data were analyzed for internal consistency – to determine the degree of homogeneity of the instrument’s items – as well as for the standardization of the participation of children and youth with and without disabilities, and their comparison with evidence from studies evaluating similar constructs. The results revealed that the Portuguese version of CAPE/PAC exhibits emerging evidence of reliability and validity.

Validation of Image Descriptions for the Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children: A Delphi Study

Introduction: The Children's Assessment of Participation and Enjoyment (CAPE) and the Preferences for Activities of Children (PAC) are useful measures to assess how children with visual impairments are meeting the nine areas of the expanded core curriculum (ECC). Each item of the CAPE and PAC includes an activity with an accompanied image to illustrate it. However, the measures do not provide standardized image descriptions for each item, which limits its validity and reliability for this population. Thus, the purpose of this Delphi study was to validate and standardize image descriptions for the CAPE and PAC so they can be used more effectively with children with visual impairments. Methods: The expert panel consisted of 11 professionals with extensive knowledge and experience with individuals with visual impairments and six dyads of parents and their child with a visual impairment. Each panel member assessed the accuracy of wording for 57 image descriptions on a 4-point Likert scale and provided feedback on items rated below 3. Results: Consensus on all image descriptions was reached after two rounds. Discussion: The results of this study help to increase the validity and reliability of the CAPE and PAC for children with visual impairments. Implications for Practitioners: The CAPE and PAC can be used more effectively by practitioners and researchers to assess the areas of the ECC for children with visual impairments.

Leisure Activity Preferences of Children and Adolescents With Cerebral Palsy in Iran and the Quality of Their Participation

Objectives: To investigate whether Iranian children and adolescents with Cerebral Palsy (CP) participate in their preferred leisure activities. Methods: A group of children and adolescents (n=152; 59.2% male; aged 7-17 years; Mean±SD of age was 10.93±3.46 years old) diagnosed with CP (39.5% hemiplegic; 28.9% quadriplegic; 31.6% diplegic) were selected to complete the children’s assessment of participation and the enjoyment (CAPE) and Preference for Activities of Children (PAC) questionnaires. Results: Recreational and social activities were the most preferred (PAC mean score=2.13±0.40; 2.08±0.40, respectively), and active-physical activities were the least preferred (PAC mean score=1.60±0.46). Preferences were strongly correlated with leisure participation (P&lt;0.001), although there were still discrepancies between them. A discrepancy score was introduced, and skill-based activities demonstrated the highest discrepancy score (discrepancy mean score=3.39±2.97). Discussion: Greater preferences for leisure activities are linked with a higher frequency of participation but, that does not necessarily mean that children and adolescents with CP always participate in their most preferred leisure activities. They sometimes cannot participate in their preferred leisure activities and sometimes participate in activities that they do not like. Occupational therapists are encouraged to consider these findings to design more effective plans to achieve improved participation outcomes.

Convergent Validity between Three Self-Report Measures of Children’s Play and Activity Interests

ABSTRACT It is important for assessments used by occupational therapists to have documented evidence of their validity. This adds to the knowledge about what specific factors assessments measure and inform their utility for use in clinical practice by occupational therapists. The convergent validity between the Children’s Assessment of Participation and Enjoyment & Preferences for Activities of Children (CAPE/PAC), Kid Play Profile (KiPP), and Pediatric Activity Card Sort (PACS) was investigated. This will address gaps in the current body of psychometric evidence related to these three participation-focused, child self-reported measures of children’s play and activity interests. Fifty Australian children without disabilities (x̅ age 8.54 ± 2.04 years; 64% female) completed the CAPE/PAC, KiPP, and PACS. Data were analyzed using Spearman Rho correlations with bootstrapping. Several significant low to moderate level correlations (rs = 0.280, p < .05 to rs = 0.552, p < .01) were found between the scale domains of the CAPE, PAC, KiPP, and PACS. Evidence of the convergent validity between the CAPE/PAC, KiPP, and PACS was established. This indicates that the three measures appear to measure several similar play and activity interest factors. Given the differences between the CAPE/PAC, KiPP, and PACS in the mode of administration, time needed to complete, purchase costs and profile of score results obtained, the convergent evidence provides additional information for occupational therapists toward making informed decisions about the most appropriate assessment(s) to potentially use. Further validity research is recommended.

Participation in leisure activities in adolescents with congenital heart defects.

To describe leisure participation in adolescents with congenital heart defects (CHD) and identify factors associated with intensity of participation. Eighty adolescents with CHD were recruited (39 males, 41 females; mean age [SD] 15y 8mo [1y 8mo] range 11y 5mo-19y 11mo) of whom 78 completed the Children's Assessment of Participation and Enjoyment (CAPE) outcome measure of leisure participation. The measure has five subscales: recreational, active-physical, social, skill-based, and self-improvement. Associations between the CAPE and age, sex, and development were examined. Motor ability (Movement Assessment Battery for Children, Second Edition), cognition (Leiter International Performance Scale-Revised), behavior (Strengths and Difficulties Questionnaire), and motivation (Dimensions of Mastery Questionnaire) were assessed. Participants exhibited impaired motor (43.5%), behavioral (23.7%), and cognitive (29.9%) development. The most intense participation was in social (mean [SD] 3.3 [0.99]) and recreational (2.9 [0.80]) activity types on the CAPE. Male sex (p<0.05) and younger age were associated with greater physical activity (<15y: 1.87; ≥15y: 1.31, p<0.05). Greater engagement in social activities was related to better cognition (r=0.28, p<0.05), higher motor function (r=0.30-0.36, p<0.01), and fewer behavioral difficulties (r=-0.32 to -0.47, p<0.01). Cognitive ability (r=0.27, p<0.05), dexterity and aiming/catching (r=0.27-0.33, p<0.05), and behavior problems (r=0.38-0.49, p=0.001) were correlated with physical activity participation. Persistence in tasks, an aspect of motivation, correlated with physical (r=0.45, p<0.001) and social activity involvement (r=0.28, p<0.05). Ongoing developmental impairments in adolescents with CHD are associated with decreased active-physical and social engagement, putting them at risk of poor physical and mental health. Health promotion strategies should be considered. Adolescents with congenital heart defects (CHD) have limited engagement in active-physical leisure activities. Cognitive, motor, and behavioral impairments are associated with decreased participation in leisure in children with CHD. Female sex and older age are associated with less engagement in leisure. Mastery motivation correlates with participation, suggesting an avenue for intervention.

The convergent validity of the Children’s Leisure Assessment Scale (CLASS) and Children’s Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC)

Background: Children’s play and leisure participation is often assessed by occupational therapists. As such, it is essential that therapists utilize play and leisure scales that are valid, reliable and responsive.Aim: To examine the convergent validity between the Children’s Leisure Assessment Scale (CLASS) and Children’s Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC).Methods: Forty healthy Australian children (60% female; mean age 9.2 ± 2.01 years) completed the CLASS and CAPE/PAC. Spearman’s rho correlations with bootstrapping were completed.Results: A number of the CLASS and CAPE/PAC subscales were significantly correlated. The CAPE’s overall scale scores and CLASS’s instrumental indoor activities, outdoor activities and games and sport activities subscales were significantly correlated (p > 0.05). The CAPE’s Social domain showed several significant correlations with the CLASS’s instrumental indoor activities, outdoor activities and self-enrichment activities domains (p < 0.05). Statistically significant relationships were found between the CLASS’s outdoor activity preference and the PAC’s recreational, physical, formal, informal and overall performance scores (r = 0.466–0.773, p < 0.05).Conclusions and Significance: Preliminary evidence in support of the convergent validity between the CAPE/PAC and CLASS was obtained. Limitations include a small sample size and convenience sampling. Further investigation of the psychometric properties of the CAPE/PAC and CLASS are recommended.

CyFiT telehealth: protocol for a randomised controlled trial of an online outpatient physiotherapy service for children with cystic fibrosis

BackgroundTelehealth and telemonitoring is an emerging area of study in people with cystic fibrosis (CF), with the potential of increasing access to care, and minimising infection control risks to patients without compromising their health outcomes. To date, limited evidence is available to support the use of telehealth in paediatric population with CF in a clinical setting. This study aims to investigate the utility of a multimodal telehealth-based outpatient physiotherapy service and assess its effect on quality of life, functional exercise capacity, hospital admission and intravenous antibiotic requirements, lung function, processes of care, participation in activities of daily living, and health economics associated with operating an innovative service.MethodThis single centre, prospective, parallel, randomised, controlled, non-inferiority trial aims to recruit 110 children with CF between the ages 8 to 18 years of age. Participants will be randomised to the Usual Outpatient Physiotherapy Service group (Usual OPS) or the telehealth intervention group (CyFiT OPS). Quality of life, participation in activity of daily living, functional exercise capacity and patient perception of care will be examined every six months using the Cystic Fibrosis Questionnaire-Revised (CFQ-R), Children’s Assessment of Participation and Enjoyment (CAPE), Preferences for Activities of Children (PAC) questionnaire, Modified Shuttle Test-25 (MST25), and Measure of Process of Care (MPOC-20) questionnaire. Physiological measurements collected during routine clinical visits such as spirometry, body weight and height, information will be retrospectively retrieved via a chart review at the end of the study.DiscussionWe anticipate that this multi-modal telehealth service will deliver a comparable service to traditional face-to-face models. An alternative to existing outpatient physiotherapy services may potentially increase patient options for access to care and patient-orientated outcomes such as quality of life. If deemed appropriate, the new model of care can be integrated into clinical practice immediately.Trial registrationThis trial is registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12617001035314) last updated 17th July 2018.

What's Physical Activity Got to Do With It? Social Trends in Less Active Students at Recess.

Public health concerns regarding childhood obesity and sedentary behavior make investigations of children's physical activity (PA) promotion crucial. School recess, a highly discretional time, plays a central role in shaping children's activity preferences. Participants included 40 children (30 girls, 10 boys) from fourth and fifth grades, categorized as low active during recess (<26% moderate-to-vigorous PA [MVPA]). PA was measured via accelerometer (Actigraph wGT3X+) and activity choice gauged through a self-report measure over a 3-day period. To assess attitudes and perceptions of recess, individual interviews were conducted. Accelerometer data were analyzed into minutes and percentage of MVPA; interviews were transcribed verbatim and analyzed utilizing open and axial coding. Participants were active for 18% of recess, choosing activities that were primarily individual-based. Interview data showed low active children attribute recess enjoyment to social interaction and time away from schoolwork as well as an intention to avoid other children who were unkind and/or caused social conflict. This study supports the importance of gaining a child's perspective of their own behavior, particularly those children classified as less active. Findings add a unique contribution to school health research through an innovative, child-centered approach to explore perceptions of PA.

The influence of personal and environmental factors on typically developing children’s activity participation

ABSTRACTParticipation is a multidimensional concept that has evolved from the International Classification of Functioning, Disability and Health as one’s engagement in life. This study investigated the impact that personal and environmental factors have on typically developing children’s activity participation (n = 18). Children and parents/caregivers completed self-report questionnaires. Children completed the Children’s Assessment of Participation and Enjoyment & Preferences for Activities of Children (CAPE/PAC) and the Children’s Leisure Assessment Scale (CLASS) while parents completed the Children Participation Questionnaire (school-aged) (CPQS), Performance Skill Questionnaire (school-aged) (PSQS), and Environmental Restriction Questionnaire (school-aged) (ERQS). Pearson correlations were performed to determine whether there were correlations between the independent variables (PSQS and ERQS) and dependent variables (CAPE, PAC, CLASS, CPQS), total scores and subscale scores. The Pearson r correlation analyses were also bootstrapped. Linear regressions analyses were used to determine whether the positive correlations identified between the variables were predictive. Personal factors (which included the child’s motor, process, and communication skills) were predictive of five out of the six dimensions of participation, diversity (40.8% variance accounted for in the dependent variables), intensity (32% variance), where (54.3% variance), with whom (30% variance), and enjoyment (54% variance). Environmental factors that include the child’s community, educational, and home environment were predictive of all six dimensions of participation. Diversity (32.4% variance accounted for in the dependent variables), intensity (32.8% variance), where (22.4% variance), with whom (25.3% variance), enjoyment (44.9% variance), and preference (49.1% variance). The results indicated that motor, process, and communication skills were significantly predictive of a child’s diversity and intensity of participation, with whom and where they completed activities, their enjoyment and parental satisfaction. Community and education environments were also found to be predictive of these elements of participation, while the home was predictive of a child’s activity preference.

Cultural adaptation and construct validation of the Arabic version of children’s assessment of participation and enjoyment and preferences for activities of children measures

Purpose: To establish the construct validity and internal consistency of the Arabic Children Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) and to determine the effects of age, gender, and disability status on diversity and intensity of participation.Methods: The World Health Organization guidelines for translation of measures were applied to translate the CAPE and PAC, 75 children with cerebral palsy (mean age = 10.7 ± 2.9 years) and 75 children with typical development (mean age = 10.8 ± 2.7 years) completed the translated measures. The construct validity of the translated measures was demonstrated by principle component analyses in addition to the known-groups method by examining the effects of age, gender, and presence of disability on diversity and intensity scores. The internal consistencies of the extracted components were examined by Cronbach’s alpha.Results: Four components emerged: (1) physical activities; (2) home-based activities; (3) self-improvement activities; and (4) social activities. Cronbach’s alpha varied from 0.61 (social activities) to 0.83 (physical activities). Age, gender, and disability were significant determinants of types of activities.Conclusions: The Arabic CAPE and PAC are culturally valid in measuring participation of children with or without disabilities in Jordan. The child’s age, gender, and disability should be considered to provide participation-based plans of care that are considerate for children and their families.Implications for rehabilitationThe Arabic CAPE and PAC are culturally valid measures for participation of children with or without disabilities in Jordan.The Arabic CAPE and PAC measures can guide participation-based plans of care that are meaningful and considerate for children and their families.Child age and gender should be considered to provide appropriate activities and to facilitate participation of children with and without disabilities.Families and service providers in Jordon are encouraged to provide children opportunities to participate in desired physical, self-improvement, and social activities.

Having Fun and Staying Active! Children with Disabilities and Participation in Physical Activity: A Follow-Up Study

ABSTRACTAim: This study investigated change in the participation profile of physical activity over 15 months after a three-week intensive rehabilitation that used physical activity as the main intervention. Methods: The Children's Assessment of Participation and Enjoyment (CAPE) was used in a longitudinal prospective study (pre- and post-design) with three measurements over 15 months. Eighty children with physical disabilities (6–17 years old; mean score 11.1; SD 2.4), some with additional cognitive challenges, completed all three measurements. Results: Participation diversity and intensity of all 55 leisure activities declined significantly over the 15-month period. The largest decline was for children aged between 10 and 13 years. Among physical activities, there was a stable level of participation of the total group, and sub-groups. Boys preferred “active physical activities” to a greater extent, while girls preferred “skill-based activities.” Both genders expressed a higher level of enjoyment in their preferred activities according to the Preferences for Activities of Children. Conclusions: This intervention may have the potential to maintain the level of physical activity among children and youths with disabilities, yet further controlled studies are needed. Gender differences should be taken into consideration to facilitate stable participation in physical activities with a high level of enjoyment.

Participation trajectories: impact of school transitions on children and adolescents with cerebral palsy.

To describe participation trajectories, and impact of school transitions on those trajectories, of children with cerebral palsy (CP). This population-based longitudinal study assessed participation in activities outside school of children with CP born in 1994/1995. Eligible children contributed data between two and five occasions over 9 years, and had parents with sufficient English proficiency to complete the measures: the Children's Assessment of Participation and Enjoyment, and the Preferences for Activities of Children. Linear mixed models were used to assess the relationships between participation and age and the impact of transition. At study commencement (2006), 233 children with CP born in 1994/1995 were registered in Victoria; 93 (51 males, 42 females; mean age 11y 2mo, age range 10-12y) contributed longitudinal data. Participation diversity and intensity decreased over time for recreational, active physical, and self-improvement activities (p<0.009). Social participation increased over time: diversity, intensity, and frequency (p<0.007). All of the identified slopes were generally small (β≤0.11, 1-point change every 9y) except for recreational diversity scores (β=-0.29). Transition from primary and secondary school had little impact on participation. Findings of increased social participation over time are encouraging. Declining participation in other activity types suggests that action is needed to ensure that meaningful recreation and leisure activities are maintained as adolescents with CP transition to adulthood.

Reliability of the German version of the Children's Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC).

The introduction of the International Classification of Functioning, Disabilities and Health of the World Health Organization in 2001 made social participation a major rehabilitation outcome and the ultimate goal of rehabilitation services. There is no available instrument to measure the youth participation in leisure activities apart from asking the youth themselves. The goal of this study was to present a German version of the Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC). The CAPE/PAC questionnaire was translated into German, a cultural adaptation process was designed and a reliability study was conducted. One hundred and fifty-two youths with and without disabilities, with a mean age of 15.2 years (standard deviation 1.7), participated in the study. The participants completed CAPE and PAC twice within 4 weeks. Reliability was examined by intraclass correlation coefficients, standard error of measurement, smallest detectable change and Cronbach's alpha. The absolute values of participation differ between the typically developed youth group and those with impairments; the reliability of the CAPE/PAC is comparable in both groups. Intraclass correlation coefficients ranged from 0.43 to 0.74 for the CAPE and from 0.71 to 0.83 for the PAC in all participants. The alpha values for internal consistency ranged from 0.42 to 0.82 for the CAPE and from 0.65 to 0.92 for the PAC. The German version of the PAC showed satisfactory reliability; however, reliability was not satisfactory for all scores of the CAPE, but comparable with versions in other languages. The need for newly developed participation measurements requires further discussion.

The extent, context and experience of participation in out-of-school activities among children with disability

BackgroundA growing literature describes the participation of children with disability, but less is known about the effect of disability type, severity and environmental factors on participation. AimTo investigate the extent, context, experience and preferences for participation in out-of-school activities among children with disability in Victoria, Australia. Methods and proceduresTwo-hundred and eighty-six children (177 boys, 109 girls; mean age 11.5 years) with physical (n=77), intellectual (n=67), multiple (n=93), and other disabilities (n=49) took part. Data were collected using the Children's Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) questionnaires. Outcomes and resultsChildren with disability participated in 28 out of 55 activities (SD 6 activities), 2–3 times per month, on average. Preference was the most important predictor of participation diversity for all activity types. Disability type was a predictor of participation diversity in active-physical activities only. Severity was a predictor of participation diversity overall, and of participation in formal and informal activities. Age, severity and preference accounted for almost 50% of the variance of diversity of recreational activities. Conclusions and implicationsThese results underscore the importance of taking a child's activity preferences into account when implementing interventions to increase participation in out-of-school activities.

Stability of leisure participation from school-age to adolescence in individuals with cerebral palsy

With increasing age, youth with disabilities are at risk for decreased participation in leisure activities, a key component for physical and mental health. This prospective study describes changes in leisure participation and leisure preferences from school-age to adolescence in children with cerebral palsy (CP). Participants were recruited at school-age (6–12 years) for a study on participation and reassessed for a second study on adolescents (12–19 years) if >12 years. Thirty-eight children (24 males) with CP who could actively participate in the completion of the Children's Assessment of Participation and Enjoyment (CAPE) and the Preferences for Activities of Children (PAC) comprised the sample. Average time between assessments was 5.0±1.3 years. Most children were ambulatory (32/38 Gross Motor Function Classification System I–II). In addition to the CAPE and PAC, children were evaluated using the Gross Motor Function Measure-66 and parents completed a socio-demographic questionnaire. Paired t-tests revealed a significant decline in leisure participation diversity and intensity (CAPE) for recreation (p<.0001), skill-based (p<.0001) and self-improvement (p<.05) activities, whereas social participation remained stable (p>.05). Diversity of active-physical activities increased modestly (p=.06) although intensity of participation in this activity domain decreased (p=.003). There was also a decline in enjoyment of leisure activities. Preferences for these leisure activities remained unchanged between school-age and adolescence, except for recreational activities. Gender, maternal education, family income and gross motor ability were not related to differences in CAPE/PAC scores with increasing age. Findings suggest that over time, children with CP's participation in leisure activities diminishes, which is of concern to their functioning and well-being. Parents may be more involved in early childhood in facilitating participation whereas in adolescence, youth may be faced with more environmental barriers and a greater awareness of challenges to participation. Adolescents demonstrated a persisting desire to do these activities, challenging rehabilitation specialists to prioritize strategies to promote greater participation as children transition to adolescence.

The relationship between children’s sensory processing patterns and their leisure preferences and participation patterns

Sensory processing patterns may be associated with children's preferences for different activities; however, knowledge about how different sensory processing patterns may relate to children's participation in leisure activities is scarce. This study investigated in what leisure activities children with extreme sensory processing patterns participate and if relationships exist between children's sensory processing patterns and their leisure preferences and participation patterns. This correlational study analyzed data from children's Sensory Profiles and reported play and leisure preferences. All 91 children in the sample completed the Children's Assessment for Participation and Enjoyment (CAPE) and the Preferences for Activities of Children (PAC). Parents of children ages 6 to 10 years completed the Sensory Profile, and children ages 11 to 14 years completed the Adolescent/Adult Sensory Profile. Children with different sensory processing patterns preferred both similar and distinct leisure activities. Low-registration quadrant summary z scores negatively correlated with CAPE overall diversity scores (rs=-.23, p=.03), sensitivity quadrant summary z scores negatively correlated with preferences for social activities (rs=-.23, p=.03) and preferences for skill-based activities (rs=-.22, p=.04), and avoiding quadrant summary z scores negatively correlated with preferences for social activities (rs=-.26, p=.01). Children's sensory preferences are related to leisure preferences and participation.