Understanding Determinants of Participation in Recreation and Leisure Activities by Preschool Children with Physical Disabilities

Participation is defined as “involvement in life situations” by the World Health Organization and encompasses the interaction of the person and environment. Participation in recreation and leisure activities is fundamental for the development of motor, cognitive, and social skills for preschool children (2-6 years of age). Children with physical disabilities often experience restrictions in recreation and leisure due to functional limitation and environmental barriers. Research has focused on school-aged children or youth, only few studies indicated that preschool children with physical disabilities participated less in family and community recreation activities than their peers with typical development. In agreement with the concept of the human right, optimizing participation is an ultimate outcome of early intervention. Influence of child, family, and environmental characteristics on participation should be considered for planning effective intervention strategies. The child, family, and environmental characteristics that together affect recreation and leisure participation of preschool children with physical disabilities have not been identified. Participation can be measured by multidimensional assessment tools that include three dimensions: “Capability”, “Performance”, and “Subjective experiences.” Currently, no single participation measure covers all three dimensions to comprehensively assess participation by preschool children with physical disabilities. Therefore, we translated the Assessment of Preschool Children’s Participation (APCP), the only measure currently available for recreation and leisure participation designed for children with physical disabilities 2-6 years of age, through collaboration with Dr. Law in McMaster University, Canada. Under the authors’ support, we added two dimensions for measuring participation, participation independence (indicator of ‘capability’) and enjoyment (indicator of ‘subjective experience’), in addition to original scales of participation diversity and intensity (indicators of ‘performance’). Further validation is needed to establish the reliability and validity to enable its use in Taiwan. The purposes of this study are: to establish reliability and validity of the Chinese version of APCP (APCP-C), to describe participation in recreation and leisure activities, and to identify the child, family, and environmental determinants of participation. We propose a two-year research project that will be executed in three phases. In Phase I we will determine the reliability and validity of the APCP-C, including test-retest and interrater reliabilities, content validity, construct validity, and convergent validity. In Phase II we will complete a pilot study to establish study protocols. In Phase III we will complete a cross-sectional study by recruiting 80 preschool children with physical disabilities. We anticipate that the APCP-C will have good reliability and validity for Taiwanese children. Based on the evaluation results of APCP-C, parents can work with early intervention professionals to set meaningful goals and outcomes related to their children’s participation and reflecting effects of early intervention services. Besides, determinants identified in this study will guide the development and implementation of effective participation-based interventions. We believe that the results will contribute to the early development and intervention effects for preschool children with physical disabilities.

Project ID:PC10308-1812
External Project ID:MOST103-2314-B182-001