Community Participation of School-Age Children: Who is at Risk of Restricted Participation?

Abstract

Aims

This study aimed to identify children with restricted community participation and examine the extent to which the child, family, and environmental factors were associated with restricted participation.

Methods

A school-based sample of 92 children with disabilities and 391 children without disabilities aged 5–12 years was recruited in Hong Kong. Parents completed the Participation and Environment Measure for Children and Youth and a demographic questionnaire. Moreover, children completed the Children’s Depression Inventory. Rasch analysis was used to determine the criteria that differentiated between children with and without participation restriction, based on frequency of activities. Logistic regression was used to identify the factors associated with participation restriction.

Results

One hundred seventy-three children (35.8% of the sample), including 42 with disabilities, were identified as having restricted participation. Participation restriction was associated with higher depressive symptoms in children (odds ratio (OR) = 1.05, 95% confidence interval (CI) [1.01, 1.08]), lower environmental resources (OR = 0.97, 95% CI [0.96, 0.99]), and coming from families with three or more children (OR = 2.80, 95% CI [1.44, 5.46]).

Conclusions

The results suggest that a sizable number of children are at risk for restricted participation in the community. Healthcare services and strategies that address the associated factors are needed to promote children’s community participation.

Keywords:

• Children
• community participation
• disability
• participation restriction
• rasch analysis

Acknowledgments

We thank the clinicians for their involvement in the online survey, and all of participating children, parents, and schools for their research participation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by The Hong Kong Polytechnic University (grant number 1-ZE4E).

Notes on contributors

Chi-Wen Chien

Chi-Wen Chien, BScOT, MEd Hons, PhD, is an Assistant Professor at Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR).

Chung-Ying Lin

Chung-Ying Lin, BScOT, MScOT, PhD, was an Assistant Professor at Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR) when this study was conducted. Now he is an Associate Professor at Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan.