Patterns of participation in school-related activities and settings in children with spina bifida

Abstract

Purpose: To evaluate how children with spina bifida (SB) participate in school-related activities and to explore if their motor and process skills in task performance were related to their level of active participation in school. Method: Fifty children from a geographical cohort of children with SB (aged 6–14 years) and their teachers rated the children’s frequency of participation in school-related activities using a Swedish adaptation of the Availability and Participation Scale. The teachers also rated each child’s level of active participation with the School Function Assessment, part one. Each child’s motor and process skills were evaluated with the Assessment of Motor and Process Skills. The relation between levels of active participation and motor and process skills was subjected to binary logistic regression analysis. Results: The children participated very frequently in school activities, but their level of active participation was restricted, particularly in the recess/playground setting. There was a highly significant relation between full active participation in most school settings and the children’s motor and process skills. Conclusion: Children with SB need support to become more actively involved, particularly in unstructured peer activities. The school staff need to be informed that not only the motor skills but also the process skills have an impact on the children’s active participation.

Implications for Rehabilitation

• The children with spina bifida (SB) showed a low level of active participation and involvement in school settings even though their frequency of participation was high.

• It is of highest importance to enable children with SB to be actively involved in peer-related and unstructured activities and to encourage them to participate in both academic and societal learning.

• To achieve active participation, it is important to inform the school staff about how this issue is affected not only by the level of the child’s motor skills but also, and probably even more so, by the level of his/her process skills. From this knowledge, individual strategies can be worked out.

• Lipo-myelomeningocele
• motor skills
• myelomeningocele
• participation
• process skill
• school
• spina bifida

Acknowledgements

We would like to thank the children and teachers who participated in this study and the staff of the Urotherapeutic Unit at the Regional Rehabilitation Centre, the Queen Silvia Children’s Hospital, Gothenburg for excellent cooperation. We would also like to thank Anne-Christine Wiking for translating the SFA into Swedish for this study and Karin Jisbrant and Julia Michelson who carried out the test–retest pilot study.