Patterns and Correlates of Caregiver Satisfaction With Young Children’s Participation in Home Activities

PURPOSE: This study examined patterns and correlates of caregiver dissatisfaction with young children’s participation in home activities to inform potential targets for occupational therapy intervention.

BACKGROUND: Results from this study can help identify home activities that are perceived to be problematic and the types of change most commonly desired across activities. Examining correlates of caregivers’ satisfaction with their young child’s participation are also critical to building knowledge about the child, family, and environmental factors that are more or less likely to impact young children’s participation.

DESIGN AND METHOD: In this cross-sectional study, 395 caregiver participants were recruited using convenience and snowball sampling. Participants were age ≥18 yr, the parent or legal guardian of a child age 0–5 yr, spoke and read English, had Internet access, and resided in North America. Measures included a demographic questionnaire, the Young Children’s Participation and Environment Measure (YC–PEM) Home section, and the Pediatric Evaluation of Disability Inventory–Computer Adaptive Test (PEDI–CAT). The demographic questionnaire gathered information on family and child factors. The YC–PEM is a caregiver report questionnaire that gathers information on young children’s participation and environmental impacts on participation. The YC–PEM’s internal consistency for home desired change is .84 and for home environmental support is .96. The PEDI–CAT assesses children’s functional task performance in daily activities, mobility, and social and cognitive domains.

Chi-square analyses were used to identify statistically significant differences in common areas of dissatisfaction and types of change desired in home participation between caregivers of children with and without disabilities and/or delays (p = .004). A multiple linear regression model examined child, family, and environmental factors related to caregiver dissatisfaction with young children’s home participation (p = .05).

RESULTS: Although there were no statistically significant differences between disability groups, caregivers of young children with disabilities or delays more often reported a desire for change in their child’s participation in nondiscretionary activities and for their child to be “more helpful” in home participation. Finally, disability status, household income, and lower environmental support were significant correlates of caregiver dissatisfaction with young children’s home participation. However, the model accounted for only 9.8% of the variance, which suggests a poor fit.

CONCLUSION: Study findings suggest that caregivers of young children with and without disabilities and/or delays have similar priorities for improving their child’s participation in nondiscretionary home activities. In addition, results suggest that caregiver satisfaction with young children’s participation at home is influenced by perceptions of environmental support within the home, as well as the child’s disability status. Future research could examine similar correlates of young children’s frequency and involvement in home activities, as well as desire for change in out-of-home contexts.

IMPACT STATEMENT: This knowledge may be beneficial for informing family and client-centered intervention practices, as caregivers concerns often influence goal setting. Additionally, it may allow practitioners to identify appropriate child- and/or context-focused intervention targets for optimizing participation in the home environment. Intervention focused on participation in the early childhood period is essential for improving young children’s health and well-being. Additionally, examining functional outcomes such as participation is important in order to understand differences among typically developing children and children with disabilities and delays.

References

Anaby, D., Law, M., Coster, W., Bedell, G., Khetani, M., Avery, L., & Teplicky, R. (2014). The mediating role of the environment in explaining participation of children and youth with and without disabilities across home, school, and community. Archives of Physical Medicine and Rehabilitation, 95, 908–917. https://doi.org/10.1016/j.apmr.2014.01.005

Benjamin, T., Lucas-Thompson, R. G., Little, L. M., Davies, P., & Khetani, M. (2016). Participation in early childhood educational environments for young children with and without developmental disabilities and delays: A mixed methods study. Physical and Occupational Therapy in Pediatrics, 37, 87–107. https://doi.org/10.3109/01942638.2015.1130007

Khetani, M. A., Graham, J., Davies, P., Law, M., & Simeonsson, R. (2015). Psychometric properties of the Young Children’s Participation and Environment Measure. Archives of Physical Medicine and Rehabilitation, 96, 307–316. https://doi.org/10.1016/j.apmr.2014.09.031