Date Presented 3/31/2017
School participation of Taiwanese children with disabilities was predicted by severity of impairments, age, and environmental factors. Findings might provide school-based practitioners insights about allocation of resources and services to promote school participation for children with disabilities.
Primary Author and Speaker: Wei-Chang Chen
Contributing Authors: Gary Bedell, Hua-Fang Liao, Linda Tickle-Degnen
PURPOSE: School participation is of importance to children because it is associated with development of physical, cognitive, and social competencies, as well as behavioral and emotional well-being (Simeonsson, Carlson, Huntington, McMillen, & Brent, 2001; World Health Organization [WHO], 2007). Previous studies have identified that children with disabilities are restricted in school participation (Bedell & Dumas, 2004; Egilson & Traustadottir, 2009; Simeonsson et al., 2001; WHO, 2007). Participation is involvement in life situations that can be supported or hindered by personal and environmental factors (WHO, 2007). Interdisciplinary services and programs have been provided to children with special needs at school for several years in Taiwan, but it remains unclear how these services address school participation. The study aims were to identify school participation restrictions and environmental barriers experienced by Taiwanese children with disabilities and the personal and environmental factors that predict their school participation.
DESIGN: This cross-sectional study was part of a national survey conducted in Taiwan. Children with disabilities who were registered in the new disability eligibility system and assessed during July 2012 to January 2014 were included.
METHOD: The Chinese version of the Child and Family Follow-up Survey (CFFS–C; Liao, Yen, Hwang, Liou, & Chang, 2013) was used to measure participation, child impairments, and environmental barriers in the home, school, and community. Data were collected on 18,119 school-age children with disabilities (M age = 12.1 yr, SD = 3.5). Boys (65%) and children with intellectual disability (53%) constituted the majority of the sample. Children with other diagnoses such as autism spectrum disorder (22%) and cerebral palsy (5%) were also included. The CFFS–C was completed by family caregivers and includes measures of participation (independence and frequency), environment barriers (physical, social, attitudinal), and child impairments (cognitive, physical, psychological). Descriptive statistics were used to identify the top school participation restrictions and environmental barriers, t tests and analyses of variance were used to assess differences among variables, and a stepwise linear multiple regression analysis was used to identify significant predictors of school participation.
RESULTS: Overall, children were most restricted in their participation in educational activities (independence) and social and recreational activities (frequency). Attitudes of others at school and family stress were the top environmental barriers. However, there were slight regional differences in the prevalence of participation restrictions and environmental barriers. The multiple linear regression results revealed that cognitive and physical impairments and child’s age accounted for 54% of the variance in school participation independence scores, and cognitive, physical, and psychological impairments accounted for 38% of the variance in school participation frequency scores.
CONCLUSION: This study points to factors that have been reported in prior research to be considered when examining school participation, such as impairment type and severity, age, and prevalence of national and regional participation restrictions and environmental barriers (Bedell & Dumas, 2004; Egilson & Traustadottir, 2009; Simeonsson et al., 2001). Results provide insights that might inform school personnel and policy makers about where services, resources, and changes are needed to reduce environmental barriers and promote school participation. For example, remodeling educational activities to include or engage children with disabilities might be warranted. Also, more opportunities and scaffolding might be needed for children with disabilities to participate in social, leisure, and recreational activities. Further research is needed to determine what specific supports and resources are available and what service delivery methods are possible to implement change effectively at the national and regional level.
References
Bedell, G., & Dumas, H. M. (2004). Social participation of children and youth with acquired brain injuries discharged from inpatient rehabilitation: A follow-up study. Brain Injury, 18, 65–82. https://doi.org/10.1080/0269905031000110517
Egilson, S. T., & Traustadottir, R. (2009). Participation of students with physical disabilities in the school environment. American Journal of Occupational Therapy, 63, 264–272. https://doi.org/10.5014/ajot.63.3.264
Liao, H.-F., Yen, C.-F., Hwang, A.-W., Liou, T.-H., & Chang, B. S. (2013). [Application of the functioning scale of the disability evaluation system]. Formosa Journal of Medicine, 17, 317–331. https://doi.org/10.6320/FJM.2013.17(3).13
Simeonsson, R. J., Carlson, D., Huntington, G. S., McMillen, J. S., & Brent J. L. (2001). Students with disabilities: A national survey of participation in school activities. Disability and Rehabilitation, 23(2), 49–63. https://doi.org/10.1080/096382801750058134
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