Participation of children with physical disabilities: relationships with diagnosis, physical function, and demographic variables

The primary goal of occupational therapy intervention for children with disabilities is enabling participation in the daily activities of childhood. The World Health Organization conceptualizes chronic health conditions and disability as two distinct aspects of health, with the primary concern on the level of health condition being with diagnosis rather than function. Participation, within the International Classification of Functioning, Disability and Health (ICF), is characterized by the interactions between a child, its family, and other personal and environmental factors. Few studies have examined the relationships between diagnosis, function, and participation in children with disabilities. Using the results of a study of the participation of 427 children with physical disabilities in activities outside mandated school, the authors examined the relative influence of diagnostic category on participation. When adjusted for age, sex, and physical function, diagnostic category does not significantly affect the intensity and diversity of participation. The results of this study confirm and highlight the limitations in using diagnostic information in children's rehabilitation in the absence of other information. Participation is a complex phenomenon so it is important to understand more clearly how personal, environmental, and family factors influence the child's involvement in everyday activities. There is a need to move beyond diagnosis to focus on other personal and environmental factors as major predictors of participation.