Enabling participation in paediatric rehabilitation: challenges and opportunities

Professor Christine Imms1

1 Professor Of Occupational Therapy, Australian Catholic University

The importance of positive participation outcomes for those experiencing childhood-onset disability is well established. The introduction of the National Disability Insurance Scheme in Australia has further endorsed the primacy of participation as a health and human services outcome. However, until recently, lack of clarity about what constitutes participation, as distinct to activity performance, has reduced our capacity to build effective intervention models and practices, and to assess whether what we do changes participation outcomes.

The aim of this presentation is to use the recently published family of Participation Related Constructs (fPRC) as a framework to interpret participation research findings in childhood disability and highlight challenges and opportunities for practice and research.

The fPRC was developed following a series of systematic reviews of participation intervention research, culminating in a conceptual paper describing the framework. In the fPRC, participation is defined as having two central constructs: being there (attendance) and involvement. Using systematic review methods, measures purporting to assess participation in childhood disability were identified and mapped to the fPRC, highlighting the frequent disconnect between what was measured and the construct of participation.

Research focused on enhancing participation outcomes, rather than describing participation patterns, is needed. Opportunities to develop and implement theoretically informed intervention models, and to test them using valid measures, rely on those designing, delivering and funding health and human services having a shared and conceptually clear understanding of the construct of participation. The fPRC offers a mechanism to support this goal.