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Relationship between geographical variations in participation and in environment in children with CP A Guyard Laboratoire TIMC THEMAS Universit Joseph Fourier Grenoble he 15 th E T me r g ing Ne w Re se a r c he r s in the Ge og r a


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A Guyard Laboratoire TIMC THEMAS Université Joseph Fourier Grenoble

Relationship between geographical variations in participation and in environment in children with CP

T he 15th E me r g ing Ne w Re se a r c he r s in the Ge og r a phy

  • f He a lth a nd Impa ir

me nt Confe r e nc e 10-11 June 2010 -Pa r is – F r a nc e http:/ / www.ir de s.fr / E nr g hi2010 e nr g hi2010@ir de s.fr

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Contents

  • SPARCLE

n Social model of disability n Project n Aims n Method

  • Results

n Participation n Environment

  • Conclusion
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Social Model of Disability

  • Disability = interaction between the

individual and their environment

  • Participation = involvement in life

situations

Impairment Participation Environmental factors Personal Factors

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SPARCLE Project

  • Study of PARticipation of Children with

cerebral palsy Living in Europe

  • 9 centres, 8 registers, 7 countries

United Kingdom (1, 3) Sweden (2) France (4, 8) Ireland (5) Denmark (6) Italy (7) Germany (9)

  • 818 8–12-year-old CP children
  • July 2004- July 2005
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Aims

  • To evaluate variations by type and

severity of impairment of children with CP

  • 1. Involvements in life situations (participation)
  • 2. Physical environment, transport and social

support

  • To investigate geographical variations in

both participation and environment

  • Recommendation to EU and local policies
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Participation: Life-H

  • Daily life

n Meals n Fitness n Personal care n Housing n Mobility n Communication

  • Social roles

n Responsabilities n Relationship n Community n School n Leisures

1 . Eating m eals, how does your child accom plish this? With/ Without difficulty 1 7 . Does your child select the type and am ount of food he or she w ants? Yes (= > With/ Without difficulty) / No (= > Too difficult/ other)

62 items based on MHAVIE (Fougerolles and al)

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Environment: ECEQ

  • European Child Environment

Questionnaire: 60 items

n Physical, social and attitudinal environment n At home, school, community + transport

1 . Does your child have suitably enlarged room s or extensions at hom e? Not needed / Yes / No 3 3 . Does your child receive em otional support from w ider fam ily and friends? Mostly yes / Mostly no

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Contextual factors

  • Gender, age of the child
  • Type of CP
  • Level and type of impairment
  • Pain felt by children
  • Family structure : parents, sibling
  • Type of school
  • Qualification of parents
  • Parents occupations
  • Type of housing
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Contents

  • SPARCLE

n Social model of disability n Project n Aims n Method

  • Results

n Participation n Environment

  • Conclusion
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Participation in children

Determinants

Highly associated with

n Walking ability and fine motor skills n Intellectual impairment n Communication difficulties n Epileptic seizures n Pain

  • Few related to visual or hearing impairment
  • No relation with

n Socioeconomical status n CP type n Schooling

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Participation in children

Geographical variations

Daily activities

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Participation in children

Geographical variations

Daily activities

Level’s participation in essential activities

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Participation in children

Geographical variations

Social roles

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Physical environm ent Social support Attitudes

Hom e School Com m unity Transport Hom e Com m unity Fam ily & friends Teachers Classm ates

Child’s im pairm ents

W alking ability I ntellectual ability Com m unication Type of CP

Socio-dem ographic characteristics

Parental em ploym ent Gender

Child’s environmental access

Determinants

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Child’s environmental access

Geographical variations

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Child’s environmental access

Geographical variations

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Child’s environmental access

Geographical variations

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Daily activities & physical environment at home

Participation in daily activities Physical environment Significantly under mean Significantly above mean

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Responsibility & home environment and social support

Participation in responsibility Home and social support Significantly under mean Significantly above mean

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Participation at school & physical and attitudinal environment at school

Participation at school Physical env. and attitudes at school Significantly under mean Significantly above mean

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Conclusion

 Participation & Environment varied by

 Level of impairment  Region

 Need for modelling relationship between participation & environment

More information on http: / / research.ncl.ac.uk/ sparcle/