Provision of paediatric wheelchairs in low resource settings: a scoping review.

PURPOSE: Inadequate wheelchair provision in children can lead to delays in growth and development, poorer health, and decreased participation. Wheelchair provision for children can be challenging, especially in low-resource settings, due to limited resources. Therefore, the purpose of the scoping review was to gain an understanding of the current state of paediatric wheelchair provision in low resource settings and identify factors, strategies, and gaps that can lead to more successful wheelchair provision. METHODS: This scoping review used literature published after 2010, related to paediatric wheelchair provision in low resource settings. We searched online databases and grey literature and extracted data based on categories from the World Health Organisation Guidelines to wheelchair provision in low resource settings. RESULTS: 34 articles were used to identify and analyse common themes and successful strategies related to wheelchair provision for children in low resource settings. Aspects of paediatric wheelchair provision were mentioned in the literature but were rarely the focus. End-user outcomes were the least represented category in the literature. CONCLUSION: Based on the currently available evidence the overall state of a wheelchair for children is inadequate. Improvements in design and production, personnel capacity, and service delivery systems are recommended to promote best practices. The lack of child-focussed wheelchair provision and end-user involvement in the research process urgently needs to be addressed.Implications for RehabilitationIdentify best practiceIdentify gaps in knowledgeDetermine areas of need for future research.

Experience of Sleep for Families of Young Adults With Autism Spectrum Disorder.

IMPORTANCE: Children with autism spectrum disorder (ASD) may experience sleep difficulties that worsen into adulthood and negatively influence both child and family, yet the experience is not well understood. Understanding the family's experience can inform occupational therapy providers, future research, and practice guidelines. OBJECTIVE: To examine experiences surrounding sleep for families raising a young adult with ASD (YA-ASD). DESIGN: Qualitative study in the phenomenological tradition of Moustakas (1994). Experienced researchers analyzed transcripts from in-depth, in-person interviews to triangulate data, distill themes, and construct the essence of family experience. Trustworthiness was established through member checking, audit trails, and epoché diaries that were maintained throughout data analyses. SETTING: Community setting (large city in the northeastern United States). PARTICIPANTS: People who self-identified as living in a family arrangement that included a YA-ASD age 15-21 yr, able to verbally participate in English. Families with children diagnosed with developmental disabilities other than ASD were excluded. RESULTS: Six eligible families identified through volunteer sampling participated. The participants' sociodemographic diversity was limited across household income, education level, and ethnicity. All YA-ASD in this study were limited verbally and unable to contribute. Analyses of interview transcripts revealed five themes that form the essence of the families' experience surrounding sleep. CONCLUSIONS AND RELEVANCE: Sleep issues for YA-ASD continue into adulthood and affect the entire family because of continuous co-occupation; occupational therapy support is therefore important for families of YA-ASD. The lack of effective evidence-based interventions supporting the YA-ASD population also reveals an area for growth. What This Article Adds: The results indicate the importance of addressing sleep for YA-ASD and their families in occupational therapy practice because of its considerable impact on family life.

The Family Meal Model: Influences on Family Mealtime Participation.

The family meal affords benefits such as positive nutritional habits, trust building, connecting, parent modeling, and teaching. During the school-aged years, families can support children's development of health behaviors and family routines. This interdisciplinary study examined families' experiences of mealtimes and the factors that support or hinder mealtime participation. Grounded theory methods guided data collection and analysis. Semi-structured interviews were conducted with 21 families with at least one school-aged child (n = 68). Interviews were audio recorded and transcribed. Researchers coded and categorized data, identified themes, and generated a model. Families defined family mealtime as all family members being together at the kitchen or dining room table eating a meal. Families enjoyed being together, conversing, and connecting through family mealtime participation. The Family Meal Model proposes relationships between factors that support or hinder a family's mealtime participation. Discussion includes support for a broadened role of occupational therapy in promoting family occupation through family meals.

Benefits of Family Meals for Children With Special Therapeutic and Behavioral Needs.

Frequency of family meals (FMs) is associated with favorable child outcomes; however, no study to date has examined the relationship between frequency of FMs and outcomes for children with disabilities. Data from the 2007 National Survey of Children's Health for children with disabilities (N = 4,336) were used. Logistic regression for each dependent variable was completed using frequency of FMs and covariates of age, gender, race, family structure, and poverty level. Each day per week increase in the frequency of FMs increased the likelihood for positive social skills (odds ratio [OR] = 1.09, 95% confidence interval [CI] [1.01, 1.19]) and engagement in school (OR = 1.09, 95% CI [1.02, 1.16]). Frequency of FMs was not associated with problematic social behaviors or parental aggravation with child. Our findings suggest that children with disabilities whose families participate in frequent FMs have a greater likelihood of positive social and family health outcomes.

Frequency of family meals and 6-11-year-old children's social behaviors.

Family meals are regarded as an opportunity to promote healthy child development. In this brief report, we examined the relationship between frequency of family meals and children's social behaviors in 6-11-year-olds. The 2007 U.S. National Survey of Children's Health (NSCH) provided data on the frequency of family meals in a sample of 6-11-year-old children (N = 24,167). The following social behavior indicators were examined: child positive social skills, child problematic social behaviors, child engagement in school, and parental aggravation with the child. Individual logistic regression analyses were calculated in unadjusted and adjusted models. On average, families had 5.3 meals together per week. In adjusted models, more frequent family meals increased the odds of child positive social skills (OR = 1.08, 95% CI [1.02, 1.16]) and child engagement in school (OR = 1.11, 95% CI [1.06, 1.15]), and decreased the likelihood of child problematic social behaviors (OR = 0.92, 95% CI [0.87, 0.98]). There was no association between frequency of family meals and parental aggravation with the child (OR = 0.98, 95% CI [0.93, 1.04]). Findings support the promotion of family meals to benefit children's development of healthy social behaviors.

Art-based occupation group reduces parent anxiety in the neonatal intensive care unit: a mixed-methods study.

OBJECTIVE: We examined whether an art-based occupation group using scrapbooking in the neonatal intensive care unit (NICU) would reduce parent stress, operationalized as anxiety. We also wanted to understand the parents' lived experience of the group. METHOD: Forty parents from a Level 3 NICU in a large metropolitan hospital participated. We administered the State-Trait Anxiety Inventory preactivity and postactivity along with a brief interview. RESULTS: The decline in parents' mean state anxiety (12.7 points, SD = 11.8; p < .0001) was clinically significant. The decline in mean trait anxiety (2.6 points, SD = 5.2; p = .0036) was statistically significant but not clinically meaningful. Parents said that participation offered distraction and engagement, pleasure, relaxation, a sense of hope, and an opportunity to share. CONCLUSION: An art-based occupation group using scrapbooking was an effective brief intervention to reduce parent anxiety in the neonatal intensive care unit; parent interviews suggested that participation has broad clinical implications for parent well-being.

How did the television get in the child's bedroom? Analysis of family interviews.

OBJECTIVE: Although recent research has shown associations between a television in the bedroom of children (BTV) and obesity, medical and negative societal consequences, the family decision making process supporting or opposing BTV is not yet understood. A qualitative research approach elicited rich, decision making experiences of families. METHODS: Structured family interviews (n=21) in spring 2011 in Oklahoma City captured direct quotations about family beliefs and practices related to BTV. Systematic constant comparative methods of grounded theory guided identification of patterns and themes across families to develop a model of family decision making for BTV. RESULTS: Nine themes represented family decision making processes for BTV. Supporting themes included "I didn't even think about it" and "benefit to me." Opposing themes included: "watch a lot more TV and get less sleep," "bedroom door would probably be closed a lot," "everyone knows it rots your brain," and "what the heck are they watching." CONCLUSIONS: Development of a conceptual model represented the basis for decisions opposing BTV in child concerns for development and missed opportunities while decisions supporting BTV reflected its use as a parenting tool. The emerged model could be useful in guiding strategies to modify family routines and address active and passive parenting strategies that negatively affect child health.