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This study explored the feasibility, impact and parent experiences of ENVISAGE (ENabling VISions And Growing Expectations)-Families, a parent-researcher co-designed and co-led program for parents/caregivers raising children with early-onset neurodisabilities. Parents/caregivers of a child with a neurodisability aged ≤6 years, recruited in Australia and Canada, participated in five weekly online workshops with other parents. Self-report measures were collected at baseline, immediately after, and 3 months post-ENVISAGE-Families; interviews were done following program completion. Quantitative data were analyzed with generalized estimating equations and qualitative data using interpretive description methodology. Sixty-five parents (86% mothers) were recruited and 60 (92%) completed the program. Strong evidence was found of effects on family empowerment and parent confidence (all p ≤ 0.05 after the program and maintained at 3-month follow-up). The ENVISAGE-Families program was relevant to parents' needs for: information, connection, support, wellbeing, and preparing for the future. Participants experienced opportunities to reflect on and/or validate their perspectives of disability and development, and how these perspectives related to themselves, their children and family, and their service providers. ENVISAGE was feasible and acceptable for parent/caregivers. The program inspired parents to think, feel and do things differently with their child, family and the people who work with them. ENVISAGE (ENabling VISions And Growing Expectations)-Families is a co-designed, validated parent/researcher "early intervention and orientation" program for caregivers raising a child with neurodevelopmental disabilities (NDDs). ENVISAGE-Families empowered parents' strengths-based approaches to their child, family, disability, and parenting. ENVISAGE-Families increased caregivers' confidence in parenting children with NDD's and provided them tools to support connection, collaboration, and wellbeing. Raising children with NDD can have a profound impact on caregivers, who can benefit from strengths-based, future focused supports early in their parenting experience. [ABSTRACT FROM AUTHOR]

Background Emotionally available parent-child relationships are supportive of child health and development. When a child has cerebral palsy, a range of child and parent factors can potentially impact the parent-child relationship; however, little research has specifically addressed this question. The aim of this study is to investigate links between parent-child emotional availability and both child functional abilities and parent distress in a sample of parents and children with cerebral palsy. Methods Twenty-three mothers (mean age 37.3+/−5.7 years) and their children (mean age 4.9+/−3.3 years) with cerebral palsy completed a 20 min videoed parent-child interaction, scored using the Emotional Availability Scales. Parents also completed the Depression Anxiety Stress Scale, the Paediatric Evaluation of Disability Inventory, and the Strengths and Difficulties Questionnaire. Correlational analyses were conducted, and qualitative observations were made. Results Parent-child dyads in which the parent reported depressive symptoms scored poorer on all aspects of parent-child emotional availability. Where parents reported experiencing anxiety or stress, increased parent hostility and decreased child responsiveness was found. There was no relationship between child functional abilities and either parent distress or parent-child emotional availability. Parent sensitivity, structuring, and nonintrusiveness were negatively associated with child peer problems. Both child responsiveness and child involvement were negatively associated with hyperactivity/inattention. Observations of video footage suggested that parent implementation of therapy strategies impacted negatively on parent-child emotional availability for some dyads. Conclusion Findings from this study are consistent with the wider literature showing a link between parental depression and the parent-child relationship and extend this link to the cerebral palsy population. The importance of routine screening for parental mental health problems in early childhood intervention is highlighted by these findings. In addition, this study emphasizes the need to better understand how therapists support parents to implement therapeutic strategies to minimize negative impact on the developing parent-child relationship. [ABSTRACT FROM AUTHOR]

Background Feeding difficulties are relatively common in children with autism spectrum disorders ( ASD), but current evidence for their treatment is limited. This review systematically identifies, reviews and analyses the evidence for intervention in young children with ASD and feeding difficulties. Methods A comprehensive search strategy was used to identify studies from January 2000 to October 2013. Studies were included if they described interventions where the goal was to increase desirable eating behaviours or decrease undesirable eating behaviours using an experimental design, including single-subject research methodology. Studies were reviewed for descriptive information, and research quality was appraised using a formal checklist. Individual study findings were compared using Improvement Rate Difference ( IRD), a method for calculating effect size in single-subject research. Results Overall, 23 papers were included. All studies reviewed had five or fewer participants, and reported on operant conditioning style intervention approaches, where the child is prompted to perform an action, and receives a contingent response. Where quality measures were not met, it was primarily due to lack of detail provided for the purposes of replication, or failure to meet social validity criteria. Meta-analysis indicated a medium-large effect size [mean = 0.69, 95% confidence interval ( CI) 0.60 to 0.79] when the outcome measured was an increase in desirable behaviours (e.g. consuming food), but a small-negligible effect size (mean = 0.39, 95% CI 0.18 to 0.60) when the outcome measured was a decrease in undesirable mealtime behaviours (e.g. tantrums). Only a small proportion of studies reported outcomes in terms of increased dietary variety rather than volume of food consumed. Conclusions The reviewed literature consisted primarily of low-level evidence. Favourable intervention outcomes were observed in terms of increasing volume, but not necessarily variety of foods consumed in young children with ASD and feeding difficulties. Further research in the form of prospective randomized trials to further demonstrate experimental effect in this area is required. [ABSTRACT FROM AUTHOR]

Aim: To systematically review the literature on the effectiveness of early intervention programmes for children with physical disabilities. Methods: Twelve electronic databases were searched for articles published between 1990 and April 2008. The quality of articles was appraised using an adapted version of the Checklist for the Evaluation of Research Articles and the Physiotherapy Evidence Database (PEDro) scale. Results: Ten studies were included in the review. Cross-sectional and interrupted time-series studies were of moderate methodological quality, whereas the non-randomised control trial was of moderate-to-high methodological quality. Studies differed considerably with respect to participants, types of intervention and outcomes measured. Conclusions: Positive outcomes for both children and families have resulted from early intervention. However, methodological limitations hamper a more rigorous analysis of findings across studies. [ABSTRACT FROM AUTHOR]

Background/aim: Supporting children's participation in health-enhancing physical activities is an important occupational goal for therapists. Fundamental movement skills (FMS) are thought to underpin and enable many activity options. This study had two goals: first, to examine the relationship between fundamental movement skills (FMS) and physical activity, and second, to use this and existing evidence to inform strategies whereby children's motivation for and engagement in physical activity can be supported. Methods: A cross-sectional investigation of 124 children, aged 6-12 years, was undertaken. FMS were assessed using the Movement Assessment Battery for Children (M-ABC) and physical activity by pedometer step counts. Results: A weak but significant association was found between weekend physical activity and balance skills for girls. Correlations between physical activity and ball skills or manual dexterity were not significant for either gender, however, having age appropriate ball skills did result in greater but not significant levels of physical activity for all children when grouped together. Conclusions: Findings from this study question the magnitude of the relationship between children's FMS and physical activity as measured by pedometers. If the goal of health enhancement through physical activity engagement is to be realised, it is proposed that community, occupation-based approaches may offer more potential than skills-based interventions at increasing activity participation. The concept of Engaging and Coaching for Health (EACH)-Child is introduced to this end. Occupational therapists are encouraged to work collaboratively with school and community organisations to assist children to find the physical activities that best accommodate their interests, abilities and offer opportunities for lifelong engagement. [ABSTRACT FROM AUTHOR]

Inadequate physical activity in children is a major health concern. The purpose of this study was to examine changes in physical activity of boys and girls, between 6-8 and 8-10 years of age and how activity patterns correlated with selected family, child, and environment factors. The sample included 59 children without motor delays (26 boys and 23 girls) between 8 and 10 years of age. Twenty-two of the children participated in a previous study at 6-8 years of age. Parents completed a questionnaire on their children 's non-physical and physical activities. Children wore a pedometer during two weekdays and two weekend days. The results indicate that girls spent more time on homework and reading and on crafts and indoor play than boys. Girls spent more time on musical and cultural activities and boys spent more time on screen-based activities at 8-10 years of age. Children spent significantly less time on physical activity at 8-10 years of age. Boys took more steps per day than girls on weekends. The average number of steps taken per weekday increased for boys, but not girls, at 8-10 years of age. There was an inverse relationship between body mass index and number of steps taken per day (weekdays r = -.28; weekend r = -.32). Socioeconomic status was associated with the number of steps taken by children on weekends (r = .34). The results have implications for physical activities for girls and school and community programs for children. [ABSTRACT FROM AUTHOR]

Background Perceived freedom in leisure (PFL) is explored as a potential mechanism mediating relationships between physical co-ordination ability and both global life satisfaction and leisure-time physical activity participation for boys with differing levels of physical co-ordination ability. Understanding psychological mechanisms contributing to low rates of participation in physical activities for boys with developmental co-ordination disorder (DCD) is a clinical and research priority with potential to inform clinical interventions and preventive health initiatives. Method Sixty boys aged 10–13 years with DCD and 113 boys without DCD completed self-report measures of PFL and life satisfaction. Seven-day leisure-time activity diaries and 12-month retrospective recall questionnaires were completed by parents. Results Lower self-appraisals of PFL and overall life satisfaction were found for boys with DCD compared with boys without DCD. PFL mediated relationships between physical ability and both life satisfaction and team sport participation. Conclusion Perceived freedom in leisure, comprising self-appraisals of leisure needs satisfaction and competence, depth of involvement and perceived control over leisure outcomes, was a significant mechanism influencing leisure-time participation and life satisfaction for boys. The implications for effective intervention and preventive health programmes are discussed. [ABSTRACT FROM AUTHOR]

Background and Aims: Children's declining physical activity has attracted attention from those concerned with the health and well-being of the young. The present study aims to determine if the extent of walking to and from a school with an active participation program differed from that in another school without a program. Method and Results: Data from 21 parents of Grade 7 children from School A, sourced from a previous study, were compared with data from parents of Grade 7 children in School B, collected using the same questionnaire. No significant difference in the mean number of days walked to (t = 0.098, P = 0.92) or from school (t = 0.251, P = 0.80) was identified. Conclusions: This small-scale project suggests that a mélange of variables has the potential to influence children's incidental activity levels. [ABSTRACT FROM AUTHOR]

The play of children with autistic spectrum disorder (ASD) is a valuable medium for assessment and intervention, and its analysis has the potential to aid diagnosis. This study investigated spontaneous play behavior and play object preferences for 24 preschool children with ASD in a typical occupational therapy clinical environment. Play behavior was rated and choice of play object noted at 10-second intervals from a 15-minute video recording of unstructured play. Statistical analyses indicated that play behavior was consistent with descriptions in the literature. In addition, the children demonstrated clear preferences for play objects in the form of popular characters (e.g., Thomas the Tank Engine) and those with sensorimotor properties. We propose that the inclusion of preferred play objects in a clinical environment may increase intrinsic motivation to play, and thereby enhance assessment and intervention. [ABSTRACT FROM AUTHOR]

The Functional Independence Measure for Children (WEEFIM) and the Pediatric Evaluation of Disability Inventory (PEDI) are the most commonly used measures of functional performance in children. The purpose of this study was to determine the concurrent validity of the instruments when used with children with developmental disabilities and acquired brain injury. The subjects were 41 children, age 1.3 to 9.5 years, who were receiving inpatient or outpatient services at a pediatric rehabilitation unit in Brisbane, Australia. Spearman correlation coefficients between the two tests were greater than 0.88 for self care, transportation/locomotion, and communication/social function. The high correlations indicate that the two tests measure similar constructs. Choosing between the tests depends on situational requirements and depth of information required. [ABSTRACT FROM AUTHOR]

Test/retest reliability and inter-rater agreement was established on the Quality of Upper Extremities Skills Test (QUEST) for 16 children between 6 and 16 years of age who had an acquired brain injury. Performance on the QUEST was videotaped for the purpose of scoring, and some modifications were made to the administration and scoring of the assessment. Intra-class correlation indicated high agreement for test/retest reliability (0.90 to 0.95), and inter-rater reliability (0.84 to 0.94) across all subtests. The findings are discussed in terms of ongoing test refinements and the extension of the original age range and diagnostic group for which the test was designed. [ABSTRACT FROM AUTHOR]

Disorder of movement is the main feature of cerebral palsy. Yet, until recently, no easy-to-use validated measure of upper limb quality of movement has been available for children with cerebral palsy. The Quality of Upper Extremities Skills Test (QUEST) was developed to meet this need. The QUEST was developed for children aged 18 months to 8 years and this review finds that initial reliability and validity data are promising. The ability of the test to detect change, however, is less clear and there is little support for its discriminative properties. Some suggestions are made regarding administration and scoring procedures. Notwithstanding these limitations, the QUEST is identified as an important first step to the measurement of upper extremity quality of movement for children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Modern cursive script, along with its precursor the beginner's alphabet, is now well established in the curricula of most Australian schools. However, debate continues regarding the advantages of this script over the previous print and cursive style. Beyond this debate, occupational therapists continue to assess and treat children with handwriting difficulties. Therefore, how children are writing using modern cursive now warrants attention, as this is the mode of choice in most Australian schools. Three hundred and seventy-two children aged between 7 and 14 years who attended Queensland government primary schools were asked to complete the speed subtest of the Handwriting Performance Test. The same writing sample was used to rate legibility on a scale from 1 (poor legibility) to 7 (good legibility). Handwriting speed (in letters per minute) did not differ significantly between boys and girls (mean (+/-SD) = 69.9+/-33.8 and 68.9+/-25.9 letters/min, respectively). In contrast, legibility was significantly better (t(370) = 3.79, P < 0.0001) for girls than boys (4.2+/-1.2 and 3.5+/-1.0, respectively). There was a low correlation between speed and legibility (r = 0.23, P > 0.05). The results are discussed in light of the shift to this new writing style and current occupational therapy practice. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Coaching parents to enable children's participation: An approach for working with parents and their children," by Sylvia Rodger, Fiona Graham and Jenny Ziviani in the previous issue.