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AIM: To explore concurrent validity, convergent validity, interrater reliability, test-retest reliability, and Rasch model analysis of the School Participation Questionnaire (SPQ), a tool for teachers to assess personal and environmental determinants of school participation.METHOD: Teachers of children with additional support needs, including intellectual disability, autism, and learning difficulties completed measures. Data were collected using the SPQ and the Participation and Environment Measure for Children and Youth (PEM-CY). Test-retest and interrater reliability were assessed using intraclass correlation coefficients (ICCs). Internal consistency was assessed with Cronbach's alpha. Concurrent and convergent validity were explored via correlations with the PEM-CY. Further psychometrics were examined using a Rasch model.RESULTS: One hundred and eighty-seven children (136 [72.7%] male; mean age 9y [range 5y 6mo-12y 10mo, SD 2y]) were assessed by 67 teachers. Cronbach's alpha, test-retest, and interrater reliability were acceptable-excellent across each SPQ scale (alphas=0.89, 0.9, 0.94, 0.79; test-retest ICCs=0.64, 0.61, 0.78, 0.62; interrater ICCs=0.85, 0.71, 0.90, 0.81). Concurrent and convergent validity were confirmed with significant positive correlations between SPQ and PEM-CY. After Mokken and Rasch model analysis, person and item reliability were good, and unidimensionality was confirmed. Mean administration time was 8.2 minutes.INTERPRETATION: The results suggest that the SPQ is a rapid, reliable, and valid tool for assessment of participation-related indicators in schools.

SummaryAdults with neurodevelopmental disorders frequently present to, but fit uneasily into, adult mental health services. We offer definitions of important terms related to neurodevelopmental disorders through unifying research data, medical and other viewpoints. This may improve understanding, clinical practice and development of neurodevelopmental disorder pathways within adult mental health services.

PurposeThe purpose of this paper is to present a case study of an intersectoral partnership that has taken place in Scotland (United Kingdom) entitled Gamechanger. The main idea of Gamechanger was for statutory, commercial and voluntary organisations to work in partnership to harness the power of football (soccer), to tackle health inequalities and social exclusion. The paper will detail how Gamechanger has been developed, with reference to the newly developed “Incite” model for effective intersectoral partnership working.Design/methodology/approachThis paper draws on the authors’ experiences of leading and evaluating intersectoral partnerships from 2015 to 2019. The report draws on the work which took place during that period, and the achievements in relation to Gamechanger.FindingsGamechanger has led to significant innovations. It has encouraged sectors to work together, and develop new ways of responding to difficult societal problems.Originality/valueGamechanger is believed to be the first initiative of its kind developed with a football club in Scotland.ConclusionsThis work has been developed through robust community-informed efforts. The scope and scale of the projects to deliver community benefits is significant. Gamechanger has provided a means for football to take a different approach to how it works to benefit communities.

Transition to adulthood can be a challenging developmental task for adolescents with common mental health problems and is linked to adverse outcomes such as ‘not in education, employment or training’ (NEET). This study investigated longitudinal associations between adolescent psychosocial factors (e.g., self-esteem, aspirations, bullying, physical activity) and later NEET status among individuals with common mental health problems (i.e., depression and anxiety). A secondary data analysis of the Next Steps cohort study was completed using waves 2 and 8. Psychosocial factors, mental health, and background characteristics were captured when participants were aged 15–16 years (wave 2) while still in compulsory education. The 12-item General Health Questionnaire was used to identify adolescents with common mental health problems. The study population consisted of 2224 participants (females 66.8%) of which 1473 (66.2%) were aged 15 years and 751 (33.8%) were aged 16 years in wave 2. The outcome was NEET status at ages 25–26 years (wave 8). The results showed that after adjusting for background characteristics, adolescent self-esteem, locus of control, bullying, physical activity, job aspirations, and attitudes to school predicted NEET status. Educational aspirations, substance use, and behavioural problems were not significantly associated with NEET status. These findings provide new insights into the role of adolescent psychosocial factors in the context of education and employment outcomes for youth at risk and highlight the necessity of targeted mental health support to improve life chances.

Visual supports are an important intervention for autistic individuals and others with neurodevelopmental differences. However, families often report limited access to visual supports and lack of information and confidence in their use at home. This pilot study aimed to evaluate the feasibility and effectiveness of a home-based visual supports intervention. Methods: 29 families with children (n = 20 males; mean age 6.59 years [Range 3.64–12.21 years SD 2.57]) receiving support for autism or related needs participated in the study. Parents engaged in an individualised assessment and intervention process through home visits, completing pre- and post-measures. Qualitative methods were used to explore the parents’ experiences of the intervention. Results: The intervention led to a statistically significant improvement in parent-reported quality of life (t28 = 3.09, p = 0.005) and parent-reported perception of autism-specific difficulties (t28 = 2.99, p = 0.006). Parents also reported improved access to resources and relevant information and increased confidence in using visual supports at home. The home visit model was strongly supported by the parents. Conclusion: The results provide initial evidence of the acceptability, practicality, and utility of the home-based visual supports intervention. These findings suggest that outreach into the family home may be a beneficial mechanism for delivering interventions related to visual supports. This study highlights the potential of home-based interventions to improve access to resources and information for families and the importance of visual supports in the home setting.

There is a variable standard of access to quality neurodevelopmental assessment and diagnosis. People may have negative experiences, encountering lengthy waiting times, and inconsistent practices. Practitioners need guidance on standards and practices for assessment and diagnosis matched to new ways of working. In this paper, we present a new pathway and recommendations for multidisciplinary neurodevelopmental assessment and diagnosis for children and young people (&lt, 19 years), developed by the Scottish Government funded National Autism Implementation Team (NAIT). Our research used the Medical Research Council guidance for the development of complex interventions and included several iterative stages. Stage 1: n = 44 stakeholders attended an event on developing new practices for diagnosis and assessment. Stage 2: a literature synthesis was completed by the research team of clinical guidelines and diagnosis and assessment tools. Stage 3: an event with n = 127 stakeholders included discussion and debate of the data from stages 1 and 2. Recommendations and a draft pathway were written. Stage 4: successive drafts of recommendations and the pathway documentation were circulated among an advisory group, including multidisciplinary clinical experts and people with lived experience, until the final pathway was agreed upon. The finalised pathway includes guidance on terminology, assessment, diagnosis, triage, time standards and engagement of people with lived experience. The new pathway has been adopted by the Scottish Government. The pathway and associated documentation are freely available online for use by others.

Background Managing school nonattendance is a priority worldwide. Frequent school nonattendance in early school years has immediate and long-term negative effects. Although strategies to address nonattendance are being developed and implemented, the number of students with school nonattendance issues is increasing. In this study, we explored students’ feelings and perceptions about attending school and the potential determinants of a positive attitude towards attending school. Methods We hypothesized that a positive perception towards attending school was influenced by relationships, perceptions of current circumstances, subjective health, and having someone to share experiences and thoughts with. For examining the hypothesized model, an original questionnaire with 14 items was developed, including perceptions towards school attendance (an item), relationships with friends and school teachers (5 items), current circumstances (4 items), subjective health (3 items), and the individuals available to share experiences and thoughts with (1 item). In total, 6860 children submitted the questionnaire (85.3% response rate) and 6841 responses were included to examine the model. Children were 10 or 11 years old, and selected from 111 state-run schools in 8 randomly selected school districts. Results The final model demonstrated good fit and showed that the latent variable of relationships with friends and school teachers directly impacted on how children felt about attending school. The latent variable of subjective health also directly impacted on how children felt about attending school but not strongly. Other latent variables were not significant. Conclusions The importance of positive relationships with friends and teachers in overcoming school nonattendance has been emphasized in previous studies. This study has provided evidence that these relationships impacted children’s positive perception about attending school in a large sample of students aged 10–11 years. The latent variable of subjective health may require more items to capture mental health.

To provide prevalence estimates of needs of people with dementia living at home, and to determine sources of variation associated with needs for this population.A systematic review and meta-analysis was performed searching CINAHL, MEDLINE, PsycINFO and ASSIA databases. Following quality checks, random effects meta-analysis produced prevalence estimates for needs reported by people with dementia and by their informal caregivers. Fixed effects models were undertaken to compare caregiver and person with dementia reported needs. Heterogeneity was explored through sensitivity analysis. The study protocol was registered with Prospero #CRD42017074119.Six retrieved studies published between 2005 and 2017 including 1011 people with dementia and 1188 caregivers were included in the analysis. All data were collected using Camberwell Assessment of Need for the Elderly. Prevalence estimates are provided for 24 needs reported by participants in The Netherlands, United Kingdom, Poland, Ireland, Germany, Norway, Portugal, Italy and Sweden. Most prevalent needs reported by people with dementia were Memory 0.713 [95% CI 0.627, 0.791]; Food 0.706 [95% CI 0.547, 0.842]; Household activities 0.677 [95% CI 0.613, 0.738]; and Money 0.566 [95% CI 0.416, 0.711]. Caregivers reported greater prevalence than people with dementia did for 22 of 24 needs, although the priority ranking of needs was similar. Exploration of heterogeneity revealed that people with young onset dementia were the major source of variation for 24 out of 48 analyses.Increased understanding of prevalence of needs of people with dementia and associated heterogeneity can assist in planning services to meet those needs.

We report the implementation of a new framework supporting teacher practice for inclusion of children with disabilities in mainstream classrooms. Eight schools in one Scottish authority took part. ...

Background: Managing school nonattendance is a priority worldwide. We aimed to explore students’ feelings and perceptions about attending school and the potential determinants of a positive attitude towards attending school. Methods: We hypothesized that a positive attitude towards attending school was influenced by positive relationships with friends and school teachers, positive perceptions of current circumstances, and positive subjective health. An original questionnaire was developed and distributed in Japan. To capture how children felt about attending school, the item wording was “I am looking forward to going to my school.” To capture positive relationships with friends and school teachers, items were positively worded, including “I get along well with friends” and “school teachers approve of my efforts.” To capture positive perceptions of current circumstances, items were positively worded, including “I am able to prepare for classes by my own” and “I am proud of myself.” For positive subjective health, selected items were “my health status,” “I get tired easily” and “I have anxieties and/or worries.” We analyzed data from 6841 elementary school children in the 5th year in Japan using a structural equation model. We examined the model using the comparative fit index (CFI), Tucker Lewis index (TLI), and root mean square error of approximation (RMSEA).Results: The final model obtained 0.055 for RMSEA, 0.933 for CFI, and 0.923 for TLI. Children’s positive views towards attending school were directly related to positive relationships with friends and school teachers (the path coefficient value was 0.465), positive perception of current circumstances (0.074), and positive subjective health (0.187). Conclusions: This study found that positive relationships with friends and school teachers were significantly and positively associated with children looking forward to attending school. Positive health status and a positive perception of current circumstances were also significant, but the relationship was not as strong.

Whist inclusion is recommended for most children most of the time it remains difficult to implement. In this paper, we present the process undertaken to review and redesign a pre-existing complex intervention (The CIRCLE Framework) which was designed to enhance teachers confidence and competence in provision of universal first level supports for 5–12 year old children with additional support needs. The approach presented draws on the Medical Research Council guidance for the development of complex interventions. A series of ten co-design workshops with 70 stakeholders was completed, applying interactive and participatory methods. Analysing outputs of each workshop revealed recurring design ideas that became the main aspects of the new framework and associated manuals. Intervention content, theoretical frameworks, manuals to support use in practice and implementation strategies were developed. On completion, the updated intervention was extended up to 18 years of age and redistributed to all teachers in the participating local authority. We present the main conclusions and interpretations around the design and naturalistic implementation of the framework, and reflections on use in practice, including a detailed list of recommendations for implementation across schools and staff.

Play is essential in childhood, allowing for a positive trend in development and learning. Health professionals need useful tools to assess it, especially in the case of children with neurodevelopmental disorders. The aim of this study was to validate and cross-culturally adapt the My Child&rsquo, s Play questionnaire and to find out if this instrument allows us to differentiate the play of children with neurodevelopmental disorders from the play of children with neurotypical development. A total of 594 parents completed the questionnaire. A confirmatory factor analysis was conducted, which showed a similar structure to the English version: (1) executive functions, (2) environmental context, (3) play characteristics, and (4) play preferences and interpersonal interactions. The reliability of the analysis was high, both for the whole questionnaire and for the factors it comprises. The results provide evidence of the potential usefulness of the My Child&rsquo, s Play questionnaire for determining play needs and difficulties of children, moreover, this tool can also be used to plan intervention programs according to the needs of each child and family.

Background Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. Methods This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). Results Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p Conclusion An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment. Trial registration NCT04083404 Registered 05 September 2019 (retrospectively registered).

Objective: There has been a significant change within clinical practice in childhood disability from "treating" at the level of body function to ecological approaches that address the child's involvement in everyday life. Clinical assessment, and robust tools to support this, are of key importance. The aim of this study was to assess the psychometric properties of the ACHIEVE Assessment in a clinical dataset. The ACHIEVE assessment is a parent and teacher report of participation in home, school and community settings, important contributory factors for participation, and environmental factors. Design: ACHIEVE scores of children were collected from parents and teachers. The Rasch Rating Scale Model produced model estimates with WINSTEPS software. Setting: Clinical rehabilitation settings in Scotland (United Kingdom). Subjects: 401 parents and 335 teachers of 402 children participated resulting in a final sample of 736 responses. Children (78% male) were 4-17 years old (mean 7.91 years SD 2.61). Children had a range of disabilities including Developmental Coordination Disorder, Autism Spectrum Disorder, and Attention Deficit Hyperactivity Disorder. Results: The study includes a large clinical sample of children with disabilities. The results demonstrate that the ACHIEVE Assessment can provide unidimensional measurements of children's participation and important contributory factors for participation. Differential item functioning analysis indicated majority of items were comparable between parent and teacher report. Conclusions: The results confirm evidence of appropriate psychometric properties of the ACHIEVE Assessment. ACHIEVE is a comprehensive tool that enables identification of patterns and issues around participation for clinical and research purposes.

Background: We report development of the SPQ (School Participation Questionnaire) a teachercompleted measure of participation related constructs. The SPQ was developed to support participation-related assessment, interventions, and research in the inclusive school context. Methods: Several iterative steps were undertaken. An international panel of experts reviewed content validity. A 66-item pilot questionnaire was administered in schools. Mokken and Rasch model analysis were applied. Internal consistency was assessed using Cronbach’s alpha. Analyses were conducted on associations with teacher and child demographic variables. Feedback was sourced from users. Participants were teachers of 101 children (5− 12 years old) with a range of disabilities, including intellectual disability, autism spectrum disorder and learning difficulties. Results: Four participation-related dimensions of the SPQ were confirmed. Rasch person and item reliability were good, and 2–4 strata were confirmed per scale. Internal consistency was good (all scales, Cronbach α > 0.8). Mean administration time was 11.7 min. Mean SPQ scores were independent of teacher characteristics. A significant effect of school support level, eligibility for free school meals and gender was found. Through synthesising analytic results and feedback, a new 46-item tool was obtained. Conclusion: The results of this study provide evidence of acceptability, practicality and validity. The SPQ is the first tool developed to assess participation related constructs in schools, and it contains novel information not given by other assessments. The SPQ may be used by practitioners and researchers to understand and improve the participation of children with a range of disabilities in schools., NHS Lothian, City of Edinburgh Council, Scottish Government

Policy internationally is supportive of intersectoral partnerships (ISPs) for promoting positive outcomes among people with complex social, psychological, and physical needs. This realist-informed study describes the development of a program theory to provide insight into enactment of effective ISPs. Interviews were completed with 18 senior staff with leadership roles in six ISPs, including voluntary, statutory, and commercial organizations, supporting people with complex health and social care needs. An iteratively developed and refined program theory, termed the “Incite” model, was developed, with collaboration with participants and an advisory group, including people with lived experience. Important contextual conditions that emerged included organizational culture, historical perspectives, policy, and social determinants of health. Mechanisms included desire for change, creating safe psychological spaces, establishing shared values, and talking about power. Outcomes included transformed world view, increased psychological safety, clarity of purpose, fluidity of relationships, and power shifting. Three phases of partnership development were also identified within the model. This study has led to a clearer, more rigorous, and systematic understanding, with recommendations for how ISPs might be developed or expanded. How the Incite model may be operationalized is discussed, as well as implications for policy, practice, and research.

In this section you can acknowledge any support given which is not covered by the author contribution or funding sections. This may include administrative and technical support, or donations in kind (e.g., materials used for experiments)., Background: The study of attention deficit hyperactivity disorder (ADHD) has traditionally focused on deficit of inhibitory control and cognitive impulsivity. However, the pathophysiology of ADHD has also been associated with the somatosensory cortex. The aim of this study was to explore if there were differences in tactile discrimination and praxis between neurotypical and ADHD children and whether these differences could be explained by cognitive impulsivity. Methods: A cross-sectional study was conducted. The sample comprised 74 children aged 7 to 11 years divided in two groups: 43 with neurotypical development, 31 with ADHD. To assess tactile discrimination, the finger localization and the graphestesia tests were used. Praxis was assessed with the Kaufman Assesment Battery for Children (K-ABC) hand movement subtest, the action program and the Zoo Map subtests of the Behavioral Assessment of Dysexecutive Syndrome, and the complex figure of Rey–Osterrieth test (ROCF). Cognitive impulsivity was assessed using the Magallanes Computerized Impulsivity Scale test (EMIC). Results: Children with ADHD showed greater cognitive impulsivity (p = 0.038) and scored lower in Zoo Map (p = 0.023) and hand-movement subtests (p = 0.002), and in ROCF test (p = 0.004). Differences in praxis skills still remained after controlling by gender and cognitive impulsivity. Conclusion: Praxis deficit might have repercussions not only on the characterization of ADHD but also on its treatment.

To describe and compare the socio-demographic characteristics and community-based participation of children with and without disabilities.This cross-sectional study reports data on 1073 children with disabilities (663 males, 410 females) and 11 122 children without disabilities (5617 males, 5505 females) aged 10 to 12 years from the fifth sweep of the Millennium Cohort Study. χChildren with disabilities were more likely to be male, have psychosocial and behavioural problems, live in single-parent households, and have a parent with a longstanding illness. Patterns of community-based participation were similar between children with and without disabilities. However, the extent to which the two groups participated differed. Children with disabilities participated with lower frequency in unstructured physical activities (adjusted odds ratio [OR] 2.41; 95% confidence interval [CI]: 1.95-2.99), organized physical activities (adjusted OR 2.29; 95% CI: 1.83-2.86), religious gatherings (adjusted OR 2.08; 95% CI: 1.35-3.20), and getting together with friends (adjusted OR 3.31; 95% CI: 2.61-4.20).Socio-demographic characteristics differed between children with and without disabilities. Children with disabilities had greater restriction in participation compared to peers without disabilities. Participation promoting interventions are required to support the participation of children with disabilities in social and physical activities.Patterns of community-based participation were similar between children with and without disabilities. Children with disabilities had lower frequency of participation in physical activities, religious gatherings, and getting together with friends.PARTICIPACIÓN COMUNITARIA DE NIÑOS CON Y SIN DISCAPACIDAD: OBJETIVO: Describir y comparar las características sociodemográficas y la participación comunitaria de niños con y sin discapacidad.Este estudio transversal informa datos de 1.073 niños con discapacidades (663 varones, 410 mujeres) y 11.122 niños sin discapacidades (5.617 varones, 5.505 mujeres) de 10 a 12 años del quinto barrido del Millennium Cohort Study, χ2 se utilizó para explorar las diferencias entre los dos grupos. Se utilizaron modelos de regresión logística para evaluar las relaciones entre la discapacidad infantil (variable dependiente) y las características sociodemográficas. Los modelos de regresión logística también se utilizaron para examinar las asociaciones entre la discapacidad infantil (variable dependiente) y la participación en actividades comunitarias.Los niños con discapacidades tenían más probabilidades de ser hombres, tener problemas psicosociales y de comportamiento, vivir en hogares monoparentales y tener un padre con una enfermedad de larga data. Los patrones de participación comunitaria fueron similares entre los niños con y sin discapacidad. Sin embargo, la medida en que los dos grupos participaron fue diferente. Los niños con discapacidades participaron con menor frecuencia en actividades físicas no estructuradas (odds ratio ajustado [OR] 2.41; intervalo de confianza [IC] 95% 1.95-2.99), actividades físicas organizadas (OR ajustado 2.29; IC 95% 1.83-2.86), reuniones religiosas (OR ajustado 2.08; IC 95% 1.35-3.20) y reunirse con amigos (OR ajustado 3.31; IC 95% 2.61-4.20).Las características sociodemográficas diferían entre los niños con y sin discapacidad. Los niños con discapacidad tenían una mayor restricción en la participación en comparación con sus compañeros sin discapacidad. Se requieren intervenciones que promuevan la participación para apoyar la participación de niños con discapacidades en actividades sociales y físicas.PARTICIPAÇÃO BASEADA NA COMUNIDADE DE CRIANÇAS COM E SEM DEFICIÊNCIAS: OBJETIVO: Descrever e comparar as características sócio-demográficas e a participação baseada na comunidade de crianças com e sem deficiências. MÉTODO: Este estudo transversal reporta dados sobre 1.073 crianças com deficiências (663 do sexo masculino, 410 do sexo feminino) e 11.122 crianças sem deficiências (5.617 do sexo masculino, 5.055 do sexo feminino) com idades de 10 a 12 anos do quinto grupo do Estudo de Coorte do Milênio. χ

The aim of this review was to synthesize empirical evidence of family factors associated with participation of children with disabilities aged 5 to 12 years to inform the development of family-centred participation-fostering interventions.A systematic search was performed for articles published in English between 2001 and 2017 in MEDLINE, PsycINFO, CINAHL, Scopus, and ASSIA following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Quality of evidence was appraised using the Research Triangle Institute Item Bank. Family factors associated with participation were identified and assessed using a multistage 'semi-quantitative' approach.Thirty studies were included in the review. Four non-modifiable 'status' factors consistently associated with participation were parental ethnicity, parental education, family type, and family socio-economic status. Six modifiable 'process' factors with consistent associations with participation were parental mental and physical health functioning, parental self-efficacy beliefs, parental support, parental time, family preferences, and activity orientation.Rehabilitation professionals should direct their focus towards modifiable family factors as primary targets for family-centred interventions. Strategies that can improve families' access to information, counselling, and community support services are likely to support children's participation by empowering families and optimizing their health and well-being.Non-modifiable 'status' and modifiable 'process' factors are important in participation of children with disabilities. Disadvantaged family circumstances shaped by status factors are associated with reduced participation. Key process factors for intervention are parental mental and physical health and parental self-efficacy beliefs. Other important process factors for intervention are parental support and time, family preferences, and activity orientation.FACTORES FAMILIARES ASOCIADOS CON LA PARTICIPACIÓN DE NIÑOS CON DISCAPACIDAD: UN ESTUDIO SISTEMÁTICO: OBJETIVO: El objetivo de esta revisión fue sintetizar la evidencia empírica de los factores familiares asociados con la participación de niños con discapacidad entre los 5 y 12 años para informar el desarrollo de intervenciones que fomentan la participación centrada en la familia METODO: Una búsqueda sistemática fue realizada en artículos publicados en ingles entre 2001 y 2017 en MEDLINE, PsycINFO, CINAHL, Scopus, y ASSIA de acuerdo con los items reportados preferentes para guías de Búsqueda Sistemática y Meta-Análisis. La calidad de la evidencia fue evaluada utilizando el Banco de Items del Research Triangle Institute (RTI). Fueron identificados los factores familiares asociados con la participación y evaluados utilizando un enfoque semicuantitativo de varias etapas. RESULTADOS: Fueron incluidos 30 estudios en esta revisión. Cuatro factores no modificables de ¨estado¨ asociados sistemáticamente con la participación fueron la etnia de los padres, el nivel de educación de los padres, el tipo de familia, y el estatus socioeconómico de las familias. Seis factores de ¨proceso ¨modificables con asociaciones consistentes con la participación fueron el funcionamiento de salud física y mental de los padres, creencia de autoeficacia de los padres, soporte parenteral, tiempo de los padres, preferencias familiares, y orientación a la actividad. INTERPRETACION: Los profesionales de la rehabilitación deben dirigir su foco hacia los factores modificables como objetivo primario para las intervenciones centradas en la familia. Estrategias que puedan mejorar el acceso de las familias a la información , asesoramiento, y servicios de apoyo comunitario que apoyen la participación de los niños y empoderar a las familias y optimizar su salud y bienestar.FATORES FAMILIARES ASSOCIADOS COM PARTICIPAÇÃO EM CRIANÇAS COM INCAPACIDADES: UMA REVISÃO SISTEMÁTICA: OBJETIVO: O objetivo desta revisão foi sintetizar a evidência empírica de fatores familiares associados com participação de crianças com incapacidades de 5 a 12 anos para informar o desenvolvimento de intevenções centradas na família que promovam a participação. MÉTODO: Uma busca sistemática foi realizada por artigos publicados em ingles entre 2001 e 2007 na Medline, PsycINFO, CINAHL, Scopus, e ASSIA seguindo as diretrizes para Itens preferidos a serem reportados em revisões sistemáticas. A qualidade da evidência foi avaliada usando o Banco de Itens Do Institututo do Triângulo das Pesquisas (ITR). Fatores familiares associados à participação foram identificados e avaliados usando uma abordagem semi-quantitativa multi-estágios. RESULTADOS: Trinta estudos foram incluídos na revisão. Quatro fatores com estado “não-modificável” consistentemente associados com participação foram etnia parental, educação parental, tipo de família e situação sócio-econômica da família. Seis fatores de “processo” modificáveis com associações consistentes com participação foram saúde e funcionamento mental e físico dos pais, auto-eficácia parental, apoio parental, tempo parental, preferências familiares e orientacões para atividades. INTERPRETAÇÃO: Profissionais de reabilitação devem direcionar o foco para fatores familiares potencialmente modificáveis como alvos primários para intervenções centradas na família. Estratégias que podem melhorar o acesso da família a informação, aconselhamento e serviços de suporte na comunidade têm probabilidade de apoiar a participação da criança por empoderar famílias e otimizar sua saúde e bem estar.

Background In order to make informed decisions about how best to support children and young people with disabilities, effective strategies that facilitate active and meaningful participation in school are required. Clinical factors, diagnosis or impairments somewhat helpful in determining what should be provided in interventions. However, clinical factors alone will not offer a clear view of how to support participation. It is helpful then to look at wider psychosocial and environmental factors. The aim of this review was to synthesise evidence of psychosocial and environmental factors associated with school participation of 4-12 year old children with disabilities to inform the development of participation-fostering interventions.Methods A systematic search and synthesis using realist methods was conducted of published research. Papers had to include consideration of psychosocial and/or environment factors for school participation of children with disabilities. The review was completed in accordance with the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Papers were identified via Boolean search of the electronic databases MEDLINE, CINAHL, PhycINFO and ERIC (January 2006-October 2018). Appraisal focussed on contributions in terms of whether the articles are appropriate for the review (relevance) and research quality (rigour). Data were analyzed using content and thematic analysis methods using a realist framework. A narrative synthesis of results was reported.Results and implicationsWe identified 1828 papers in the initial search. Seventy two papers were included in the final synthesis. Synthesis of findings led to three overarching mechanisms representing psychosocial factors for children (1) identity (2) competence and (3) experience of mind and body. Environmental aspects (context) compromised five interrelated areas: (1) structures and organization, (2) peers, (3) adults, (4) space and (5) objects. Our synthesis provides insights on how professionals may organize efforts to improve children’s participation. Consideration of these findings will help to proactively deal with suboptimal participation outcomes. Development of theoretically determined assessments and interventions for management of school participation are now required.

Introduction This study examined the psychometric properties of the model of human occupation screening tool single observation form. Method Clinical records were extracted pre- and post-treatment for 152 mental health service users. Data were model of human occupation screening tool single observation form scores and demographics. We investigated the form using Rasch analysis; we also present an analysis of change over time. Results We identified four misfitting items and evidence of instability with respect to change over time. After anchoring to adjust for unstable estimates, it was possible to measure client change, and there were significant differences in form scores pre–post treatment indicating client improvement in ability. Conclusion The study provides initial psychometric assessment of this version of the model of human occupation screening tool.

This article describes a new approach in a group of National Health Service trusts in the United Kingdom. The assessment and intervention were focused on using the Model of Human Occupation in Mental Health services. An occupation focused assessment and intervention protocol were developed based on the Model of Human Occupation Screening Tool Single-Observation Form (MOHOST-SOF). The aim was to develop a guide to treatment and monitoring to support efficient practice while maintaining an occupation and client-centered focus. Implementation has been successful to date.

Purpose – The purpose of this paper is to present a qualitative analysis of the facilitators of recovery in in-patient psychiatric rehabilitation from the service users’ perspective. Design/methodology/approach – Interviews with 31 in-patients were coded and analysed thematically at an interpretive level using an inductive approach. Findings – The dominant themes identified were hope, agency, relationships and opportunity. Totally, 20 subthemes were identified. Agency was more important to men than women and agency, hope and relationships were all more important to detained patients. Research limitations/implications – Interview data were collected in writing rather than taped. The results may not be transferrable to patient populations with significantly different demographic or service factors. Practical implications – Services need to target interventions at the areas identified by service users as important in their recovery. The findings suggest both environmental and relational aspects of care that may optimise recovery. Services also need to be able to measure the quality of the care they provide. A brief, culturally valid and psychometrically assessed instrument for measuring the recovery orientation of services is required. Originality/value – As far as the authors are aware no qualitative work to date has examined the recovery experiences of psychiatric rehabilitation in-patient service users in order to understand what services require to do to enable recovery from their perspective. The conceptual framework identified in this paper can be used to develop a service user self-report measure of the recovery orientation of services.

The increase in the number of individuals with disabilities in general education has led to an increased interest in how to best provide support. Despite an emphasis on inclusion and participation in policy and practice, defining and describing the support provided for these learners is still an important task.This multisite, mixed method collective case study reports on 125 education and other staff from seven schools who took part in interviews and focus groups to reflect on a range of topics related to learners with disabilities in high schools. We focused on what the participants did, what they considered to be successful and what their "best" practices were.Descriptions of practices were rich, nuanced and complex. The analysis identified over 200 "strategies" which were synthesized into two meta-themes and eight subthemes. We discuss the results in the context of an ecological perspective, and the importance of focusing on the full range of influences and outcomes for young people in designing supports.We have drawn on evidence from this study as a basis for professional development activities and identified that focusing on the environment and the role of practitioners has a potential to improve the inclusion outcomes for older learners with disabilities. Implications for Rehabilitation Inclusion is influenced by the physical environment, attitudes, expectations and opportunities, in addition to a learner's skills and abilities. Schools should focus on the environment and teachers' practices, rather than on what an individual learner can or cannot do. The practices discussed in this study reflect those that a range of educators and related services personnel agree are realistic, appropriate and effective. Change may be led by the school management team; however, there are many ways in which all staff can contribute; indeed, approaches will not work effectively unless they are understood and implemented by everyone.

Background: Dementia is a major cause of disability among older people and constitutes one of the greatest challenges currently facing families and health and social care services in the developed world. In response to trends in dementia prevalence and the impact the condition has on peoples’ lives, dementia care has been placed high on the public and political agenda in the United Kingdom. However, despite significant public resources being allocated to combat the impact of the disease, recent evidence indicates that numerous challenges in relation to service provision remain. This study aimed to develop a deeper understanding of the lived experience of people with dementia regarding their service-related needs.Method: The study made use of data gathered through individual semi-structured, narrative interviews conducted with persons with experience of dementia and their unpaid carers.Results: Although participants were generally satisfied with the services they received, a number of unmet needs related to service provision were identified. In terms of diagnostic procedures the findings of this study indicate the need for early diagnosis delivered through a comprehensive assessment package. The participants also highlighted the need for well-coordinated post-diagnostic support, greater continuity of care concerning the personnel involved, and enhanced access to non-pharmacological interventions to support identity and social engagement.Conclusion: This study contributes to a better understanding of service-related needs of people with dementia in relation to diagnostic procedures and post-diagnostic support.

Work is good for both physical and mental health, and access to work is a basic human right. People with mental health conditions want to work and with the right support can work but are often excluded from the workplace. We explored factors influencing individual's perceptions of their readiness for employment. Participants' narratives focused particularly on personal causation and it's inter-reactions with other aspects of volition, habituation and the environment and highlight a number of key areas, which are discussed in relation to service provision. Sheltered workshops offer support and some structure and routine but may limit an individual's readiness for employment. Services should be evidence based and focused on real work opportunities which fit with individual's interests and values. Occupational therapy theory offers a unique and valuable perspective in understanding perceptions of readiness for employment and occupational therapists offer valid and useful assessments and interventions for vocational rehabilitation.

Research purpose: Vocational rehabilitation (VR) has been the focus of recent UK government policy, which outlines objectives to support individuals with mental illness into work. To provide such support, individual placement and support (IPS) as one approach, is frequently referred to. This has ignited both discussion and research within the occupational therapy (OT) profession to re-examine its contribution to VR and consider IPS as part of its practice. Aim: To explore occupational therapists’ (OTs) perceptions about their role within mental health (MH) VR and IPS. Method: Semi-structured interviews were used to generate data in this qualitative study. The interview transcripts were subject to thematic framework analysis. Findings: The findings revealed similarities and compatibility with OT and IPS. Participants acknowledged the value of IPS for clients who wish to obtain paid employment but also recognized the value of all worker roles which is in keeping with the professions values. Conclusion: The findings are congruent with discursive literature regarding OT and VR. Consideration given by OTs to the uniqueness and complexities of work as an occupation reinforces their distinct contribution to VR and could extend to IPS. Further research is needed to verify and extend this study's findings.

Introduction: This article, co-authored by experts in research, child and adolescent mental health, occupational therapy and education services, considers service provision in Attention Deficit Hyperactivity Disorder (ADHD). Contents: This article outlines the roles of those who are involved in service provision for children and young people with ADHD, and identifies the challenges faced by ADHD services. Care pathways are then described, with details of factors that need to be considered in the mapping of potential local pathways. Conclusions: The development of local care pathways for the diagnosis and management of ADHD is suggested as a method of meeting the challenges identified.

Aim. This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. Background. Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. Data sources. Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. Review methods. An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). Findings. Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). Conclusion. Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Background Parents provide valuable information on their experiences of engaging with therapy services for their children, which can inform the future development of these services. The aim of this study was to explore the views and experiences of parents who had accessed therapy services for their child with developmental co-ordination disorder (DCD). Methods Seven focus groups were conducted incorporating 52 parents who had a child diagnosed with, or fitting the diagnostic criteria for DCD. Focus groups were audiotaped, transcribed and analysed thematically. Findings Parents reported struggling to gain access to therapy services. When they gained access, they found the services beneficial for their child but continued to experience difficulties regarding the quality of service delivery. Conclusions/implications The study suggests that parents thought some health-care professionals lacked knowledge and understanding of DCD, which they believed impacted upon early recognition and access to services. They perceived that therapy at an early age was vital for children's development, and indicated that a clearer path for accessing these services was necessary in addition to improved service quality. They called for an increase in awareness of DCD by all therapy service professionals to aid early recognition and improved treatment. © 2011 Blackwell Publishing Ltd.

Children with Developmental Coordination Disorder (DCD) lack the motor coordination necessary to perform tasks considered appropriate for their age, given normal intellectual ability and the absence of other neurological disorders. DCD is a common childhood disorder that can develop into a long‐term condition that has a significant impact on society. A key method of managing DCD is through the assessment and interventions of allied health professionals (AHPs). To date, no integrated AHP framework for the assessment and treatment of DCD exists. The present article illustrates the methods used to synthesise multiple data sources (policy, scientific evidence, service user views and AHP perspectives) by a multidisciplinary group of AHP researchers and practitioners. Through this process a series of principles of good practice were identified, and then developed into a framework for AHPs working with children with DCD. In this article the methodology used to enable synthesis from different evidence sources wil...

The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework.A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data.Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children's participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision.Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children's participation.There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

Purpose of the Study To identify and examine the published qualitative research evidence relative to the experience of living with dementia. Design and Methods Metasynthesis was used as the methodological framework to guide data collection and analysis. Results Three themes were identified. The first theme considered the main condition-related changes experienced by people with dementia (PWD) and showed how these are interlinked and impact upon various areas of people’s lives. The second theme indicated that amidst these changes, PWD strive to maintain continuity in their lives by employing various resources and coping strategies. The third theme underlined the role of contextual factors. The reviewed evidence indicates that, the emerging experience of PWD and their potential to adjust to the continuous changes is influenced by access to and quality of both personal and contextual resources which remain in a constant, transactional relationship to each other. Implications The findings were interpreted and discussed in the context of relevant theoretical frameworks and research evidence. It was considered that current evidence and findings presented in this review can be further explored and expanded upon in a more systematic way through research conducted within the theoretical framework of dynamic systems theory. Further research would be also beneficial to explore the subjective experience of dementia from a participatory perspective. Exploring the application of these theoretical standpoints would contribute to the current state of knowledge and offer both PWD and carers fresh perspective on the nature of change and potential for adaptability in dementia.

Basing treatment, policy and planning decisions on the best available research knowledge remains a central principle in modern health care around the world, yet many health professionals find acquiring and managing published research knowledge challenging. In this paper, we report on a Soft Systems Methodology-based collaborative action research initiative with a specialist mental health service from the United Kingdom's National Health Service. Our objective was to design and implement improvements to their knowledge acquisition and management activities in order to facilitate sustained and effective evidence-based practices. We report on both the factors found to impede effective research knowledge acquisition and management and the development of more integrated knowledge management processes designed to improve the situation.

Research, by informing evidence-based practice, should be the foundation for occupational therapy. Research requires skilled and trained individuals to carry it out effectively. In this piece, two postregistration occupational therapists, currently undertaking PhDs, discuss the limited opportunities available to use their research skills to develop occupational therapy. They explore the barriers that exist for PhD-level basic grade clinicians and, by highlighting the variety of skills that they offer to the workplace, show the benefits of employing research-competent individuals.

Children with additional support needs (ASNs) often require physiotherapy intervention to help maximise their participation within the primary school setting. The aim of this research was to investigate paediatric physiotherapy practice in supporting primary school aged children with ASNs, in order to identify a language to describe this, which could be used to support communication with teachers, parents and others outside the profession. Design Using a qualitative research multiple methods design, 2 focus groups and 5 structured interviews were held to investigate physiotherapy practice for this group. Participants Senior paediatric physiotherapists (n=13) from a range of specialities, with experience of supporting primary school aged children with ASNs. Analysis Focus groups and interviews were digitally recorded, transcribed verbatim and analysed to establish links and patterns: followed by a cyclical process of respondent validation, and expert review. Results Eight targets for physiotherapy intervention and twelve technique headings were synthesised from the data. The language used for labelling and description of these was aimed to be easily understood by colleagues outside the profession. Conclusions The findings clearly identified the role of the paediatric physiotherapist as being to support primary school aged children with ASNs to acquire aspects of postural control, mobility and cardio-respiratory function. By grouping the data into eight areas of challenge as the focus of intervention, and twelve commonly used techniques, the researchers generated a language which can be used by paediatric physiotherapists to support communication with teachers, parents and others outside the profession, when describing their intent and interactions regarding these children. Keywords: Physiotherapy, paediatrics, intervention, communication, primary-school, education