Needs, problems and rehabilitation goals of young children with cerebral palsy as formulated in the rehabilitation activities profile for children

Objective: To describe the content of needs, problems and goals of 41 Dutch children with cerebral palsy using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a classification system. To evaluate the adherence of formulations of needs, problems and goals to specifications of the Rehabilitation Activities Profile for Children. Methods: Raw text data were extracted and organized. Two raters independently weighed the entries' quality against the specifications and linked the extracted content to ICF-CY categories. Results: In 12% of the reports no needs, and in 24% no principal goals, were formulated. Needs mostly pertained to the activities-and-participation domain (65%), whereas problems and goals covered all 3 ICF-CY domains. None of the needs were prioritized and 79% met the quality criterion of description of a problem/desire. Twenty-four percent of the problems were described in the activity-and-participation domain and 83% referred to a treatable problem. Fifty-six percent of the goals were formulated in terms of intended result/effect and 63% as child/parent actions. Conclusion: Insight is provided into the content of rehabilitation programmes for children with cerebral palsy. To optimize the quality of the reports, research on reasons for non-adherence to specifications of the Rehabilitation Activities Profile is needed

Social functioning in adulthood: Understanding long-term outcomes of adolescents with chronic pain/fatigue treated at inpatient rehabilitation programs

Background: Chronic pain and fatigue are both common complaints in childhood and adolescence and often persist over time. The aim of the study was to investigate whether chronic pain/fatigue persists during adulthood and how former patients function and participate in society as adults. Methods: This historical cohort study used questionnaires to gather the data. Predictors for social participation in adulthood were also identified. Differences in functioning and health care use between young adults with current pain/fatigue complaints and those without were also discussed. Results: Ninety-four young adults responded; their mean age was 26.6 years and 91.5% were women. The average time since treatment was 10.2 years. 63.4% reported ongoing or new pain/fatigue complaints. 72.0% had a paid job; of those who worked, 22.1% reported taking sick leave in the past month. 78.7% of them reported having one or more chronic diseases. A higher level of pain/fatigue measured pre-treatment was identified as a predictor for more impaired social participation in adulthood. Young adults with current pain/fatigue complaints reported more healthcare utilization, lower levels of physical functioning and limitations in daily activities due to physical problems. Conclusions: A considerable number of these young adults still have pain/fatigue complaints in adulthood. More pain/fatigue pre-treatment during adolescence predict impaired functioning in the work-educational domain in young adulthood. What does this study add?: This study examines the social participation of young adults who suffered from severe chronic pain/fatigue during adolescence. Predictors for social participation are reported, as are the differences between young adults with and without persistent pain/fatigue complaints

Barriers and facilitators of sports in children with physical disabilities:a mixed-method study

Purpose: This study explored barriers and facilitators of sports participation of children with physical disabilities from the perspective of the children, their parents and their health professionals. Method: Thirty children and 38 parents completed a questionnaire, and 17 professionals were interviewed in a semi-structured way. Data from the three groups were combined in a mixed-method design, after which the results were triangulated. Results: Mean age (SD) of the children was 14.1 (2.9) years old, 58% were boys. Sixty-seven percent of the children had cerebral palsy and 77% participated in sports after school. Most commonly practiced sports were swimming, cycling and football. Children specifically experienced dependency on others as a barrier, parents did not have enough information about sports facilities, and professionals observed that the family's attitude had influence on the child's sports participation. Facilitators were health benefits, fun and social contacts. Conclusion: Sports participation of children with physical disabilities is a complex phenomenon because children, their parents and professionals reported different barriers. Sports participation is more physically challenging for children with severe physical disabilities, as their daily activities already require much energy. However, the psychosocial benefits of sports are applicable to all children with physical disabilities

Does Signal Degradation Affect Top-Down Processing of Speech?

Speech perception is formed based on both the acoustic signal and listeners' knowledge of the world and semantic context. Access to semantic information can facilitate interpretation of degraded speech, such as speech in background noise or the speech signal transmitted via cochlear implants (CIs). This paper focuses on the latter, and investigates the time course of understanding words, and how sentential context reduces listeners' dependency on the acoustic signal for natural and degraded speech via an acoustic CI simulation. In an eye-tracking experiment we combined recordings of listeners' gaze fixations with pupillometry, to capture effects of semantic information on both the time course and effort of speech processing. Normal-hearing listeners were presented with sentences with or without a semantically constraining verb (e.g., crawl) preceding the target (baby), and their ocular responses were recorded to four pictures, including the target, a phonological (bay) competitor and a semantic (worm) and an unrelated distractor. The results show that in natural speech, listeners' gazes reflect their uptake of acoustic information, and integration of preceding semantic context. Degradation of the signal leads to a later disambiguation of phonologically similar words, and to a delay in integration of semantic information. Complementary to this, the pupil dilation data show that early semantic integration reduces the effort in disambiguating phonologically similar words. Processing degraded speech comes with increased effort due to the impoverished nature of the signal. Delayed integration of semantic information further constrains listeners' ability to compensate for inaudible signals

A review of salient elements defining team collaboration in paediatric rehabilitation

Objective: To explicate the complex process of team collaboration and identify salient elements of team collaboration in paediatric rehabilitation. Data sources: After an initial search to define key features of team collaboration a systematic search on team collaboration and the key features was executed to identify salient elements. The systematic search was carried out in Index Medicus (MEDLINE), Educational Resource Information Clearinghouse (ERIC) and American Psychological Association (PsycINFO) covering the period from January 1993 to December 2004. Review methods: Based on title and abstract relevant publications were identified and qualitatively assessed by two reviewers. To facilitate the interpretation of the salient elements, the articles were also classified according to the criteria 'participants and setting' and 'research method'. Results: Of the total of 930 identified publications 28 studies proved eligible and were subsequently assessed. The evaluation yielded 29 salient elements defining five key features of team collaboration (i.e. communication, decision making, goal setting, organization and team process). Parent involvement proved to play a dominant role and was mentioned in relation to all five features. Conclusions: Based on the results, rather than an underlying element, it is proposed to consider parent involvement as the sixth feature of team collaboration. The 29 distinctive elements of teamwork could be useful as a guideline and checklist for empirical studies and may help enhance multidisciplinary collaboration in paediatric care. However, additional exploratory research focusing on the way these elements interact with each other and the key features and whether they facilitate or restrict team collaboration is warranted

Health-Related Physical Fitness in Dutch Children With Developmental Coordination Disorder

Objective: To compare components of health-related physical fitness between Dutch children with clinically diagnosed developmental coordination disorder (DCD) and typically developing children (TDC), and to examine associations between motor performance problems and components of health-related fitness in children with DCD. Methods: A multicenter case-control study was used to compare health-related physical fitness in children with DCD (N = 38; age, 7-12 years; 10 girls and 28 boys) with that in age-and gender-matched TDC. Motor coordination problems (manual dexterity, ball and balance skills) were assessed using the Movement Assessment Battery for Children. Health-related physical fitness was indicated by (1) cardiorespiratory fitness, (2) muscle strength, and (3) body mass index. Results: Significantly lower values of cardiorespiratory fitness (6.7% lower maximal cardiorespiratory fitness) were found in children with DCD compared with TDC. Extension and flexion of the elbow and flexion of the knee were also significantly lower (by 15.3%, 16.7%, and 18.4%, respectively) in DCD children compared with TDC. A significant negative and large association was found between cardiorespiratory fitness and balance performance. Conclusion: Lower cardiorespiratory fitness and muscle strength in children with clinically diagnosed DCD compared with TDC support the importance of examining and training cardiorespiratory fitness and muscle strength, besides the regular attention for motor coordination problems