To examine the utility of a coordinated, family/community-focused programme (PABICOP) vs. a standard approach for improving outcomes for children with ABI and their families.
Pre-test-post-test design, with comparison group and follow-up.
Ninety-six children (64 children receiving PABICOP services and 32 children receiving standard care) participated in the study. Measures were completed at baseline and 3 and 12 months later.
Parents/caregivers with more than 10 contacts with PABICOP scored significantly higher on an ABI knowledge quiz than either parents/caregivers with 10 contacts or less or the comparison group at post-test and follow-up. Parents/caregivers with 10 contacts or less with PABICOP reported significantly greater improvements in children's school and total competence on the CBCL than either parents/caregivers with more than 10 contacts or the comparison group at post-test and follow-up.
PABICOP may be more useful for enhancing knowledge of ABI for parents/caregivers and for integrating children into the community over a 1-year period than a standard approach. The amount of service received appears to influence outcomes.
Youth En Route (YER) is a transition program for youth and young adults with multiple disabilities. It offers a multifaceted approach that includes self-discovery, skill development, and community experience. Underlying the service delivery model is a philosophy of self-determination. This program evaluation measured the self-determination skills, sense of personal control over life choices, and community participation of 34 youth prior to and one year following their involvement with YER. Youth reported statistically and clinically significant improvement from pretest to posttest with respect to both self-determination and sense of personal control. Moreover, youth reported spending significantly more time at posttest than at pretest engaged in volunteer/work activities and community leisure activities. On average, youth reported high satisfaction with YER services. Practical and research implications are discussed.
The objective of this study was to provide a national health and disability profile of Canadian school-aged children based on the World Health Organization's definitions of health condition and disability that would facilitate international comparisons of child health data.
Data were used from the National Longitudinal Survey of Children and Youth, a 1994 - 95 population-based sample of 22 831 children.
An estimated total of 30.3% of Canadian children aged 6 to 11 had one or more chronic physical health conditions/impairments, while 3.6% had activity-limiting conditions/impairments. Children living with one parent were significantly more likely to have activity-limiting conditions/impairments than those living with two parents. Children with conditions/impairments, particularly those with activity limitations, were significantly more likely than children without health problems to have experienced mental health conditions and learning disabilities, missed school days, received special education, visited health professionals, been hospitalized, and used prescription medication.
Important differences were found among children in a number of areas as a function of overall physical health status. The findings emphasize the importance of measuring activity limitations distinctly from chronic conditions and impairments, and, perhaps, of measuring impairments distinctly from chronic conditions, and of comparing children with such health problems to children without health problems in order to obtain a more accurate picture of the impact of health on children's lives. The World Health Organization's distinct definitions of health condition and disability facilitate a dimensional approach for describing child health that can serve to clarify this field of study and improve comparability of data across countries.
A framework of operating models for interdisciplinary research programs in clinical service organizations is presented, consisting of a "clinician-researcher" skill development model, a program evaluation model, a researcher-led knowledge generation model, and a knowledge conduit model. Together, these models comprise a tailored, collaborative approach to enhancing research-informed practice in community-based clinical service organizations. The models place different degrees of emphasis on the development of research-related skills in practitioners, the generation of knowledge tailored to clinical practice, and knowledge sharing. The nature, philosophical basis, roles of research staff members, outputs and impacts, and strengths and limitations of each model are described, in the context of a long-standing, interdisciplinary research program in a children's rehabilitation service organization. The use of the model framework as a tool for the design of interdisciplinary, community-based research programs is discussed.
With the aim of improving the measurement of child health and disability in survey research, this paper reviews the coverage of chronic health conditions and the domains of disability and related environmental factors as they are laid out in the ICD-10 and ICF, respectively, in national surveys of school-aged children conducted in Canada since 1980. Recommendations are made for future survey use and construction.
Two reviewers independently examined each of the surveys. Coverage of chronic health conditions, the domains of disability, and environmental factors in survey questions was identified by mapping question content onto ICD-10 and ICF codes. The reviewers then compared their findings and came to a final consensus.
Surveys vary in the range and depth of coverage of the ICD-10 and ICF chapters. Disability surveys and health surveys for persons aged 12 and over contain the most comprehensive lists of chronic conditions. Coverage of impairments is limited. Coverage of activity limitations and participation restrictions is most limited in the domains of personal care and domestic life. Environmental factors not covered include natural environmental changes, attitudes, and policies.
Development of a comprehensive standard list of chronic health conditions based on the ICD-10 and development of standard survey measures of the domains of disability and environmental factors based on the ICF for use in surveys of school-aged children would facilitate an understanding of children's health and disability in the context of the current international health framework provided by the World Health Organization.