title: Sociocultural influences on disability status in Puerto Rican children.
abstract: OBJECTIVE
  This article describes culturally defined meanings of childhood function and disability in Puerto Rico to provide a context for the interpretation of test scores from the Spanish translation of the Pediatric Evaluation of Disability Inventory (PEDI).
  
  
  METHODS
  More than 600 Puerto Rican teachers, parents and caregivers of children with and without disabilities, and members of the general community participated in ethnographic interviews, which were designed to describe their beliefs, attitudes, and knowledge about childhood function and disability.
  
  
  RESULTS
  Qualitative and quantitative data analysis confirmed that differences exist between Puerto Ricans and the norms established in the United States for the performance of functional skills by children, and the analysis also described Puerto Rican beliefs and attitudes toward disability.
  
  
  CONCLUSIONS
  Puerto Rican values of interdependence, añoñar (pampering or nurturing behaviors), and sobre protectiva (overprotectiveness) influence parental expectations for the capability of children with disabilities and should be considered when interpreting scores from the PEDI and establishing plans of care. Additional research is needed on the influence of contextual variables on child development and behavioral adaptations to disability.
authors.affiliation: Department of Pediatrics, Yale Center for Children with Special Health Care Needs, School of Medicine, Yale University, New Haven, Conn, USA. gannotti@mail.hartford.edu
authors.forename: M E
authors.initials: ME
authors.lastname: Gannotti
authors.forename: W P
authors.initials: WP
authors.lastname: Handwerker
authors.forename: N E
authors.initials: NE
authors.lastname: Groce
authors.forename: C
authors.initials: C
authors.lastname: Crux
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D004185:Disability Evaluation; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D011647:Puerto Rico; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires