title: Identification and description of environmental factors that influence participation of children with cerebral palsy.
abstract: Physical, social, and attitudinal environment may restrict participation in children with cerebral palsy (CP). Here we discuss existing/possible approaches in order to identify and describe this environment. We used a critical review of evidence from the World Health Organization Literature Review on Environmental Factors; a search of electronic databases; and talked to specialists in order to find unpublished papers and 'grey' literature. Both children with disabilities and their parents identified a range of barrier and facilitator factors. These included psychosocial pressures (family, school), financial difficulties, and inadequate public services. Observational studies suggest that building structure, loss of income, and provision of specific equipment have a direct impact on levels of child participation. Some available instruments attempt to capture environmental factors by client survey or objective measurement; most relate to adult contexts, but there are a few child-specific instruments for surveying attitudes of children to peers with disabilities and for observation of the school environment. Defining and measuring potential environmental determinants of participation for children with CP needs further development; and here we propose how this might be done.
authors.affiliation: Centre for Health Services Research, School of Population and Health Sciences, University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Svetozar I
authors.initials: SI
authors.lastname: Mihaylov
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Jarvis
authors.forename: Allan F
authors.initials: AF
authors.lastname: Colver
authors.forename: Bryony
authors.initials: B
authors.lastname: Beresford
mesh_terms: D000203:Activities of Daily Living; D002547:Cerebral Palsy / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003628:Database Management Systems; D002658:Developmental Disabilities; D019988:Children with Disabilities / Q000523:psychology*; D005190:Family; D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence; D006306:Health Surveys; D006801:Humans; D007062:Identification, Psychological; D007398:Interpersonal Relations; D008297:Male; D012931:Social Environment; D012959:Socioeconomic Factors; D014944:World Health Organization