title: Participation-based therapy for children with physical disabilities.
abstract: OBJECTIVE
  Optimizing home and community participation of children with physical disabilities is an important outcome of rehabilitation.
  
  
  METHODS
  A review of literature identified research and theory on participation of children with physical disabilities. The authors' incorporated current knowledge to conceptualize the experience of optimal participation, formulate principles of participation-based physical and occupational therapy, and develop a five-step process for intervention. A case report was completed to illustrate application to practice.
  
  
  RESULTS
  Optimal participation involves the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation. Real-life experiences enable children to learn new activities and develop skills that optimize their participation and self-determination. Interventions are: goal-oriented, family-centered, collaborative, strengths-based, ecological, and self-determined. A distinguishing feature of intervention is that the therapist's primary role is to support the child and family to identify challenges to participation and solutions to challenges. The therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity.
  
  
  CONCLUSIONS
  The model may have utility for collaboration with families and community providers, determining goals for participation, and providing evidence-informed interventions.
authors.affiliation: Department of Physical Therapy and Rehabilitation Sciences (MS 502), Drexel University, 245 N. 15th Street, Philadelphia, PA 19102-1192, USA. robert.j.palisano@drexel.edu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Palisano
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Chiarello
authors.forename: Gillian A
authors.initials: GA
authors.lastname: King
authors.forename: Iona
authors.initials: I
authors.lastname: Novak
authors.forename: Tracy
authors.initials: T
authors.lastname: Stoner
authors.forename: Alyssa
authors.initials: A
authors.lastname: Fiss
mesh_terms: D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D019988:Children with Disabilities; D006305:Health Status Indicators; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009788:Occupational Therapy / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D010358:Patient Participation; D026741:Physical Therapy Modalities; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D012931:Social Environment