title: Association between participation in life situations of children with cerebral palsy and their physical, social, and attitudinal environment: a cross-sectional multicenter European study.
abstract: OBJECTIVE
  To evaluate how participation of children with cerebral palsy (CP) varied with their environment.
  
  
  METHODS
  Home visits to children. Administration of Assessment of Life Habits and European Child Environment Questionnaires. Structural equation modeling of putative associations between specific domains of participation and environment, while allowing for severity of child's impairments and pain.
  
  
  METHODS
  European regions with population-based registries of children with CP.
  
  
  METHODS
  Children (n=1174) aged 8 to 12 years were randomly selected from 8 population-based registries of children with CP in 6 European countries. Of these, 743 (63%) agreed to participate; 1 further region recruited 75 children from multiple sources. Thus, there were 818 children in the study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participation in life situations.
  
  
  RESULTS
  For the hypothesized associations, the models confirmed that higher participation was associated with better availability of environmental items. Higher participation in daily activities-mealtimes, health hygiene, personal care, and home life-was significantly associated with a better physical environment at home (P<.01). Mobility was associated with transport and physical environment in the community. Participation in social roles (responsibilities, relationships, recreation) was associated with attitudes of classmates and social support at home. School participation was associated with attitudes of teachers and therapists. Environment explained between 14% and 52% of the variation in participation.
  
  
  CONCLUSIONS
  The findings confirmed the social model of disability. The physical, social, and attitudinal environment of disabled children influences their participation in everyday activities and social roles.
authors: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. allan.colver@ncl.ac.uk
authors: Allan
authors: A
authors: Colver
authors: Ute
authors: U
authors: Thyen
authors: Catherine
authors: C
authors: Arnaud
authors: Eva
authors: E
authors: Beckung
authors: Jerome
authors: J
authors: Fauconnier
authors: Marco
authors: M
authors: Marcelli
authors: Vicki
authors: V
authors: McManus
authors: Susan I
authors: SI
authors: Michelsen
authors: Jackie
authors: J
authors: Parkes
authors: Kathryn
authors: K
authors: Parkinson
authors: Heather O
authors: HO
authors: Dickinson
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001290:Attitude; D002547:Cerebral Palsy / Q000523:psychology* / Q000534:rehabilitation*; D002648:Child; D003430:Cross-Sectional Studies; D004777:Environment; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D012111:Residence Characteristics; D012574:Schools; D012720:Severity of Illness Index; D012931:Social Environment