title: Influence of the environment on participation in social roles for young adults with down syndrome.
abstract: BACKGROUND
  The concept of disability is now understood as a result of the interaction between the individual, features related to impairment, and the physical and social environment. It is important to understand these environmental influences and how they affect social participation. The purpose of this study is to describe the social participation of young adults with Down syndrome and examine its relationship with the physical and social environment.
  
  
  METHODS
  Families ascertained from the Down syndrome 'Needs Opinion Wishes' database completed questionnaires during 2011. The questionnaires contained two parts, young person characteristics and family characteristics. Young adults' social participation was measured using the Assessment of Life Habits (LIFE-H) and the influences of environmental factors were measured by the Measure of the Quality of the Environment (MQE). The analysis involved descriptive statistics and linear and logistic regression.
  
  
  RESULTS
  Overall, participation in daily activities was higher (mean 6.45) than in social roles (mean 5.17) (range 0 to 9). When the physical and/or social environment was reported as a facilitator, compared to being no influence or a barrier, participation in social roles was greater (coef 0.89, 95%CI 0.28, 1.52, coef 0.83, 95%CI 0.17, 1.49, respectively). The relationships between participation and both the physical (coef 0.60, 95% CI -0.40, 1.24) and social (coef 0.20, 95%CI -0.47, 0.87) environments were reduced when age, gender, behavior and functioning in ADL were taken into account.
  
  
  CONCLUSIONS
  We found that young adults' participation in social roles was influenced more by the physical environment than by the social environment, providing a potentially modifiable avenue for intervention.
authors.affiliation: Telethon Kids Institute, University of Western Australia, Perth, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales, Sydney, Australia.
authors.forename: Kitty-Rose
authors.initials: KR
authors.lastname: Foley
authors.affiliation: School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
authors.forename: Sonya
authors.initials: S
authors.lastname: Girdler
authors.affiliation: Telethon Kids Institute, University of Western Australia, Perth, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Bourke
authors.affiliation: Telethon Kids Institute, University of Western Australia, Perth, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Jacoby
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, Australia.
authors.forename: Gwynnyth
authors.initials: G
authors.lastname: Llewellyn
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, Australia; Brain and Mind Research Institute, University of Sydney, Sydney, Australia.
authors.forename: Stewart
authors.initials: S
authors.lastname: Einfeld
authors.affiliation: Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Tonge
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Trevor R
authors.initials: TR
authors.lastname: Parmenter
authors.affiliation: Telethon Kids Institute, University of Western Australia, Perth, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Leonard
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D006233:Persons with Disabilities; D004314:Down Syndrome / Q000523:psychology*; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012931:Social Environment; D058992:Social Participation; D011795:Surveys and Questionnaires; D055815:Young Adult