Culture, Health, Function, and Participation Among American Indian and Alaska Native Children and Youth With Disabilities: An Exploratory Qualitative Analysis.
Molly Fuentes, Kathryn Lent
PMID 30578776WHAT IT FOUND
Families said American Indian and Alaska Native children with disabilities often watched cultural events instead of taking part, because terrain, equipment, and transport blocked them.
Providers did not ask about these cultural participation needs.
Key findings
01All child participants were involved to some degree in cultural activities, but participation was often through observation rather than direct involvement.
02Lack of wheelchair-accessible transportation and inaccessible spaces or rough terrain limited cultural participation.
03Providers did not address culture or culturally related functional needs, and most participants said culture was never addressed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study interviewed 17 participants representing 11 children, so the themes are not generalizable to all American Indian and Alaska Native children with disabilities. Participants were purposively sampled and mostly recruited from families who had care at one regional children's hospital, so children without access to that subspecialized care may have different experiences. The study did not measure cultural identity, cultural variability, or the child's functional ability, so it cannot say how strongly these factors shaped participation. The findings are qualitative themes from participant reports, not tested outcomes or effects of rehabilitation services.
Declared interests
The authors report no conflicts of interest. The paper is listed as receiving NIH extramural research support.
The easy way to misread this
Do not read these themes as proof that asking about culture improves rehabilitation participation. The study describes what 17 participants said, with no comparison group and no measured rehabilitation outcome.