Family factors associated with participation of children with disabilities: a systematic review.
Stella Arakelyan, Donald Maciver, Robert Rush and 2 others
PMID 30613957WHAT IT FOUND
Lower parental education, lower socio-economic status, poorer parental mental health, lower self-efficacy, less support, less time, and less activity orientation were associated with reduced participation in children with disabilities.
Family income was inconsistent.
Key findings
01In 30 included studies, parental education and socio-economic status were consistently associated with participation; lower education and lower socio-economic status were linked to reduced participation, although two studies reported the opposite for education.
02Parental mental health functioning was consistently associated with participation; higher parental stress was associated with reduced leisure participation for children with cerebral palsy and with less assistance for participation for children with attention-deficit/hyperactivity disorder.
03Parental self-efficacy, parental support, parental time, family preferences, and activity orientation were positively associated with participation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Most studies were cross-sectional, so the review can show association but not cause. The included studies varied too much in design, family factors, and participation measures to combine statistically. Several studies used convenience samples, had small samples without justification, did not report measure validity or reliability, or did not adjust adequately for confounding. Six studies shared samples but were retained as separate studies. Participation was mostly measured in leisure and recreational activities, with little evidence from school or other settings. The review only assessed family factors, not child, environmental, or service factors. Only English peer-reviewed studies were included, which may miss relevant work. Only a few corresponding authors acknowledged requests for missing statistics.
Declared interests
The supplied text does not state who funded the review or whether authors had conflicts of interest.
The easy way to misread this
Do not treat these associations as proof that changing a family factor will improve a child's participation. Most studies were cross-sectional, and the review did not test interventions.