Routines-based early intervention (RBEI) for children with or at risk for developmental delay encourages collaboration between professionals and families to enhance children's participation in family routines with family-selected goals. We conducted the first single-blinded randomized control trial to examine the effectiveness of a 6-month RBEI vs. traditional home visiting (THV), which uses a curriculum focused on children's developmental domains. Thirty-one families with children aged 5-30 months (mean age 17.4 months) with or at risk for developmental delay were randomly assigned to an RBEI group (n=15) or a THV group (n=16). The enrolled children were evaluated using the Chinese version of Pediatric Evaluation of Disability Inventory (PEDI-C) and the Comprehensive Development Inventory for Infants and Toddlers (CDIIT) at 5 time points. Two-way mixed analysis of variance (ANOVA) was used to examine the group by stage interactions. Goal Attainment Scaling (GAS) and the Canadian Occupational Performance Measure (COPM) were applied to explore between-group differences on individualized goal achievement. PEDI-C showed that the RBEI group had a faster progress rate in self-care functions and independence in social functions in the first 3 months of intervention and at the 6-month follow-up. The RBEI group also scored higher on the GAS in the first 3 months of intervention. However, between-group differences in changes in the developmental domains on the CDIIT were not significant. Thus, RBEI was more effective than THV in promoting functional outcomes and reaching family-selected goals, while both interventions allowed equal improvement in developmental domains.

Participation has significant impact on children’s health and well-being. Knowledge is limited on how children with disabilities perceive their participation and whether their perceptions differ from their parents. This pilot study aimed to explore whether self-reported frequency of participation and prioritized activities differ between children with disabilities and their parents. Thirty children with disabilities eligible for special education in elementary school and their parents were included. Each of them were interviewed with the Chinese version of Picture My Participation (PMP), separately, to identify the child’s participation frequency in 21 activities at home, school, and community, desire-to-change activities, and the level of involvement in these activities. The results indicated that children’s ratings of participation frequency were significantly lower than parents’ ratings in home activities but not in school and community activities, as analyzed by the Wilcoxon Signed Ranked test. Nineteen (63%) child–parent pairs had selected entirely different items as their desire-to-change activities. Children selected the activities that they were somewhat to very involved in; while parents selected the activities they thought their children were less involved in. Our findings suggest that children with disabilities had unique views on life and this should be supported in their health care and individualized education plans.

Environment plays a vital role in affecting participation of young children in home, school, and community. Knowledge of environmental barriers helps to develop solutions or strategies that enable participation. The study compared the environmental barriers perceived by parents of preschool children with physical disabilities (PD, n = 142) and with typical development (TD, n = 192) in Taiwan. Parents identified environmental barriers by structured interview using the Chinese version of the Child and Adolescent Scale of Environment (CASE-C). The CASE-C is an 18-item measure of the impact of problems with physical, social, and attitudinal environmental features. Differences between the PD and TD groups in the summary scores for the CASE-C and the percentages of parents who perceived a problem for each item were examined by the analysis of covariance (ANCOVA) and Chi-square test. Parents of children with PD more often identified barriers related to family resources and community programs or services, social attitudes, assistance and supports outside of home, physical design of home and community, transportation, and assistive devices or equipment. Greater impacts of barriers were also reported by parents of preschool children with PD. Our findings provide evidence of environmental barriers that inform practice and policies to modify the barriers and provide an accessible and inclusive environment for families with young children.

Use of eye-gaze assistive technology (EGAT) provides children/youths with severe motor and speech impairments communication opportunities by using eyes to control a communication interface on a computer. However, knowledge about how using EGAT contributes to communication and influences dyadic interaction remains limited. Aim: By video-coding dyadic interaction sequences, this study investigates the impacts of employing EGAT, compared to the Non-EGAT condition on the dyadic communicative interaction. Method: Participants were six dyads with children/youths aged 4–19 years having severe physical disabilities and complex communication needs. A total of 12 film clips of dyadic communication activities with and without EGAT in natural contexts were included. Based on a systematic coding scheme, dyadic communication behaviors were coded to determine the interactional structure and communicative functions. Data were analyzed using a three-tiered method combining group and individual analysis. Results: When using EGAT, children/youths increased initiations in communicative interactions and tended to provide more information, while communication partners made fewer communicative turns, initiations, and requests compared to the Non-EGAT condition. Communication activities, eye-control skills, and communication abilities could influence dyadic interaction. Conclusion: Use of EGAT shows potential to support communicative interaction by increasing children’s initiations and intelligibility, and facilitating symmetrical communication between dyads.

Purpose: To examine change in, and longitudinal relationships between motor capacity and activity performance across the Gross Motor Function Classification System (GMFCS). Methods: Ninety-two youths with cerebral palsy were examined at 2 time points, 1 year apart, using the Gross Motor Function Measure–66 (GMFM-66) for motor capacity, and the Chinese version of the Activities Scale for Kids-Performance Version (ASKp-C) for activity performance. The score changes and capacity-to-performance/performance-to-capacity pathways were explored across GMFCS levels. Results: The GMFM-66 scores declined over time in GMFCS levels IV-V while ASKp-C scores increased in GMFCS level I. The correlations for both pathways in GMFCS levels I, III, and IV-V were significant with a higher correlation for performance-to-capacity pathway in GMFCS levels IV-V. Conclusions: Longitudinal changes in and relationships between capacity and performance differ between GMFCS levels. The opportunities to perform activities need to be emphasized in GMFCS levels IV-V.

The journal is published for the purpose of advancing scholarship in disability studies and rehabilitation sciences in a uniquely African context. Widely read by scholars, professionals and students, it encourages scholarly exchange between all disciplines and academics from low, middle and high-income countries to work towards the improvement of human development and its practices across the continent.