Which activities did the children participate in most frequently

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Data collection; the instrument

Many of the children had problems with grading both within the category “Frequency of involvement” and “Level of involvement”. Many children also had problems with knowing the difference of the amount of apples presented at each level at the “Frequency of involvement table”. According to the translator the children often answered one thing, but then pointed at another level on the tables. The authors took the decision to record the answer that the child had given the translator, and not what he or she had pointed at. This could of course question the validity and reliability of the instrument and this thesis.
The authors speculate about the fact that the participants had different kinds of intellectual disabilities and that it affected the results of this thesis. The interviews varied much in time, the shortest one was 25 minutes and the longest one was 65 minutes. The authors speculate that the time spent in each interview depended on how much the child understood and how well they could express themselves. Those interviews that took the longest time were also performed with children who had problems with concentration. Therefore, this instrument may not be the most appropriate one for children with concentration difficulties or intellectual disabilities.
According to Pendzick and Demi (2009) it is common that people with intellectual disabilities have problems with abstract thinking. Based on this fact the authors believe that some of pictures in the instrument were hard for the children to understand. The picture representing “Organised leisure activities” seemed to be somewhat confusing for the children since the child in the picture is playing three different sports at the same time. This activity is also supposed to contain clubs, music, art and dance, but the children seemed to only focus on the soccer. The picture for “Taking part in social activities in the community” also seemed to be a bit hard for the children to understand. On the picture there are three children playing in a band, but the intention is in fact to ask the child if he or she participates in social activities in the society, such as playgroups, parties and parades. This was problematic for the children to understand. The picture representing “Paid and unpaid employment” was also difficult for the children to understand. On the picture it looks like the child works in the garden, but the fact is that in this culture is also common to work at the minibuses, selling things on the street and so on. Overall it seemed like the majority of the children had some trouble with generalizing what they saw in the pictures to other activities or situations.
Many of the pictures in the section of “Barriers and facilitators” in the instrument seemed to be difficult for the children to understand. The picture representing “Services and policies” had a number of flags from different countries. These flags were confusing for the children. They started to explain which flag that belonged to which country and lost their concentration on the task. Additionally the translator explained that the children did not understand this concept at all. The authors believe that all concepts under “Barriers and facilitators” should be simplified as well as the pictures representing them.
The picture for “Social environment” was a child sitting in a wheelchair and a friend pushing the child. This category included support/relationships and products and technology. This was confusing for the children since they thought that this was the same as the attitudes of the family and the community, which are two categories that comes later in the instrument. The authors believe that telling the child that the same category can mean two different things, brings confusion to the child.
On the picture for “Beliefs/value systems of society” there are nine different symbols for different religions. This made it hard for the children since it was not adapted to their culture and religion. The children often started to explain the meaning of the different symbols and lost focus on the question that was asked.

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Facilitators and barriers

The majority of the children answered that they most often saw all the categories presented as facilitators to participation in activities. This result correspond with the results found by Harding et al. (2009) where the participants most often saw supports to participation rather than barriers. Furthermore, Kielhofner (2008) describes that personal factors and environmental factors can facilitate a person’s participation in occupation, and the fact that a person has a disability may change his or her ability to participate, but this does not mean that it restricts a person’s participation in occupation.
The result show that the children most often see the attitudes of their family as a “Barrier” to participation in activities in everyday life. The authors speculate that this could in fact be true. According to Lygnegård et al. (2013) it is common that the beliefs of the community are that children with disabilities are embarrassing, shameful, and should not be shown to other people. This can contribute to loneliness and isolation among children with disabilities. Additionally, this result corresponds with the results from a study performed by Harding et al. (2009), which showed that the participants viewed their parents as a barrier to participation since they sometimes gave them different kinds of restrictions. Kielhofner (2008) describes that the social environment, such as the values of the family, is something that can restrict a person’s participation in occupation. Furthermore, the author states that having an intellectual disability may contribute to alienation and isolation from the rest of the society.

Introduction .
Background
Method
Study design
Participants
Data collection .
Data analysis
Ethical considerations .
Results
Which activities did the children participate in most frequently?
Which activities did the children prioritize as most important?
How involved were the children in the prioritized activities? .
Which were the facilitators or barriers affecting the children’s participation in activities?
Discussion
Method discussion
Result discussion
The importance for occupational therapy
Future research
Conclusion
References