Occupational Therapy Program Student Theses, Dissertations and Capstones

Document Type



Environmental and family factors affecting the participation of young children with cerebral palsy: An ecocultural perspective

Degree Name

Doctor of Philosophy (PhD) in Occupational Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.


College of Health Care Sciences – Occupational Therapy Department

First Advisor

Max Ito

Publication Date / Copyright Date



Nova Southeastern University


"May 2015" A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy. Typescript Project Advisor : Max A. Ito

Participation in social roles and daily activities is considered a primary outcome for children with cerebral palsy (CP) and thus is an important focus of pediatric therapy. The purpose of this study was to describe the participation patterns of children ages 2 to 6 years with CP, investigate how gross motor impairment affects participation, and identify those family and environmental factors that may influence participation in daily activities and social roles. A convenience sample of 51 children with CP between the ages of 2 and 6 years and their parents completed this study. Parents completed four standardized instruments: the Assessment of Life Habits (LIFE-H), the Impact on Family Scale, The Child and Adolescent Scale of Environment, and the Child Health Conditions Questionnaire, which measured participation, family burden, the environment, and associated conditions respectively. Hierarchical multiple regression analysis was used to determine the extent to which family and environmental factors explained participation in daily activities and social roles while controlling for gross motor impairment (GMFCS), associated conditions and age. The findings of this study suggest that very young children with CP experience substantial restrictions across 10 of 11 domains of participation. Parents report greater environmental barriers, associated health conditions and impact on family as GMFCS levels increase. Gross motor impairment, associated health conditions, and age accounted for 65% of the variance in participation. The environment and family factors did not contribute significantly to the model. For the children in this study, intrinsic factors accounted for most of the variance in participation.


Occupational Therapy


Health and environmental sciences, Cerebral palsy, Children, Ecological model, Environmental factors, Participation, Personal factors

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