Participation-based therapy for children with physical disabilities

Disabil Rehabil. 2012;34(12):1041-52. doi: 10.3109/09638288.2011.628740. Epub 2011 Nov 14.


Purpose: Optimizing home and community participation of children with physical disabilities is an important outcome of rehabilitation.

Method: A review of literature identified research and theory on participation of children with physical disabilities. The authors' incorporated current knowledge to conceptualize the experience of optimal participation, formulate principles of participation-based physical and occupational therapy, and develop a five-step process for intervention. A case report was completed to illustrate application to practice.

Results: Optimal participation involves the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation. Real-life experiences enable children to learn new activities and develop skills that optimize their participation and self-determination. Interventions are: goal-oriented, family-centered, collaborative, strengths-based, ecological, and self-determined. A distinguishing feature of intervention is that the therapist's primary role is to support the child and family to identify challenges to participation and solutions to challenges. The therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity.

Conclusion: The model may have utility for collaboration with families and community providers, determining goals for participation, and providing evidence-informed interventions.

Publication types

  • Case Reports

MeSH terms

  • Cerebral Palsy / rehabilitation*
  • Child
  • Disabled Children*
  • Health Status Indicators
  • Humans
  • Interpersonal Relations
  • Male
  • Occupational Therapy / methods*
  • Outcome and Process Assessment, Health Care
  • Patient Participation*
  • Physical Therapy Modalities
  • Professional-Family Relations
  • Professional-Patient Relations
  • Social Environment*