Participation of children with disabilities in school: A realist systematic review of psychosocial and environmental factors

• Published in: PloS one 2019-01, Vol.14 (1), p.e0210511-e0210511
• Main Authors: Maciver, Donald, Rutherford, Marion, Arakelyan, Stella, Kramer, Jessica M, Richmond, Janet, Todorova, Liliya, Romero-Ayuso, Dulce, Nakamura-Thomas, Hiromi, Ten Velden, Marjon, Finlayson, Ian, O'Hare, Anne, Forsyth, Kirsty
• Format: Article
• Language: English
• Subjects: Adults; Analysis; Biology and Life Sciences; Boolean algebra; Child; Child, Preschool; Children; Children & youth; Children with disabilities; Data processing; Developmental disabilities; Disabilities; Disability; Disability Evaluation; Disabled children; Disabled Children - education; Disabled Children - psychology; Disabled Children - rehabilitation; Environmental aspects; Environmental factors; Health sciences; Humans; International Classification of Functioning, Disability and Health - standards; International Classification of Functioning, Disability and Health - statistics & numerical data; Medicine and Health Sciences; Occupational therapy; Participation; Pediatric research; Pediatrics; People and Places; People with disabilities; Professionals; Qualitative Research; Rehabilitation; Reviews; Schools; Searching; Social aspects; Social Environment; Social Participation; Social Sciences; Students; Synthesis; Systematic review; Teacher education; Young adults
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0210511

In order to make informed decisions about how best to support children and young people with disabilities, effective strategies that facilitate active and meaningful participation in school are required. Clinical factors, diagnosis or impairments somewhat helpful in determining what should be provided in interventions. However, clinical factors alone will not offer a clear view of how to support participation. It is helpful then to look at wider psychosocial and environmental factors. The aim of this review was to synthesise evidence of psychosocial and environmental factors associated with school participation of 4-12 year old children with disabilities to inform the development of participation-fostering interventions. A systematic search and synthesis using realist methods was conducted of published research. Papers had to include consideration of psychosocial and/or environment factors for school participation of children with disabilities. The review was completed in accordance with the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Papers were identified via Boolean search of the electronic databases MEDLINE, CINAHL, PhycINFO and ERIC (January 2006-October 2018). Appraisal focussed on contributions in terms of whether the articles are appropriate for the review (relevance) and research quality (rigour). Data were analyzed using content and thematic analysis methods using a realist framework. A narrative synthesis of results was reported. We identified 1828 papers in the initial search. Seventy two papers were included in the final synthesis. Synthesis of findings led to three overarching mechanisms representing psychosocial factors for children (1) identity (2) competence and (3) experience of mind and body. Environmental aspects (context) compromised five interrelated areas: (1) structures and organization, (2) peers, (3) adults, (4) space and (5) objects. Our synthesis provides insights on how professionals may organize efforts to improve children's participation. Consideration of these findings will help to proactively deal with suboptimal participation outcomes. Development of theoretically determined assessments and interventions for management of school participation are now required.