Children’s Assessment of Participation and Enjoyment
Upon review the previous information is accurate and still current. The details are still up to date.
Article Summary:
MacDonald M, Leichtman J, Esposito P, Cook N, Ulrich DA. The Participation Patterns of Youth with Down Syndrome. Frontiers in Public Health. 2016;4:253. doi:10.3389.
The purpose of this article was to evaluate the participation using the Children’s Assessment of Participation and Enjoyment (CAPE) in different life situations of children with Down Syndrome based on the ICF definition. The goal of this investigation is to use the information gathered to help set up interventions and community programs that will help to encourage increased participation.
The interviewer administered version of the CAPE was used to collect the data in one on one sessions that took about 45 minutes. 62 children (28 male and 34 female) with Down Syndrome were recruited through a activity program in the US. The children ranged in age from 9 to 17 years. The CAPE scores participation in activities in for the past 4 months and a higher score demonstrates more participation in the community. In the interview process each activity was presented with and illustration and a phrase to describe it. If a child answered yes to participation further questions were asked based on the 5 dimensions of the CAPE. In the interview the parents were allowed assist in framing the questions to a familiar context if needed.
Data was analyzed using PASW Statistics. In the diversity dimension: Recreational activities were participated in more than all the other types. Physical activity more than skill based but less than social and self-improvement. Social more than skilled and self-improvement. Self-improvement more than skill based. All of these were significant differences with p < 0.001.
In the Intensity dimension: recreational activities had more participation than all but self-improvement. Self-improvement had more than physical and skill based. These also had significant differences of p < 0.001.
The best involvement in the community was seen when children participated in social activities compared to any other type recreation (p <0.001), physical (p < 0.05), skill (p <0.01), self-improvement (p < 0.001). Recreational activity was worst for involvement in the community.
In the enjoyment dimension social activities had higher enjoyment than physical, skill, and self-improvement; all with p < 0.001. Recreational activities were also more enjoyed than physical and skill with p < 0.001 for both.
Informal activities also showed higher participation than formal with p < 0.001.
15 of the participants were interviewed twice to investigate the test-retest reliability for children with Down Syndrome. The results diversity R = 0.67, intensity R = 0.69, with whom R= 0.58, where R= 0.91, enjoyment R = 0.80.
From the results of this article it shows that children with Down Syndrome participate in activities across all the dimensions of the CAPE but that different activities change the level on involvement in the community. Social and physical activities promoted the most involvement in the community with recreational having the least effect despite being the type with most participation. Knowing the preferences for children with Down Syndrome may help to develop Individualized Education Plans that include activities to promote further involvement in the community.
Limitations: The large amount of time it takes to administer this test may make it more difficult for children to maintain attention and answer each question accurately. Small sample used for testing reliability. Parental cues or assistance was often needed which may have influenced the child’s answers.
Strengths: One of the first studies to look at the preferences in participation of children with Down Syndrome. The administrators of the test had multiple years of experience in using interview based assessments for children with Down Syndrome, and autism spectrum disorders among others. Extended time was allowed during testing in order to be sure the children fully understood each question.
3 responses to “Children’s Assessment of Participation and Enjoyment”
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45 minutes does seem like an incredible amount of time for children to be answering a questionnaire. I would be interested to know if there was a short form – or any push towards creating one for this population.
I do not think that there is a short form at the moment. The article I reviewed mentioned that it might have been better to administer this test in pieces with a few breaks. The thought behind breaking it up is that it would allow some time for the children refocus to be able to give full attention to each question and answer as accurately as possible.
Nice comments! Time is definitely something to consider. Let’s hope it was 45 minutes start to finish. I agree it would be useful to maybe have some play embedded. It might make it longer but more tolerable!