The effect of child, family and environmental factors on the participation of young children with disabilities

Erica Di Marino, M.Sc. A.O.T., Stephanie Tremblay, M.Sc. A.O.T., Mary Khetani, Ph.D., OTR/L, Dana Anaby, Ph.D.

Disability and Health Journal, Volume 11, Issue 1, January 2018, Pages 36-42


While participation is essential to a child’s health and well-being, little is known about participation patterns of young children with disabilities.


This study described the participation of children with disabilities under age 6, and examined the extent to which the child’s factors (i.e., age, complexity of child’s condition), family factors (i.e., general family functioning, income) and environmental factors (i.e., environmental helpfulness) affect participation dimensions (frequency, involvement, desire for change) in three different settings: home, daycare/preschool and community.


Cross-sectional design was employed. Parents (n = 90) of children aged 1.4–6 years old (mean = 4.15, SD = 1.03) with disabilities completed the French Young Children’s Participation and Environment Measure (YC-PEM) and Family Assessment Device. Descriptive statistics and multiple linear regressions were performed to describe participation patterns and identify the significant explanatory factors in each setting.


Participation restriction, based on frequency of activities, was primarily observed in the community setting. Environmental helpfulness (resources, supports) consistently explained participation levels for at least one of the dimensions across all settings, whereas contribution of the child’s factors was less evident. Family functioning had a significant effect when examining participation involvement in the community and desire for change in the home setting and, in combination with environmental helpfulness, explained 18% and 21% of the variance respectively.


This study emphasizes the role of the environment in supporting participation of young children with disabilities. Findings can re-direct practitioners’ attention towards modifying the environment as a primary target of intervention aimed at promoting health through participation.