Impact of adapted bicycle riding on outcomes for children and adolescents with disabilities: A systematic review.

AIM: To review the evidence for the effects of adapted bicycle riding on body structures and functions, activity, participation, and quality of life outcomes in children with disabilities, along with family-level participation outcomes. METHOD: A systematic review with searches of nine electronic databases to identify studies involving participants with a developmental disability aged 4 to 18 years who used a dynamic adapted bicycle was completed in August 2021. Risk of bias was assessed based on individual study designs. A narrative synthesis integrated the findings of the included studies. Certainty of evidence was synthesized using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Ten studies were included with 234 participants. Five studies reported outcomes at the body structures and functions level, ten reported activity-level outcomes, two reported participation-related outcomes, and none assessed quality of life or family participation in social and recreational activities. INTERPRETATION: Adapted bicycle riding interventions may improve gross motor function, enhance lower-limb muscle strength, and promote physical activity; however, certainty of evidence of effects was rated very low using GRADE. Further research is required to understand the impact of adapted bicycle riding on the participation outcomes of children and adolescents with disabilities and on family-level participation in social and recreational activities. WHAT THIS PAPER ADDS: Adapted bicycle riding interventions may improve motor functions and physical activity. Evidence about participation outcomes after adapted bicycle riding is limited. Research on adapted bicycle riding interventions in natural settings is needed.

Effectiveness of interventions for school-aged-children and adolescents with fetal alcohol spectrum disorder: a systematic review and meta-analysis.

PURPOSE: To describe allied health and educational interventions and their effectiveness for children and adolescents with fetal alcohol spectrum disorder (FASD). To appraise the quality and strength of studies. METHODS: Electronic databases were searched between 2005 and March 2022, identifying non-pharmacological studies supporting function, activity, or participation for FASD participants aged 5-18 years using any quantitative research design. Outcomes were coded using International Classification of Functioning, Disability and Health, family of Participation Related Constructs and behaviour categories. Multi-level random-effects meta-analysis examined intervention effects. Study methodological quality was evaluated using Cochrane risk of bias tools, RoBiNT, AMSTAR 2 and NHMRC Hierarchy levels of evidence. Certainty of findings were synthesised using GRADE approach. RESULTS: The systematic review included 25 studies with 735 participants, 10 of which were analysed by meta-analysis. Body function and structure, activity, behaviour, and sense of self outcomes were pooled. A small, positive effect favouring interventions was found (g = 0.29, 95% CI = 0.15-0.43), however the GRADE certainty was rated as low. No participation outcomes were identified. CONCLUSIONS: Some interventions targeting body function and structure, activity and behaviour outcomes were effective. Evidence of interventions that support children's and adolescent's participation as an outcome is lacking.Implications for rehabilitationTo address participation outcomes for children and adolescents with fetal alcohol spectrum disorder (FASD), it is important to understand their participation needs and directly measure these.Interventions identified targeted body function and structure, activity, and behaviour outcomes.Participation outcomes of children's/adolescent's attendance, involvement and preferences were not identified.A combination of individual- and context-focused interventions is recommended to maximise rehabilitation outcomes for children and adolescents with FASD.

Employment profiles of autistic adults in Australia.

Autistic adults experience a high number of job changes, reduced working hours, minimal workplace supports, and overrepresentation in entry-level and low paid positions. This study adds to the existing evidence base to guide clinical decisions and interventions for this population. This study utilized baseline data collected between 2015 and 2017 from the Autism CRC's Australian Longitudinal Study of Autism in Adulthood. The aim was to describe the employment profiles and explore factors related to employment for Australian autistic adults aged 25 and older (N = 149). Comparisons between participants and the Australian workforce were made using Australian Bureau of Statistics (ABS) data. Two logistic regression models were conducted to explore the association between underemployment and underutilisation with personal and environmental factors. In comparison to the Australian workforce, autistic adults were more likely to work part-time, work reduced hours and be employed at skill levels lower than their qualifications warranted. Logistic regressions reported that more autistic traits, more social supports and having workplace adjustments implemented were significantly associated with a higher odds of autistic adults being appropriately employed and/or utilized in the workforce. Results suggest that interventions implementing appropriate workplace adjustments, a supportive workplace environment, and adequate social supports may improve employment outcomes for autistic adults. All employees may benefit from workplace resources targeted toward fostering an inclusive workplace environment. LAY SUMMARY: This study aimed to describe the employment profiles and explore factors related to employment for Australian autistic adults. We compared this with the Australian workforce using data from the Australian Bureau of Statistics. Autistic adults with more autistic traits and more social and workplace supports were more likely to be employed and have jobs that were better suited to them. Autistic adults might have better employment outcomes if they have the appropriate workplace adjustments, a supportive workplace and adequate social supports.

Children's participation in home, school and community life after acquired brain injury.

AIMS: This study aimed to describe participation at home, school and in the community of Australian children who had sustained an acquired brain injury (ABI). Parent ratings regarding the impact of cognitive, motor and behavioural impairments on participation were obtained. In addition, the influence of environmental factors on participation was investigated. METHODOLOGY: This study used a cross-sectional design with convenience sampling to recruit 20 children who attended a rehabilitation review clinic between September 2006 and September 2007. Participants completed the Child and Family Follow-up Survey (Bedell, 2004) to describe the participation of their children in home, school and community settings. The CFFS was developed based on the International Classification of Function, and uses parent report to measure the impact of impairments and environmental factors on children's participation in home, school and community life. RESULTS: The children were reported to have the greatest participation restrictions for structured events in the community, and social, play or leisure activities with peers either at school or in the community. Children were least restricted moving about in and around their own homes. CONCLUSIONS: This research describes difficulties encountered by Australian children with ABI in participating in community-based activities with their same aged peers. This study adds to the current literature describing patterns of participation of United States children who have sustained brain injuries, and provides useful information for Australian therapists to consider when addressing children's return to school and engagement with their peers following brain injury.

Evaluation of the Australian adaptation of the Keeping It Together (KIT-Australia) information package with carers of children with special needs.

BACKGROUND: Australian carers of children with special needs have expressed concerns about the limited availability and accessibility of suitable information resources. The 'Keeping It Together' (KIT) information package was developed and trialled in Canada and found to be effective in meeting the information needs of this population. AIM: The study aimed to evaluate the KIT-Australian Adaptation (KIT-Australia) to determine if it met its purpose of providing carers of children with special needs with strategies to access resources, organise information and communicate with others about their child. The study also aimed to determine whether additional changes were required to increase the KIT-Australia's utility. METHODS: Eighteen carers of children with special needs participated in the study. All participants had accessed services from the Royal Children's Hospital, Melbourne, Victoria. Demographic information was collected and carers were orientated to the KIT-Australia prior to using it. After eight weeks, a telephone survey interview was completed with each participant. A content analysis of qualitative and quantitative data provided the results. RESULTS: Most participants stated that they would continue to use the KIT-Australia, and would recommend it to other carers. Six key themes were identified: getting started, accessing resources, organising and storing information, communicating information about my child to others, recommendations and non-use of the KIT-Australia. CONCLUSIONS: Preliminary data from this study suggests that the KIT-Australia met its purpose of assisting carers of children with special needs, to access resources, organise information and communicate with others about their child. Participant recommendations to improve the usability of the KIT-Australia should be implemented for future editions of the resource. Further research may be required to adapt and facilitate use of the KIT-Australia in other Australian states and territories.

Sensory processing abilities of children who have sustained traumatic brain injuries.

OBJECTIVE: This study describes the sensory processing abilities of children ages 3-10 who sustained a moderate or severe traumatic brain injury (TBI). METHOD: We used a prospective, descriptive study design with convenience sampling of 20 children who were admitted to a pediatric neurosurgical unit. Caregivers provided information regarding their child's sensory processing abilities using the Sensory Profile (Dunn, 1999). We also collected demographic information related to the mechanism and severity of injury. Data were analyzed descriptively, and summary statistics were used to describe the Sensory Profiles of the children in comparison to normative data. RESULTS: Proportionally more children with TBI than children in the normative sample demonstrated behaviors outside of the typical range in all sections of the Sensory Profile except for oral sensory processing. CONCLUSION: These findings strongly support the need to include evaluation of sensory processing in any clinical assessment of children who have sustained TBI.

The relationship between physical performance and self-perception in children with and without cerebral palsy.

AIM: This study examined the relationship between physical performance and perceived self-competence and global self-worth in children with and without spastic diplegia. METHOD: A matched-pairs design, including eight children with spastic diplegia and eight typically developing children, was used to compare the children's performance and to examine relationships. Children aged 7 to 11 years were assessed to determine their gross and fine motor abilities and they completed a modified version of the Harter Self-Perception Profile for Children. RESULTS: Children with diplegia performed at lower levels in all gross and fine motor assessments compared with children without diplegia. Self-perception was lower in children with diplegia in fine motor competence (P = 0.03) and global self-worth (P = 0.05). Clinically important differences (> 10%) in gross motor and athletic competence were also found. Positive correlations between physical performance assessments and some self-perception domains were present, although strength and direction of relationships differed for each group in some instances. CONCLUSION: This small study found that in addition to having reduced physical skills, children with spastic diplegia may experience a less positive global self-worth than typically developing children. These findings are in contrast to some previous research. Future research should examine the hypothesised relationship more definitively to determine whether improvement in physical skills results in a higher level of self-competence and consequently a higher global self-worth. This might further justify interventions aimed at improving fine and gross motor skills of children with cerebral palsy. Clinicians should be mindful of addressing both physical issues and self-worth with clients.

Leisure participation and satisfaction in autistic adults and neurotypical adults.

Leisure participation is important for well-being and has been attributed to improved quality of life for autistic individuals. Rigorous studies exploring the leisure participation of autistic adults are sparse. This study aimed to compare the type of leisure activity and frequency of participation between autistic adults and neurotypical adults as well as compare and identify factors associated with their leisure satisfaction. Data for 145 autistic and 104 neurotypical adults were obtained from time point one of the Australian Longitudinal Study of Adults with Autism. The primary outcome measure used was the Leisure Satisfaction Scale. Autistic adults were less satisfied with their leisure overall (mean = 3.29, standard deviation = 0.75) compared with neurotypical adults (mean = 3.69, standard deviation = 0.55). Multiple linear regression revealed being younger and reporting less depressive symptoms were significantly associated with higher leisure satisfaction in autistic but not neurotypical adults. Engagement in solitary leisure activities was comparable across participants, but socialising in person was predominated by neurotypical adults. Leisure activity preferences of autistic adults' and the frequency of their leisure participation are important factors for clinicians to understand when working with this population and tailoring well-being interventions.