Family factors associated with participation of children with disabilities: a systematic review

Aim The aim of this review was to synthesize empirical evidence of family factors associated with participation of children with disabilities aged 5 to 12 years to inform the development of family-centred participation-fostering interventions. Method A systematic search was performed for articles published in English between 2001 and 2017 in MEDLINE, PsycINFO, CINAHL, Scopus, and ASSIA following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Quality of evidence was appraised using the Research Triangle Institute Item Bank. Family factors associated with participation were identified and assessed using a multistage ‘semi-quantitative’ approach. Results Thirty studies were included in the review. Four non-modifiable ‘status’ factors consistently associated with participation were parental ethnicity, parental education, family type, and family socio-economic status. Six modifiable ‘process’ factors with consistent associations with participation were parental mental and physical health functioning, parental self-efficacy beliefs, parental support, parental time, family preferences, and activity orientation. Interpretation Rehabilitation professionals should direct their focus towards modifiable family factors as primary targets for family-centred interventions. Strategies that can improve families’ access to information, counselling, and community support services are likely to support children's participation by empowering families and optimizing their health and well-being. What this paper adds - Non-modifiable ‘status’ and modifiable ‘process’ factors are important in participation of children with disabilities. - Disadvantaged family circumstances shaped by status factors are associated with reduced participation. - Key process factors for intervention are parental mental and physical health and parental self-efficacy beliefs. - Other important process factors for intervention are parental support and time, family preferences, and activity orientation