Caregiver Strategies Explaining School Participation Among Children and Youth with Craniofacial Microsomia and Childhood-Onset Disabilities

Research Objectives: To examine the role of caregiver strategies in explaining school participation (i.e., attendance and involvement) among children and youth with craniofacial microsomia (CFM) and childhood-onset disabilities. For both groups, we hypothesized a significant indirect effect of caregiver strategies on the relationships of known predictors of participation (i.e., school environmental support, child and youth’s physical functioning problems and behavioral problems) and school participation.

Design: Cross-sectional study design applying structural equation modeling.

Setting: School setting.

Participants: We employed secondary analyses of a subset of data (n=120 caregivers of children and youth with CFM; n=140 caregivers of children and youth with childhood-onset disabilities) from the second follow-up phase of a longitudinal cohort study.

Interventions: N/A

Main Outcome Measures: School participation, school environmental support, and caregiver strategies were captured with the Participation and Environment Measure – Child and Youth version (PEM-CY). Child and youth’s physical functioning problems were assessed using the physical functioning scale of the Pediatric Quality of Life Inventory (PedsQL) and behavioral problems were assessed using the Child Behavior Checklist (CBCL).

Results: Models reached acceptable to close model fit (CFI=0.962-0.974; RMSEA= 0.054 -0.066; SRMR=0.055-0.057; TLI=0.940-0.959). For children and youth with CFM, caregiver strategies had an indirect effect on the relationship between school environmental support and school participation attendance. For children and youth with childhood-onset disabilities, caregiver strategies had an indirect effect on the relationship between physical functioning problems and school participation attendance. No indirect effects were found for school participation involvement.

Conclusions: Findings highlight the role of caregiver strategies in two ways: 1) strengthening the positive effect of school environmental support for children and youth with CFM; and 2) attenuating the negative effect of physical functioning problems on school participation attendance among children and youth with childhood-onset disabilities.

Author(s) Disclosures: We have no conflict of interest to declare.