Predictors of Brazilian children's participation at home and at daycare/preschool
Participation; Child; Preschool; Environment; Disability; Predictors
Background: Participation has been identified as a primary objective of rehabilitation interventions and can be affected by personal, familial and environmental factors. In young children from low-and-middle-income countries (LMICs), there is little data regarding the factors that can predict participation at home and in daycare/preschool. Methods: Data were collected from the guardians of 276 children (mean age 34.83 months, SD = 19.59; girls = 130 and boys = 146) in five study centers in Brazil through an online survey, using the YC-PEM (Young Children's Participation and Environment Measure) instrument. A prediction model was employed to ascertain whether the child's personal factors (age, diagnosis, and attendance at daycare/preschool), family factors (family income, schooling, and occupation of the guardian), and environmental factors (supports and barriers) were capable of predicting frequency and involvement at home and daycare/preschool. Results: The level of education of the guardian (β=-0.13, p=0.030) was able to predict attendance at home. The involvement at home was explained by supports (β=0.266, p<0.001), the presence of a disability (β=-0.221, p<0.001) and attendance at daycare/preschool (β=-0.199, p=0.001). In daycare/preschool, Supports (β=0.806, p<0.001; β=0.832, p<0.001), Barriers (β=0.226, p<0.001; β=0.155, p<0.001) and presence of disability (β=-0.066, p<0.001; β=-0.109, p<0.001) were able to predict attendance and involvement, respectively. Conclusions: This study represents the inaugural investigation of the participation of children with and without disabilities in early childhood at home and in daycare/preschool settings within a LMICs, Brazil. The findings indicate that environmental factors exert a more significant influence in predicting participation. This underscores the necessity of modifying the environmental structure to facilitate participation.