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- Title
Assessment of Self-Determination in Adolescents with Neonatal Brachial Plexus Palsy.
- Authors
Bergman, Donna; Rasmussen, Lynnette; Chang, Kate Wan-Chu; Yang, Lynda J-S; Nelson, Virginia S
- Abstract
<bold>Background: </bold>The term self-determination refers to decision-making, goal setting, and perseverance to achieve those goals. Numerous studies have established the importance of self-determination to enhance learning and improve postschool outcomes. However, most studies evaluate students with learning disabilities, cognitive impairment, or behavioral disabilities. There is an absence of research on self-determination for adolescents with physical disabilities.<bold>Objective: </bold>To assess self-determination of adolescents with neonatal brachial plexus palsy (NBPP) compared with their typically developing peers via self-reported measures of function.<bold>Design: </bold>Case-control study.<bold>Setting: </bold>Brachial plexus clinic.<bold>Participants: </bold>Twenty adolescents with NBPP (aged 10-17 years) and their parents and 20 age/gender-matched typically developing adolescents and their parents were recruited. Non-English-speaking participants and those with other physical impairments were excluded from study.<bold>Methods: </bold>Participants completed demographic and American Institutes for Research (AIR) self-determination surveys. One of two designated occupational therapists evaluated participant physical function.<bold>Main Outcome Measurements: </bold>A demographic survey and AIR self-determination assessment were administered, and active range of motion measurements in shoulder forward flexion, elbow flexion, elbow extension, forearm pronation, and supination were obtained. Grip/pinch strength, MRC muscle strength, 9-Hole Peg Test, and Mallet scale scores also were evaluated.<bold>Results: </bold>Despite physical differences, adolescents with NBPP presented similar self-determination levels as their typically developing peers. Adolescents with NBPP rated their opportunities to engage in self-determined behaviors at school significantly lower than at home. Both adolescents with NBPP and those in the control group rated their opportunities to engage in self-determined behaviors at school significantly lower than at home.<bold>Conclusions: </bold>Adolescents with NBPP presented similar self-determination scores as their age/gender-matched typically developing peers. These results could be a reflection of our program's patient- and family-centered care approach. Therefore, caregivers and providers should encourage personal development and fulfillment in adolescents with NBPP. Teachers and schools should be aware that opportunities for acquiring self-determination skills might be more limited at school than at home in this age group.<bold>Level Of Evidence: </bold>III.
- Subjects
AUTONOMY (Psychology); BRACHIAL plexus; COMPARATIVE studies; DISABILITY evaluation; ELBOW; RANGE of motion of joints; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MUSCLE strength; PROGNOSIS; RESEARCH; EVALUATION research; CASE-control method; SKELETAL muscle
- Publication
PM & R: Journal of Injury, Function & Rehabilitation, 2018, Vol 10, Issue 1, p64
- ISSN
1934-1482
- Publication type
journal article
- DOI
10.1016/j.pmrj.2017.06.013