Foundation research
Through extensive literature reviews I have explored the ways in which family centred care and play is used for disabled children.
A scoping review illustrated that the processes of family-centred care are inconsistent between studies, which may be largely due to the diverse nature of disabled children. Outcome measures used in family-centred care studies are strongly focused on health condition, body structure or functional limitations, rather than activity or participation. The findings provide a framework to guide the processes of implementation for future interventions for this population of children and their families to improve consistency between studies.
Publications and conference contributions
Carrington, L.; Hale, L.; Freeman, C.; Qureshi, A.; Perry, M. (2021). Family-Centred Care for Children with Biopsychosocial Support Needs: A Scoping Review. Disabilities, 1(4), 301-330; https://doi.org/10.3390/disabilities1040022
Carrington, L. (2022) Family centred care – what does it mean and why physiotherapists should care. [conference abstract]. Physiotherapy New Zealand Conference, Rotorua, New Zealand.
A systematic review and meta-synthesis illustrated that play can be adapted to suit the child’s developmental stage and interests, can facilitate engagement between individuals, and provides a meaningful person-centred intervention delivery method. While a small positive effect of play used in therapeutic settings for disabled children was found, differences in the concept of play and how it is employed resulted in heterogenous differences between studies and a lack of standardisation of outcomes. This review illustrates the complexities of play, the challenges of measuring play effectiveness, and the importance of identification of a central outcome that is meaningful to the child and their family.
Clinical implications
- Play-based interventions trend towards a positive effect on ICF outcomes, but the certainty of effect is limited
- Play is used in diverse ways making it a versatile method to promote engagement or deliver therapy to a wide variety of children with disabilities
- Play-based studies measuring outcomes solely related to body function and structure domains of the ICF may not capture the broader holistic benefits of play
- When using play in clinical practice, professionals should consider the child’s personal and
environmental factors and the influence of play on activity and participation
Publications and conference contributions
Carrington, L.; Hale, L.; Freeman, C.; Smith, D.; Perry, M. (2023). The effectiveness of play as an intervention using International Classification of Functioning outcome measures for children with disabilities – a systematic review and meta-synthesis Disability and Rehabilitation. Published online 26 Sept 2023, https://doi.org/10.1080/09638288.2023.2259305
Carrington, L. et al. (2023) The effectiveness of play as an intervention using International Classification of Functioning outcome measures for children with disabilities – a systematic review and meta-synthesis. [review]. Rehabilitation Research Review, 65. https://www.researchreview.co.nz
Carrington, L. 2023. Play is powerful, but is it effective? [conference abstract]. International Symposium of Adapted Physical Activity. Dunedin, New Zealand
Carrington, L. 2022. Play – what do we know? [conference abstract] Physiotherapy New Zealand Paediatric Special Interest Group Symposium, Dunedin, New Zealand
Current Project
Exploring home-based, play-focused family-centred interventions for disabled children and their families.
This research seeks to identify additional opportunities to support disabled children through a holistic home-based whānau-supported programme of play-focused physiotherapy. Perceptions and experiences of key stakeholders are explored using qualitative semi-structured interviews and focus groups. [ongoing]
Publications and conference contributions
Carrington, L. 2024. Learning from Families: Disabled youth and their families’ experiences of family-centred care. [conference abstract]. Physiotherapy New Zealand Conference 2024. Christchurch, New Zealand.
Carrington, L. 2024. Who’s the expert? What families really want. [summit abstract] eHealth Clinical Excellence Summit for Pediatric Therapists
Carrington, L. 2024. Family-centred care and relationships. [symposium abstract] Physiotherapy New Zealand Paediatric Special Interest Group Symposium, Auckland, New Zealand