Assessment of Selfâ Determination in Adolescents with Neonatal Brachial Plexus Palsy
Bergman, Donna; Rasmussen, Lynnette; Chang, Kate Wan‐chu; Yang, Lynda J‐s.; Nelson, Virginia S.
2018-01
Citation
Bergman, Donna; Rasmussen, Lynnette; Chang, Kate Wan‐chu ; Yang, Lynda J‐s. ; Nelson, Virginia S. (2018). "Assessment of Selfâ Determination in Adolescents with Neonatal Brachial Plexus Palsy." PM&R 10(1): 64-71.
Abstract
BackgroundThe term selfâ determination refers to decisionâ making, goal setting, and perseverance to achieve those goals. Numerous studies have established the importance of selfâ 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 selfâ determination for adolescents with physical disabilities.ObjectiveTo assess selfâ determination of adolescents with neonatal brachial plexus palsy (NBPP) compared with their typically developing peers via selfâ reported measures of function.DesignCaseâ control study.SettingBrachial plexus clinic.ParticipantsTwenty adolescents with NBPP (aged 10â 17 years) and their parents and 20 age/genderâ matched typically developing adolescents and their parents were recruited. Nonâ Englishâ speaking participants and those with other physical impairments were excluded from study.MethodsParticipants completed demographic and American Institutes for Research (AIR) selfâ determination surveys. One of two designated occupational therapists evaluated participant physical function.Main Outcome MeasurementsA demographic survey and AIR selfâ 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, 9â Hole Peg Test, and Mallet scale scores also were evaluated.ResultsDespite physical differences, adolescents with NBPP presented similar selfâ determination levels as their typically developing peers. Adolescents with NBPP rated their opportunities to engage in selfâ 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 selfâ determined behaviors at school significantly lower than at home.ConclusionsAdolescents with NBPP presented similar selfâ determination scores as their age/genderâ matched typically developing peers. These results could be a reflection of our program’s patientâ and familyâ 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 selfâ determination skills might be more limited at school than at home in this age group.Level of EvidenceIIIPublisher
Wiley Periodicals, Inc. Elsevier Saunders
ISSN
1934-1482 1934-1563
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