Assessment of Self‐Determination in Adolescents with Neonatal Brachial Plexus Palsy. Issue 1 (23rd June 2017)

• Record Type: Journal Article
• Authors: Bergman, Donna; Rasmussen, Lynnette; Chang, Kate Wan‐Chu; Yang, Lynda J‐S.; Nelson, Virginia S.
• Is Part Of: PM&R. Volume 10:Issue 1(2018)
• Page Start: 64
• Page End: 71
• Publication Date: 2017-06-23
• Subjects: Medical rehabilitation -- Periodicals; Physical therapy -- Periodicals; Physical Therapy Modalities -- Periodicals; 615.5
• DOI: 10.1016/j.pmrj.2017.06.013
• Languages: English
• ISSNs: 1934-1482

Abstract

Abstract: Background: 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. Objective: To assess self‐determination of adolescents with neonatal brachial plexus palsy (NBPP) compared with their typically developing peers via self‐reported measures of function. Design: Case‐control study. Setting: Brachial plexus clinic. Participants: 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. Methods: Participants completed demographic and American Institutes for Research (AIR) self‐determination surveys. One of two designated occupational therapists evaluated participant physical function. Main Outcome Measurements: 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. Results: 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. Conclusions: 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. Level of Evidence: III