Family factors associated with participation of children with disabilities: a systematic review

AIM: The aim of this review was to synthesize empirical evidence of family factors associated with participation of children with disabilities aged 5 to 12 years to inform the development of family‐centred participation‐fostering interventions. METHOD: A systematic search was performed for articles published in English between 2001 and 2017 in MEDLINE, PsycINFO, CINAHL, Scopus, and ASSIA following the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) guidelines. Quality of evidence was appraised using the Research Triangle Institute Item Bank. Family factors associated with participation were identified and assessed using a multistage ‘semi‐quantitative’ approach. RESULTS: Thirty studies were included in the review. Four non‐modifiable ‘status’ factors consistently associated with participation were parental ethnicity, parental education, family type, and family socio‐economic status. Six modifiable ‘process’ factors with consistent associations with participation were parental mental and physical health functioning, parental self‐efficacy beliefs, parental support, parental time, family preferences, and activity orientation. INTERPRETATION: Rehabilitation professionals should direct their focus towards modifiable family factors as primary targets for family‐centred interventions. Strategies that can improve families’ access to information, counselling, and community support services are likely to support children's participation by empowering families and optimizing their health and well‐being. WHAT THIS PAPER ADDS: Non‐modifiable ‘status’ and modifiable ‘process’ factors are important in participation of children with disabilities. Disadvantaged family circumstances shaped by status factors are associated with reduced participation. Key process factors for intervention are parental mental and physical health and parental self‐efficacy beliefs. Other important process factors for intervention are parental support and time, family preferences, and activity orientation.