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Ullenhag, Anna
Publications (9 of 9) Show all publications
Adair, B., Ullenhag, A., Rosenbaum, P., Granlund, M., Keen, D. & Imms, C. (2018). Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review. Developmental Medicine & Child Neurology, 60(11), 1101-1116
Open this publication in new window or tab >>Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review
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2018 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 60, no 11, p. 1101-1116Article, review/survey (Refereed) Published
Abstract [en]

AimWe aimed to identify measures used to assess the participation of disabled children and to map the measures' content to the family of participation-related constructs (fPRC) to inform future research and practice. MethodSix databases were searched to identify measures used to assess participation in health, psychology, and education research. Included studies involved children aged 0 to 18 years with a permanent impairment or developmental disability and reported use of a quantitative measure of participation. A second search sought relevant literature about each identified measure (including published manuals) to allow a comprehensive understanding of the measure. Measurement constructs of frequently reported measures were then mapped to the fPRC. ResultsFrom an initial yield of 32 767 articles, 578 reported one or more of 118 participation measures. Of these, 51 measures were reported in more than one article (our criterion) and were therefore eligible for mapping to the fPRC. Twenty-one measures quantified aspects of participation attendance, 10 quantified aspects of involvement as discrete scales, and four quantified attendance and involvement in a manner that could not be separated. InterpretationImproved understanding of participation and its related constructs is developing rapidly; thoughtful selection of measures in research is critical to further our knowledge base.

Place, publisher, year, edition, pages
WILEY, 2018
National Category
Other Health Sciences Neurology Pediatrics Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-41220 (URN)10.1111/dmcn.13959 (DOI)000446560300013 ()30022476 (PubMedID)2-s2.0-85050730294 (Scopus ID)
Available from: 2018-10-25 Created: 2018-10-25 Last updated: 2019-10-01Bibliographically approved
Eliasson, A.-C., Ullenhag, A., Wahlstrom, U. & Krumlinde-Sundholm, L. (2017). Mini-MACS: development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy. Developmental Medicine & Child Neurology, 59(1), 72-78
Open this publication in new window or tab >>Mini-MACS: development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy
2017 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 59, no 1, p. 72-78Article in journal (Refereed) Published
Abstract [en]

AIM To develop the Mini-Manual Ability Classification System (Mini-MACS) and to evaluate the extent to which its ratings are valid and reliable when children younger than 4 years are rated by their parents and therapists. METHOD The Mini-MACS was created by making adjustments to the MACS. The development involved a pilot project, consensus discussions within an expert group, and the creation of a test version of the Mini-MACS that was evaluated for content validity and interrater reliability. A convenience sample of 61 children with signs of cerebral palsy aged 12 to 51 months (mean age 30.2 mo [SD 10.1]) were classified by one parent and two occupational therapists across a total of 64 assessments. Agreement between the parents' and therapists' ratings was evaluated using the intraclass correlation coefficient (ICC) and the percentage of agreement. RESULTS The first sentence of the five levels in the MACS was kept, but other descriptions within the Mini-MACS were adjusted to be more relevant for the younger age group. The ICC between parents and therapists was 0.90 (95% confidence interval [CI] 0.79-0.92), and for the two therapists it was 0.97 (95% CI 0.78-0.92). Most parents and therapists found the descriptions in the Mini-MACS suitable and easy to understand. INTERPRETATION The Mini-MACS seems applicable for children from 1 to 4 years of age.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2017
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45851 (URN)10.1111/dmcn.13162 (DOI)000392829900020 ()27273427 (PubMedID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Ullenhag, A. (2016). Fritiden. In: Arbetsterapi för barn och ungdom: (pp. 193-202). Studentlitteratur AB
Open this publication in new window or tab >>Fritiden
2016 (Swedish)In: Arbetsterapi för barn och ungdom, Studentlitteratur AB, 2016, p. 193-202Chapter in book (Other academic)
Place, publisher, year, edition, pages
Studentlitteratur AB, 2016
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45857 (URN)9789144092485 (ISBN)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Imms, C., Mathews, S., Richmond, K. N., Law, M. & Ullenhag, A. (2016). Optimising leisure participation: a pilot intervention study for adolescents with physical impairments. Disability and Rehabilitation, 38(10), 963-971
Open this publication in new window or tab >>Optimising leisure participation: a pilot intervention study for adolescents with physical impairments
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2016 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 10, p. 963-971Article in journal (Refereed) Published
Abstract [en]

Purpose: To assess the feasibility of an intervention to improve participation in leisure activities of adolescents with physical impairments by changing aspects of the activity or environment. Methods: A pre-test/post-test pilot study of a multi-strategy intervention was used to explore the effectiveness of the strategies and to determine whether the intervention was practical to apply in a community setting. The intervention involved establishing adolescent and family focused goals, measuring and addressing environmental barriers and building activity performance skills. The Goal Attainment Scale (GAS) and the Canadian Occupational Performance Measure measured outcomes. Results: Eight participants (aged 12-19 years; five males) with physical disabilities set participation goals using a structured approach. Analysis of personal and environmental barriers and facilitators for participation guided the choice of intervention strategies to support goal attainment. The natural environment, government policies and availability of transport were identified as the most frequent barriers to participation in leisure. Support to secure appropriate devices to enable participation was commonly required. As a group, attainment of 12 of 17 GAS goals, and progress on four more goals, was demonstrated. Conclusions: The intervention model was applicable and practical to use in a community therapy setting and the majority of the participation goals set were achieved.Implications for RehabilitationThis ICF-based intervention model was applicable and practical to use in a community therapy setting.The majority of the adolescent's leisure participation goals were achieved following engagement in the multi-strategy intervention.Adolescents with sufficient communication skills (CFCS Levels I-III) benefited from a group-based intervention in addition to individualised support.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2016
Keywords
Adolescent, intervention, leisure, participation
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45852 (URN)10.3109/09638288.2015.1068876 (DOI)000371815900005 ()26208244 (PubMedID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Imms, C., Adair, B., Keen, D., Ullenhag, A., Rosenbaum, P. & Granlund, M. (2016). 'Participation': a systematic review of language, definitions, and constructs used in intervention research with children with disabilities. Developmental Medicine & Child Neurology, 58(1), 29-38
Open this publication in new window or tab >>'Participation': a systematic review of language, definitions, and constructs used in intervention research with children with disabilities
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2016 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 58, no 1, p. 29-38Article, review/survey (Refereed) Published
Abstract [en]

AIM Improving participation of children with disabilities is a priority; however, the participation construct lacks clarity. This systematic review investigated how researchers defined 'participation' and the language used in participation intervention research. METHOD Nine health and education databases were searched for intervention studies of children with disabilities that included a participation outcome. Quantitative data were extracted using a customized form, and participation text data were extracted verbatim. Themes were derived using a thematic coding approach. These participation themes were applied to the outcome measures used in the included studies to compare participation language with the methods used to quantify participation changes. RESULTS Of the 2257 articles retrieved, 25 were included in this review. Five participation themes and nine subthemes were developed. Two themes, attendance and involvement, were directly related to the participation construct. Three additional themes described related concepts: preferences, activity competence, and sense of self. INTERPRETATION Attendance and involvement seem to describe the essence of the participation concept. The related themes may provide important avenues to enhance participation outcomes. This review highlighted the need for researchers to define the construct under investigation clearly and select measures carefully, as measurement choice is the mechanism through which the concept is operationalized in research.

Place, publisher, year, edition, pages
WILEY, 2016
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45853 (URN)10.1111/dmcn.12932 (DOI)000368982600013 ()26411643 (PubMedID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Adair, B., Ullenhag, A., Keen, D., Granlund, M. & Imms, C. (2015). The effect of interventions aimed at improving participation outcomes for children with disabilities: a systematic review. Developmental Medicine & Child Neurology, 57(12), 1093-1104
Open this publication in new window or tab >>The effect of interventions aimed at improving participation outcomes for children with disabilities: a systematic review
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2015 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 57, no 12, p. 1093-1104Article, review/survey (Refereed) Published
Abstract [en]

AIM Enhancement of participation has been described as the ultimate outcome for health and educational interventions. The goal of this systematic review was to identify and critically appraise studies that aimed to improve the participation outcomes of children with disabilities. METHOD Nine databases that index literature from the fields of health, psychology, and education were searched to retrieve information on research conducted with children with disabilities aged between 5 years and 18 years. Articles were included if the author(s) reported that participation was an intended outcome of the intervention. The articles included were limited to those reporting high-level primary research, as defined by Australia's National Health and Medical Research Council evidence hierarchy guidelines. No restrictions were placed on the type of intervention being investigated. RESULTS Seven randomized controlled or pseudo-randomized studies were included. Only three of these studies identified participation as a primary outcome. Both individualized and group-based approaches to enhancing participation outcomes appeared to be effective. Studies of interventions with a primary focus on body function or activity level outcomes did not demonstrate an effect on participation outcomes. INTEPRETATION Few intervention studies have focused on participation as a primary outcome measure. Approaches using individually tailored education and mentoring programmes were found to enhance participation outcomes, while exercise programmes, where participation was a secondary outcome, generally demonstrated little effect.

Place, publisher, year, edition, pages
WILEY, 2015
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45854 (URN)10.1111/dmcn.12809 (DOI)000367684600009 ()26010935 (PubMedID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Ullenhag, A. (2012). Participation in leisure activities of children and youths with and without disabilities. (Doctoral dissertation). Stockholm: Karolinska institutet
Open this publication in new window or tab >>Participation in leisure activities of children and youths with and without disabilities
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The World Health Organization (WHO) defines participation as a person’s involvement in a life situation, and to participate in leisure activities is one of the most important aspects of health and well-being. When a child is involved and engaged in a leisure activity, it gives the child a sense of belonging, opportunities to make friendships, and possibilities to develop physical and social competences and skills. Children with disabilities tend to be restricted in their abilities to participate in leisure activities due to mobility problems, communication disorders, and pain, but also as a result of negative attitudes from others and problems with transportation and accessibility.Knowledge of the personal and environmental factors that facilitate or hinder participation in leisure activities for children with disabilities is essential to be able to implement successful interventions with the aim of increasing participation. This requires a valid assessment of participation that can give both an objective and subjective view of the multidimensional construct.The overall aim of this doctoral thesis is to describe and compare patterns of participation in leisure activities of children with and without disabilities by cultural validation and use of the Children’s Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC) in the Swedish context. A specific goal is to develop and implement a client-centred model of intervention with the aim of improving participation in leisure activities by children with disabilities.The result from Study I showed that the slightly modified Swedish version of the CAPE was valid for Swedish children. The outcome of standardized mean diversity score was significantly higher compared with the outcome of the original version of the CAPE, indicating that validation of the item relevance in the new context was necessary. The overall findings in Study II indicated that Swedish children with disabilities participated in a higher diversity of leisure activities, but with less intensity, compared to children without disabilities. Study III showed that there are differences between countries in patterns of participation in leisure activities for children with disabilities in regards to both diversity and intensity. For children without disabilities there were only minor differences between the countries. The results of Study IV showed that a designed intervention approach could be applied in the clinic for increasing participation in leisure activities by children with neuropsychiatric diagnosis.The overall clinical implications and conclusions from this thesis are three-fold. First, a cultural validation of the CAPE/PAC is necessary when surveying Swedish children’s participation in leisure activities. Second, the patterns of participation in leisure activities of children with and without disabilities differ both nationally and internationally, and this provide evidence of the need for changes in national legislations, policies, and therapeutic approaches that promote participation of children with disabilities. Third, an intervention model with a client-centred approach in which children with disabilities define their own leisure activity goals by using the CAPE and PAC appears to be effective in increasing participation in leisure activities.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2012
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45858 (URN)978-91-7457-961-1 (ISBN)
Available from: 2019-10-29 Created: 2019-10-25 Last updated: 2019-10-29Bibliographically approved
Ullenhag, A., Persson, K. & Nyqvist, K. H. (2009). Motor performance in very preterm infants before and after implementation of the newborn individualized developmental care and assessment programme in a neonatal intensive care unit. Acta Paediatrica, 98(6), 947-952
Open this publication in new window or tab >>Motor performance in very preterm infants before and after implementation of the newborn individualized developmental care and assessment programme in a neonatal intensive care unit
2009 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 6, p. 947-952Article in journal (Refereed) Published
Abstract [en]

Aim: To compare motor performance in supine position at the age of 4-months corrected age (CA) in very preterm (VPT) infants cared for in a neonatal intensive care unit (NICU) before and after the implementation of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Methods: Assessments of motor performance in supine position according to level of motor development and quality of motor performance were made, using the Structured Observation of Motor Performance in Infants (SOMP-I). Subjects: VPT infants cared for in a NICU at a Swedish university hospital before, Group A (n = 68), and after, Group B (n = 58), the implementation of developmentally supportive care based on NIDCAP. Results: The infants who were treated after the introduction of NIDCAP showed higher level of motor development in the arms/hands and trunk. No significant group differences were noted in total deviation score for the respective limbs, but lower frequency of lateral flexion in head movements, extension-external rotation-abduction, extension-internal rotation-adduction and varus and valgus position in the feet was found in the NIDCAP group, compared with those treated before the introduction. Conclusion: The infants who were treated after NIDCAP care had been implemented showed a higher level of motor development in arms/hand and trunk and fewer deviations in head, legs and feet at 4-months CA than infants treated before NIDCAP implementation. The observed changes may be due to NIDCAP and/or improved perinatal and neonatal care during the studied time period.

Place, publisher, year, edition, pages
WILEY, 2009
Keywords
Development, Infant, Motor, NIDCAP, Very preterm
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45855 (URN)10.1111/j.1651-2227.2009.01258.x (DOI)000266636300007 ()19397529 (PubMedID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Nyquist, A., Jahnsen, R. B., Moser, T. & Ullenhag, A. The coolest I know: a qualitative study exploring the participation experiences of children with disabilities in an adapted physical activities program. Disability and Rehabilitation
Open this publication in new window or tab >>The coolest I know: a qualitative study exploring the participation experiences of children with disabilities in an adapted physical activities program
(English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed) Epub ahead of print
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45856 (URN)10.1080/09638288.2019.1573937 (DOI)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-12-10Bibliographically approved
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