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Secondary conditions in children with disabilities: spina bifida as a case example
Rune J Simeonsson1, Janey Sturtz McMillen, Gail S Huntington
1School of Education & Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill 27599-3500, USA. rune_simeonsson@unc.edu
Insights
Secondary conditions in childhood disability, like those in spina bifida, are preventable impairments and participation restrictions. Understanding their environmental context is key to developing effective prevention programs.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Public Health
Background:
- Secondary conditions are common in children with disabilities, impacting their overall health and participation.
- Spina bifida serves as a model to understand these secondary conditions in childhood disability.
- The International Classification of Functioning, Disability and Health (ICF) offers a framework for analyzing disability.
Purpose of the Study:
- To examine the concept of secondary conditions in childhood disability.
- To apply the ICF framework to understand secondary conditions in children with spina bifida.
- To identify mechanisms for developing secondary condition prevention programs.
Main Methods:
- Conceptual analysis of secondary conditions.
- Application of the ICF framework to classify impairments, activity limitations, and participation restrictions.
- Review of research on children and adolescents with spina bifida.
Main Results:
- The ICF provides a valuable conceptual framework and taxonomy for studying secondary conditions.
- Environmental factors play a mediating role in the manifestation of secondary conditions.
- Physical and mental impairments, activity limitations, and participation restrictions are identified as secondary conditions in children with spina bifida.
Conclusions:
- Secondary conditions in children with spina bifida are preventable.
- Understanding the mechanisms of secondary condition manifestation is crucial for prevention.
- The ICF framework aids in profiling children's difficulties and environmental barriers.
Abstract:
This paper examines the concept of secondary conditions and its application in studies of childhood disability focusing on children with spina bifida as a representative group. The "International Classification of Functioning, Disability and Health" (World Health Organization, Geneva, 2001) provides a classification of body function/structure, activities, participation and the environment to document dimensions of human functioning in context. The ICF is of value in the study of secondary conditions in two ways: as a conceptual framework for defining impairments, activity limitations and participation restrictions, and the mediating role of the environment in their expression; and as a taxonomy for coding these dimensions of disability. The ICF can yield a profile of a child's difficulties, and documentation of environmental barriers experienced by that child. Research studies with children and adolescents with spina bifida reveal that physical and mental impairments and limitations in performing activities and participating in communal life are experienced as secondary conditions. The significance of secondary conditions is that they are preventable. Identifying the mechanisms associated with their manifestation is thus an important priority for the development of effective prevention programs.