Eco-cultural frameworks and childhood disability: a case study from Puerto Rico

Social and physical environments are powerful influences on disability status. The purpose of this case report is to consider the usefulness of scores on the Pediatric Evaluation of Disability Inventory (PEDI) of a child living in Puerto Rico for developing an intervention plan within the context of the child's eco-cultural niche. A 5 year-old boy with cerebral palsy, his family, therapists, and teacher are described by using ethnographic interviews and participant observation of the family, speech, occupational, and physical therapists, and teachers over a 9-month period. A physical therapy evaluation of the child, including administration of the PEDI and use of the eco-cultural niche concept to develop an intervention plans are described... The child's abilities and inabilities as measured by the PEDI were influenced by several aspects of the environment; family beliefs, values and resources; community resources; and personal characteristics of the child. An eco-cultural framework was useful for interpreting the scores of this standardized measure of disability.