Exploring self-care in children with and without motor impairment

Abstract

The ability to participate successfully in self-care, such as dressing, eating, toileting, and washing, is fundamental for a healthy life. It affects a child’s daily functioning. It plays a crucial role in their balanced development and significantly impacts their health, wellbeing, and participation in society. Improving support for self-care is a priority for NHS improvement as set by families, providers, and decision-makers. However, there has been limited research into how self-care develops in childhood, what factors influence this, and how this is best supported. This doctoral research identified: (i) personal and environmental factors influencing selfcare in children and young people, (ii) intervention techniques for supporting self-care, and (iii) impacts of the COVID-19 pandemic restrictions on children’s self-care and parents. The research drew on Bronfenbrenner's Ecological Systems Theory, the World Health Organisation’s International Classification of Function, Disability and Health, and the Discourse-Historical Approach. In the form of a mixed methods design, this research included a systematic evidence synthesis of self-care in children and young people (n=97 studies), two longitudinal cohort studies of children aged 2-5 years (n=24 children, n=299 children), a qualitative analysis of parents’ (n=69) social media views on their children’s self-care during the COVID-19 restrictions in the United Kingdom (UK), and an analysis of teachers’ responses to a UK government survey on school readiness. Young people were involved in the research design. A sequential synthesis was implemented from which the main overall messages were: 1) motor and cognitive ability are key predictors of self-care; 2) socioeconomic status may play a role in self-care development; 3) the COVID-19 pandemic significantly impacted children’s self-care and consequent school readiness; and 4) children’s self-care difficulties also significantly impact parents, and the relationship between children and parents.