Mary Law

• BsC (OT), PhD
• McMaster University

Date Presented 04/04/19 This study demonstrates the effectiveness of a novel, client-centered OT intervention, named PREP, for improving the participation of youth with disabilities. By removing environmental barriers, OTs enabled 28 youth to successfully take part in the activities they identified, such as shopping with friends, riding a bike, and...

Objective The purpose of this study is to assess the influences of environment, population characteristics, and service utilization on participation frequency and involvement in the home setting among children 0 to 5 years. Method Data was collected from parents of 236 children (mean age 3 years and 5 months, SD = 1.30, girls = 152, and boys = 84)...

Minimal research exists on the participation of young children who are five years and younger. The purpose of this study is to describe the participation of young children who use a large children’s treatment centre in Ontario, Canada in relation to primary diagnosis and complexity (cumulative number of functional concerns). One hundred and seventy...

Aims. To estimate the psychometric properties of a culturally adapted version of the Young Children’s Participation and Environment Measure (YC-PEM) for use among Singaporean families. Methods. This is a prospective cohort study. Caregivers of 151 Singaporean children with (n=83) and without (n=68) developmental disabilities, between 0 and 7 year...

Aims: To determine construct validity of the Korean Participation and Environment Measure for Children and Youth (KPEM-CY) in South Korea. Methods: A total of 184 parents of children with (n = 80) and without disabilities (n = 104) aged 5 to 13 years completed the KPEM-CY. Construct validity was analyzed by assessing differences in the participa...

Aim: To examine participation-preference congruence, regional differences in participation-preference congruence, and predictors of whether children with cerebral palsy participate in preferred activities. Method: The sample (n=236) included 148 males and 88 females aged 10 to 13 years, living in Victoria, Australia (n=110), Ontario (n=80), or Q...

This study examines caregivers’ perceptions of participation patterns and environmental supports and barriers for young children with and without developmental disabilities within their child care/preschool and community settings. The Young Children’s Participation and Environment Measure (YC-PEM) was completed by 151 parents of Singaporean childre...

This knowledge translation project was conducted to increase occupational therapy practitioners' awareness of the importance of measuring participation of children with disabilities. The Knowledge to Action process framework (KTA framework) guided knowledge translation via a web-based seminar (webinar) to practitioners working with children and edu...

Aim: Impairments in social communication are the hallmark of autism spectrum disorder (ASD). Operationalizing 'severity' in ASD has been challenging; thus, stratifying by functioning has not been possible. The purpose of this study is to describe the development of the Autism Classification System of Functioning: Social Communication (ACSF:SC) and...

Purpose: A step toward advancing research about rehabilitation service associated with positive outcomes for children with cerebral palsy is consensus about a conceptual framework and measures. Methods: A Delphi process was used to establish consensus among clinicians and researchers in North America. Results: Directors of large pediatric reha...

Aims: To describe the focus of therapy practices in occupational and physical therapy for school-aged children with cerebral palsy, and better understand whether it is congruent with recommended practices. Methods: A Canada-wide Web-based survey was completed by 62 occupational and 61 physical therapists to identify problems, assessments, and tr...

Purpose: To develop the Korean version of the Participation and Environment Measure for Children and Youth (KPEM-CY) and examine its psychometric properties. Method: The PEM-CY was cross-culturally translated into Korean using a specific guideline: pre-review of participation items, forward/backward translation, expert committee review, pre-test of...

Purpose: To identify and inform the experience and roles of occupational therapists (OTs) in the contexts of a natural disaster. Method: This scoping review was conducted via five steps: (1) identify the research question, (2) identify relevant academic articles published between 2000 and 2014 in English, (3) select articles based on the inclusi...

The environment plays a key role in supporting children’s participation and can serve as a focus of intervention. This study aimed to elicit the perceptions and experiences of occupational therapists who had applied the PREP approach—Pathways and Resources for Engagement and Participation. PREP is a novel 12-week intervention for youth with physica...

Aims: Establishing the cultural equivalence of clinical assessments is critical to ensuring culturally competent care. Developed in North America, the Young Children's Participation and Environment Measure (YC-PEM) is a caregiver questionnaire of participation in home, preschool, and community activities and perceptions of environmental impact on...

Background While participation in leisure activities is beneficial to youth’s health, little is known about effective intervention strategies to promote participation. Purpose The aim of this study was to examine the effectiveness of environment-based interventions on participation of youth with physical disabilities. Method Six adolescents ages...

Occupational therapists around the world are taking up the challenge to implement an evidence-based practice approach to the development of occupational therapy services. The emphasis in applying evidence-based practice within occupational therapy has been strongly biomedical in focus. In South Africa, many occupational therapists work in communiti...

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. 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 w...

Introduction Occupational therapists advocate with/for people with disabilities. In the occupational therapy literature, advocacy is mentioned within the context of specific populations or practice settings and thus there is no consistent way of describing advocacy itself. The objective of this article is to describe advocacy in action for occupati...

Introduction Participation in community leisure occupations of children with disabilities is important, yet poorly integrated into practice. This knowledge translation strategy tested an intervention to increase clinicians' awareness and to bring about change in practice toward a focus on participation. Method During this qualitative study, 14 cli...

Youth with physical disabilities experience restrictions to participation in community-based leisure activities; however, there is little evidence about how to improve their involvement. This study examined whether an intervention to remove environmental barriers and develop strategies using a coaching approach improved youth participation in leisu...

Background. Few protocols exist for returning children/youth to school after concussion. Childhood concussion can significantly affect school performance, which is vital to social development, academic learning, and preparation for future roles. The goal of this knowledge translation research was to develop evidence based materials to inform physic...

Background. Consensus-based guidelines exist for adult athletes returning to play after concussion, but there are no protocols developed specifically for children. The goal of this knowledge translation research was to develop evidence-based materials to inform physicians about pediatric concussion. Methods. A pediatric concussion protocol was deve...

Background This article presents findings from the development and evaluation of The KIT: Keeping It Together™ for Youth (the ‘Youth KIT’). The Youth KIT is a resource intended to assist youth with disabilities during their teenage years and during the transition to adulthood to give information to others about themselves, get from others about the...

Objective: To evaluate the psychometric properties of the newly developed Young Children’s Participation and Environment Measure (YC-PEM). Design: Cross-sectional study. Setting: Data were collected online and by telephone. Participants: Convenience and snowball sampling methods were used to survey caregivers of 395 children (93 children with devel...

Background: Participation in occupations is vital for learning and development. Children with disabilities are at risk for decreased participation. Purpose: The purpose of this study is to examine peer-reviewed literature about the participation-based experiences of children and youth with disabilities in activities outside of formal preschool a...

AimThe Canadian Occupational Performance Measure (COPM) is an outcome measure of clients' self perceptions of performance and satisfaction with occupational performance and is widely used in paediatric research. The aim of this study was to explore how a new outcome measure, the Belief in Goal Self-Competence Scale (BiGSS), was perceived by paediat...

Study Design Prospective cohort Introduction Effects of patient-centered care on distal radius fracture recovery lacks evidence. Purpose of the Study To understand from the perspective of a patient with a distal radius fracture: if the Patient Perception of Patient-Centeredness Questionnaire (PPPC) subscales apply to distal radius fracture populat...

Background The purpose of this scoping review was to describe how three tenants of patient-centered care provision: communication, partnership, and health promotion are addressed in patient-centered care models/frameworks across the literature. Methods A scoping review of literature published in English since 1990 was conducted using Medline, CINA...

Participation in leisure is a human right and is central to the health of children and youth. The World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth supported a change in thinking about what outcomes are most relevant in the context of children's health and places participation as o...

Background Supports for evidence-based practice (EBP) and research utilization are needed for moving evidence into practice. Purpose The purpose of this study was to identify the presence of individual and organizational EBP supports (based on a previous scoping review) and the attitudes toward the supports in a convenience sample of Canadian occu...

Children and youth with cerebral palsy receive ongoing physical and occupational therapy services to improve their functional performance and participation in activities at home, school, and in the community. Over the past 2 decades, rehabilitation interventions have become more functional and goal oriented. In this article, we discuss factors that...

Participation in home, school, and community activities is an important indicator of child health and well-being. Evaluating environmental influences on children's participation can inform efforts to develop sustainable built environments, but few validated measures exist. To examine the concurrent validity and utility of the Participation and Envi...

Background: Supports for evidence-based practice (EBP) and research utilization are needed for moving evidence into practice. Purpose: The purpose of this study was to identify the presence of individual and organizational EBP supports (based on a previous scoping review) and the attitudes toward the supports in a convenience sample of Canadian...

Background Serial joint range of motion (ROM) measurements are an important component of assessments for children with cerebral palsy. Most research has studied ROM stability using group data. Examination of longitudinal intra-individual measures may provide more clinically relevant information about measurement variability.Objective To examine the...

Client-centred occupational therapy approaches aim to increase client motivation and confidence in working towards self-identified occupational performance goals. In this opinion piece we explore whether measurement of confidence in goal pursuit could complement existing tools, such as the Canadian Occupational Performance Measure (Law et al 1998),...

Purpose: The purpose of this qualitative study was to explore the experiences of youth with different disabilities from across Canada during their transitions from adolescence to adulthood. Methods: Qualitative methods, using a phenomenological tradition, explored the meaning of the lived experiences of youth with disabilities in transition to a...

Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent's perceptions of child's HRQoL across 18 months and 3) explore factors that predic...

Occupational therapists can bring a unique and valuable perspective to the national dialogue on health promotion. Current approaches have a narrow focus on diet and exercise; a broader focus on occupation has the potential to enrich understanding regarding forces that contribute to health and well-being. A new "Do-Live-Well" framework will be prese...

To test the effect of personal and environmental factors on children's participation across three different settings (home, school and community) and to ascertain the inter-relations between these factors. In this secondary analysis study, three models, one for each setting, were proposed and tested using Structural Equation Modeling. Survey, cross...

Objective: Little is known about the impact of acquired brain injury (ABI) on the long-term quality-of-life (QoL) in children and youth. The objectives of this study were to illustrate the long-term QoL trajectories at 5 years post-ABI. Methods: The QoL of children between 5-18 years (n = 94) admitted to McMaster Children's Hospital with ABI wer...

ABSTRACT Comparative effectiveness research (CER) strives for evidence to inform clinical decisions for specific clients in typical health care settings. While the randomized controlled trial (RCT) is well-aligned with the objectives of CER, this design may not be feasible or applicable to all research questions, particularly those pertaining to cl...

Unlabelled: Social support can improve participation in everyday activities among older adults with chronic health conditions, but the specific types of support that are needed are unclear. Purpose: This study examined the types of social support that most strongly predict participation in everyday activities. Method: Two hundred and twenty-se...

Qualitative studies describe environmental influences on participation in adults with chronic disease, but translating these findings into practice can be difficult. This study sought to synthesize qualitative research findings regarding the influence of environmental factors on participation among adults with chronic disease. Searching revealed 31...

ABSTRACT Secondary analysis using data from a clinical trial was performed to evaluate the stability of individual items of the Mobility and Self-Care functional skills scales of the Pediatric Evaluation of Disability Inventory (PEDI). Parents of 113 children aged 1-6 years old with cerebral palsy completed the PEDI twice by questionnaire 6 months...

Objective: This study aimed at describing leisure activity preferences of adolescents with cerebral palsy (CP) and their relationship to participation and to identify factors associated with greater interest in particular leisure activities. Methods: A cross-sectional design was used. Participants were adolescents (n = 127; 59.5% male; ages 12-1...

We compared school participation patterns of students ages 5-17 with and without disabilities and examined whether features of the school environment were perceived to help or hinder their participation. Parents (n = 576) residing in the USA and Canada completed the Participation and Environment Measure for Children and Youth (PEM-CY) via the inter...

Many articles have been written on the barriers to and facilitators of the use of evidence in practice in nursing and medicine, but to date no extensive review has been published of the literature on evidence-based practice (EBP) supports in occupational therapy. This article presents the results of a scoping review that examined factors that suppo...

Sleep problems are more common among children with disabilities. Mothers are likely to provide night-time care. Mothers of children with disabilities are known to experience high levels of stress and mental health issues compared with other mothers. Relationships between a child's sleep problems, and chronic maternal sleep interruption and subjecti...

ABSTRACT Psychosocial determinants of children's out of school participation were examined, using secondary analyses of data from 427 children with physical disabilities (from 12 service locations in Ontario Canada) and 354 children without disabilities, ages 6 to 14. For both groups of children, hierarchical regression analyses indicated that psyc...

ABSTRACT The purpose of this study was to examine the relationship between goal achievement measured by the Canadian Occupational Performance Measure (COPM) and child, goal, and intervention factors. Participants were 41 preschool children with cerebral palsy (CP) who were in the context-focused therapy arm of a randomized controlled trial. Factors...

This study determined the extent to which parents of adolescents with cerebral palsy seek out complementary and alternative medicine services. A regional sample of 166 adolescents (15.5 ± 2.4 years) with cerebral palsy were recruited. Parents completed a questionnaire identifying the complementary and alternative medicine services received over the...

Background: Paediatric rehabilitation involves the therapist delivering intervention-specific and non-specific behaviours. Non-specific (or general therapy) characteristics are a key part of family-centred service (FCS); however, little research identifies observable behaviours to examine intervention fidelity to FCS principles and their impact on...

Statement of context Occupational therapists may have difficulty using evidence from systematic reviews. Critical reflection on practice The use of Summary of Findings (SoFs) tables of systematic reviews, sent via email, was explored in two focus groups with six occupational therapists at a school-based practice. Descriptive content analysis was u...

Although the value of occupation for health and well-being is fundamental to the occupational therapy profession, this view is not well recognized in the field of public health. In this article, we argue that occupational therapists have a unique and valuable perspective to bring to the field of public health, particularly with respect to the impor...

Purpose: To examine geographical variation in the leisure participation of children/youth with cerebral palsy (CP), using Children's Assessment of Participation and Enjoyment (CAPE) data from Australia, Canada (Ontario and Quebec) and the U.S. Method: Data from 1076 children/youth ages 6-20 years with CP were included. Analyses examined CAPE div...

Background: The Child's Challenging Behaviour Scale (CCBS) was designed to measure a mother's rating of her child's challenging behaviours. The CCBS was initially developed for mothers of school-aged children with developmental disability and has previously been shown to have good psychometric properties using classical test theory techniques. The...

Aim: To increase research rigour and create a plausible way to assess clinical effectiveness, it is necessary to measure the degree to which interventions are delivered as intended (fidelity). Generic fidelity measures enable evaluation of more than one intervention through observation of unique and general characteristics relevant across interven...

This study is a scoping review of 21 years of international occupational therapy literature. Its purpose is to identify and describe interventions used by occupational therapists to enable self-care, productivity, and leisure. The scoping review produced 59 articles published between 1990 and 2010. Nine articles evaluated the effectiveness of occup...

Introduction This study examines participation patterns and environmental supports and barriers for children with and without disabilities within their home setting. Method The Participation and Environment Measure for Children and Youth (PEM-CY) is a newly developed, reliable parent/caregiver-report tool, which combines assessment of children's p...

The authors examined the extent to which parent expectations, perceptions about resource availability and supports, and strategies used to promote participation in home and community activities varied by setting and activity type. Sixteen 90-min semistructured interviews were completed with families receiving Part C early intervention services in t...

Aim: To describe the pattern of use of rehabilitation services in children and adolescents with cerebral palsy (CP), and to identify factors associated with use. Methods: In this study, parents of 91 school-age children and 167 adolescents with CP completed a questionnaire regarding educational and rehabilitation resources received within the la...

Objective: The study’s purpose was to identify and synthesize research evidence regarding the effect of the environment on community participation of children with disabilities. Methods: A scoping review of peer-reviewed studies published from 1990 to 2011 was performed. Two independent reviewers selected studies based on a systematic procedure....

ABSTRACT This study examined the relationship between gross motor function and manual ability in 120 adolescents with cerebral palsy (CP) (15.2, SD 2.1 years, 59.8% male). Adolescents were evaluated using the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). A neurologist classified CP subtype....

In recent years attention has been paid to the participation levels of children and youth with Cerebral Palsy (CP), particularly the extent to which they have the opportunity to be involved in and enjoy leisure activities. The objective of this study is to describe the level of participation and enjoyment in leisure activities among adolescents wit...

Purpose: Children's participation is an indicator of their health and wellness. The Participation and Environment Measure for Children and Youth (PEM-CY) was designed for use in population-level studies to examine children's participation patterns specific to the home, school, and community. For this study, we examined participation patterns and en...

Background Optimizing pain care requires ready access and use of best evidence within and across different disciplines and settings. The purpose of this randomized trial is to determine whether a technology-based “push” of new, high-quality pain research to physicians, nurses, and rehabilitation and psychology professionals results in better knowle...

Behavioral problems are common in children with cerebral palsy; however, little is known about the persistence of these difficulties during adolescence. This study aimed to describe the nature and frequency of behavioral difficulties in adolescents with cerebral palsy and to explore associated factors. Parents of the participants completed the Stre...

Objective: To examine patterns of community participation and environmental factors that affect community participation for school-age children with and without disabilities. Design: Cross-sectional, descriptive, and exploratory study. Setting: Parents from the United States and Canada completed the main outcome measure online in their homes o...

ABSTRACT To increase the rigor of pediatric rehabilitation research, there is a need to evaluate the degree to which an intervention is conducted as planned (i.e., fidelity). Generic fidelity measures evaluate more than one intervention and often include nonspecific attributes of the therapy process common to both interventions. The objective of th...

The objective of this study was to examine the association between leisure participation and quality of life (QoL) in school-age children with cerebral palsy (CP). Leisure participation was assessed using the Children's Assessment of Participation and Enjoyment (CAPE) and QoL using the Pediatric Quality of Life Inventory (PedsQL). Pearson correlati...

Aim This study described the process used in developing an outcome measurement framework for system planning to improve services for children and youth with special needs and their families in a Canadian province. The study reports the results of several parent-completed measures, which would be useful in service planning as well as the acceptabili...

The purpose of this study was to examine factors that best discriminated among families based on their level of community participation when transitioning from Part C early intervention services. Data were drawn from 2,003 families enrolled in the National Early Intervention Longitudinal Study and who completed a 40-minute computerized telephone in...

There are no guidelines in the obesity or occupational therapy literature to address how participation in occupations of everyday living should be maintained or improved for individuals with obesity. Achieving this goal requires an understanding of the factors associated with participation in daily living activities for this group. To address this,...

Many mothers of children with developmental disabilities are known to experience high levels of stress, and compromised mental health. Research is crucial to better understand and assist mothers with compromised mental health, and ultimately better service families raising and supporting a child with a disability. Data were collected using cross se...

Background Children with disabilities and their families experience environmental barriers in the school and community environments. There is a need to understand and appropriately measure environmental factors that influence activity and participation for disabled children. The purpose of this paper is to describe the adaptation process of the Cra...

The Canadian Occupational Performance Measure (COPM) is recommended as a systematic approach to identify issues and determine client progress in occupational therapy, yet little empirical evidence is available that supports this practice. To determine if COPM administration was associated with changes in eight dimensions of occupational therapy pra...

We examined the relationships between perceptions of neighbourhood characteristics and satisfaction with participation in everyday activities among 248 older adults with chronic health conditions in Hamilton, Ontario, Canada. We used a cross-sectional survey to collect data regarding neighbourhood characteristics, social support, social network siz...

Participation in activities provides the means for young children to learn, play, develop skills, and develop a sense of personal identity. The Assessment of Preschool Children's Participation (APCP) is a newly developed measure to capture the participation of children aged 2 to 5 years and 11 months in the areas of play, skill development, active...

The purpose of this paper is to describe the conceptual foundation of a new parent-report measure of the participation and environment of children and youth: the Participation and Environment Measure - Children and Youth version (PEM-CY). The ICF-CY provided an initial conceptual framework. Results from a qualitative study to obtain parent perspect...

Although behavioural problems are frequent in children with Cerebral Palsy (CP), the exact nature of these difficulties and their relationship with intrinsic or extrinsic factors are just beginning to be explored. To describe and characterize behavioural problems in children with CP and to determine the nature of any relationships with child and fa...

The purpose of this study was (1) to examine the changes in participation rates over 1 year among children and adolescents after acquired brain injury and (2) to explore the effect of child and family factors on these changes. The participation levels of 136 children and young people (88 males; 48 females; age range 4y 11mo-17y 6mo; mean age 11y 6m...

To describe family distress as reported by parents of children with cerebral palsy (CP) and to identify factors associated with distress. In this descriptive, historical cohort study, parents of school-age children (9.2 ± 2.1 years) with CP completed the Parenting Stress Index, the Impact on Family Scale and family-related items on the Child Health...

Older adults with chronic health conditions face difficulties participating in everyday occupations but may gain support to do so from neighborhood environments. This article describes research regarding neighborhood influences on participation in this population. A scoping review identified 689 articles, of which 15 met the selection criteria. Fin...

OBJECTIVE. The Health Promoting Activities Scale (HPAS) measures the frequency with which mothers participate in self-selected leisure activities that promote health and well-being. We undertook an initial evaluation of the scale with mothers of school-age children with developmental disabilities (N = 152). METHOD. We used a mixed methodology in th...

The aim of this study was to examine the psychometric properties (reliability and validity) of the Participation and Environment Measure for Children and Youth (PEM-CY). The PEM-CY examines participation frequency, extent of involvement, and desire for change in sets of activities typical for the home, school, or community. Items in the 'Environmen...

Poster presentation at the International Society of Quality of Life Research Conference, October 2011, Denver, Colorado.

The purpose of this study was to describe the time use and associated perceptions of performance, importance, and enjoyment for adults in treatment for obesity classified as severe. Adults (n = 128) from obesity treatment programs in Ontario, Canada, completed a survey that included the Occupational Questionnaire, a measure of the distribution and...

This study used a phenomenological approach to explore the relationship between habitual occupations and environmental features that can support aging-in-place with 10 community-dwelling older adults. In their respective interviews, participants were asked to consider community supports and other adaptations they used to maintain participation in r...