Abstract:
In a low-and middle-income country (LMIC) such as South Africa, not much is known
about how children with intellectual disabilities (ID) participate in everyday activities, as no studies to
date have compared their participation to peers without ID from the same background. Using a newly
developed, contextually valid measure of participation, Picture my Participation (PmP), 106 children
with (73) and without ID (33), rated their frequency of participation in activities of daily living.
Previous international research has established that children with ID tend to participate less frequently
than children without ID in everyday activities outside of the school setting. However, much of this
research is based on proxy ratings from caregivers rather than children with ID themselves. There is a
growing body of evidence that suggests children with disabilities have uniquely different views of their
own participation than their caregivers. The existing research evidence is also delimited to studies
conducted predominantly in high income contexts (HICSs). Since it is universally acknowledged that
participation patterns are affected by the environment, it is important to evaluate the generalizability
of the current evidence to LMICs. The current study found that there were many similar patterns of
participation between the two groups although significant differences were noted in social, community,
leisure and self-care activities. We compare these results to findings from studies conducted in HICs
and find that there are similarities but also differences across contexts. This study highlights the
importance of gaining a child’s perspective of participation and understanding how intellectual
disability can affect participation relative to peers without ID in LMICS.
