Document Type : Original Articles



Background: Participation is an important component in a child’s growth, which is not just affected by child's functional abilities, skills, interests and family culture; but also affected by the physical, social and institutional environment. Hearing and visual impairment in children may cause growth delay including cognitive, mobility and communication skills. The aim of this study was to compare the environmental barriers to social participation from parent perception in primary-school children with hearing/visual impairment and normal ones in Shiraz City (2015).Methods: This was a cross-sectional and comparative study. Convenience sampling was used and 75 children with visual, hearing impairment and normal ones (25 in each group) were selected from 4 areas of Shiraz Schools. Demographic data and environmental factors of Craig Hospital questionnaire were used. The findings were analyzed by using SPSS 21 software with One-way ANOVA and post hoc tests at a significant level less than 0.05.Results: The results did not show statistically significant difference in the environmental barriers to participation from parent perception among three groups of normal children, children with hearing/ visual impairment (P-value=0.12). Moreover, there was no statistically significant difference between three groups of children in terms of the physical and structural barriers subscales (P-value=0.341), attitudes and support (P-value= 0.424), services and help (P-value=0.115), work and school (P-value=0.221). However, there is a significant difference between the 3 groups in Policy barriers subscales (P-value=0.003).Conclusion: No differences in environmental barriers to participation between normal children and those with hearing/visual impairments can be resulted from excessive families’ support to meet the needs of children with disabilities. Therefore, serious challenges may not be created for independent participation of children to reveal the existing barriers.


  1. Engel-Yeger B, Hamed-Daher S. Comparing participation in out of school activities between children with visual impairments, children with hearing impairments and typical peers. Research in Developmental Disabilities. 2013;34(10):3124-32.
  2. Law M. Participation in the occupations of everyday life. American Journal of Occupational Therapy. 2002;56(6):640-9.
  3. Mackenzie L, O'Toole G. Occupation Analysis in Practice: John Wiley & Sons; 2011.
  4. Nobakht z, Rassafiani M, Rezasoltani P, Sahaf R, Yazdani F. Environmental barriers to participation of children with cerebral palsy. Iranian Rehabilitation Journal. 2013;11(0):61-70.
  5. Anaby D, Hand C, Bradley L, DiRezze B, Forhan M, DiGiacomo A, et al. The effect of the environment on participation of children and youth with disabilities: a scoping review. Disability & Rehabilitation. 2013;35(19):1589-98.
  6. Coster W, Khetani MA. Measuring participation of children with disabilities: Issues and challenges. Disability & Rehabilitation. 2008;30(8):639-48.
  7. Granberg S, Pronk M, Swanepoel DW, Kramer SE, Hagsten H, Hjaldahl J, et al. The ICF core sets for hearing loss project: Functioning and disability from the patient perspective. International Journal of Audiology. 2014;53(11):777-86.
  8. Bedell G, Coster W, Law M, Liljenquist K, Kao Y-C, Teplicky R, et al. Community participation, supports, and barriers of school-age children with and without disabilities. Archives of Physical Medicine and Rehabilitation. 2013;94(2):315-23.
  9. Law M, Petrenchik T, King G, Hurley P. Perceived environmental barriers to recreational, community, and school participation for children and youth with physical disabilities. Archives of Physical Medicine and Rehabilitation. 2007;88(12):1636-42.
  10. King G, Lawm M, King S, Rosenbaum P, Kertoy MK, Young NL. A conceptual model of the factors affecting the recreationand leisure participation of children with disabilities. Physical & Occupational Therapy in Pediatrics. 2003;23(1):63-90.
  11. Coster W, Law M, Bedell G, Liljenquist K, Kao YC, Khetani M, et al. School participation, supports and barriers of students with and without disabilities. Child: Care, Health and Development. 2013;39(4):535-43.
  12. Moller K, Danermark B. Social recognition, participation, and the dynamic between the environment and personal factors of students with deafblindness. American Annals of the Deaf. 2007 Spring;152(1):42-55. PubMed PMID: 17642363.
  13. Masse LC, Miller AR, Shen J, Schiariti V, Roxborough L. Patterns of participation across a range of activities among Canadian children with neurodevelopmental impairments and disabilities. Developmental Medicine and Child Neurology. 2013 Aug;55(8):729-36. PubMed PMID: 23701369.
  14. Rassafiani M, Zeinali R. Occupational therapy in Iran. 2007.Originally published on the The World Federation of Occupational Therapists website ( in 2007.
  15. Movallali G, Abdollahzadeh Rafi M, Nemati S. Comparison of general health status in mothers of hearing and hearing-impaired children. Audiol. 2013;22(2):33-9.
  16. Silva MRd, Nobre MIRdS, Carvalho KMd, Montilha RdCI. Visual impairment, rehabilitation and International Classification of Functioning, Disability and Health. Revista Brasileira de Oftalmologia. 2014;73(5):291-301. [Abstract].
  17. Perkins K, Columna L, Lieberman L, Bailey J. Parents' perceptions of physical activity for their children with visual impairments. Journal of Visual Impairment & Blindness (Online). 2013;107(2):131.