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Phillips K-A1, Scott D1, Corten L1
1University of Cape Town, Department of Health & Rehabilitation Sciences, Cape Town, South Africa
Background: It is estimated that the majority of the 150 million children with a disability worldwide live in low- and middle-income countries. Despite the enrolment of children with physical disabilities in educational institutions; access to schools remains a challenge.
Learners with a physical disability (LPD), particularly children with poor postural control, may need adaptive seating to improve postural support and sitting ability within the vehicle. Standard car restraint systems (CRS) might be unsafe or inappropriate for children with physical disabilities.
Purpose: This study aimed to determine the prevalence of CRS use among LPD and explore the barriers faced by parents during transportation.
Methods: A descriptive quantitative survey was performed amongst parents of learners between the age of four and 18 years enrolled at three special needs schools in the Western Cape, South Africa. Focus group discussions were conducted to validate the self-designed questionnaire.
Results: Parents of 264 children were enrolled in the study (mean (SD) age 11.69 (3.66) years; 58% male). The most common diagnosis was cerebral palsy (30%), and most children were transported to school with the school bus (69%).
The mode of transport was linked to the distance travelled and affordability, and each had its own challenges. A quarter of parents (25%) using private transport described the main barriers as transporting the wheelchair and the unavailability of demarcated disability parking bays. A fifth of parents (20%) using public transport identified their child's poor sitting balance and lack of space within the vehicle as the greatest barriers.
The majority of children (59%) came from low-to-middle income households ( R6500 per month), significantly impacting the use of a CRS, with more children from higher income families being transported in a CRS (X²= 45.62, p 0.001).
Difficulties with sitting balance was reported in 26% of the children, with a significant association between the parents understanding of their child's sitting balance and the current use of CRS (X²= 19.46, p 0.001). Furthermore, a significant association between currently using a CRS and child's weight was observed (X²= 10.60, p=0.014).
Most parents (53%, n=141) did not know South Africa's current legislation on CRS, which was significantly associated with the use of a CRS (X²= 17.17, p 0.001).
Conclusion(s): Parents of LPD reported many challenges in transporting their child to school. The parent's perception on the child's sitting abilities impacted the use of CRS, as most parents who reported no sitting problems in their child did not transport their child in a CRS; even though the child is in the age and weight range to use a CRS as required by law. This could link in with the failure to know the legislation on CRS by parents.
Implications: This study highlights the need for national campaigns to promote and educate citizens on road safety and CRS legislation.
Due to the lack of financial resources in low to middle income countries, it is vital that an affordable CRS is made available or is subsidized by the government, particularly in public transport, where families are unable to afford the cost themselves.
Keywords: Car Restraint Systems, Barriers to transport, Adaptive Car Seat
Funding acknowledgements: Faculty Research Committee (FRC): Research Training: Postgraduate Researcher Award from University of Cape Town
Learners with a physical disability (LPD), particularly children with poor postural control, may need adaptive seating to improve postural support and sitting ability within the vehicle. Standard car restraint systems (CRS) might be unsafe or inappropriate for children with physical disabilities.
Purpose: This study aimed to determine the prevalence of CRS use among LPD and explore the barriers faced by parents during transportation.
Methods: A descriptive quantitative survey was performed amongst parents of learners between the age of four and 18 years enrolled at three special needs schools in the Western Cape, South Africa. Focus group discussions were conducted to validate the self-designed questionnaire.
Results: Parents of 264 children were enrolled in the study (mean (SD) age 11.69 (3.66) years; 58% male). The most common diagnosis was cerebral palsy (30%), and most children were transported to school with the school bus (69%).
The mode of transport was linked to the distance travelled and affordability, and each had its own challenges. A quarter of parents (25%) using private transport described the main barriers as transporting the wheelchair and the unavailability of demarcated disability parking bays. A fifth of parents (20%) using public transport identified their child's poor sitting balance and lack of space within the vehicle as the greatest barriers.
The majority of children (59%) came from low-to-middle income households ( R6500 per month), significantly impacting the use of a CRS, with more children from higher income families being transported in a CRS (X²= 45.62, p 0.001).
Difficulties with sitting balance was reported in 26% of the children, with a significant association between the parents understanding of their child's sitting balance and the current use of CRS (X²= 19.46, p 0.001). Furthermore, a significant association between currently using a CRS and child's weight was observed (X²= 10.60, p=0.014).
Most parents (53%, n=141) did not know South Africa's current legislation on CRS, which was significantly associated with the use of a CRS (X²= 17.17, p 0.001).
Conclusion(s): Parents of LPD reported many challenges in transporting their child to school. The parent's perception on the child's sitting abilities impacted the use of CRS, as most parents who reported no sitting problems in their child did not transport their child in a CRS; even though the child is in the age and weight range to use a CRS as required by law. This could link in with the failure to know the legislation on CRS by parents.
Implications: This study highlights the need for national campaigns to promote and educate citizens on road safety and CRS legislation.
Due to the lack of financial resources in low to middle income countries, it is vital that an affordable CRS is made available or is subsidized by the government, particularly in public transport, where families are unable to afford the cost themselves.
Keywords: Car Restraint Systems, Barriers to transport, Adaptive Car Seat
Funding acknowledgements: Faculty Research Committee (FRC): Research Training: Postgraduate Researcher Award from University of Cape Town
Topic: Paediatrics; Disability & rehabilitation; Service delivery/emerging roles
Ethics approval required: Yes
Institution: University of Cape Town, Faculty of Health Sciences
Ethics committee: Human Research Ethics Committee
Ethics number: 837/2017
All authors, affiliations and abstracts have been published as submitted.
