Readiness Support: Improving attendance and engagement in children’s rehabilitation

Phoenix Michelle
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McMaster University, School of Rehabilitation Science


Attendance and engagement are necessary in children’s rehabilitation. Families who miss appointments are described as ‘hard-to-reach’, with little known about how best to engage these families. In Ontario, Canada, practices of discharging families following missed appointments exist; however these raise ethical concerns1

1. Applied family-stress theory to identify who is ‘hard-to-reach’ in pediatric rehabilitation
2. Completed a qualitative grounded theory study to examine how parents attend, participate and engage in their child’s therapy
3. Conducing a participatory-action case study to determine whether Readiness Support improves attendance and engagement in a children’s treatment centre

There are child, family and environmental factors that can adversely affect families’ attendance and engagement in their child’s therapy. Clinicians and organizations can help families to overcome these challenges through policies and procedures that help clinicians to identify families who are in need of support. We developed and implemented tailored scripts and counselling services to investigate access barriers and create unique family solutions. Current evaluation will determine whether this improves client attendance and engagement in children’s therapy.

Missed appointments and disengagement in therapy limit the ability of clinicians and organizations to help children reach their goals in an efficient and cost-effective manner. We can better support families and improve access to care.
1. Phoenix M. (2016). Service provision for hard-to-reach families: What are our responsibilities?
In: Rosenbaum P, Ronen G, Racine E, Johannesen J, Dan B, editors. Clinical ethics in child health:Principles and cases in Neurodisability

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