Exploring Participative Environments of Children with Learning and Physical Disabilities: Perspectives from Parents and Practitioners
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
The paper investigates parents’ and practitioners’ conceptions of the environmental factors and collaboration that support the participation of children with learning and physical disabilities.
The introduction section begins by discussing the significance of environmental factors in the participation of children with disabilities, referencing the ICF framework. It highlights the role of the family, particularly the parents, as enablers of participation for children with disabilities.
The authors review current literature in the field and underscore possible environmental barriers for children with disabilities, which are often caused by negative attitudes, physical barriers, and a lack of support from staff and service providers.
At the end of the introduction, the main research questions guiding the study are presented. At this point, it is mentioned for the first time that the research specifically focuses on children with learning and physical disabilities. It would be important to understand why the research focuses on these two types of disabilities (as they are explicitly mentioned in the title of the article). This clarification could be introduced earlier in the introduction.
The methods section outlines a clear research design. Relevant background information about conducting the study in a Finnish context is provided, which helps to clarify the aims of the study. Overall, this section provides a solid rationale for the investigation. Participant recruitment and the research procedure are well described. Data were generated through qualitative interviews, and inductive data analysis was employed, which seems appropriate for answering the research questions.
However, I believe more detail should be provided regarding the model used for the inductive approach to data analysis. Currently, two references are provided to justify the general suitability of this approach. Expanding the data analysis section to include references to established models (e.g., those based on Kuckartz or Mayring) could enhance the credibility of the methods section.
The findings report various physical barriers, fears, attitudes, and a lack of resources across different environments that inhibit children's participation. In line with previous research, the authors conclude that the main limiting factors of participation are related to both the physical environment (e.g., the lack of barrier-free spaces) and the social environment (e.g., attitudes of adults). The authors suggest improvements, such as promoting child-centered collaboration among adults.
Overall, the topic of this article is both relevant and timely. The novelty of this study lies in its provision of new insights co-created by parents and professionals regarding the influence of environmental factors on the functioning and participation of children with disabilities.
In my assessment, this paper has potential and could be of interest to the readership of this journal. I therefore recommend publishing the paper with some minor revisions. These revisions pertain mainly to the introduction and methods sections, which could be expanded or modified as mentioned earlier. Additionally, some minor language editing is needed (for instance, there is an extra comma in the introduction, and some spelling errors need correction).
Author Response
Comment 1: The introduction section begins by discussing the significance of environmental factors in the participation of children with disabilities, referencing the ICF framework. It highlights the role of the family, particularly the parents, as enablers of participation for children with disabilities.
The authors review current literature in the field and underscore possible environmental barriers for children with disabilities, which are often caused by negative attitudes, physical barriers, and a lack of support from staff and service providers.
At the end of the introduction, the main research questions guiding the study are presented. At this point, it is mentioned for the first time that the research specifically focuses on children with learning and physical disabilities. It would be important to understand why the research focuses on these two types of disabilities (as they are explicitly mentioned in the title of the article). This clarification could be introduced earlier in the introduction.
Response 1: Thank you for pointing this out. We agree with you and we have now clarified in the introduction why our research focusis on this types of disabilities. It is now in the beginnig of introduction. Marked in red in the text.
Comment 2: The methods section outlines a clear research design. Relevant background information about conducting the study in a Finnish context is provided, which helps to clarify the aims of the study. Overall, this section provides a solid rationale for the investigation. Participant recruitment and the research procedure are well described. Data were generated through qualitative interviews, and inductive data analysis was employed, which seems appropriate for answering the research questions.
However, I believe more detail should be provided regarding the model used for the inductive approach to data analysis. Currently, two references are provided to justify the general suitability of this approach. Expanding the data analysis section to include references to established models (e.g., those based on Kuckartz or Mayring) could enhance the credibility of the methods section.
Response 2. Thank you for this valuable comment. We have now added Kuckartz and Rädicks model to it. Marked ib red in the text.
Comment 3: Additionally, some minor language editing is needed (for instance, there is an extra comma in the introduction, and some spelling errors need correction).
Response 3: Thank you for your comment. We have now corrected spelling errors.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Comments and Suggestions for Authors
Thank you for the opportunity to read the manuscript Investigating Participative Environments of a Child with Learning and Physical Disabilities: Perspectives from Parents and Practitioners
I really enjoyed reading it and I believe it represents a timely and valuable contribution to the field of inclusion and inclusive education.
I do have several comments that may contribute to the improvement of the paper’s quality and coherence.
Introduction
The introductions` first paragraph is some unclear. Please consider revising it. I would construct an introduction in the following way:
6. Definitions -what unfamiliar terms does the paper use (short and informative)
You write that environmental factors have a significant impact on the participation of children with disabilities. What factors? It can be numerous. So, you try to be more precise and state that environmental factors, such as community and social factors, should be given more attention. Please explain why? And then you express the need for creating a participative environment. It is not so convincing. Why so? You are giving the explanation later in the article. However, consider some structural changes to build logic and coherence between the paragraphs.
Introduction should inform readers about:
1. Identify what the overall problem?
2. Why is it important?
3. What has been done before?
4. What is currently missing?
5. Objectives – what is the paper doing?
6. Definition of the concepts used in the paper
Research questions are unclear. What environmental factors in children’s daily life enhance their functioning and participation in everyday life? – How does adult collaboration enhance a children’s functioning and participation in their different environments? My question is from whose perspective? Please consider being more precise in the formulation of your questions.
Theoretical part
Your paper uses complex terms as collaboration and supportive and participating environment (this term is not used in the RQs).
There are already numerous articles and books in which all concepts have been defined, justified, analysed and discussed. But what do you mean when using these concepts in this paper? What encompasses the concepts, and which aspects are your focus? It will be fruitful to discuss those in depth in the part theory.
The theoretical part should also comprehensively cover all components of the main concepts that are highlighted in the results section. Otherwise, the discussion will lack depth and coherence. Upon reviewing your results, you have identified several complex concepts such as the psychological environment, home environment, physical environment, leisure environment, and adult collaboration. It would be beneficial to select a few of these concepts and delve into them in greater detail, ensuring a thorough and focused discussion, rather than present a broad and superficial introduction and results.
Method
The research method is described, but how did you develop the interview guide? How did you create the focus group interview guide? Did you use the same guides for both individual and focus group interviews? Why did you choose to conduct both individual and focus group interviews? Was qualitative content analysis applied to both types of interviews? Ethical aspects should be included in the methods section. There is no discussion of validity and reliability issues related to the study.
It is unclear to me how your findings are presented. Which of those are individual interviews and which are focus group interviews.
References are not used in appropriate way.
Comments on the Quality of English Language
Manusctipt should be profread.
Author Response
Comments1: You write that environmental factors have a significant impact on the participation of children with disabilities. What factors? It can be numerous. So, you try to be more precise and state that environmental factors, such as community and social factors, should be given more attention. Please explain why? And then you express the need for creating a participative environment. It is not so convincing. Why so? You are giving the explanation later in the article. However, consider some structural changes to build logic and coherence between the paragraphs.
Response 1. Thank you for your valuable comments. We have now revised our introduction based on your comments trying to make it more logical and clarified. The are marked in red in the text.
Comments 2: Research questions are unclear. What environmental factors in children’s daily life enhance their functioning and participation in everyday life? – How does adult collaboration enhance a children’s functioning and participation in their different environments? My question is from whose perspective? Please consider being more precise in the formulation of your questions.
Response 2: Thank you for your comments. We have modified our research questions to be more precise. The are marked in red in the text.
Comments 3:
There are already numerous articles and books in which all concepts have been defined, justified, analysed and discussed. But what do you mean when using these concepts in this paper? What encompasses the concepts, and which aspects are your focus? It will be fruitful to discuss those in depth in the part theory.
The theoretical part should also comprehensively cover all components of the main concepts that are highlighted in the results section. Otherwise, the discussion will lack depth and coherence. Upon reviewing your results, you have identified several complex concepts such as the psychological environment, home environment, physical environment, leisure environment, and adult collaboration. It would be beneficial to select a few of these concepts and delve into them in greater detail, ensuring a thorough and focused discussion, rather than present a broad and superficial introduction and results.
Response 3: Thank you for pointing this out. We have now revised our theoretical part to be more clear and logical. The are marked in red in the text.
Comments 4:
The research method is described, but how did you develop the interview guide? How did you create the focus group interview guide? Did you use the same guides for both individual and focus group interviews? Why did you choose to conduct both individual and focus group interviews? Was qualitative content analysis applied to both types of interviews? Ethical aspects should be included in the methods section. There is no discussion of validity and reliability issues related to the study.
It is unclear to me how your findings are presented. Which of those are individual interviews and which are focus group interviews.
Response 4: Thank you for these comments. We have now revised these parts. The ethical considerations have been now added to data analysis section and given more detailed information about validity and reliability. Marked in red in the text.
Reviewer 3 Report
Comments and Suggestions for Authors
Dear Authors,
Thank you for an interesting manuscript on environmental factors and collaborations that impacts and affect participation in children with learning and physical disabilities.
You find my commentaries below, but also in the attached PDF of your manuscript, so they are easy to find.
Page 1, Title
I would suggest Exploring instead of investigating - the 10 participants increased the knowledge about the topic but is too small to make decisions.
I wonder if it should be children instead of a child - as it was adults around more than one child.
I also wonder if it would be a good idea to include focus groups in the title?
Page 3
2 Materials and Methods
Participants and Procedure
Line 5. How many children? and what was their age range?
Line 16. Could you please give information about how you constructed the content of the open-ended questions and the theme for group interviews. Please also give some examples of this content.
Page 4, Line 6 Please inform which were the tools needed
Data analysis
Line 17. Could you please create a table or figure where you illustrate the theme, the two main categories and the eight subcategories. This would clarify your result and make it easier to digest for the reader.
This table /figure could be placed in the beginning of the result.
3. Result
Environmental Factors Enhancing the Functioning and Participation of Children with Disabilities
In the following text you describe both enhancing and limiting factors, I suggest as alternative "factors impacting"
Page 5, citation (Therapist 2)
This citation is the same as in Table 1, I suggest you give another example here.
Page 6, Lines 21-23
This looks as a citation, so please indent and use cursive text.
Page 7
Line 1. Adult Collaboration to Promote Functioning and Participation
You describe collaboration both as promoting and obstructing. I suggest as alternative "collaboration affecting"
Page 9
Limitations and Future Directions
Line 2. Please provide a short explanation of what changes and why they limited the study
Line 4. I agree 10 is a small sample, and I also miss the children’s perspectives (under 15 years of age, so they could have a perspective of their own)
References
Wonder if this article from 2023 would add to the manuscript Ref 2. points at looking at school environment, Xia would add with viewing the child's family environment. (What you do is trying to capture the multiplicity and combine listening to parents, therapists and teachers perspectives on the influences on participation in the different environments)
Xia, C.; Jing, Q.; Chen, G.; Sun, M.; Lu, J. Association between Participation of Children with Disabilities and the Child, Family, and Environmental Factors in Shanghai, China: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2023, 20, 615.
https://doi.org/10.3390/ijerph20010615
Comments for author File: 
Comments.pdf
Author Response
Comments 1: I would suggest Exploring instead of investigating - the 10 participants increased the knowledge about the topic but is too small to make decisions.
I wonder if it should be children instead of a child - as it was adults around more than one child.
I also wonder if it would be a good idea to include focus groups in the title?
Response 1: We have now revised our title from investigating to exploring and also changed child to children. Marked in red in the text.
Comments 2:
2 Materials and Methods
Participants and Procedure
Line 5. How many children? and what was their age range?
Line 16. Could you please give information about how you constructed the content of the open-ended questions and the theme for group interviews. Please also give some examples of this content.
Page 4, Line 6 Please inform which were the tools needed
Response 2: We have no revised this part. Marked in red in the text.
Comments 3:
Data analysis
Line 17. Could you please create a table or figure where you illustrate the theme, the two main categories and the eight subcategories. This would clarify your result and make it easier to digest for the reader.
This table /figure could be placed in the beginning of the result.
Response 3: Thank you for your valuable comment. We have now made a table of these categories, you can find it in the beginning of the result section. Also marked in red in the text.
Comments 4:
n the following text you describe both enhancing and limiting factors, I suggest as alternative "factors impacting"
Page 5, citation (Therapist 2)
This citation is the same as in Table 1, I suggest you give another example here.
Page 6, Lines 21-23
This looks as a citation, so please indent and use cursive text.
Page 7
Line 1. Adult Collaboration to Promote Functioning and Participation
You describe collaboration both as promoting and obstructing. I suggest as alternative "collaboration affecting"
Page 9
Limitations and Future Directions
Line 2. Please provide a short explanation of what changes and why they limited the study
Line 4. I agree 10 is a small sample, and I also miss the children’s perspectives (under 15 years of age, so they could have a perspective of their own)
Response 4: thank you for good comments. We have now made suggsted changes, you can find them in he article marked in red.
Commetns 5: Wonder if this article from 2023 would add to the manuscript Ref 2. points at looking at school environment, Xia would add with viewing the child's family environment. (What you do is trying to capture the multiplicity and combine listening to parents, therapists and teachers perspectives on the influences on participation in the different environments)
Response 5. Thank you for your good suggestion. We have added it to our article.
Author Response File: Author Response.docx
Round 2
Reviewer 2 Report
Comments and Suggestions for Authors
Thank you very much for the possibility to read your revised paper.
The paper has improved, but I still find the introduction somewhat incoherent. Please avoid clarifying the concept at the very beginning; instead, do this after presenting the research questions (RQ). You mention that you will focus primarily on physical disability, but your RQ also includes learning disabilities. However, you only clarify the term physical disability and not learning disability. Additionally, you lack a theoretical section where you discuss the main phenomena under study. I have tried to outline the main phenomena in three colours – these should be the primary topics in the introduction, theory, interviews and discussion.
Q1: What are the supportive and participative environmental factors in the everyday life of children with learning and physical disabilities?
RQ2: How does adult collaboration improve children’s functional capacity and participation in the daily environments of children with learning and physical disabilities?
Your introduction is also too long, part of the material used in the introduction could be in-depth explored in the part theoretical framework.
If I interpret it right, your theoretical part may be structured as follows:
1. Children with learning and physical disabilities – about this group
2. Functioning and Participation of Children with Disabilities and Factors Impacting the Functioning and Participation of Children with Disabilities
3. A collaboration between adults- do you mean interprofessional or family- professional collaboration (choose and explain).
4. And how this collaboration improves the supportive and participative environment for those children.
In the findings and discussion, you talked about environmental Factors Impacting the Functioning and Participation of Children with Disabilities – probably you need to adjust the research question along with your findings?
As I mentioned before, the topic is too broad and could be split into two separate papers: 1) Factors Impacting the Functioning and Participation of Children with Disabilities, and 2) Collaboration to Promote the Functioning and Participation of These Children. By doing this, you will have more space to delve deeper into and properly discuss two important concepts that deserve more attention than they currently receive in your paper.
are the supportive and participative environmental factors in the every-
day life of children with learning and physical disabilities?
RQ2: How does adults collaboration improve a children’s functional capacity and
participation in the daily environments of children with learning and physical disa-
bilities?
Author Response
The paper has improved, but I still find the introduction somewhat incoherent. Please avoid clarifying the concept at the very beginning; instead, do this after presenting the research questions (RQ).
Answer: Thank you for your comment. We have revised the beginning of the first chapter in Introduction and added the focus of the study to it.
You mention that you will focus primarily on physical disability, but your RQ also includes learning disabilities. However, you only clarify the term physical disability and not learning disability.
Answer: We have now clarified the term learning disability also.
Additionally, you lack a theoretical section where you discuss the main phenomena under study. I have tried to outline the main phenomena in three colours – these should be the primary topics in the introduction, theory, interviews and discussion.
Q1: What are the supportive and participative environmental factors in the everyday life of children with learning and physical disabilities?
RQ2: How does adult collaboration improve children’s functional capacity and participation in the daily environments of children with learning and physical disabilities? Your introduction is also too long, part of the material used in the introduction could be in-depth explored in the part theoretical framework. If I interpret it right, your theoretical part may be structured as follows:
1. Children with learning and physical disabilities – about this group
2. Functioning and Participation of Children with Disabilities and Factors Impacting the Functioning and Participation of Children with Disabilities
3. A collaboration between adults- do you mean interprofessional or family- professional collaboration (choose and explain).
4. And how this collaboration improves the supportive and participative environment for those children.
Answer: Thank you for your comment on the structure of Introduction part which - according to the instruction for authors- is the theoretical part of this study. To make the Introduction clearer and to better show the structure of it, we have added the subtitles by modifying your good suggestions for the structure. Now chapters 2 and 3 are under the sub-title Participation in Children with Disabilities. The chapters 4,5, and 6 are under the sub-title Factors Impacting the Functioning and Participation of Children with Disabilities in Different Environments. And finally, the two final theoretical chapters include the collaboration between adults.
In the findings and discussion, you talked about environmental Factors Impacting the Functioning and Participation of Children with Disabilities – probably you need to adjust the research question along with your findings?
Answer: We have harmonized the text in these parts.
As I mentioned before, the topic is too broad and could be split into two separate papers: 1) Factors Impacting the Functioning and Participation of Children with Disabilities, and 2) Collaboration to Promote the Functioning and Participation of These Children. By doing this, you will have more space to delve deeper into and properly discuss two important concepts that deserve more attention than they currently receive in your paper.
Answer: Thank you for your suggestions that we have been considered but decided to keep the present form to it. The reason for this is, that from our view the novelty of this work comes specifically from the set-up where we analyze the data co-created by the parents, teachers and therapists about the influence of environmental factors affecting a child’s functioning and participation and how adults collaborate enhancing and improve the environmental factors.
Round 3
Reviewer 2 Report
Comments and Suggestions for Authors
The paper is now clearer and presents stronger structure and coherence.
Author Response
Thank you for your support and comment to our manuscript.
