I recently read an article called “The ‘F-Words’ in childhood disability: I swear this is how we should think!” by Rosenbaum and Gorter (2011) (reference listed at bottom of post).

The paper discusses the importance of a holistic viewpoint when seeing children with disabilities in your practice. The six ‘F’ words are: function, family, fitness, fun, friends and future. The authors discuss how these should all be incorporated into all aspects of clinical services with regards to children with disabilities and their families. Below I will summarize the gist of the 6 words and how they can and should be implemented.

Function. This focuses on what people do (e.g. role, job, task etc.). The authors emphasize the importance of having children with disability experience many different things in life without a huge focus on how well it is done. They explain that there is often too much focus on having children with disabilities do things “normally” or “typically” but that this can limit the experiences these children have which is not ok. Therefore, the development of function should be emphasized to assist in the breadth of these children’s experiences, however, function does not mean “typical” or “perfect.”
Family. As the authors explain, the patient is not just the child but also the parents. Including parents as active members in therapy services has proven to provide the best results to the child’s experience in therapy. Ways to include families is through goal setting, explaining what you are doing in therapy and why and providing a safe space for them to ask questions, learn and advocate for their child and family. Therefore, family-centred practice is best practice.
Fitness. Children with disabilities are often less “fit” than children without disabilities. There are also less recreational opportunities for children with disabilities. There should be focus on the health and wellness of children with disabilities in addition to their impairment, not just on their impairment alone.
Fun. In therapy find out what the child enjoys doing and do that. Children like doing all kinds of things that they are not necessarily “perfect” at so try all kinds of things even if you are concerned they can’t do it “perfectly.” Modify activities if needed and make sure there is always an emphasis on having fun! There is plenty of research that shows that people with disabilities have less participation than their typically developing peers which needs to change.
Friends. Focus more on quality of friendships than the quantity of friendships. Group therapy services or setting up play dates (the clinic I am at right now does both!) is a great way to help these children form meaningful friendships which is extremely beneficial for their emotional and social development and overall wellbeing.
Future. The authors discuss how all children are in a state of becoming. Therefore, it is important to think about children’s future at the very beginning of therapy services. This can and should involve discussions with parents and the child. As the authors state, it is not up to service providers to decide what is and is not possible for the child and their family.

-S

Reference

Rosenbaum, P. & Gorter, J.W. (2011). The ‘F-Words’ in childhood disability: I swear this is how we should think!. Child:Care, health and development, 38(4), 457-463.