Building inclusive dance communities : A codesigned approach to enhancing participation for children with cerebral palsy

Background: Participation in chosen activities is a fundamental right for all children, yet children with cerebral palsy (CP) engage less frequently in leisure-time activities compared to typically developing children. Many barriers hinder their full participation in community-based activities, including environmental challenges such as inaccessible classes, ableist cultures, and a general lack of disability awareness, leading to unintentional exclusion. While participation-focused programs exist, they are often therapy-centred rather than community-based. This gap highlights the need for community-based activities that not only facilitate physical rehabilitation and enhance participation outcomes but also promote true inclusion within the community.

Aim: This thesis aimed to co-design an evidence-based, inclusive dance approach that promotes the inclusion of children with CP in community-based dance classes and enhances their participation. The research sought to incorporate the voices of children with CP, their families, and dance educators, ensuring their experiences and needs guide the development of a dance class that fosters robust inclusion and participation.

Methods: This research employed a participatory design methodology, integrating both quantitative and qualitative approaches in two main phases. The first phase involved a systematic review and meta-analysis, conducted according to PRISMA guidelines, to assess the efficacy of dance-related interventions for individuals with CP, with a focus on participation outcomes. The review was followed by qualitative consultations with children with CP (n = 2), their families (n = 2), and dance educators and health professionals (n = 5) to prioritise their goals and needs, grounding the co-design process in real-world experiences. In the second phase, the co-design of a dance approach guide used the Experience-based Co-design (EBCD) methodology, with six interactive workshops that allowed eleven stakeholders to actively contribute to the guide’s development. The process was adapted to ensure flexibility and responsiveness to feedback. A review phase using an explanatory sequential mixed methods design, involved five dance teachers not previously engaged in the co-design process to provide additional feedback through online survey and a semi-structured focus group, particularly regarding the guide’s practicality and adaptability for diverse community settings.

Results: The systematic review revealed a lack of interventions focusing on participation outcomes for children with CP, with existing approaches mostly centred on physical rehabilitation focused on body structure and function. Qualitative insights from children with CP, their families, therapists, and dance educators stressed the need for inclusive environments that could accommodate a wide range of abilities, promoting equitable participation. The co-design phase led to the creation of a dance approach that incorporated adaptive strategies, supportive peer interactions, and opportunities for community engagement, all tailored to enhance inclusion and participation. During the review phase, dance teachers praised the guide’s adaptability to different community contexts, though they suggested the need for further training to support teachers unfamiliar with adaptive techniques. Overall, the feedback affirmed the guide’s focus on fostering inclusion and improving participation, noting its potential to create more inclusive community dance environments.

Conclusion: This thesis demonstrates the value of a co-designed, evidence-based inclusive dance approach that addresses the diverse needs of children with CP by fostering inclusion and participation in community settings. The research moves beyond traditional medical model, by shifting the focus to the social model. Through the co-design process, knowledge users played an active role in developing a flexible guide that can be adapted to different community settings. Feedback from dance educators highlighted the guide’s practicality, adaptability and appropriateness. The research underscores the importance of participatory design in creating inclusive classes and calls for future research to explore the long-term impacts and sustainability of such approaches, with the aim of ensuring broader implementation and enhancing inclusion in community-based activities.

Duarte Machado, E. (2024). Building inclusive dance communities : A codesigned approach to enhancing participation for children with cerebral palsy [PhD Thesis]. Australian Catholic University. https://doi.org/10.26199/acu.920x4

This work © 2024 by Eduardo Duarte Machado is licensed under Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).