Habilitation and rehabilitation in children and adolescents: Opportunities and limitations

Abstract

Background: The concept of participation is central to the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and the German Social Security Legislation. The aim of all measures and interventions is to increase children’s and adolescents’ involvement in life situations. This applies to the field of child and adolescent rehabilitation and social pediatrics as well as an inclusive education and child welfare systems. Objective: The term participation is defined and the conceptual background as well as important related aspects, such as family orientation and process participation are explained. Material and methods: The results of a literature search, data from the statistics of funding agencies and current qualitative empirical results from interview studies are presented. Results: The paradigm shift from improvement of functioning to participation and family-oriented care forges progress; however, the transformation is affected by slow adaption of the social legislation and the complex reorganization of segregated services for children and adolescents with and without chronic health conditions and disabilities. Conclusion: Major efforts in the social legislation, cooperation of social insurances, service providers, the education system and child welfare systems are needed to overcome the historical segregation of services along the lines of types of disabilities and settings.