Participation (people’s engagement in life) is an essential component of the World Health Organization’s International Classification of Functioning, Disability and Health.1 The classification connects body structure and function (including the impairments caused by any disease) with their effects on activity and participation, and it puts them in the context of personal and environmental factors. This biopsychosocial framework reflects a social model of disability in which a person may be disabled by external factors, including environmental and social forces beyond their control.

Children and young people with disabilities constitute about 4-6.5% of the population in many countries.2 3 4 They are disadvantaged in terms of their participation and engagement in life,5 and the limitations in their activity may be two to three times greater than for typically developing children. …