Beyond words: children with disabilities’ conceptualization of community participation in resource-constrained urban settings

PURPOSE: Participation perspectives of children with disabilities remain underexplored despite calls for their inclusion. Hence, this study explores how Filipino children with disabilities aged 9-16 years conceptualize participation in community-based rehabilitation (CBR) programs in low-resource communities. MATERIALS AND METHODS: A combined grounded theory and participatory research engaged eight children with varying disabilities through a mosaic approach of storytelling, drawing, photo-elicitation, and interviews across 24 online sessions. Inductive analysis using NVivo software employed open, axial, and selective coding. RESULTS: Children's conceptualizations yielded six categories: "tools for participation," "participation evokes happiness and confidence," "participation recognizes a sense of connection," "participation begins at home," "child-friendly space for participation," and "participation for a community purpose." Children identified meaningful activities to participate in their communities, such as caring for the environment, promoting health, advocating for safety and resilience, and forming values. Findings also suggest how the International Classification of Functioning, Disability, and Health domains intersect with social determinants of health to shape opportunities for community participation. CONCLUSIONS: CBR programs must transition from tokenistic consultation to authentic partnerships that view children with disabilities as beings, not becomings. The six categories provide practical guidance for developing participatory approaches that honor children's insights in resource-constrained settings.