PEM-CY participation items for each setting represent broad types of activities typically performed in that setting. For each
activity type, parents are asked (a) how frequently their child participates (neverZ0 to dailyZ7); (b) how involved their child is while participating (minimallyZ1 to veryZ5); and (c) whether they desire change in their child’s participation (no or
yes; if yes, parents identify where change is desired: frequency,involvement, and/or variety). Parents are then asked whether certain features of the environment help or make it harder for their child to participate in activities in that setting (not an issue,usually helps, sometimes helps/sometimes makes harder, usually makes harder) or about perceived adequacy/availability of resources (not needed, usually yes, sometimes yes/sometimes no,usually no).