Structural equation modeling was used to test a theoretically based model of environmental, family, and child factors as determinants of the leisure and recreation participation of children with physical disabilities. Participants were 427 families and children (229 boys and 198 girls) with physical functional limitations, in 3 age groups (6-8, 9-11, and 12-14 years). Data were collected via home interviews and self-administered standardized questionnaires. The significant direct predictors of children's participation intensity in both formal and informal activities were child functional ability, family participation in social and recreational activities, and child preferences for formal and informal activities. Family cohesion, unsupportive environments, and supportive relationships for the child had significant indirect effects on participation. The findings indicate the vital role played by families and the importance of multifaceted approaches to supporting participation.
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