Participation and activity performance of students with cerebral palsy within the school environment

The aims of this study were to investigate the levels of participation and activity performance of students with cerebral palsy within the inclusive school context, to explore the relationships between these two aspects of function and to identify predictors of participation among the various school activities.

Two hundred and forty-eight elementary school students were divided into three groups: 100 fully included (FI) students with CP, 100 matched by class and gender typical students (TS) and 48 students with CP in self-contained classes (SC). The School Function Assessment (SFA) was used as the main measurement for assessing the levels of participation and functional performance profiles.

Significant differences (P<0.0001) in levels of participation were evident across the three study groups using MANOVA and ANOVAs analyses, where the TS level was the highest and the SC was the lowest. Comparison of the mean score of the physical and the cognitive/behavioural tasks performance revealed similar results among the three groups. Positive Pearson correlations were obtained between participation and both motor and cognitive/behavioural activity performance in the FI and the SC groups. Regression models for the FI and the SC groups were found significant (P<0.0001) and explained above 69% of the participation variance with physical activity performance as the most predictive variable.

Significant differences exist between participation and activity performance of typical students and students with CP included in regular schools. Moreover, activity performance limitations were found to impact on school participation. These findings stress the continuing need to provide rehabilitative intervention towards removing existing barriers within the inclusive environment.