Comparison of developmental pattern change in preschool children with spastic diplegic and quadriplegic cerebral
Chia-Ling Chen1, Kai-Hua Chen, Keh-Chung Lin
1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Insights
Children with spastic quadriplegic (SQ) cerebral palsy (CP) show declining developmental quotients (DQs) with age, unlike those with spastic diplegic (SD) CP who show improvement.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neurorehabilitation
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture.
- Spastic diplegic (SD) and spastic quadriplegic (SQ) CP represent distinct subtypes with varying impacts on development.
- Understanding longitudinal developmental changes is crucial for targeted interventions in young children with CP.
Purpose of the Study:
- To compare the longitudinal changes in developmental patterns between children with spastic diplegic (SD) and spastic quadriplegic (SQ) cerebral palsy (CP).
- To analyze differences in developmental quotients (DQs) across various domains, including motor, language, and self-help skills.
- To investigate the impact of age on developmental trajectories in these distinct CP subtypes.
Main Methods:
- Sixty preschool children (aged 1-5 years) with spastic CP were classified into SD (n=29) and SQ (n=31) groups.
- Developmental profiles, assessed via development quotients (DQs) in multiple domains, were evaluated at baseline and one year later.
- The DQ change index was calculated to quantify longitudinal developmental progress.
Main Results:
- Children with SQ CP consistently exhibited lower DQs across all developmental domains compared to those with SD CP (p < 0.01).
- Both groups showed the most significant delays in the gross motor domain.
- While DQs generally increased with age in the SD group, they tended to decrease in the SQ group (p < 0.05).
Conclusions:
- Distinct subtypes of cerebral palsy, specifically SD and SQ, are associated with unique developmental profiles.
- The trajectory of developmental patterns over time differs significantly between children with SD and SQ CP.
- These findings underscore the importance of subtype-specific approaches in managing and supporting children with cerebral palsy.
Background:
This study compares the longitudinal change of developmental patterns in preschool children with spastic diplegic (SD) and spastic quadriplegic (SQ) cerebral palsy (CP).
Methods:
Sixty children with spastic CP, aged 1-5 years (3.2 +/- 1.2 years), were classified into 2 groups: SD (n = 29) and SQ (n = 31). Gross Motor Function Classification System (GMFCS) levels were classified during the initial assessments. Developmental profiles, including development quotients (DQs) of gross motor, fine motor, expressive language, concept comprehension, situation comprehension, self help, personal social and general development, were evaluated on initial and final assessments and an average of one year later. The DQ change index (%) was calculated as 100% x (final DQ - initial DQ)/initial DQ.
Results:
Children with SQ had lower DQs in all developmental functions than those with SD on both assessments (p < 0.01). The DQ distributions of developmental profiles were different in SD and SQ groups, although both groups displayed the lowest DQs in the gross motor domain. As indicated by the DQ change index, most DQs increased with age in children with SD; however, most decreased with age in children with SQ (p < 0.05).
Conclusion:
These findings suggest different CP subtypes demonstrate various development profiles. The evolvement of developmental patterns with age was different in children with various CP subtypes.
