The relationship between physical performance and self-perception in children with and without cerebral palsy

This study examined the relationship between physical performance and perceived self-competence and global self-worth in children with and without spastic diplegia.

A matched-pairs design, including eight children with spastic diplegia and eight typically developing children, was used to compare the children's performance and to examine relationships. Children aged 7 to 11 years were assessed to determine their gross and fine motor abilities and they completed a modified version of the Harter Self-Perception Profile for Children.

Children with diplegia performed at lower levels in all gross and fine motor assessments compared with children without diplegia. Self-perception was lower in children with diplegia in fine motor competence (P = 0.03) and global self-worth (P = 0.05). Clinically important differences (> 10%) in gross motor and athletic competence were also found. Positive correlations between physical performance assessments and some self-perception domains were present, although strength and direction of relationships differed for each group in some instances.

This small study found that in addition to having reduced physical skills, children with spastic diplegia may experience a less positive global self-worth than typically developing children. These findings are in contrast to some previous research. Future research should examine the hypothesised relationship more definitively to determine whether improvement in physical skills results in a higher level of self-competence and consequently a higher global self-worth. This might further justify interventions aimed at improving fine and gross motor skills of children with cerebral palsy. Clinicians should be mindful of addressing both physical issues and self-worth with clients.