Development of daily activities in school-age children with cerebral palsy
Dirk-Wouter Smits1, Marjolijn Ketelaar, Jan Willem Gorter
1Centre of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Centre De Hoogstraat, Utrecht, The Netherlands. d.smits@dehoogstraat.nl
Insights
Capabilities in self-care, mobility, and social function improve in children with cerebral palsy (CP). Gross motor function, intellectual capacity, and family factors influence these improvements, aiding tailored treatment plans.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) affects motor skills, impacting daily functioning in children.
- Understanding the developmental trajectory of capabilities in school-aged children with CP is crucial for intervention.
- Longitudinal data on self-care, mobility, and social function in CP are limited.
Purpose of the Study:
- To describe the longitudinal changes in self-care, mobility, and social function in school-aged children with CP.
- To identify CP-specific, child-related, and family-related factors associated with these functional changes.
- To inform the development of targeted interventions and realistic expectations for children with CP.
Main Methods:
- Longitudinal study of 116 school-aged children with CP (mean age 6y 3mo).
- Three yearly assessments using the Pediatric Evaluation of Disability Inventory Functional Skills Scale (PEDI-FSS).
- Analysis of associations with Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), intellectual capacity, and paternal education.
Main Results:
- Significant improvements observed in PEDI-FSS scores across self-care, mobility, and social function domains over time.
- Self-care improvements predicted by GMFCS level and intellectual capacity.
- Mobility improvements predicted by GMFCS level.
- Social function improvements predicted by MACS level and paternal educational level.
Conclusions:
- Different factors influence the developmental course of distinct functional domains in children with CP.
- Gross motor function is a key predictor for self-care and mobility.
- Intellectual capacity and family factors like paternal education also play significant roles, particularly in self-care and social function.
- Findings support individualized treatment planning and expectation setting for children with CP based on their specific functional profiles.
Abstract:
The purpose of this study was to describe the course of capabilities in self-care, mobility, and social function in school-age children with cerebral palsy (CP) and to investigate associations with CP-, child-, and family-characteristics. A clinic-based sample of children with CP (n = 116; 76 males, 40 females; mean age 6 y 3 mo, SD 12 mo) was followed longitudinally in three yearly measurements. Children's capabilities were assessed with the Pediatric Evaluation of Disability Inventory Functional Skills Scale (PEDI-FSS). Averaged for the total group, significant increases over time were shown in PEDI-FSS scores in all three domains. For self-care, the course was best predicted by a model including level of gross motor function (measured by the Gross Motor Function Classification System) and intellectual capacity (measured by Raven's Coloured Progressive Matrices). For mobility, the course was best predicted by a model containing only level of gross motor function. For social function, the course was best predicted by a model comprising level of bimanual function (measured by the Manual Ability Classification System) and paternal educational level. Generally, the increase in capabilities was greater if level of functioning was higher, except for level of paternal education. The findings indicate that there are different sets of determinants for the course of different domains of daily activities. Such different sets of determinants may help to set realistic expectations and to create appropriate treatment plans for different domains of daily activities in school-age children with CP.
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