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Published on: June 20, 2020
Aspects of birth history and outcome in diplegics attending specialised educational facilities
Faith Bischof1, Alan Rothberg, Ingrid Ratcliffe
1University of the Witwatersrand, Johannesburg. faithbischof@gmail.com
Insights
Spastic diplegia affects functional mobility and visual-motor skills in children and adolescents. Many require mobility aids and face educational delays, necessitating tailored school support.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Spastic diplegia (SD) is a common form of cerebral palsy affecting motor function.
- Understanding the impact on functional mobility and visual performance is crucial for educational and therapeutic interventions.
Purpose of the Study:
- To investigate functional mobility and visual performance in children and adolescents with spastic diplegia.
- To explore potential correlations between birth history (birth weight, gestational age) and functional outcomes.
Main Methods:
- Clinical examination confirmed spastic diplegia (SD).
- Data collected via parental recall included birth history and school grade.
- Functional mobility scale (FMS), Beery visuomotor integration (VMI), and visual perception (VIS) tests were administered.
Main Results:
- Forty participants (age 7.4-19.5 years) were studied; term and preterm births were equally represented.
- Twenty participants walked independently; the rest used mobility aids.
- No significant correlations were found between birth weight/gestational age and FMS, VIS, or VMI scores. VIS and VMI scores correlated with chronological age and school grade appropriateness.
Conclusions:
- Spastic diplegia impacts visual-motor and visual perception skills, irrespective of gestational age.
- Half of the participants required mobility aids, and a majority experienced educational delays.
- Specialized educational strategies and supportive school environments are essential for this population.
Aim:
We aimed to study functional mobility and visual performance in spastic diplegic children and adolescents attending specialised schools.
Methods:
Spastic diplegia (SD) was confirmed by clinical examination. Birth and related history were added to explore relationships between SD, birth weight (BW) and duration of pregnancy. Place of birth, BW, gestational age (GA) and length of hospital stay were obtained by means of parental recall. Outcome measures included the functional mobility scale (FMS) and Beery tests of visuomotor integration (VMI) and visual perception (VIS).
Results:
Forty participants were included (age 7 years 5 months - 19 years 6 months). Term and preterm births were almost equally represented. Functional mobility assessments showed that 20 were walking independently in school and community settings and the remainder used walking aids or wheelchairs. There were no significant correlations between BW or GA and outcomes (FMS, VIS-Z scores or VMI-Z scores) and Z scores were low. VIS scores correlated significantly with chronological age (p=0.024). There were also significant correlations between VIS and VMI scores and school grade appropriateness (p=0.004;p=0.027 respectively).
Interpretation:
Both term and preterm births were represented, and outcomes were similar regardless of GA. VIS and VMI were affected in both groups. Half of the group used assistive mobility devices and three-fifths were delayed in terms of their educational level. These problems require specialised teaching strategies, appropriate resources and a school environment that caters for mobility limitations.
