Predictors for changes in various developmental outcomes of children with cerebral palsy--a longitudinal study
Chien-Min Chen1, Hung-Chih Hsu, Chia-Ling Chen
1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Insights
Gross Motor Function Classification System (GMFCS) level and age are key predictors impacting developmental changes in preschool children with cerebral palsy (CP). Higher GMFCS levels and older age correlate with poorer outcomes in cognition, language, and motor skills.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Neurology
Background:
- Cerebral palsy (CP) affects motor function and can impact multiple developmental domains in young children.
- Identifying predictors of developmental change is crucial for targeted interventions in children with CP.
Purpose of the Study:
- To identify predictors for changes in cognitive, language, self-help, social, and motor functions in preschool children with CP.
- To investigate the influence of factors like GMFCS level and age on developmental trajectories.
Main Methods:
- A cohort of 78 preschool children with CP (mean age 3y 8m) was assessed at baseline and 6-month follow-up.
- Evaluated predictors included age, sex, CP subtype, GMFCS level, motor control, muscle tone (Modified Ashworth Scale), and spinal alignment/range of motion (SAROMM).
- Developmental outcomes were measured using the Comprehensive Developmental Inventory for Infants and Toddlers.
Main Results:
- Gross Motor Function Classification System (GMFCS) level negatively predicted changes in language, motor, social, and self-help functions.
- Age negatively predicted changes in cognition and language functions.
- Spinal Alignment (SA) subscale of SAROMM negatively predicted cognitive changes.
Conclusions:
- GMFCS level and age are significant negative predictors for developmental changes across most domains in preschool children with CP.
- These findings highlight the importance of considering motor function and chronological age when assessing developmental trajectories.
- Further research could explore interventions targeting these predictive factors to improve developmental outcomes.
Abstract:
We aimed to identify predictors for the changes of various developmental outcomes in preschool children with cerebral palsy (CP). Participants were 78 children (49 boys, 29 girls) with CP (mean age: 3 years, 8 months; SD: 1 year, 7 months; range: 1 year to 5 years, 6 months). We examined eight potential predictors: age, sex, CP subtype, Gross Motor Function Classification System (GMFCS) level, selective motor control, Modified Ashworth Scale, and the spinal alignment (SA) and range of motion subscales of the Spinal Alignment and Range of Motion Measure (SAROMM). Developmental outcomes for cognition, language, self-help, and social and motor functions were measured at baseline and a 6-month follow-up with the Comprehensive Developmental Inventory for Infants and Toddlers. Regression model showed GMFCS level was a negative predictor for change of language (adjusted r(2)=0.30, p<.001), motor function (adjusted r(2)=0.26, p<.001), social function (adjusted r(2)=0.07, p=0.014), and self-help (adjusted r(2)=0.26, p<.001). Age was a negative predictor for change of cognition (adjusted r(2)=0.21, p<.001) and language functions (adjusted r(2)=0.26, p<.001). SAROMM-SA was a negative predictor for cognitive change (adjusted r(2)=0.30, p<.001). The GMFCS levels and age are robust negative predictors for change of most developmental domains in these children.
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