Developmental trajectories of mobility and self-care capabilities in young children with cerebral palsy
Marjolijn Ketelaar1, Jan Willem Gorter2, Paul Westers3
1Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands; Partner of NetChild, Network for Childhood Disability Research, Utrecht, The Netherlands.
Insights
Young children with cerebral palsy show distinct developmental paths for mobility and self-care skills based on their Gross Motor Function Classification System (GMFCS) level. These findings aid in setting realistic expectations for children with cerebral palsy.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Rehabilitation medicine
Background:
- Cerebral palsy (CP) affects motor function, impacting mobility and self-care in young children.
- Understanding developmental trajectories is crucial for early intervention and support.
Purpose of the Study:
- To describe the development of mobility and self-care in children aged 1-4 years with CP.
- To investigate if these developmental trajectories differ based on CP severity, categorized by Gross Motor Function Classification System (GMFCS) levels.
Main Methods:
- Prospective longitudinal cohort study of 100 children with CP (aged 1.5 or 2.5 years at baseline).
- Mobility and self-care assessed annually using the Pediatric Evaluation of Disability Inventory up to age 4.5.
- Linear mixed models with random coefficient analysis used for longitudinal data of 92 children.
Main Results:
- Distinct developmental trajectories for mobility and self-care were observed across different GMFCS levels, despite individual variations.
- The rate of development per month significantly differed between GMFCS levels for both mobility and self-care outcomes.
Conclusions:
- This study provides evidence for the prognosis of daily mobility and self-care skills in young children with CP.
- GMFCS-based developmental trajectories can improve professional communication and family discussions on expectations and goal-setting for mobility and self-care in children with CP.
Objective:
To describe development of mobility and self-care capabilities in young children (aged 1-4 years) with cerebral palsy, and to examine whether the development of mobility and self-care capabilities differs by cerebral palsy severity in terms of 5 distinct Gross Motor Function Classification System (GMFCS) levels.
Study Design:
This prospective longitudinal cohort study included 100 children with cerebral palsy (aged 1.5 or 2.5 years at baseline) and their parents. Mobility and self-care capabilities were assessed by the Pediatric Evaluation of Disability Inventory during yearly assessments from inclusion up to age 4.5 years. Longitudinal data for 92 children were available for analysis. Repeated-measures analyses with random coefficient analysis were performed using linear mixed models.
Results:
Despite large variations among individuals in the development of mobility and self-care capabilities in young children with cerebral palsy, distinct developmental trajectories were found for children in different GMFCS levels. The estimated change per month differed significantly by GMFCS level for both outcomes.
Conclusions:
This longitudinal study provides an evidence base for prognosis in daily mobility and self-care skills in young children with cerebral palsy. The developmental trajectories for GMFCS levels can be helpful in communication between professionals and also in discussions of expectations and goal setting with families regarding mobility and self-care in the daily life of young children with cerebral palsy in neonatal follow-up and pediatric practice.
