Determinants of self-care participation of young children with cerebral palsy
Doreen J Bartlett1, Lisa A Chiarello, Sarah Westcott McCoy
1School of Physical Therapy, Western University , London, ON , Canada.
Insights
Optimizing self-care participation in children with cerebral palsy (CP) involves enhancing gross motor function, managing health conditions, and improving adaptive behaviors. These factors significantly influence a child
Area of Science:
- Pediatric Rehabilitation
- Developmental Pediatrics
- Child Health Services Research
Background:
- Self-care participation is crucial for children with cerebral palsy (CP) but is influenced by various factors.
- Understanding these determinants is essential for developing targeted interventions.
- Previous models have not fully integrated child, family, and service factors.
Purpose of the Study:
- To evaluate a comprehensive model predicting self-care participation in children with CP.
- To differentiate determinants based on Gross Motor Function Classification System (GMFCS) levels.
- To identify key areas for intervention to enhance child independence.
Main Methods:
- Structural equation modeling was used to analyze data from 429 children (18-60 months) with CP.
- Data included child's motor function, health conditions, adaptive behavior, family life, and services received.
- Longitudinal data collection occurred over one year, with parent-reported outcomes.
Main Results:
- The proposed model significantly explained variance in self-care participation.
- Higher gross motor function was strongly associated with greater self-care.
- Fewer health conditions and higher adaptive behavior scores also predicted increased participation.
Conclusions:
- Interventions should focus on improving gross motor function in children with CP.
- Addressing health conditions and promoting adaptive behaviors are key to optimizing self-care.
- A holistic approach considering child, family, and service factors is recommended.
Objective:
To test a model of child, family and service determinants of self-care participation of children with cerebral palsy (CP), grouped by Gross Motor Function Classification System levels (I-II and III-V).
Methods:
Participants were a convenience sample of 429 children (242 males) with CP, aged 18-60 months. Data on impairments and gross motor function were collected by reliable therapists; parents provided information about children's health conditions and adaptive behaviour. Seven months later parents reported on family life and services received. One year after study onset, parents documented children's self-care participation. Data from two groups of children were analysed using structural equation modelling.
Results:
The model explained a significant proportion of the variance of self-care participation, with higher motor function, fewer health conditions and higher levels of adaptive behaviour being associated with greater self-care participation.
Conclusion:
Supporting children's gross motor function, health and adaptive behaviour may optimize self-care participation.
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