Determinants of playfulness of young children with cerebral palsy

Area of Science:

• Pediatric Rehabilitation
• Child Development
• Cerebral Palsy Research

Background:

• Playfulness is crucial for development in young children.
• Understanding factors influencing playfulness in children with cerebral palsy (CP) is essential for targeted interventions.
• Previous research has not fully elucidated the interplay of child, family, and service factors on playfulness in this population.

Purpose of the Study:

• To identify child, family, and service determinants of playfulness in young children with cerebral palsy.
• To explore these determinants across different severity levels of CP.

Main Methods:

• A cohort of 429 children (18-60 months) with CP, stratified by Gross Motor Function Classification System (GMFCS) levels I-II and III-V.
• Data collected on child's body functions, motor function, health conditions, adaptive behavior, family life, and services received.
• Parent and therapist-reported outcomes, with playfulness assessed by therapists at one-year follow-up.
• Structural equation modeling used for data analysis.

Main Results:

• Higher gross motor function correlated with increased playfulness in both GMFCS groups.
• For GMFCS I-II, greater health condition impact on daily life was linked to lower playfulness.
• For GMFCS III-V, better adaptive behavior was associated with higher playfulness, while higher perceived therapist family-centeredness was linked to lower playfulness.

Conclusions:

• Interventions should focus on enhancing gross motor function, managing health impacts, and promoting adaptive behaviors to support playfulness in children with CP.
• Findings suggest a nuanced approach is needed, considering CP severity when addressing determinants of playfulness.
• Therapeutic strategies should aim to optimize child engagement and development through play.