Participation patterns and determinants of participation of young children with cerebral palsy
Sana M N Abu-Dahab1, Rawan A Alheresh2, Somaya H Malkawi1
1Department of Occupational Therapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.
Insights
Young children with cerebral palsy (CP) participate less than typically developing peers, facing more child-related barriers. Occupational therapists should use tools like the Manual Ability Classification System (MACS) to tailor interventions for better participation outcomes.
Area of Science:
- Pediatric Occupational Therapy
- Child Development Research
- Cerebral Palsy Studies
Background:
- Understanding participation is key for tailoring services for children with cerebral palsy (CP).
- This study compares participation patterns and barriers in young children with CP versus typically developing (TD) children.
- It also examines age, gender, and child-related factors influencing participation in children with CP.
Purpose of the Study:
- To compare participation levels and barriers between young children with CP and TD children.
- To investigate the effects of age and gender on participation in these groups.
- To identify child-related determinants of participation for children with CP.
Main Methods:
- Convenience sample of 110 young children with CP and 150 TD children (36-72 months).
- Classifications included Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS).
- Arabic Preschool Activity Card Sort measured participation and barriers; T-tests, ANOVA, and regression analyses were used.
Main Results:
- Children with CP showed significantly lower overall and domain-specific participation than TD children (p < .001).
- Participation barriers were primarily child-related for children with CP.
- The Manual Ability Classification System (MACS) was the sole significant predictor of participation for children with CP (p = .001).
Conclusions:
- Occupational therapists must prioritize enhancing participation for children with CP.
- Interventions should address identified participation barriers.
- Utilizing the MACS can aid in more effective intervention planning for children with CP.
Introduction:
Understanding participation patterns of young children with cerebral palsy (CP) will enable occupational therapists to tailor family- and child-centred services. This study compares participation patterns and participation barriers of young children with CP with those of typically developing (TD) children. In addition, effect of age and gender on participation were examined as well as child-related determinants of participation for young children with CP.
Methods:
Participants were a convenience sample of 110 young children with CP and 150 TD children, aged 36-72 months. Children with CP represented different levels of the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The Arabic Preschool Activity Card Sort was used to measure participation level as well as barriers of participation. T-tests, ANOVA, and exploratory regressions were employed. Significance was set at p < .05.
Results:
Young children with CP showed significant decreased overall and domain-specific participation compared to TD children (p < .001). Perceived barriers of participation were mostly related to child-factors for young children with CP compared to greater variability in barriers in TD children. Gender had no significant effect on participation regardless of diagnosis; however, pattern of the effect of age was different among the two groups. MACS was found to be the only significant predictor of participation for children with CP (p = .001).
Conclusion:
Occupational therapists should focus on enhancing participation for young children with CP and consider participation barriers when designing their interventions. Several factors need to be considered when aiming to enhance participation of children with CP. The use of the MACS could contribute to better intervention planning.
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