Exploring demographic, medical, and developmental determinants of adaptive behaviour in children with hemiplegic
Sandra Abdel Malek1, Ronit Mesterman2, Lauren Switzer3
1School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada.
Insights
Children with hemiplegic cerebral palsy (CP) often struggle with daily functioning. Autism diagnosis and communication challenges significantly impact adaptive skills, not motor function alone.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Rehabilitation Medicine
Background:
- Hemiplegic cerebral palsy (CP) is the most common subtype, often associated with significant mobility.
- Despite motor capabilities, children with hemiplegic CP encounter daily life functional and adaptive challenges.
- Understanding factors beyond motor deficits is crucial for comprehensive care.
Purpose of the Study:
- To identify demographic, medical, and developmental factors associated with adaptive behavior in children with hemiplegic CP.
- To explore the relationship between these factors and adaptive skills using data from the Hemi-NET database.
- To inform clinical practice and research regarding non-motor aspects of hemiplegic CP.
Main Methods:
- Cross-sectional study design utilizing the Hemi-NET database.
- Inclusion of 59 children aged 4-18 with hemiplegic CP (GMFCS I-IV).
- Multivariate regression analyses to assess predictors of adaptive behavior (BASC-2 Adaptive Skills Composite score).
Main Results:
- 34% of children exhibited impaired adaptive skills.
- Autism diagnosis and lower communication functioning were significantly linked to poorer adaptive skills (R² = 0.42, p < 0.001).
- Intellectual Quotient (IQ) scores and Gross Motor Function Classification System (GMFCS) levels did not show significant associations.
Conclusions:
- Adaptive behavior in hemiplegic CP is influenced by factors beyond motor function, such as communication abilities and co-occurring diagnoses.
- Clinicians and researchers should consider a broader range of factors, including communication and developmental diagnoses, when assessing and supporting children with hemiplegic CP.
- These findings highlight the need to move beyond a purely motor-focused approach in managing hemiplegic CP.
Abstract:
Hemiplegic cerebral palsy (CP), the most common subtype, is characterized by high levels of mobility. Despite this, children with hemiplegic CP can face challenges functioning in and adapting to situations of everyday life. The purpose of this cross-sectional study (Hemi-NET database) was to identify factors associated with adaptive behaviour in 59 children with hemiplegic CP (ages 4-18; GMFCS I-IV). Using multivariate regression analyses, the relationship between demographic, medical, and developmental factors and adaptive behaviour (measured by the Adaptive Skills Composite score of the BASC-2) was explored. Results indicate that 34% of children had impaired adaptive skills. An autism diagnosis and lower communication functioning were significantly associated with poorer adaptive skills (R2 = 0.42, F(4, 43) = 7.87, p < 0.001), while factors such as IQ scores and GMFCS level were not. The results contribute to the growing literature that suggests that clinicians and researchers need to look beyond motor functioning when working with individuals with CP.
