Development and Validation of the Toileting Function Classification System for Children With Cerebral Palsy Ages...

Area of Science:

• Pediatric Rehabilitation
• Developmental Disabilities
• Functional Classification Systems

Background:

• Children with cerebral palsy (CP) experience significant toileting challenges due to impairments and environmental factors.
• These challenges impact daily function and participation but are often overlooked in care planning.
• Existing classification systems do not adequately address specific toileting difficulties in children with CP.

Purpose of the Study:

• To develop and validate the Toileting Function Classification System (TFCS) for children with CP aged 6-18.
• To create a standardized tool for assessing and documenting toileting function.
• To facilitate tailored interventions and resource allocation for improved care.

Main Methods:

• A six-phase development approach including conceptualization, expert consultation, and stakeholder consensus.
• Delphi-based validation and reliability assessments (interrater and test-retest) were conducted.
• Involved 180 children with CP, 180 caregivers, and 24 CP and toileting experts.

Main Results:

• The TFCS achieved over 80% agreement on key components after two Delphi rounds.
• Reliability values ranged from .61 to 1.00, indicating substantial to almost perfect agreement.
• The system effectively classified toileting functions across five distinct levels.

Conclusions:

• The TFCS offers a reliable framework for documenting and managing toileting challenges in children with CP.
• Implementation of the TFCS enhances communication between families and professionals.
• The system supports rehabilitation programs, ultimately aiming to improve the quality of life for children with CP.