Self-Care in Children and Young People With and Without Developmental Disabilities-A Systematic Review

Looking after oneself (e.g., eating, keeping clean) and making decisions about how this is done ('self-care') is a key health outcome for children with a developmental disability, but guidelines are limited and support for children and families is variable. This systematic review investigated (1) factors influencing self-care in children and young people and (2) interventions that support self-care in children and young people with developmental disabilities.

Following PRISMA guidelines, a comprehensive electronic search of Medline (via Ovid) and CINAHL (via EBSCO) (2007-2024) was carried out. The protocol for this study was registered in PROSPERO. Studies and systematic reviews where self-care was the main outcome were selected. Data were extracted on participant and intervention characteristics, self-care outcomes and explanatory factors.

Of the 16 586 studies screened, 115 were included (10 RCTs, 4 qualitative, 101 observational). These involved 14 590 participants, the individual study sample sizes ranging from 1 to 818 (median 64). The largest two studies (n = 818 each) were in children with cerebral palsy. Movement functions were the most frequently studied explanatory factor and showed consistent association with self-care, as did cognitive and executive function. Pain was investigated in two studies and sensory processing in one study, and both were consistently associated with self-care. Of personal and environmental factors investigated, age, socio-economic status, physical environment, accessibility and caregiver characteristics were associated with self-care. Interventions showing promise to improve self-care in those with developmental disabilities included adaptive seating, goal-setting training, motor skills training, educational programmes for primary caregivers and constrained-induced movement therapy. Overall, evidence about effectiveness is limited, and research has focused on children with cerebral palsy.

Meta-analysis was not possible because of study heterogeneity.

The importance of movement and cognitive functions in self-care is well-established. Personal and environmental factors and intervention effectiveness require further research.