Home, School, and Community Participation of Children With Unilateral Cerebral Palsy and Peers With Typical...

To compare participation patterns across home, school, and community settings between children with unilateral cerebral palsy (UCP) and peers with typical development (TD), and examine environmental facilitators and barriers to participation.

Parents of 70 children with UCP and 70 peers with TD completed the Participation and Environment Measure for Children and Youth (PEM-CY). Frequency, involvement, desire for change, and environmental facilitators and barriers were compared across home, school, and community settings.

Children with UCP demonstrated significantly lower participation than peers with TD across all settings, with the largest differences in school desire for change and community activity frequency. Parents of children with UCP reported fewer facilitators and more barriers. Regression models showed the strongest explanatory power for school outcomes, particularly total environmental scores $\left(R^2,0.528\right)$ and school environmental facilitators and barriers $\left(R^2,0.520\right)\text{,}$ with community environment scores emerging as the strongest predictors. Age modestly predicted home participation. Sex differences emerged exclusively in the home domain.

Participation across settings is reduced in children with UCP compared with peers with TD. Community environmental factors influenced school participation.