Social Functioning in Children with Cerebral Palsy with and Without Cerebral Visual Impairment: A Multidimensional...

Objective: This study aimed to compare social functioning and social communication characteristics between children with CP and CVI and children with CP without CVI, and to identify demographic, clinical, and functional factors independently associated with social functioning. Methods: This observational cross-sectional study included 70 children with CP aged 48-84 months, including 35 children with CP and CVI and 35 children with CP without CVI. Gross motor function was assessed using the Gross Motor Function Classification System (GMFCS), manual ability using the Manual Ability Classification System (MACS), speech performance using the Viking Speech Scale (VSS), social communication using the Social Communication Questionnaire (SCQ), and social functioning using the Social Function domain of the Pediatric Evaluation of Disability Inventory (PEDI). Between-group comparisons were performed, and hierarchical multiple linear regression analysis was conducted to identify factors independently associated with social functioning. Results: Significant between-group differences were found in the distributions of GMFCS (p = 0.007), MACS (p = 0.043), and VSS (p = 0.027) levels. Children with CP and CVI had lower PEDI Social Function scores and higher SCQ total scores than children with CP without CVI (p < 0.001). Across all SCQ domains, including reciprocal social interaction, communication, and restricted, repetitive, and stereotyped behaviors, children with CP and CVI showed higher scores (all p < 0.001). In the hierarchical regression analysis, the final model explained 96.7% of the variance in social functioning (R² = 0.967; adjusted R² = 0.963; p < 0.001). Age (β = 0.089; p = 0.008), CVI status (β = -0.295; p < 0.001), GMFCS level (β = -0.270; p < 0.001), VSS level (β = -0.211; p < 0.001), and SCQ total score (β = -0.272; p < 0.001) were independently associated with social functioning. Conclusions: Children with CP and CVI had lower social functioning and higher scores for SCQ-assessed social communication and behavioral characteristics than children with CP without CVI. The independent associations of CVI status, gross motor function, speech performance, and SCQ total score with social functioning highlight the importance of a multidimensional approach to evaluating social functioning in children with CP.