Understanding participation of children with cerebral palsy in family and recreational activities

Mohammed S Alghamdi,Lisa A Chiarello,Robert J Palisano,Sarah W Mccoy

doi:10.1016/j.ridd.2017.07.006

Abstract

AimsThe primary aim of this study was to determine the effect of age, sex, gross motor, manual ability, and communication functions on the frequency and enjoyment of children's participation in family and recreational activities. The secondary aim was to determine the relationships between motor and communication functions and participation. MethodsParticipants were 694 children, 1.5–12 years old, with cerebral palsy (CP) and their parents across the US and Canada. Parents rated children's frequency and enjoyment of participation using the Child Engagement in Daily Life measure. Parents and therapists identified children's level of function using Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). ResultsDifferences in frequency and enjoyment of participation were found based on children's GMFCS, MACS, and CFCS levels but not age or sex. Children with higher gross motor, manual, and communication functions had higher frequency and enjoyment of participation, compared to children with lower functions. Frequency of participation was associated with GMFCS and CFCS levels whereas enjoyment of participation was only associated with CFCS level. ImplicationsKnowledge of child's gross motor, manual ability, and communication functions of children with CP is important when setting goals and planning interventions for participation.

Highlights

In the past two decades, there has been an increasing interest in understanding and promoting participation of children with cerebral palsy (CP)
Significant differences in frequency of participation were found between levels of function within the three classification systems, overall children classified in levels I to IV participated, on average, often whereas children in level V participated once in a while
We do not believe that the statistically significant differences within each classification system are clinically meaningful as children, on average, reported to enjoy their participation very much to a great deal

Summary

Introduction

In the past two decades, there has been an increasing interest in understanding and promoting participation of children with cerebral palsy (CP). The authors further described attendance as the physical presence of the child in the activity, whereas involvement represents the “in-moment experience” of participation and includes elements of affect, motivation, and social connection (Imms et al, 2016). Chiarello (in press), suggests that involvement includes “affective, cognitive, and behavioral elements: how the person is feeling, thinking, and behaving”. There is a general consensus among researchers that participation is a multidimensional construct that can be influenced by a wide range of child, family, and environmental factors (Imms et al, 2016; Chiarello et al, 2016; Palisano et al, 2011; King et al, 2006)

Results

Discussion

Conclusion