The aims of this study were to describe physical therapy (PT) and occupational therapy (OT) services for a cohort of 399 children with cerebral palsy (CP), 2-6 years old, residing in the United States and Canada. Parents completed a services questionnaire by telephone interview. Therapists classified children's Gross Motor Function Classification System (GMFCS) level. Mean minutes per month of PT and OT were greater for children receiving services in both an educational and clinic setting. Mean minutes per month of PT and OT were greater for children in levels IV-V than children in level I and greater for children in the United States than children in Canada. Parents reported that interventions focused a moderate to great extent on primary impairments, secondary impairments, activity, and structured play activities, a moderate extent on environmental modifications and equipment; and a moderate to small extent on self-care routines. The results support the importance of coordination of PT and OT services.

Participation in home, school, and community activities is a primary outcome of early intervention services for children with disabilities and their families. The objectives of this study were to (a) describe participation of preschool-age children with cerebral palsy (CP); (b) determine effects of sex, age, and gross motor function on intensity of participation; and (c) identify child, family, and service determinants of intensity of participation. A convenience sample of 85 preschool-age children with CP and their parents participated. Parents completed self-report measures on children's participation, adaptive behavior, physical function, family functioning, and services. Children's Gross Motor Function Classification System levels (Palisano, Rosenbaum, Bartlett, & Livingston, 2008) were determined by assessors. A multiple linear regression analysis was conducted to determine the variance in intensity of participation explained by the determinants. Children with limited self-mobility had a lower intensity of participation than children with independent upright mobility. Adaptive behavior, transfers and basic mobility function, and upper extremity and physical function explained 46% of the variance of intensity of participation.

An intensive episode of physical therapy of reasonable frequency and duration that includes partial body weight treadmill training may be effective in improving motor skills of children with spastic CP.

The ability to transfer from sitting to standing and from standing to sitting predicted independent walking in young children with CP. Prospective longitudinal studies are recommended to determine indicators of readiness for independent walking.