AIM
To investigate the relationships among the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) in children with cerebral palsy (CP).
METHOD
Using questionnaires describing each scale, mothers reported GMFCS, MACS, and CFCS levels in 222 children with CP aged from 2 to17 years (94 females, 128 males). Children were referred from pediatric developmental/behavioral, physiatry, and child neurology clinics, in the USA, for a case–control study of the etiology of CP. Pairwise relationships among the three systems were assessed using Spearman’s correlation coefficients (rs), stratifying by age and CP topographical classifications.
RESULTS
Correlations among the three functional assessments were strong or moderate. GMFCS levels were highly correlated with MACS levels (rs=0.69) and somewhat less so with CFCS levels (rs=0.47). MACS and CFCS were also moderately correlated (rs=0.54). However, many combinations of functionality were found. Of the 125 possible combinations of the three five-point systems, 62 were found in these data.
INTERPRETATION
Use of all three classification systems provides a more comprehensive picture of the child’s function in daily life than use of any one alone. This resulting functional profile can inform both clinical and research purposes.
This study explored the safety and efficacy of synthetic melatonin in the treatment of sleep problems in 20 children with developmental disabilities, in a randomized, double-blind, placebo-controlled 6-week trial of melatonin versus placebo. All but 2 children fell asleep more quickly when receiving melatonin than placebo. Overall, the greater the sleep latency (time to fall asleep) was at baseline or when receiving placebo, the more pronounced was the decrease in sleep latency with melatonin. The effect of melatonin on sleep latency was significant (P < .05). The duration of sleep while receiving melatonin was significantly greater than baseline (P < .007) but was not significantly different from placebo, and no difference in the number of awakenings was noted. No side effects were reported. Eleven of 18 parents (61%) correctly identified the weeks their child received melatonin. This study suggests that synthetic melatonin reduces sleep latency in children with developmental disabilities.
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