A systematic review of activities of daily living measures for children and adolescents with cerebral palsy

Abstract

AIM This study aimed to systematically review the psychometric properties and clinical utility of measures of activities of daily living (ADL) for children with cerebral palsy (CP) aged 5 to 18 years.METHOD Five electronic databases were searched to identify available ADL measures with published psychometric data for school-aged children with CP. Measures were included if at least 60% of the items addressed ADL in the full assessment or in an independent domain. A modified CanChild Outcome Rating Form was used to report the validity, reliability, responsiveness, and clinical utility of the measures.RESULTS Twenty-six measures were identified and eight met inclusion criteria. The Pediatric Evaluation of Disability Inventory (PEDI) had the strongest psychometric properties but was limited by its age range. The Assessment of Motor and Process Skills (AMPS) was the most comprehensive evaluation of underlying motor and cognitive abilities yet further psychometric testing is required for children with CP.INTERPRETATION The PEDI should be used to measure ADL capability in elementary school aged children. The AMPS is the best measure to evaluate ADL performance or capacity and is suitable for all ages. Future research should examine the reliability of the AMPS to determine its stability in children and adolescents with CP.The focus of assessment and treatment of children with cerebral palsy (CP) has changed in response to the introduction of the International Classification of Functioning, Disability and Health (ICF). 1 The ICF has evolved since its inception and today comprises four components: (1) body structures; (2) body functions; (3) activities and participation; and (4) environmental factors.2 The conceptualisation of disability in the ICF highlights its biopsychosocial nature and emphasises the need to support individuals to achieve optimal capacity and participation in all aspects of life.3 Broadening intervention goals to address all areas of functioning necessitates the identification of outcome measures that capture each aspect. 4 Cerebral palsy is defined as 'a group of permanent disorders of the development of movement and posture, causing activity limitations, that are attributed to non-progressive disturbances which occurred in the developing fetal or infant brain '. 5 Activities of daily living (ADL) are tasks that are fundamental to supporting participation across school, home and community environments. ADL are conceptualised in the 'Activities and Participation' domain of the ICF and defined as life tasks required for self-care and self-maintenance such as grooming, bathing, eating, and doing chores. 6 These tasks are classified as either (1) personal ADL tasks, which are oriented towards self-care (e.g. grooming, bathing); or (2) instrumental ADL tasks, which are oriented towards sustaining independence and require a higher level of physical and cognitive competency than personal ADL (e.g. preparing meals, taking care of pets). 7 Personal ADL are more commonly performed by younger children, whi...

Cognitive functioning in children with cerebral palsy

“…Disorders of intellectual development can be considered with an IQ less than 70, but the diagnostic criteria specifies that there should also be significant impairment in mastery of everyday activities. Difficulties with the latter should not be solely attributable to motor impairment, which complicates the diagnostic process for children in GMFCS levels III to V as there is a lack of appropriate tools for assessing adaptive functioning . Further, although a full‐scale IQ score might be below 70, it would not be advisable to diagnose intellectual disability if the profile is skewed and functioning is as expected for age in one or more areas.…”

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Patient‐reported outcome measures for young people with developmental disabilities: incorporation of design features to reduce cognitive demands

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Upper limb impairments, process skills, and outcome in children with unilateral cerebral palsy

“…ISC was described by the motor component of the AMPS, the Pediatric Evaluation of Disability Inventory caregiver section, and the CP Register Assessment of Bimanual Upper Limb Function . The AMPS is a reliable and valid tool measuring instrumental activities of daily living . Two activities the child undertakes regularly are assessed, evaluating actions used to complete the task .…”

“…15,26 The AMPS is a reliable and valid tool measuring instrumental activities of daily living. 27 Two activities the child undertakes regularly are assessed, evaluating actions used to complete the task. 28 Higher logit scores (À3 to +3) indicate greater motor abilities.…”