Developmental Trajectories of Daily Activities in Children and Adolescents With Cerebral Palsy

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Rehabilitation of people with cerebral palsy aims to achieve and maintain optimal performance in mobility and daily activities. Although insight into the developmental trajectories of activities from childhood into adulthood is important, little is known about long-term development. WHAT THIS STUDY ADDS:The gross motor function of children with cerebral palsy determines the developmental trajectories of mobility performance but not of daily activities, where intellectual disability was shown to be the determining factor. abstract OBJECTIVES: To describe the developmental trajectories of mobility performance and daily activities in children and young adults with cerebral palsy (CP). To explore the influence of gross motor function and intellectual disability on these trajectories. METHODS:Four hundred and twenty-four Dutch participants with CP (aged 1-20 years at study onset) were followed yearly over a period of 2 to 4 years. Developmental trajectories (from ages 1-16 years) were described for mobility performance and performance of daily activities, assessed by using the Vineland Adaptive Behavior Scale for gross motor function (classified by the Gross Motor Function Classification System) and intellectual disability (by IQ or school type). A subanalysis was done for performance of daily activities in a subgroup of participants without intellectual disability (aged 1-24 years). RESULTS:The developmental trajectories of mobility performance differed according to levels of gross motor function but not levels of intellectual disability. Intellectual disability affected the performance of daily activities, with lower overall trajectory levels for participants with intellectual disabilities. For participants without intellectual disability, high-level developmental trajectories were found, with values similar to those of typically developing children despite differences in gross motor function level.CONCLUSIONS: Mobility performance is determined mainly by levels of gross motor function. For performance of daily activities, intellectual disability was a more important determinant. Participants without intellectual disability showed developmental trajectories approaching values for typically developing participants. These estimated trajectories can guide rehabilitation interventions and future expectations for children and young adults with CP. Pediatrics 2013;132:e915-e923 AUTHORS:

Self‐care and manual ability in preschool children with cerebral palsy: a longitudinal study

“…The new PEDI‐Computer Adaptive Test (PEDI‐CAT), which has succeeded the PEDI, will be used to measure self‐care in this subsequent study, and conversion formula is available which allows scores to be transformed between the two versions. Finally, a measure of cognition was not included in the CP Child Study, and it is acknowledged that this is an important component of self‐care . A measure of cognition will be included in the subsequent study, Predict‐CP (NHMRC 1077257) .…”

Early Diagnosis and Early Intervention in Cerebral Palsy

“…This result is in line with the animal studies on early intervention (33, 34). The effect on cognitive outcome is, however, essential as cognitive function determines to a much larger extent activities and participation of children with CP than motor function (137, 138). …”

Long-Term Trajectories of Health-Related Quality of Life in Individuals With Cerebral Palsy: A Multicenter Longitudinal Study

“…14,15,17,18 For the total sample of individuals with CP aged 1 to 24 years, we have recently described long-term trajectories of objective functioning, that is, performance of physical activities and social participation. [19][20][21] These trajectories show that the level of objective functioning increased toward adult age. It might be questioned whether subjective functioning in individuals with CP will also increase toward adult age or will stay stable over many years.…”