Neuroimpairments, activity performance, and participation in children with cerebral palsy mainstreamed in elementary schools

Abstract

Participation and activity performance (motor and cognitive or behavioural) were examined in 148 children with cerebral palsy (CP; 87 males, 61 females; mean age 9y 8mo, SD 1y 11mo; range 6y 1mo to 13y 7mo), mainstreamed in fully inclusive (n=100) and in self-contained classes (n=48) within general schools in Israel, using the School Function Assessment. Differences in participation within these groups were analyzed in relation to the type of CP (mainly spastic hemiplegia, spastic diplegia, and spastic tetraplegia), the level of impairment according to the Gross Motor Function Classification System (GMFCS; level II 55%, level III 37%, and level IV 8%), and additional neuroimpairments. Univariate analyses of variance revealed significant differences in levels of participation and levels of activity performance between different types of CP and GMFCS levels. With regard to additional neuroimpairments, significant differences in participation were found for fully included children with speech and language impairments and those with learning disability within the self-contained group. Physical activity performance partly accounted for differences in participation between children with different types of CP and different levels of motor impairment. These findings suggest that within the mainstreamed environment, participation and activity performance increase as motor disability and/or additional neuroimpairments (speech and language impairments and learning disability) decrease.

Self-Reported Health Status and Quality of Life in Youth With Cerebral Palsy and Typically Developing Youth

“…This is consistent with documented decreased social participation by youth with CP and may warrant psychosocial, physical activity, and/or recreational interventions. 23,24 Independent ambulators (levels I and II) with CP in this study perceived themselves to be less healthy than TDY. This may be a function of the age range sampled and history of therapy and medical interventions.…”

“…The youth with CP also participated significantly less often than their typically developing peers in daily school activities (ie, playground games, moving to other areas of the school). 24 Motor function has also been shown to be predictive of restrictive participation in mobility, education, and social relations for children with CP. 23 The Activity Scale for Kids also addresses participation related to physical activity.…”

Desempenho funcional de crianças com paralisia cerebral de níveis socioeconômicos alto e baixo

“…According to Schenker et al (10) , the development of motor skills of children with CP presents a characteristic delay. Therefore, basic motor skills can be acquired later in childhood, generating a difference of years of delay, compared with healthy children regarding gross motor skills.…”

Development and initial validation of the Children Participation Questionnaire (CPQ)

“…Although the number of researchers investigating participation in various paediatric populations has increased [11][12][13][14][15][16][17][18], most focus on school age children older than 6 years, with severe developmental disabilities. A literature search [2,10,19,20] for the assessment tools designed to measure child participation reveals a paucity of tools appropriate to capture the full essence of the construct of participation.…”