Determinants of playfulness of young children with cerebral palsy

ABSTRACT

Purpose: To identify child, family, and service determinants of playfulness of young children with cerebral palsy.

Methods: Participants were 429 children, 18–60 months. Children were divided into two groups, Gross Motor Function Classification System levels I-II and III-V. Therapists collected data on body functions and gross motor function; parents provided information about children’s health conditions and adaptive behavior, family life, and services. One year after the beginning of the study, therapists assessed children’s playfulness. Data were analyzed using structural equation modeling.

Results: Higher gross motor function was associated with higher playfulness for both groups. Greater impact of health conditions on daily life was associated with lower playfulness for children in levels I-II. More effective adaptive behavior was associated with higher playfulness, and higher parent perception of therapists’ family-centeredness was associated with lower playfulness for children in levels III-V.

Conclusion: Supporting gross motor function, health, and adaptive behavior may foster playfulness.

KEYWORDS:

• Adaptive behavior
• gross motor function
• health
• prospective cohort study
• structural equation modeling

Acknowledgments

We thank Peter Rosenbaum for his help with case ascertainment; Anita Bundy for calibration analysis of assessors on the Test of Playfulness; Lisa Avery for calculation of Test of Playfulness scores; and Barbara Stoskopf, overall study coordinator at CanChild Centre for Childhood Disability Research, Audrey Wood, Philadelphia Region site coordinator, and Allison Yocum, Seattle Site coordinator for their able assistance in this project. Input from parent consultants Tina Hjorngaard (Canada) and Barbara Sieck-Taylor (USA) was invaluable at all stages.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research [MOP 81107]; US Department of Education, National Institute for Disability and Rehabilitation Research [H133G060254].