Determinants of self-care participation of young children with cerebral palsy

Abstract

Objective: To test a model of child, family and service determinants of self-care participation of children with cerebral palsy (CP), grouped by Gross Motor Function Classification System levels (I–II and III–V). Methods: Participants were a convenience sample of 429 children (242 males) with CP, aged 18–60 months. Data on impairments and gross motor function were collected by reliable therapists; parents provided information about children's health conditions and adaptive behaviour. Seven months later parents reported on family life and services received. One year after study onset, parents documented children's self-care participation. Data from two groups of children were analysed using structural equation modelling. Results: The model explained a significant proportion of the variance of self-care participation, with higher motor function, fewer health conditions and higher levels of adaptive behaviour being associated with greater self-care participation. Conclusion: Supporting children's gross motor function, health and adaptive behaviour may optimize self-care participation.

• Biopsychosocial approach
• prospective cohort study
• structural equation modelling

Acknowledgements

We thank Peter Rosenbaum for his help with case ascertainment, 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.