Managing to learn bimanual activities – experiences from children and adolescents with cerebral palsy – a qualitative analysis

Abstract

Purpose

Children and adolescents with cerebral palsy often have impaired hand function. This makes it difficult for them to deal with everyday activities. The aim of the study was to explore the experiences of children and adolescents with unilateral spastic cerebral palsy when it comes to learning and dealing with activities requiring bimanual use.

Method

Ten participants, attending mainstream schools, with unilateral spastic cerebral palsy (10–18 years, MACS-level I-III) took part in semi-structured interviews. Qualitative analysis with verbatim transcripts were analysed using a Grounded Theory approach.

Results

The learning of bimanual activities was described as a process taking place in interaction with the dynamics of everyday situations. Five categories describing the participants experiences emerged: “Reaching a point where you want to learn”, “Awareness and acceptance of your own abilities”, “Dealing with the boundaries of the disability”, “Dealing with the impact of people around you” and “Strategies for learning”. A multi-dimensional theory was derived, summarising how the participants learned bimanual activities in daily life.

Conclusions

Children and adolescents with unilateral spastic cerebral palsy express that the process of learning bimanual activities can only take place when it fits in with life as it unfolds. Thus, they have to adapt to a changing context and their own developing skills.

Implications for Rehabilitation

• This study support a person-centred perspective in the process of learning bimanual activities.

• Interventions need to be tailored to life situations and embedding in child's and adolescents everyday lives.

• The therapist must be compliant with the child's and adolescents desire for learning.

Keywords:

• Adolescents
• cerebral palsy
• child
• hand
• learning
• qualitative research

Acknowledgements

We would like to express our sincere gratitude to all the children and adolescents as well as their parents who took the time to participate in and contribute to this study. We also thank Anna-Lisa Thorén-Jönsson and Lage Person, who contributed valuable thoughts and experiences.

Disclosure statement

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

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Notes

1. I.e.,”the participant is wondering about what she could have done if she was able to use both arms”.

2. This participant actually said “independent person” in English, which could be seen as increasing the humorous effect.

3. A light handshake, i.e., lacking the physical strength to perform a powerful handshake.

4. At Swedish schools, handicraft (including mainly woodworking and sewing) is a compulsory subject for all children.

Additional information

Funding

The findings are based on research funded by the Petter Silfverskiöld Memorial Foundation, the Swedish National Association for Disabled Children and Young People – the RBU Research Foundation, the Linnea and Josef Carlsson Foundation, the Swedish Association of Occupational Therapists Scholarship Foundation, the Norrbacka–Eugenia Foundation, the Linnea & Josef Carlsson Foundation, the Bertha and Felix Neubergh Memorial Foundation, and the Fredrik and Ingrid Thuring Memorial Foundation.