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The gross motor function of children/youth with CP has implications for collaboration with families to identify needs and co-ordinate services. Health professionals have a role to assist families with information needs and locating community services and leisure activities. Family needs for future planning suggest that health professionals should assist families to prepare for key periods in the lives of their children with CP.

AIM Participation in home, extracurricular, and community activities is a desired outcome of rehabilitation services for children and young people with cerebral palsy (CP). The purpose of this study was to investigate the effect of age and gross motor function on participation among children and young people with CP.METHOD Five hundred participants (277 males, 223 females) were grouped by age and Gross Motor Function Classification System (GMFCS) level. There were 291 children aged 6 to 12 years and 209 young people aged 13 to 21 years. There were 128 participants in GMFCS level I, 220 in levels II ⁄ III, and 152 in levels IV ⁄ V. Participants completed the Children's Assessment of Participation and Enjoyment to measure number of activities (diversity) and how often they were performed (intensity) in the past 4 months. RESULTSChildren had higher overall participation diversity and intensity than young people (p<0.001). Children and young people in GMFCS level I had the highest overall participation, followed by children and young people in levels II ⁄ III and IV ⁄ V. Children had higher participation in recreational (p<0.001) but not formal (such as team sports or clubs) or physical activities. Children (p<0.01) and young people (p<0.001) in level I had the highest participation in physical activities; diversity and intensity were generally low. INTERPRETATIONThe findings provide evidence of the effect of age and gross motor function on participation of children and young people with CP. Low participation in physical activities may have implications for fitness and health, especially for children and young people in GMFCS levels IV and V.Participation is the context in which children develop skills and competences, experience socialization, and foster initiative and self-efficacy.

AIM To test a model of child, family, and service determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy (CP).METHOD Participants were 288 children with CP, age range 6 to 12 years (mean 9y 8mo, SD 2y), and their parents from seven children's hospitals. The sample comprised 166 (57.6%) males and 122 (42.4%) females, and between 40 (13.9%) and 74 (25.7%) children in each of the five levels of the Gross Motor Function Classification System. Children completed the Children's Assessment of Participation and Enjoyment by interview. Parents completed the Pediatric Outcomes Data Collection Instrument, Family Environment Scale, Coping Inventory, Measure of Processes of Care, and two questionnaires. Structural equation modeling was used to test the model. RESULTSFit statistics indicated a good model fit. The model explains 32% of the variance in intensity of participation. Path coefficients (p£0.05) indicate that higher gross motor function, higher enjoyment, more effective adaptive behavior, younger age, and higher family activity orientation are associated with higher intensity of participation. The path between services and participation was not significant. INTERPRETATIONIntensity of participation of children with CP is influenced by multiple child and family determinants. Children's gross motor function and behavior in life situations are important for participation; knowledge of activities the child and family enjoy has implications for opportunities for participation. Professionals are encouraged to address priorities for leisure and recreation identified by children with CP and their families.Participation (involvement in home, school, and community life 1 ) is of utmost importance to children with cerebral palsy (CP) and their families. Through participation children form friendships, gain knowledge, learn skills, and express creativity. 2 Enablement models such as the International Classification of Functioning, Disability, and Health 1 have increased awareness of participation as an outcome of health and rehabilitation services. Among individuals with CP, diversity and intensity of participation in leisure and recreation activities is higher in children than young people and those with more gross motor function. 3,4 A systematic review identified age, sex, activity limitations, family preferences and cohesion, and environmental resources and supports as factors that might influence participation in leisure activities of children with CP. 5 Among children with CP, lower ability to communicate and higher activity level were constraints to participation whereas higher intelligence and gross motor function were associated with increased participation. 6 King et al. 7 tested a model of predictors of participation in leisure and recreation activities in children with varied physical conditions including CP, congenital and traumatic spinal cord injury, traumatic brain injury, amputation, juvenile arthritis, muscular disorders, and orthopedic conditions. Child...