Behavioural and emotional symptoms of preschool children with cerebral palsy: a population‐based study

Abstract

AIM To describe behavioural and emotional symptoms among Icelandic preschool children with cerebral palsy (CP).METHOD Children with congenital CP, assessed with the Child Behavior Checklist ⁄ 1½-5 (CBCL ⁄ 1½-5) and Caregiver-Teacher Report Form (C-TRF), were enrolled in the study. A comparison group was recruited from the general population. Thirty-six children (53% males) with CP were assessed at a mean age of 4 years 11 months (SD 5mo, range 4-6y); 26 (72%) had bilateral distribution of symptoms and 32 (89%) had spastic CP. Thirty (83%) were at Gross Motor Function Classification System levels I or II and six at levels III or IV. For comparison, 110 (43% males) and 120 (48% males) children were assessed with the CBCL ⁄ 1½-5 and the C-TRF respectively, at a mean age of 4 years 6 months (SD 6mo, range 4-6y).RESULTS Sixteen children (48%) with CP had high scores on total problems scale of the CBCL ⁄ 1½-5 and 20 (65%) on the C-TRF compared with 18% of the comparison group, both on the CBCL ⁄ 1½-5 and the C-TRF (p<0.001). Children with CP had higher scores on all subscales of the CBCL ⁄ 1½-5 and the C-TRF, except somatic complaints. Attention difficulties, withdrawn, aggressive behaviour, and anxious ⁄ depressed symptoms were most pronounced among children with CP.INTERPRETATION A large proportion of preschool children with CP have substantial behavioural and emotional difficulties, which need to be addressed in their treatment.Cerebral palsy (CP) is the most common motor impairment of childhood. It is caused by a lesion of the brain occurring early in development. CP frequently affects behaviour and emotional well-being of children, most likely as a result of complex interactions between biological factors in the brain and psychosocial surroundings.

Behavioral problems in children with motor and intellectual disabilities: Prevalence and associations with maladaptive personality and marital relationship

“…Communitybased studies have revealed that parents report higher prevalence rates of behavioral problems than teachers (e.g., Grietens et al, 2004). However, Sigurdardottir et al (2010) found that teachers reported higher prevalence rate of behavior problems for children with Cerebral Palsy. In this study, we extended past research by including daily caretakers, in addition to parents, as informants.…”

“…Prevalence estimates vary from 21% to 65% (e.g., Sigurdardottir et al, 2010). This wide prevalence range may be accounted for by different psychometric characteristics of the different instruments or differences in the definition of behavior problems (e.g., use of the borderline or clinical range).…”

“…This wide prevalence range may be accounted for by different psychometric characteristics of the different instruments or differences in the definition of behavior problems (e.g., use of the borderline or clinical range). Studies using the CBCL reported prevalence rates ranged from 21% (Hendriks, De Moor, Oud, Franken, & Savelberg, 2001), 24% (Peters, Huisman, & Van Emmerik-Levelt, 1999), 30% (Sniekers et al, 2002) to 65% (Sigurdardottir et al, 2010). Using the SDQ, prevalence rates among children with Cerebral Palsy ranged from 26% to 40% (Brossard-Racine et al, 2012;Parkes et al, 2008).…”

“…Accordingly, the types of behavioral problems in children with motor disabilities also varied. The most reported problems are anxiety (Hendriks et al, 2001;Van Handel, Swaab, De Vries, & Jongmans, 2010), attention problems (Peters et al, 1999;Sigurdardottir et al, 2010), social problems (Hinton, Nereo, Fee, & Cyrulnik, 2006) and hyperactivity (Brossard-Racine et al, 2012;McDermott et al, 1996;Parkes et al, 2008). However, the use of different questionnaires hampers the comparability of studies addressing the prevalence of different types of problem behavior.…”

“…Past research in behavioral problems of children with motor disabilities relied largely on parent reports (e.g., BrossardRacine et al, 2012;Parkes et al, 2008) and to a lesser extent on teacher reports (e.g., Sigurdardottir et al, 2010). Communitybased studies have revealed that parents report higher prevalence rates of behavioral problems than teachers (e.g., Grietens et al, 2004).…”