Childhood factors predict participation of young adults with cerebral palsy in domestic life and interpersonal relationships: a prospective cohort study

Abstract

Purpose:To determine childhood predictors of participation in domestic life and interpersonal relationships of young adults with cerebral palsy (CP). Materials and methods: This 13-year follow-up of an existing cohort (baseline age 9-13 years) included 67 young adults with CP (age 21-27 years). The Vineland adaptive behavior scales (VABS) and Life Habits questionnaire were used to assess attendance and difficulty in participation in domestic life and interpersonal relationships. Baseline factors were categorised according to the international classification of functioning, disability, and health. Stepwise multiple linear regression analyses determined significant predictors (p < 0.05). Results: Lower manual ability, intellectual disability (ID), epilepsy and lower motor capacity predicted decreased future participation in domestic life, and/or interpersonal relationships (explained variance R 2 ¼ 67-87%), whereas no association was found with environmental and personal factors. Extending models with baseline fine motor skills, communication, and interpersonal relationships increased R 2 to 79-90%. Conclusions: Childhood factors account for 79-90% of the variation in young adult participation in domestic life and interpersonal relationships of individuals with CP. Children with limited motor capacity, low manual ability, ID, or epilepsy are at risk for restrictions in participation in young adulthood. Addressing fine motor, communication, and social skills in paediatric rehabilitation might promote young adult participation. ä IMPLICATIONS FOR REHABILITATIONChildhood risk factors for limited participation in domestic life and interpersonal relationships as a young adult with CP are ID, epilepsy, low manual ability, low motor capacity, and low activity & participation levels. In line with current practice, this study confirms the importance of addressing gross and fine motor skills in children with CP for their future participation in domestic life. In addition, results suggest that addressing communication and social skills during paediatric rehabilitation may optimise future participation in interpersonal relationships. ARTICLE HISTORY

Physical Activity, Ketogenic Diet, and Epilepsy: A Mini-Review

“…In general, several studies reported that physical activity has a positive influence on seizure frequency and severity Vancampfort, Ward, & Stubbs, 2019). As a result, attitudes regarding sports and epilepsy have changed considerably in recent decades, and presently, the risk of convulsive seizures during sports practice is minimal in cases of well-managed epilepsy (van Gorp et al, 2019). Evaluating the control of convulsive disease is, therefore, a key point in allowing sports for children and adolescents.…”

Differences in the support needs of children with developmental disabilities among groups of medical and behavioral needs

“…However, the influence of low-medium levels of needs appears to be dependent on the situation since it was significant only in some support domains. Thus, we identified that the greatest impact of behavioral needs was in the areas of Social and School participation, in which the relationship with peers is also the most common behavioral difficulty among children with higher impairments ( Parkes et al, 2008 ; van Gorp et al., 2019 ).…”

“…The support model considers five elements in assessing the individual’s support needs ( Thompson et al, 2004 ): personal competence (defined as intellectual and adaptive behavioral skills), the number and complexity of environments in which the person participates, the number and complexity of activities, the presence of exceptional medical needs, and the presence of exceptional behavioral needs. Thus, one individual may have higher support needs than another because of additional medical and behavioral needs or the existence of restricted environments for participation ( van Gorp et al., 2019 ; van Timmeren et al., 2017 ; Zijlstra & Vlaskamp, 2005 ). Furthermore, persons with medical and behavioral needs might require greater support than those with fewer limitations, including a wider range of resources to be deployed.…”

Peer Review #1 of "Differences in the support needs of children with developmental disabilities among groups of medical and behavioral needs (v0.1)"

“…However, the influence of low-medium levels of needs appears to be dependent on the situation since it was significant only in some support domains. Thus, we identified that the greatest impact of behavioral needs was in the areas of Social and School participation, in which the relationship with peers is also the most common behavioral difficulty among children with higher impairments (Parkes et al, 2008;van Gorp et al, 2019).…”

“…The support model considers five elements in assessing the individual's support needs (Thompson et al, 2004): personal competence (defined as intellectual and adaptive behavioral skills), the number and complexity of environments in which the person participates, the number and complexity of activities, the presence of exceptional medical needs, and the presence of exceptional behavioral needs. Thus, one individual may have higher support needs than another because of additional medical and behavioral needs or the existence of restricted environments for participation (van Gorp et al, 2019;van Timmeren et al, 2017;Zijlstra & Vlaskamp, 2005). Furthermore, persons with medical and behavioral needs might require greater support than those with fewer limitations, including a wider range of resources to be deployed.…”