Elementary school enrolment and its determinants among children with cerebral palsy in Thiruvananthapuram district, Kerala, India

Abstract

Context:There is enough documented evidence to prove the benefits of early and appropriate initiation of education among children with cerebral palsy (CP).Aim:To find out the proportion of children with CP who are enrolled for some kind of formal education and to study the determinants of the same.Setting and Design:This cross sectional study was done among children, attending the special clinics at government medical college, Thiruvananthapuram.Materials and Methods:Children between 3 and 12 years of age diagnosed with CP were subjects for the study.Statistical Analysis Used:Enrollment for any form of formal education was the major outcome variable. The factors associated with initiation of formal education were tested using Chi-square test or Fischer's exact test. Independent association of each factor was evaluated through binary logistic Regression analysis.Results and Conclusions:The mean (SD) age of the children (n = 86) was 5.7 (2.3) years with forty-six (53.5%) of them being girls. Diplegia was the commonest limb abnormality found. Fifty-two (60.5%) children were undergoing some kind of schooling. Those children who were less dependent physically and those who had achieved better language development were regular school goers. After binary logistic regression the ability of a child to speak in sentences (P = 0.008) and ambulatory level of the child (P = 0.019) were factors which favored, whereas delay in attaining the adaptive developmental milestone of transferring objects from one hand to another (P = 0.014) was found to be detrimental for school enrollment.

Multiple nutritional deficiencies in cerebral palsy compounding physical and functional impairments

“…Most of these children belong to socioeconomically disadvantageous families and were more vulnerable to malnutrition. [ 4 ] Similar to children with severe malnutrition, nutritional rehabilitation centers and locally prepared therapeutic food is recommended to children with CP also. [ 22 ] Other community feeding programs such as Integrated Child Development Scheme may be re-directed to tackle the nutritional problems of these special group of children.…”

“…The physical and mental disabilities due to the disease pose serious challenges; both to the patient and to the caregiver. [ 4 5 6 ] Providing proper care to them requires massive commitment from the part of all caregivers, particularly the parents. With increased physical disability or decreased functional capability of the patient, the stress on the caregiver rises.…”

Treatment and re/habilitation of children with cerebral palsy in India: a scoping review

“…Rehabilitation of neurological disorders is not a high priority in government policies . In India, environmental factors like social attitudes, sociocultural beliefs, lack of knowledge among parents, limited availability of skilled health care professionals (HCPs) and resources, as well as infrastructural, transport, and financial barriers, have been found to affect treatment and participation among children and adolescents with CP . Health care systems, literacy rates, use of the internet for health information, and the use of technology in rehabilitation differ significantly between resource‐rich and resource‐limited countries .…”

“…26 In India, environmental factors like social attitudes, sociocultural beliefs, lack of knowledge among parents, limited availability of skilled health care professionals (HCPs) and resources, as well as infrastructural, transport, and financial barriers, have been found to affect treatment and participation among children and adolescents with CP. [28][29][30][31][32][33][34][35][36][37][38][39][40] Health care systems, literacy rates, use of the internet for health information, and the use of technology in rehabilitation differ significantly between resource-rich and resourcelimited countries. [41][42][43][44][45][46] All these factors might affect the generalizability of the literature from developed countries to developing countries.…”

Impact of Comprehensive Intervention in Children with Cerebral Palsy

“…1 The available data from India also shows the prevalence of 3 per 1000 children 2 Various risk factors operating during prenatal and natal period have been proved as risk factors for the cause of "CP" 3 The physical and mental handicaps due to the disease pose serious challenges; both to the patient and to the caregiver. [4][5][6] Providing proper care to them require massive commitment from the part of all caregivers particularly the parents. With increased physical disability or decreased Functional capability of the patient, the stress on the caregiver rises.The types of cerebral palsy include quadriplegia(20%) spastic diplegia(35%), hemiplegia (25%) and extrapyramidal(15%) 7 .…”