Developmental Trajectories of Mobility and Self-Care Capabilities in Young Children with Cerebral Palsy

• Published in: The Journal of pediatrics Vol. 164; no. 4; pp. 769 - 774.e2
• Main Authors: Ketelaar, Marjolijn, PhD, Gorter, Jan Willem, MD, PhD, Westers, Paul, PhD, Hanna, Steven, PhD, Verhoef, Marjolein, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.04.2014
• Subjects: Cerebral Palsy - classification; Cerebral Palsy - physiopathology; Cerebral Palsy - therapy; Child Development; Child, Preschool; Female; Humans; Infant; Male; Pediatrics; Prospective Studies; Self Care; Gross Motor Function Classification System; Pediatric Evaluation of Disability Inventory; Pediatric Evaluation of Disability Inventory, computer adaptive testing; GMFCS; PEDI-CAT; PEDI-FSS; Pediatric Evaluation of Disability Inventory, Functional Skills Scale; PEDI
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2013.11.070

Objective To describe development of mobility and self-care capabilities in young children (aged 1-4 years) with cerebral palsy, and to examine whether the development of mobility and self-care capabilities differs by cerebral palsy severity in terms of 5 distinct Gross Motor Function Classification System (GMFCS) levels. Study design This prospective longitudinal cohort study included 100 children with cerebral palsy (aged 1.5 or 2.5 years at baseline) and their parents. Mobility and self-care capabilities were assessed by the Pediatric Evaluation of Disability Inventory during yearly assessments from inclusion up to age 4.5 years. Longitudinal data for 92 children were available for analysis. Repeated-measures analyses with random coefficient analysis were performed using linear mixed models. Results Despite large variations among individuals in the development of mobility and self-care capabilities in young children with cerebral palsy, distinct developmental trajectories were found for children in different GMFCS levels. The estimated change per month differed significantly by GMFCS level for both outcomes. Conclusions This longitudinal study provides an evidence base for prognosis in daily mobility and self-care skills in young children with cerebral palsy. The developmental trajectories for GMFCS levels can be helpful in communication between professionals and also in discussions of expectations and goal setting with families regarding mobility and self-care in the daily life of young children with cerebral palsy in neonatal follow-up and pediatric practice.