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    Self-care and manual ability in preschool children with cerebral palsy: a longitudinal study

    Access Status
    Fulltext not available
    Authors
    Burgess, A.
    Boyd, Roslyn
    Ziviani, J.
    Ware, R.
    Sakzewski, L.
    Date
    2018
    Type
    Journal Article
    
    Metadata
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    Citation
    Burgess, A. and Boyd, R. and Ziviani, J. and Ware, R. and Sakzewski, L. 2018. Self-care and manual ability in preschool children with cerebral palsy: a longitudinal study. Developmental Medicine and Child Neurology.
    Source Title
    Developmental Medicine and Child Neurology
    DOI
    10.1111/dmcn.14049
    ISSN
    0012-1622
    School
    School of Occ Therapy, Social Work and Speech Path
    URI
    http://hdl.handle.net/20.500.11937/73371
    Collection
    • Curtin Research Publications
    Abstract

    © 2018 Mac Keith Press Aim: To describe longitudinal development of self-care and its relationship to manual ability in children with cerebral palsy (CP) aged 18 months to 5 years across all functional abilities. Method: This was a prospective longitudinal population-based study of 290 children with CP (178 [61%] males, 112 [39%] females). Self-care was assessed using the Pediatric Evaluation of Disability Inventory (PEDI). At 60 months (n=242), children were classified using the Manual Ability Classification System (MACS); 113 in level I (47%), 61 in MACS level II (25%), 24 in MACS level III (10%), 14 in MACS level IV (6%), and 30 in MACS level V (12%). Measures were taken at 18 months, 24 months, 30 months, 36 months, 48 months, and 60 months of age. Longitudinal analyses were performed using mixed-effects linear regression models. Results: Self-care development achieved by 60 months was negatively associated with the severity of manual ability impairment. Distinct self-care developmental trajectories were found with estimated changes in PEDI self-care scaled scores per month: 0.61 for MACS level I, 0.46 for MACS levels II, 0.31 for MACS level III, 0.16 for MACS level IV, and 0.03 for MACS level V. Children classified in MACS level V had the lowest level of self-care skills at 18 months and showed no progress in self-care development. Interpretation: This study reports rate of self-care development in preschool children with CP. Self-care performance was highest in children with greatest manual ability. Clinicians may use rates of change to predict or monitor self-care performance. PEDI trajectories inform goal setting in discussions with families regarding expected levels of independence in self-care. What this paper adds: Distinct self-care developmental trajectories in children with cerebral palsy were found according to Manual Ability Classification System (MACS) levels. Children in MACS levels IV and V with epilepsy did not show any significant change in self-care. Children in MACS levels IV and V without epilepsy demonstrated small yet significant gains in self-care performance.

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