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Rehabilitation service utilization in children and youth with cerebral palsy

Authors

  • A. Majnemer,

    Corresponding author
    1. School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
    2. Montreal Children's Hospital-MUHC and Centre for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, QC, Canada
    • Correspondence:

      Annette Majnemer, Montreal Children's Hospital-MUHC, 2300 Tupper St., Room A-509, Montreal, QC, Canada H3H 1P3

      E-mail: annette.majnemer@mcgill.ca

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  • K. Shikako-Thomas,

    1. Rehabilitation Sciences Program, School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
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  • L. Lach,

    1. Montreal Children's Hospital-MUHC and Centre for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, QC, Canada
    2. School of Social Work, McGill University, Montreal, QC, Canada
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  • M. Shevell,

    1. Montreal Children's Hospital-MUHC and Centre for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, QC, Canada
    2. Department of Pediatrics, McGill University, Montreal, QC, Canada
    3. Departments of Neurology & Neurosurgery, McGill University, Montreal, QC, Canada
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  • M. Law,

    1. School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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  • N. Schmitz,

    1. Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
    2. Douglas Hospital, Montreal, QC, Canada
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  • C. Poulin,

    1. Departments of Neurology & Neurosurgery, McGill University, Montreal, QC, Canada
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  • and the QUALA Group

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    • The QUALA Group includes the following collaborators: Michele Gardiner, Danielle Guimond, Celine Lepage, France Martineau, Kathleen Montpetit and Sylvie Thibault. These individuals assisted with recruitment of participants and were asked to provide feedback on the research proposal and the manuscript submitted for publication.

Abstract

Aim

To describe the pattern of use of rehabilitation services in children and adolescents with cerebral palsy (CP), and to identify factors associated with use.

Methods

In this study, parents of 91 school-age children and 167 adolescents with CP completed a questionnaire regarding educational and rehabilitation resources received within the last 6 months. Rehabilitation services included occupational therapy (OT), physical therapy (PT), speech language pathology (SLP), psychology and special education. Demographic characteristics were documented and developmental and functional status was assessed. Relationships between service utilization and sociodemographic factors, functioning and school setting were determined.

Results

Over half of children (53.2%) and adolescents (57.5%) were in regular schools; however, 41% of these required special education resources. The remainder (42.5–46.8%) was in special schools. The majority of children (84.6%) were receiving at least one rehabilitation service although this decreased (68.1%) in adolescence. PT and OT were most common and services were provided predominantly in the school setting. Services were primarily weekly direct interventions at school age, with weekly interventions or consultations most common for adolescents. Younger age was associated with service receipt at school age only. Children with greater motor limitations, lower IQ and greater activity limitations were more likely to receive OT, PT, SLP or special education. Children in segregated schools were significantly more likely to receive rehabilitation services, when compared with children in regular schools.

Conclusions

The majority of children and youth received one or more services. Individuals with greater motor or cognitive challenges were more likely to receive a range of school-based services from rehabilitation specialists. When compared with children of school age, adolescents were less likely to receive services and when provided, services were more likely to be consultative. Services may need to be more optimally organized through childhood to enhance benefits to children with CP across activity limitation profiles.

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