School readiness of children with cerebral palsy

Authors

  • Frances E Gehrmann,

    1. Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
    2. School of Medicine, The University of Queensland, Brisbane, Qld, Australia
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  • Andrea Coleman,

    1. Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
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  • Kelly A Weir,

    1. Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
    2. Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Qld, Australia
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  • Robert S Ware,

    1. School of Population Health, The University of Queensland, Brisbane, Qld, Australia
    2. Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Qld, Australia
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  • Roslyn N Boyd

    Corresponding author
    1. Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
    2. School of Medicine, The University of Queensland, Brisbane, Qld, Australia
    3. Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Qld, Australia
    • Correspondence to Roslyn Boyd at Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Level 7, Block 6, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia. E-mail: r.boyd@uq.edu.au

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Abstract

Aim

To examine school readiness in preschool-age children with cerebral palsy (CP) on three of five domains compared with reported norms of children with typical development (CTD).

Method

A representative population of 151 preschool-age children with CP (87 males, 64 females; 131 [87%] with spasticity, 17 [11%] dyskinesia, 3 [4%] hypotonia) were assessed at 48 or 60 months corrected age. Children were functioning in the following Gross Motor Function Classification System (GMFCS) levels: I, 74 (49%); II, 17 (11%); III, 14 (9%); IV, 26 (17%); V, 20 (13%). Children's motor performance, self-care, and social function were assessed using the Pediatric Evaluation of Disability Inventory (PEDI) and communication using the Communication and Symbolic Behaviour Scales Developmental Profile (CSBS-DP). Results were compared with a reference sample of CTD (PEDI CTD n=412; CSBS-DP CTD n=790). Linear regression was used to compare these data by functional severity.

Results

Children with CP had significantly lower PEDI scores in all domains than CTD. Self-care scores ranged from 0.5 to more than 4SD below CTD, motor performance was 2 to >4SD below CTD, and social function between 0.5 and >4SD below CTD. Fifty-five per cent of children demonstrated significantly delayed communication skills. Non-ambulant children displayed significantly lower scores than ambulant children.

Interpretation

Preschool-age children with CP perform significantly below their peers in three of five key readiness-to-learn skill areas including mobility, self-care, social function, and communication abilities. Broader emphasis needs to be placed on multimodal screening and intervention to prepare children with CP for school entry.

Ancillary