1. Top of page
  2. Abstract
  3. References

The aim of this study was to investigate the participation of children with cerebral palsy (CP) in activities outside school and to compare their participation with a large representative sample of children. A population-based survey was conducted of children with CP born in Victoria, Australia in 1994 and 1995. Of 219 living children identified, 114 (52.1%) returned completed surveys. The children (65 males, 49 females) were aged between 10 years 9 months and 12 years 9 months (mean age 11y 9mo, SD 6mo). Thirty-eight per cent had hemiplegia, 23% diplegia, 4% triplegia, 34% quadriplegia, and 1% was of unknown topography. Distribution according to the Gross Motor Function Classification System (GMFCS) was 22.8% Level I, 36% Level II, 10.5% Level III, 8.8% Level IV, and 21.9% Level V. Distribution according to the Manual Ability Classification System (MACS) was: 19.3% Level I, 38.6% Level II, 14.0% Level III, 8.8% Level IV, and 19.3% Level V. Participation was measured using the Children's Assessment of Participation and Enjoyment. Participation in selected sport, cultural, and quiet leisure activities was compared with population-based data for 11-year-olds from the Australian Bureau of Statistics. Children with CP undertook a median of 26.5 activities (interquartile range 10) in 4 months which were commonly informal rather than formal. Intensity of participation was low. Diversity and intensity of participation was similar for children in each level of the MACS and the GMFCS, except for participants in Level V. More children with CP participated in organized sports (p<0.001) compared with other Australian children, although with lower frequency (p<0.001). Participation diversity and level of intensity of Australian children with CP were similar to those reported in a Canadian study.

List of abbreviations:

Australian Bureau of Statistics


Children's Assessment of Participation and Enjoyment


Manual Ability Classification System


Socio-Economic Indexes for Areas


Victorian Cerebral Palsy Register


  1. Top of page
  2. Abstract
  3. References
  • 1
    Law M, King G, King S, et al. Patterns of participation in recreational and leisure activities among children with complex physical disabilities. Dev Med Child Neurol 2006; 48: 33742.
  • 2
    World Health Organization. International Classification of Functioning, Disability and Health: Short version. Geneva : World Health Organization, 2001.
  • 3
    Coster W Occupation-centered assessment of children. Am J Occup Ther 1998; 52: 33744.
  • 4
    Humphry R. Young children's occupations: explicating the dynamics of developmental processes. Am J Occup Ther 2002; 56: 17179.
  • 5
    Wiseman JO, Davis JA, Polatajko HJ. Occupational development: towards an understanding of children's doing. J Occup Sci 2005; 12: 2635.
  • 6
    Imms C. Children with cerebral palsy participate: a review of the literature. Disabil Rehabil Published online early 28th November 2007; DOI: 10.1080/09638280701673542.
  • 7
    Ehrmann LC, Aeschleman SR, Svanum S. Parental reports of community activity patterns: a comparison between young children with disabilities and their non-disabled peers. Res Dev Disabil 1995; 16: 33143.
  • 8
    Law M, Finkelman S, Hurley P, et al. Participation of children with physical disabilities: relationships with diagnosis, physical function and demographic variables. Scand J Occup Ther 2004; 11: 15662.
  • 9
    Longmuir PE, Baror O. Factors influencing the physical activity levels of youths with physical and sensory disabilities. Adapted Phys Activity Quart 2000; 17: 4053.
  • 10
    Chan HSS, Lau PHB, Fong KH, Poon D, Lam CCC. Neuroimpairment, activity limitation, and participation restriction among children with cerebral palsy in Hong Kong. Hong Kong Med J 2005; 11: 34254.
  • 11
    Maher CA, Williams MT, Olds T, Lane AE. Physical and sedentary activity in adolescents with cerebral palsy. Dev Med Child Neurol 2007; 49: 45057.
  • 12
    Hammal D, Jarvis SN, Colver AF. Participation of children with cerebral palsy is influenced by where they live. Dev Med Child Neurol 2004; 46: 29298.
  • 13
    King GA, Law M, King S, Rosenbaum P, Kertoy MK, Young NL. A conceptual model of the factors affecting the recreation and leisure participation of children with disabilities. Phys Occ Ther Pediatr 2003; 23: 6390.
  • 14
    King GA, Law M, King S, et al. Children's Assessment of Participation and Enjoyment and Preferences for Activities of Kids. San Antonio, Texas : PsychCorp, 2004.
  • 15
    Rosenbaum P, Palisano RJ, Walter S, Russell D, Wood E, Galuppi B. Development of the Gross Motor Function Classification System: reliability and validity results. 1996 (accessed 4th March 2008).
  • 16
    Eliasson AC, Krumlinde-Sundholm L, Rosblad B, et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 2006; 48: 54954.
  • 17
    Morris C, Galuppi B, Rosenbaum P. Reliability of family report for the Gross Motor Function Classification System. Dev Med Child Neurol 2004; 46: 45560.
  • 18
    Morris C, Kurinczuk JJ, Fitzpatrick R, Rosenbaum P Reliability of the Manual Ability Classification System for children with cerebral palsy. Dev Med Child Neurol 2006; 48: 95053.
  • 19
    Australian Bureau of Statistics. Children's participation in cultural and leisure activities. 2006. (accessed September 20 2007).
  • 20
    Australian Bureau of Statistics. Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA) 2001. (accessed January 23 2007).
  • 21
    Blum RW, Resnick MD, Nelson R, St Germaine A. Family and peer issues among adolescents with spina bifida and cerebral palsy. Pediatr 1991; 88: 28085.
  • 22
    Wilhite B, Devine MA, Goldenberg L. Perceptions of youth with and without disabilities: implications for inclusive leisure programs and services. Ther Recreation J 1999; 33: 1528.
  • 23
    Taub DE, Greer KR. Physical activity as a normalizing experience for school-age children with physical disabilities. J Sport Soc Iss 2000; 24: 395414.
  • 24
    Lepage C, Noreau L, Bernard P-M, Fougeyrollas P Profile of handicap situations in children with cerebral palsy. Scand J Rehab Med 1998; 30: 26372.
  • 25
    King GA, Tucker MA, Baldwin P, Lowry K, LaPorta J, Martens L. A life needs model of pediatric service delivery: services to support community participation and quality of life for children and youth with disabilities. Phys Occup Ther Pediatr 2002; 22: 5377.