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

Abstract

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.