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Social and Community Participation of Children and Youth With Cerebral Palsy Is Associated With Age and Gross Motor Function Classification

R.J. Palisano, PT, ScD, is Professor, Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Mail Stop 502, 245 N 15th St, Philadelphia, PA 19102-1192 (USA) and a member of the scientific staff of Shriners Hospitals for Children, Philadelphia, Pennsylvania.
L.-J. Kang, PT, MS, is a doctoral candidate in the Department of Physical Therapy and Rehabilitation Sciences, Drexel University.
L.A. Chiarello, PT, PhD, PCS, is Associate Professor, Department of Physical Therapy and Rehabilitation Sciences, Drexel University, and a member of the scientific staff of Shriners Hospitals for Children, Philadelphia.
M. Orlin, PT, PhD, is Associate Professor, Department of Physical Therapy and Rehabilitation Sciences, Drexel University, and a member of the scientific staff of Shriners Hospitals for Children, Philadelphia.
D. Oeffinger, PhD, is Director of Research Development, Shriners Hospitals for Children, Lexington, Kentucky.
J. Maggs, DocEd, MCSP, is Assistant Professor, Department of Physical Therapy and Rehabilitation Sciences, Drexel University.

robert.j.palisano{at}drexel.edu

Background: Through social and community participation, children and youth with cerebral palsy (CP) form friendships, gain knowledge, learn skills, express creativity, and determine meaning and purpose in life.

Objective: The purposes of this study were: (1) to determine whether social and community participation of children and youth with CP differ based on age, sex, and gross motor function; and (2) to identify the types of activities in which social and community participation are highest.

Design and Methods: A prospective cross-sectional analytic design was used. The participants were a sample of convenience of 291 children (6–12 years of age) and 209 youth (13–21 years of age) with CP (55.4% males, 44.6% females) receiving services from 7 children's hospitals. Participants completed the Children's Assessment of Participation and Enjoyment (CAPE) by structured interview. Gross Motor Function Classification System (GMFCS) level was determined by the researchers.

Results: Youth did a higher percentage of activities with friends and others and outside the home than children. Children and youth in level I did a higher percentage of activities with friends and others compared with children and youth in levels II and III and in levels IV and V. Children and youth in level I and in levels IV and V did a higher percentage of activities outside the home than children and youth in levels II and III. Differences were not found between females and males. The percentage of activities done with friends and others and outside the home was highest for physical and skill-based activities.

Limitations: Findings cannot be attributed only to GMFCS level.

Conclusions: The ability to walk without restrictions is desirable for social and community participation. For children and youth with CP who have limitations in mobility, physical therapists have roles as consultants for accessibility, activity accommodations, and assistive technology and as advocates for inclusive environments.

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