Daily activities of school-age children with cerebral palsy : development and learning

In care and research, there is increasing interest in the daily lives of children with cerebral palsy (CP). So far, we know that CP can have a limiting impact on daily activities such as locomotion and self-care. What we, however, don’t know is how children with CP develop over time in terms of their daily activities. Is there progress, stagnation, or decline, and to what degree, in which activities, in which children? Besides, little is known about how children with CP learn their daily activities. Therefore, the main aim of this thesis was to gain knowledge about both development and learning of daily activities in school-age children with CP. The development of daily activities in children with CP was examined between the age of 5 and 9 years in three domains: self-care, locomotion, and social functioning. To measure daily activities in these domains, the Pediatric Evaluation of Disability Inventory was used. First, the development over time was analyzed using the linear mixed models procedure. Averaged for the total group, significant increases over time were shown on each of the three domains. Then, each domain was analyzed for factors that may determine development over time. For self-care, development was best predicted by a model with gross motor function and intellectual capacity. For locomotion, development was best predicted by a model with gross motor function. For social functioning, development was best predicted by a model with arm-hand function and paternal educational level. Thus, it was found that many children with CP make progress in daily activities between the age of 5 and 9 years and, furthermore, that the development of specific daily activities can be predicted by multiple determinants. In addition to knowledge about development, knowledge about individual learning seems useful in order to optimize daily activities of children with CP. In this respect, classifying learning styles, as known in education and sports, could be one guide. The idea of classifying learning styles was introduced to pediatric rehabilitation and its relevance was examined among pediatric physical therapists and physical educators. Qualitative analyses showed that professionals’ perceptions of classifying learning styles in children with CP were mostly positive, giving three main reasons: individual approach, professional communication, and treatment awareness. In this thesis, it is concluded that knowledge about both development and learning of daily activities in children with CP can help to create realistic expectations and goals for children with CP, their parents, and others involved. Moreover, this knowledge may help to optimize the daily activities of children with C