Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy.
OBJECTIVE
To test a model of child, family, and service determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy (CP).


METHODS
Participants were 288 children with CP, age range 6 to 12 years (mean 9y 8mo, SD 2y), and their parents from seven children's hospitals. The sample comprised 166 (57.6%) males and 122 (42.4%) females, and between 40 (13.9%) and 74 (25.7%) children in each of the five levels of the Gross Motor Function Classification System. Children completed the Children's Assessment of Participation and Enjoyment by interview. Parents completed the Pediatric Outcomes Data Collection Instrument, Family Environment Scale, Coping Inventory, Measure of Processes of Care, and two questionnaires. Structural equation modeling was used to test the model.


RESULTS
Fit statistics indicated a good model fit. The model explains 32% of the variance in intensity of participation. Path coefficients (p ≤ 0.05) indicate that higher gross motor function, higher enjoyment, more effective adaptive behavior, younger age, and higher family activity orientation are associated with higher intensity of participation. The path between services and participation was not significant.


CONCLUSIONS
Intensity of participation of children with CP is influenced by multiple child and family determinants. Children's gross motor function and behavior in life situations are important for participation; knowledge of activities the child and family enjoy has implications for opportunities for participation. Professionals are encouraged to address priorities for leisure and recreation identified by children with CP and their families.
Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA 19102-1192, USA. robert.j.palisano@drexel.edu
Robert J
RJ
Palisano
Lisa A
LA
Chiarello
Margo
M
Orlin
Donna
D
Oeffinger
Marcy
M
Polansky
Jill
J
Maggs
Anita
A
Bagley
George
G
Gorton
D000223:Adaptation, Psychological; D002547:Cerebral Palsy / Q000145:classification* / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D002648:Child; D004185:Disability Evaluation; D005190:Family / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007899:Leisure Activities; D008297:Male; D051346:Mobility Limitation; D009042:Motivation; D011998:Recreation; D012931:Social Environment; D014481:United States