Predicting leisure participation of school-aged children with cerebral palsy: longitudinal evidence of child, family and environmental factors.
OBJECTIVE
This longitudinal study aims to determine which child, family and environmental variables measured at 2 years of age predict leisure participation in formal and informal activities in school aged children with cerebral palsy (CP).


METHODS
Parents of 46 children with CP (mean age at baseline: 2 years 6 months, SD 0 years 1 month; at follow-up 6 years 7 months, SD 0 years 9 months; n = 26 boys, n = 20 girls; Gross Motor Classification System I = 30%, II = 7%, III = 28%, IV = 24%, V = 11%) completed the Children's Assessment of Participation and Enjoyment indicating their child's participation. Multivariate regression models were used to identify early predictors of participation.


RESULTS
Movement ability was a significant child-related predictor for formal activities (R(2) 17%, P < 0.05). Movement ability and social skills were most predictive (R(2) 62%, P < 0.00) for informal activities. The feeling of being restricted in family participation was the single most predictive factor for formal and informal activities at family level (R(2) 12%, P < 0.05, R(2) 25%, P < 0.05). Type of daycare was the only environmental variable that was predictive, and only for informal activities (R(2) 16%, P < 0.05). In the overall model movement ability was most predictive for leisure participation in formal activities (R(2) 17%, P < 0.05). Movement ability and social skills are the most important predictors for informal leisure participation (R(2) 62%, P < 0.01).


CONCLUSIONS
Several variables are found to be related to formal and informal participation at age 6. Movement ability and social skills at age 2 are most predictive of leisure participation when the child is 6 years old.
Rudolph Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center de Hoogstraat, Utrecht, the Netherlands.
M K
MK
Bult
O
O
Verschuren
E
E
Lindeman
M J
MJ
Jongmans
P
P
Westers
A
A
Claassen
M
M
Ketelaar
D002547:Cerebral Palsy / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D004777:Environment; D005192:Family Health; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007899:Leisure Activities; D008137:Longitudinal Studies; D008297:Male; D009048:Motor Skills; D011594:Psychometrics; D058992:Social Participation; D012944:Social Support; D011795:Surveys and Questionnaires