Rehabilitation service utilization in children and youth with cerebral palsy.
OBJECTIVE
To describe the pattern of use of rehabilitation services in children and adolescents with cerebral palsy (CP), and to identify factors associated with use.


METHODS
In this study, parents of 91 school-age children and 167 adolescents with CP completed a questionnaire regarding educational and rehabilitation resources received within the last 6 months. Rehabilitation services included occupational therapy (OT), physical therapy (PT), speech language pathology (SLP), psychology and special education. Demographic characteristics were documented and developmental and functional status was assessed. Relationships between service utilization and sociodemographic factors, functioning and school setting were determined.


RESULTS
Over half of children (53.2%) and adolescents (57.5%) were in regular schools; however, 41% of these required special education resources. The remainder (42.5-46.8%) was in special schools. The majority of children (84.6%) were receiving at least one rehabilitation service although this decreased (68.1%) in adolescence. PT and OT were most common and services were provided predominantly in the school setting. Services were primarily weekly direct interventions at school age, with weekly interventions or consultations most common for adolescents. Younger age was associated with service receipt at school age only. Children with greater motor limitations, lower IQ and greater activity limitations were more likely to receive OT, PT, SLP or special education. Children in segregated schools were significantly more likely to receive rehabilitation services, when compared with children in regular schools.


CONCLUSIONS
The majority of children and youth received one or more services. Individuals with greater motor or cognitive challenges were more likely to receive a range of school-based services from rehabilitation specialists. When compared with children of school age, adolescents were less likely to receive services and when provided, services were more likely to be consultative. Services may need to be more optimally organized through childhood to enhance benefits to children with CP across activity limitation profiles.
School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada; Montreal Children's Hospital-MUHC and Centre for Interdisciplinary Research in Rehabilitation (CRIR), Montreal, QC, Canada.
A
A
Majnemer
K
K
Shikako-Thomas
L
L
Lach
M
M
Shevell
M
M
Law
N
N
Schmitz
C
C
Poulin
D000293:Adolescent; D002547:Cerebral Palsy / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D002648:Child; D003362:Cost-Benefit Analysis; D002658:Developmental Disabilities / Q000453:epidemiology / Q000534:rehabilitation*; D019988:Children with Disabilities / Q000534:rehabilitation; D004519:Education, Special; D005260:Female; D006801:Humans; D008297:Male; D009788:Occupational Therapy / Q000706:statistics & numerical data; D010290:Parents; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012572:School Health Services / Q000706:statistics & numerical data; D013070:Speech Therapy; D011795:Surveys and Questionnaires; D055815:Young Adult
cerebral palsy; rehabilitation