title: Does Context Matter? Mastery Motivation and Therapy Engagement of Children with Cerebral Palsy.
abstract: OBJECTIVE
  To determine if mastery motivation at baseline predicts engagement in two goal-directed upper limb (UL) interventions for children with unilateral cerebral palsy (UCP).
  
  
  METHODS
  Participants were 44 children with UCP, mean age 7 years 10 months, Manual Ability Classification System level I (N = 23) or II (N = 21). Twenty-six children received intensive novel group-based intervention (Hybrid Constraint Induced Movement Therapy, hCIMT) and 18 received distributed individual occupational therapy (OT). Caregivers completed the Dimensions of Mastery Questionnaire (DMQ) parent-proxy report at baseline. Children's engagement was independently rated using the Pediatric Volitional Questionnaire (PVQ). Associations between children's mastery motivation and engagement were examined using linear regression.
  
  
  RESULTS
  Children who received hCIMT had lower DMQ persistence at baseline (p = .05) yet higher PVQ volitional (p = .04) and exploration (p = .001) scores. Among children who received hCIMT, greater object-oriented persistence was associated with task-directedness (β 0.25, p = .05), seeking challenges (β = 0.51, p = .02), exploration (β = 0.10, p = .03), and volitional scores (β = 0.23, p = .01).
  
  
  CONCLUSIONS
  Despite having lower levels of persistence prior to engaging in UL interventions, children who received hCIMT demonstrated greater engagement in goal-directed tasks than children who received individual OT. Within hCIMT, children's motivational predisposition to persist with tasks manifested in their exploration and engagement in therapy.
authors.affiliation: a School of Allied Health , Australian Catholic University , Brisbane , Australia.|b Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland , Brisbane , Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Miller
authors.affiliation: c Queensland Children's Allied Health Research , Children's Health Queensland , Brisbane , Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Ziviani
authors.affiliation: d School of Population Health , The University of Queensland , Brisbane , Australia . Queensland Children's Medical Research Institute , The University of Queensland , Brisbane , Australia.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.affiliation: b Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland , Brisbane , Australia.
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
mesh_terms: D000293:Adolescent; D017028:Caregivers; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D009788:Occupational Therapy / Q000379:methods*; D010358:Patient Participation / Q000379:methods*; D026741:Physical Therapy Modalities; D011615:Psychotherapy, Group / Q000379:methods*; D011795:Surveys and Questionnaires; D034941:Upper Extremity
keywords: Cerebral palsy; context; engagement; motivation; rehabilitation; upper limb