title: Course of employment in adults with cerebral palsy over a 14-year period.
abstract: To explore the course of employment in adults with cerebral palsy (CP) over 14 years, and to identify subgroups at risk for unemployment.
  
  
  
  Sixty-five adults with CP (33 males, 32 females; baseline age 25y 8mo, standard deviation [SD] 3y 2mo; intellectual impairment 25%; bilateral CP 65%) participated in a prospective cohort study. Self-reports of employment and work hours per week in 1996, 2000, and 2010 were documented. The course of employment (including sheltered work) and work hours per week were analysed, using generalized estimating equations (GEE).
  
  
  
  Overall, employment rate was stable over time (38-45%, p=0.413), but lower than in the general population (75-86%, p<0.001). Employment rates were specifically low in adults with intellectual impairment, bilateral CP, and in adults with Gross Motor Function Classification System (GMFCS) levels IV and V. Work hours per week declined (35.0 [SD 7.9] to 31.2 [SD 10.3], p=0.033), especially among females (32.3 [SD 6.4] to 23.4 [SD 7.4], p<0.001). Similar to the general population, females often worked part-time.
  
  
  
  Employment was low compared with the general population, but remained stable in the long term; however, work hours per week decreased. Adults with intellectual impairment, bilateral CP, and GMFCS levels IV and V are subgroups at risk for unemployment.
authors.affiliation: Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Joyce L
authors.identifier: 0000-0003-0829-7825
authors.initials: JL
authors.lastname: Benner
authors.affiliation: Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Sander R
authors.initials: SR
authors.lastname: Hilberink
authors.affiliation: Sophia Rehabilitation Center, The Hague, the Netherlands.
authors.forename: Thessa
authors.initials: T
authors.lastname: Veenis
authors.affiliation: Rijndam Rehabilitation Institute, Rotterdam, the Netherlands.
authors.forename: Wilma M A
authors.initials: WMA
authors.lastname: van der Slot
authors.affiliation: Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Marij E
authors.initials: ME
authors.lastname: Roebroeck
mesh_terms: D000328:Adult; D002547:Cerebral Palsy / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D004522:Educational Status; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D012306:Risk; D057566:Self Report; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult