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Lookup NU author(s): Emeritus Professor Allan ColverORCiD, Dr Heather Dickinson, Dr Kathryn Parkinson
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
We investigated whether childhood factors that are amenable to intervention (parenting stress, child psychological problems and pain) predicted participation in daily activities and social roles of adolescents with cerebral palsy (CP). We randomly selected 1174 children aged 8-12 years from eight population-based registers of children with CP in six European countries; 743 (63%) agreed to participate. One further region recruited 75 children from multiple sources. These 818 children were visited at home at age 8-12 years, 594 (73%) agreed to follow-up at age 13-17 years.We used the following measures: parent reported stress (Parenting Stress Index Short Form), their child's psychological difficulties (Strength and Difficulties Questionnaire) and frequency and severity of pain; either child or parent reported the child's participation (LIFE Habits questionnaire). We fitted a structural equation model to each of the participation domains, regressing participation in childhood and adolescence on parenting stress, child psychological problems and pain, and regressing adolescent factors on the corresponding childhood factors; models were adjusted for impairment, region, age and gender.Pain in childhood predicted restricted adolescent participation in all domains except Mealtimes and Communication (standardized total indirect effects beta -0.05 to -0.18, 0.01 < p < 0.05 to p < 0.001, depending on domain). Psychological problems in childhood predicted restricted adolescent participation in all domains of social roles, and in Personal Care and Communication (beta -0.07 to -0.17,0.001 < p < 0.01 top < 0.001). Parenting stress in childhood predicted restricted adolescent participation in Health Hygiene, Mobility and Relationships (beta -0.07 to -0.18, 0.001 < p < 0.01 to p < 0.001). These childhood factors predicted adolescent participation largely via their effects on childhood participation; though in some domains early psychological problems and parenting stress in childhood predicted adolescent participation largely through their persistence into adolescence.We conclude that participation of adolescents with CP was predicted by early modifiable factors related to the child and family. Interventions for reduction of pain, psychological difficulties and parenting stress in childhood are justified not only for their intrinsic value, but also for probable benefits to childhood and adolescent participation. (C) 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).
Author(s): Dang VM, Colver A, Dickinson HO, Marcelli M, Michelsen SI, Parkes J, Parkinson K, Rapp M, Arnaud C, Nystrand M, Fauconnier J
Publication type: Article
Publication status: Published
Journal: Research in Developmental Disabilities
Year: 2015
Volume: 36
Pages: 551-564
Print publication date: 01/01/2015
Online publication date: 14/11/2014
Acceptance date: 24/10/2014
Date deposited: 23/02/2015
ISSN (print): 0891-4222
ISSN (electronic): 1873-3379
Publisher: Pergamon Press
URL: http://dx.doi.org/10.1016/j.ridd.2014.10.043
DOI: 10.1016/j.ridd.2014.10.043
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