Article

The objective of this longitudinal study was to describe the course of
social functioning and communication in children with cerebral palsy (CP) over a
3-year period, its difference with the normative course, and its relationship
with disease characteristics and personal and environmental factors. METHOD:
Participants in this study were 110 children with CP (70 males, 40 females) with
a mean age of 11 years and 3 months (SD 1y 8mo). Social functioning and
communication were measured with the Vineland Adaptive Behavior Scales.
Comparisons were made with normative data; data were analysed with generalized
estimating equations. According to the Gross Motor Function Classification System
(GMFCS), 50 of the 110 children were categorized as GMFCS level I, 16 as level
II, 13 as level III, 13 as level IV, and 18 as level V. RESULTS: The course of
social functioning over a 3-year period showed an increase in restrictions in
children with CP (p<0.001). Restrictions in communication increased more in
children with the most severe forms of CP (p<0.001). In addition to disease
characteristics (GMFCS category, presence of epilepsy, and speech problems),
personal factors (externalizing behaviour problems) and environmental factors
(having no siblings, low parental level of education, and parental stress) were
associated with greater restrictions in social functioning and communication.
INTERPRETATION: The results indicate that it is important to focus not only on
the medical treatment of children with CP, but also on their behavioural problems
and social circumstances, and to support the parents so that social functioning
and communication in these children may be improved.

Langue : ANGLAIS