Commentary on “Interrelationships of Functional Status and Health Conditions in Children With Cerebral Palsy: A Descriptive Study”
This study informs practice by combining 3 classifications systems with the Child Health Conditions Questionnaire for improved screening and intervention for children with cerebral palsy. It demonstrates the inverse relationship between functional classification system levels (I-V) and associated health conditions. Interestingly, children in classification level I were more impacted by their impairments, although they had fewer than their counterparts (levels II-V). Since children with better function tend to be seen less frequently, it is important for therapists to assess all possible challenges. Controlling emotions/behaviors and pain are often overlooked, yet they negatively affect all children. The Holland Bloorview Chronic Pain Assessment Toolbox may help families better understand their child's needs and enhance dialogue with their primary care physician. Outcome measures should be comprehensive to improve care and communication with families and other disciplines. More consistent use of the 3 classification systems, and appropriate outcome measures among pediatric therapists would make epidemiological research more feasible.
“What should I be mindful about when applying this information?”
Although children from suburban/urban rural areas were included, there was no record of socioeconomic status. The ability of parents to comprehend and accurately answer the Child Health Conditions Questionnaire may have been influenced by their education level. Parents may be uncertain about which impairment/health condition is affecting their child, possibly leading to inaccurate responses.
This study lacked information on participation and environmental factors, which can either facilitate or create barriers for mobility. Outcome measures to address these areas (eg, Participation and Environment Measure Children and Youth, Assessment of Life Habits, Canadian Occupational Performance Measure) may improve future research. Therapists should be mindful about connecting families with community resources to increase patient participation and inclusion. The consistent use of comprehensive outcome measures would help therapists educate stakeholders on the complexities of cerebral palsy and in improving the human experience for children with CP.