Determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy

• Published in: Developmental medicine and child neurology 2011-02, Vol.53 (2), p.142-149
• Main Authors: PALISANO, ROBERT J, CHIARELLO, LISA A, ORLIN, MARGO, OEFFINGER, DONNA, POLANSKY, MARCY, MAGGS, JILL, BAGLEY, ANITA, GORTON, GEORGE
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adjustment (to Environment); Age Differences; Cerebral Palsy; Cerebral Palsy - classification; Cerebral Palsy - epidemiology; Cerebral Palsy - psychology; Cerebral Palsy - rehabilitation; Child; Children; Coping; Coping Inventory; Disability Evaluation; Family - psychology; Family Environment; Family Environment Scale; Female; Health Surveys; Humans; Interviews; Leisure Activities; Leisure Time; Male; Mobility Limitation; Motivation; Parents; Participation; Preadolescents; Psychological Patterns; Psychomotor Skills; Questionnaires; Recreation; Recreational Activities; Social Environment; Structural Equation Models; United States
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/j.1469-8749.2010.03819.x

Aim  To test a model of child, family, and service determinants of intensity of participation in leisure and recreational activities by children with cerebral palsy (CP). Method  Participants were 288 children with CP, age range 6 to 12 years (mean 9y 8mo, SD 2y), and their parents from seven children’s hospitals. The sample comprised 166 (57.6%) males and 122 (42.4%) females, and between 40 (13.9%) and 74 (25.7%) children in each of the five levels of the Gross Motor Function Classification System. Children completed the Children’s Assessment of Participation and Enjoyment by interview. Parents completed the Pediatric Outcomes Data Collection Instrument, Family Environment Scale, Coping Inventory, Measure of Processes of Care, and two questionnaires. Structural equation modeling was used to test the model. Results  Fit statistics indicated a good model fit. The model explains 32% of the variance in intensity of participation. Path coefficients (p≤0.05) indicate that higher gross motor function, higher enjoyment, more effective adaptive behavior, younger age, and higher family activity orientation are associated with higher intensity of participation. The path between services and participation was not significant. Interpretation  Intensity of participation of children with CP is influenced by multiple child and family determinants. Children’s gross motor function and behavior in life situations are important for participation; knowledge of activities the child and family enjoy has implications for opportunities for participation. Professionals are encouraged to address priorities for leisure and recreation identified by children with CP and their families.