The socio-emotional behavioural problems of children with cerebral palsy according to their parents' perspectives

Quality of life and mental health in emerging adults with cerebral palsy compared to the general population

Background

While evidence concerning Quality of Life (QoL) in youth with cerebral palsy (CP) in comparison to the general population has been accumulating, there is a lack of studies exploring differences on a wider range of positive and negative mental health outcomes in emerging adults.

Methods

This binational case control study is part of the SPARCLE cohort study on QoL and participation of youth with CP. QoL (WHOQOL-BREF), depression (PHQ-9), anxiety (GAD-7) and self-efficacy (GSE) were assessed in 198 emerging adults with CP and 593 emerging adults from the general population, matched for country of residence, age and gender. ANCOVAs with impairment and pain as covariates were run.

Results

Similar levels of QoL were found in both samples, except for the environmental domain, with better QoL for emerging adults with CP compared to the general population. There were significant descriptive differences regarding depression with worse levels in the CP sample, however, also worse levels of self-efficacy. Pain as a covariate had a significant negative impact on all measures, leading to poorer self-efficacy while worsening depression and anxiety; impairment had a significant worsening impact on physical QoL and self-efficacy only.

Conclusion

Similar expressions of mental health outcomes in emerging adults with CP and the general population indicate the high adaptive capability of emerging adults with CP.

Current Experiences and Future Expectations for Physical Activity Participation: Perspectives of Young People with Physical Disabilities and Their Rehabilitation Clinicians

Purpose: Researchers investigated current physical activity experiences of youth with physical disabilities and expectations for continued participation as they transition to adult services. Method: Youth (n = 6) and clinicians (n = 7) from a rehabilitation center participated in two separate focus groups. Researchers used inductive thematic analysis. Results: Four themes emerged among youth: "good for your health"; "motivation is key"; "social opportunities in safe environments"; "wanting to stay active." Among clinicians, five themes arose: "added therapeutic benefits with participation"; "development as individuals through physical activity"; "inclusive and supportive environments"; "parents as advocates"; "transitioning to adult services is important." Conclusions: Themes across focus groups were comparable. Participants expressed positive experiences for youth attending a dedicated adapted fitness center. To facilitate current and future physical activity in adulthood for youth with physical disabilities in integrated settings, the following are warranted: accessible buildings, trained staff, adapted equipment, and positive attitudes toward disability.

Social anxiety symptoms among youth with chronic health conditions: trajectories and related factors

Purpose: This study explored three-year trajectories of social anxiety symptoms among youth with chronic health conditions and investigated factors influencing those trajectories.Methods: Participants (N = 439) were recruited from eight pediatric rehabilitation centers. The Social Anxiety Scale for Children-Revised measured social anxiety across four time points. Latent Class Growth Analysis was used to study trajectories and logistic regression to identify related factors.Results: A three-class solution was supported: a "high anxiety and stable" group (17.1%), a "moderate anxiety and stable" group (44.4%), and a "low anxiety and stable" group (38.5%). Youth in the "moderate and stable" group were less likely to be male compared to the "low and stable" group. Youth in the "high and stable" group were more likely to have greater cognitive symptoms and less likely to have higher levels of social participation compared to the "low and stable" group. Youth in both the "high and stable" and "moderate and stable" groups were less likely to have high support from classmates or close friends compared to the "low and stable" group. Moreover, both the "high and stable" and "moderate and stable" groups were less likely to have positive family functioning.Conclusion: Youth with chronic conditions belonging to "high and stable" and "moderate and stable" social anxiety trajectories can be distinguished from those in a "low and stable" trajectory using personal, functional, and environmental level variables.Implications for RehabilitationYouth with chronic health conditions are at risk of developing and maintaining moderate to high levels of social anxiety symptoms as they move through adolescence.Compared to youth with "low and stable" social anxiety, those with "moderate and stable" social anxiety are less likely to be male, have high peer support or high family functioning.Compared to youth with "low and stable" social anxiety, those with "high and stable" social anxiety are more likely to have greater cognitive symptoms, and less likely to have high social participation, high peer support, or high family functioning.Rehabilitation and other professionals should not only consider factors that are functional in nature; they should also consider personal and environmental level factors when supporting youth with chronic health conditions who experience social anxiety symptoms.