Participation and enjoyment of leisure activities in school‐aged children with cerebral palsy

TLDR

Children with cerebral palsy in this study were predominantly mild, with 59 % at Gross Motor Function Classification System level I, 23 % at level II, and 18 % at levels III–V, and most had a spastic subtype. The study aimed to describe leisure activity participation in school‑aged children with CP and to identify factors that promote greater involvement. Ninety‑five school‑aged CP children were recruited, and participation was assessed in 67 of them using the Children’s Assessment of Participation and Enjoyment, while biomedical, child, family, and environmental predictors were examined. Children with CP engaged in diverse leisure activities with high enjoyment, yet participation was lower in skill‑based, active physical, and community activities; mastery motivation and rehabilitation involvement increased participation, whereas cognitive/behavioral challenges, activity limitations, and parental stress hindered it.

Abstract

The objective of this study was to characterize participation in leisure activities in children with cerebral palsy (CP) and identify determinants of greater involvement. Ninety-five children of school age (9y 7mo [SD 2y 1mo]) with CP were recruited, and participation was evaluated with the Children's Assessment of Participation and Enjoyment in a subset (67/95; 42 males, 25 females) who could actively participate in completion of the assessment. Most had mild motor dysfunction (Gross Motor Function Classification System: 59% level I, 23% level II, 18% levels III-V) and had a spastic subtype of CP (23 hemiplegia, 17 diplegia, 16 quadriplegia, 11 other). Biomedical, child, family and environmental predictor variables were considered in the analysis. Results demonstrated that these children were actively involved in a wide range of leisure activities and experienced a high level of enjoyment. However, involvement was lower in skill-based and active physical activities as well as community-based activities. Mastery motivation and involvement in rehabilitation services enhanced involvement (intensity and diversity) in particular leisure activities, whereas cognitive and behavioral difficulties, activity limitations, and parental stress were obstacles to participation.