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Determinants of playfulness of young children with cerebral palsy
Authors:Lisa A Chiarello  Doreen J Bartlett  Robert J Palisano  Sarah Westcott McCoy  Lynn Jeffries  Alyssa LaForme Fiss
Institution:1. Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA;2. School of Physical Therapy, Western University, London, Ontario, Canada;3. Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA;4. Department of Rehabilitation Sciences, The University of Oklahoma Health Sciences Centre, Oklahoma City, Oklahoma, USA;5. Department of Physical Therapy, Mercer University, Atlanta, GA, USA
Abstract:Purpose: To identify child, family, and service determinants of playfulness of young children with cerebral palsy.

Methods: Participants were 429 children, 18–60 months. Children were divided into two groups, Gross Motor Function Classification System levels I-II and III-V. Therapists collected data on body functions and gross motor function; parents provided information about children’s health conditions and adaptive behavior, family life, and services. One year after the beginning of the study, therapists assessed children’s playfulness. Data were analyzed using structural equation modeling.

Results: Higher gross motor function was associated with higher playfulness for both groups. Greater impact of health conditions on daily life was associated with lower playfulness for children in levels I-II. More effective adaptive behavior was associated with higher playfulness, and higher parent perception of therapists’ family-centeredness was associated with lower playfulness for children in levels III-V.

Conclusion: Supporting gross motor function, health, and adaptive behavior may foster playfulness.

Keywords:Adaptive behavior  gross motor function  health  prospective cohort study  structural equation modeling
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