Disadvantaged Kids with CP Likely To Have More Severe Disease, Study Says

A new study suggests that socioeconomically disadvantaged children with cerebral palsy are at greater risk of having more severe disease.

The study, “Impact of social disadvantage on cerebral palsy severity,” was published in the journal Developmental Medicine & Child Neurology.

The study used data from the Australian Cerebral Palsy Register, which routinely collects demographic and clinical characteristics of people with cerebral palsy in Australia.

The researchers looked for connections between cerebral palsy characteristics at age 5 (motor function, intellectual disabilities, etc.) and predicted socioeconomic disadvantage, which was assessed using three factors: a measurement of socioeconomic status of the neighborhood in which the person was born, as well as the age at birth and nationality of the patient’s biological mother (with younger age at birth and mothers who came from lower-income countries considered indicative of lower socioeconomic status).

The population studied included 6,289 children born between 1993 and 2009 and for whom demographic information was available.

Patients who were socioeconomically disadvantaged were statistically more likely to have worse disease. As an illustration of this, in the lowest socioeconomic quintile (the bottom 20%), 32% of the children were unable to walk, 32% had an IQ lower than 50 (indicative of intellectual disability), and 48% had a severe comorbidity such as epilepsy, blindness, deafness, or being unable to communicate verbally. In contrast, in the highest socioeconomic quintile, these rates were 26%, 26%, and 40%, respectively.

As to why this association exists, the researchers were careful to stress in their paper that this study shows a correlation, not a causation — that data suggest socioeconomic status and disease risk are associated, but do not demonstrate any kind of cause-and-effect relationship. They also noted that this study is limited by its indirect measurement of socioeconomic status, which did not include key factors such as parental education or income.

“It is important that this is examined in detail in future research to better understand why socio-economic disadvantage confers an increased risk of having a child with severe [cerebral palsy] at age 5 … so that the risk might be modified through appropriate prevention strategies,” the researchers said.

“Potentially, this also means that the children with [the] greatest need for early intervention services are the most likely to have the least financial resources available to them and to live in neighborhoods with fewer available services. We thus need to ensure that our family- and neighborhood-level early interventions for CP have the reach and intensity to support families of children with CP who are socioeconomically disadvantaged,” they added.

Some of these interventions may include “digital strategies for adolescent mothers and culturally safe services for mothers from minority ethnicities,” the researchers said.

Because cerebral palsy is a lifelong condition, “reducing this inequity in the severity of its impairments” can help all children with cerebral palsy fully participate in society.