Model May Aid Doctors in Predicting Course of Key Developmental Skills in Child

Researchers have developed a trend line that describes the development of people with cerebral palsy from the end of infancy (age 1) through to adulthood (age 21), and that may allow doctors to give parents more concrete information about their child’s likely progression.

The study, “Mobility and self-care trajectories for individuals with cerebral palsy (aged 1–21 years): a joint longitudinal analysis of cohort data from the Netherlands and Canada,” was published in The Lancet Child & Adolescent Health.

Upon finding out that their child has cerebral palsy, parents often want to know what that child’s future will look like: How mobile will they be? How able to take care of themselves?

Healthcare professionals have had little data to go on in answering these two and other questions. This new study may allow such professionals to make more accurate predictions.

“The diagnosis of cerebral palsy is very scary for any parent, but we’re glad now we can give a better idea of the child’s developmental future,” Jan Willem Gorter, MD, PhD, a professor at McMaster University in Ontario and a study co-author, said in a press release.

To develop their trend line, the researchers used data from 551 people with cerebral palsy in Canada and the Netherlands. All were between the ages of 1 and 17 and were followed for up to four years.

Motor function was measured using the Gross Motor Function Classification System (GMFCS), a validated measurement of motor skills for people with cerebral palsy that puts an individual at one of five levels based on their spontaneous movements (rolling, crawling, walking (with or without support, etc).

Mobility and self-care capability were measured with the Pediatric Evaluation of Disability Inventory (PEDI), which is designed to measure functional disability in children.

The researchers found that, based on which of the five GMFCS levels an individual was at, they could make predictions about what PEDI scores they would have between the ages of 1 and 21 — thus creating the curve.

“We have systematically assessed their daily functioning in terms of mobility and self-care. This has resulted in the description of developmental trajectories for the various GMFCS levels,” said Marjolijn Ketelaar, PhD, a researcher at University Medical Centre Utrecht and another study co-author.

“It also enables better monitoring of the development of individual children with CP, setting realistic goals and providing targeted intervention activities, providing a customized treatment for the right child at the right time,” added Jeanine Voorman, MD, PhD, another researcher at University Medical Centre Utrecht and study co-author.