What constitutes self-concept for children with CP? A delphi consensus survey

This study aimed to identify constructs (factors) and content (items) that constitutes self-concept for children with cerebral palsy (CP). Three participant groups were recruited for a three-round Delphi survey: 12 children with CP aged 8–12 years, 18 caregivers, and 21 professionals working with this population. Delphi Round I involved item generation and literature review. In Round II, participants used a five-point scale to rate the importance of factors/items collated from (a) existing self-concept measures identified from literature review and (b) additional factors/items raised in Round I. To increase understanding for children, the rating process was incorporated into a game-based format called “myTREEHOUSE” where ramps leading up to the tree house represented progressively higher ratings. Each item was presented by the researcher verbally (short standard phrase) and visually (Pictorial Communication Symbols card). Factors and items reaching 75 % consensus within each group were removed and those not reaching consensus were repeated in Round III. Consensus on factors and items reaching consensus after Rounds II and III was examined within and between groups. A total of 117 items were identified by the review and 24 from Delphi Round I, totalling 141 items. After Delphi Rounds II and III, 52 items achieved consensus from two or more participant groups. While many areas of self-concept recognised as important for children with CP were similar to typically developing children, several additional CP-specific elements were identified through the Delphi survey.