Participation trajectories: impact of school transitions on children and adolescents with cerebral palsy

AIM To describe participation trajectories, and impact of school transitions on those trajectories, of children with cerebral palsy (CP). METHOD This population-based longitudinal study assessed participation in activities outside school of children with CP born in 1994/1995. Eligible children contributed data between two and five occasions over 9 years, and had parents with sufficient English proficiency to complete the measures: the Children’s Assessment of Participation and Enjoyment, and the Preferences for Activities of Children. Linear mixed models were used to assess the relationships between participation and age and the impact of transition. RESULTS At study commencement (2006), 233 children with CP born in 1994/1995 were registered in Victoria; 93 (51 males, 42 females; mean age 11y 2mo, age range 10–12y) contributed longitudinal data. Participation diversity and intensity decreased over time for recreational, active physical, and self-improvement activities (p < 0.009). Social participation increased over time: diversity, intensity, and frequency (p < 0.007). All of the identified slopes were generally small (b≤0.11, 1-point change every 9y) except for recreational diversity scores (b=_0.29). Transition from primary and secondary school had little impact on participation. INTERPRETATION Findings of increased social participation over time are encouraging. Declining participation in other activity types suggests that action is needed to ensure that meaningful recreation and leisure activities are maintained as adolescents with CP transition to adulthood.