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AIM Longitudinal studies that have examined cognitive performance in children with intellectual disability more than twice over the course of their development are scarce. We assessed population and individual stability of cognitive performance in a clinical sample of children with borderline to mild non-syndromic intellectual disability. METHOD Thirty-six children (28 males, eight females; age range 3-19y) with borderline to mild intellectual disability (Full-scale IQ [FSIQ] 50-85) of unknown origin were examined in a retrospective clinical case series using linear mixed models including at least three assessments with standardized intelligence tests. RESULTS Average cognitive performance remained remarkably stable over time (high population stability, drop of only 0.38 IQ points per year, standard error=0.39, p=0.325) whereas individual stability was at best moderate (intraclass correlation of 0.58), indicating that about 60% of the residual variation in FSIQ scores can be attributed to between-child variability. Neither sex nor socio-economic status had a statistically significant impact on FSIQ. INTERPRETATION Although intellectual disability during childhood is a relatively stable phenomenon, individual stability of IQ is only moderate, likely to be caused by test-to-test reliability (e.g. level of child's cooperation, motivation, and attention). Therefore, clinical decisions and predictions should not rely on single IQ assessments, but should also consider adaptive functioning and previous developmental history. [ABSTRACT FROM AUTHOR]

Aim To determine the extent to which children's mastery motivation predicts occupational performance outcomes following upper limb intervention ( ULI). Method In this cohort study, participants received 45 hours of ULI, either in an intensive group-based or distributed individualized model. The Dimensions of Mastery Questionnaire ( DMQ) measured mastery motivation at baseline. Occupational performance outcomes were assessed at baseline and 13 weeks' post-intervention using the Canadian Occupational Performance Measure ( COPM). Multivariable models determined the contribution of mastery motivation to COPM outcome irrespective of group membership. Results Forty-two children with congenital hemiplegia (29 males, 13 females; mean age 7y 8mo [ SD 2y 2mo]; range 5y 1mo-12y 8mo; Manual Ability Classification System [ MACS] I=20 and II=22; predominant motor type unilateral spastic n=41) participated in the study. Significant gains were seen in COPM performance and satisfaction scores ( p<0.001) post-intervention with no between group differences. Children who had greater persistence with object-oriented tasks ( p=0.02) and better manual ability ( p=0.03) achieved higher COPM performance scores at 13 weeks. Children's persistence on object-oriented tasks was the strongest predictor of COPM satisfaction ( p=0.01). Interpretation Children's persistence with object-oriented tasks as well as manual abilities needs to be considered when undertaking ULI. Predetermining children's motivational predispositions can assist clinicians to tailor therapy sessions individually based on children's strengths, contributing to effective engagement in ULI. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to examine the relationship between mastery motivation and individual and environmental characteristics in school-aged children with congenital hemiplegia. Method Forty-eight child-caregiver dyads (children's mean age 7y 11mo, SD 2y 4mo; 33 males, 15 females; Manual Ability Classification System [ MACS] level I, n=25, and level II, n=23; predominant motor type spastic hemiplegia, n=47) were recruited to this cross-sectional study. Children were assessed using the Melbourne Assessment of Unilateral Upper Limb Function ( MUUL) and the Assisting Hand Assessment. Caregivers completed the Dimensions of Mastery Questionnaire, the Parenting Scale, and a demographic questionnaire. Results Consistent and positive parental disciplinary practices were associated with higher total motivation ( p=0.006) and instrumental aspect scores ( p=0.009). Children with siblings and from single-parent families experienced greater negative reactions to failure ( p=0.006). Children from two-parent families ( p=0.018) and with better bimanual performance ( p=0.015) demonstrated greater object-oriented persistence. Age, sex, limitations in manual ability ( MACS), and movement and body function of the impaired limb ( MUUL) did not contribute significantly to mastery motivation. Interpretation Inconsistent, excessively lax, and verbose parenting practices may discourage children from persevering with challenging tasks. Functional parenting styles, positive discipline practices, and autonomy-supportive strategies for task engagement should be encouraged when intervening with children with cerebral palsy. Parents should be supported to engage in these practices in all aspects of daily activities. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe and identify factors associated with motivation in children with cerebral palsy (CP). Children with CP were recruited for this cross-sectional study. Children were assessed using the Leiter Intelligence Test, the Gross Motor Function Measure, and the Vineland Adaptive Behavior Scale. Parents completed the Dimensions of Mastery Questionnaire (DMQ) and questionnaires on demographics, child behaviour, and family functioning. The parents of 74 children (46 males, 28 females; mean age 9y 2mo, SD 2y 1mo, range 5y 10mo-12y 11mo) completed the DMQ. Just over half of the children (39/74) were classified at Gross Motor Function Classification System (GMFCS) level I, with 13 classified at GMFCS level II, one at level III, six at level IV, and 14 at level V; one child was not classified. The most common diagnoses were spastic hemiplegia and quadriplegia (23 each), followed by diplegia (14). The highest motivation scores were obtained for the dimensions of mastery pleasure and social persistence and the lowest for persistence with motor or cognitive tasks. Age and sex were not predictive of scores on the DMQ. Higher IQ ( r=0.41), better motor ability ( r=0.43), and fewer limitations in self-care, communication, and socialization ( r=0.44-0.53) were positively associated with motivation total score. A negative impact of the child's disability on the family was associated with lower motivation ( r=−0.44). Positive social behaviours were positively correlated with motivation ( r=0.38-0.66), whereas hyperactivity and peer problems were negatively associated. High motivation was associated with fewer activity limitations and behavioural problems and reduced family burden. Low motivation may adversely influence a child's functional potential and the effectiveness of interventions. Strategies focusing on the child, peers, adults, or activities are proposed to enhance the children's motivation to engage in more challenging activities. [ABSTRACT FROM AUTHOR]

This commentary is on the original article by Miller et al. on pages 976–983 of this issue. [ABSTRACT FROM AUTHOR]