Search

The article investigates whether Intensive Mobility training with Variability and Error (iMOVE) therapy is as effective as conventional therapist-directed (CONV) therapy in enhancing gross motor development in young children with cerebral palsy.

The article examines the effectiveness of intensive child-initiated mobility training with variability and error (iMOVE) compared to conventional therapist-directed training in improving gross motor skills in young children with cerebral palsy.

Despite the importance of knowing the cognitive capabilities of children with neurodevelopmental conditions, less than one-third of children with cerebral palsy participate in standardized assessments. Globally, approximately 50% of people with cerebral palsy have an intellectual disability and there is significant risk for domain-specific cognitive impairments for the majority of people with cerebral palsy. However, standardized cognitive assessment tools are not accessible to many children with cerebral palsy, as they require manual manipulation of objects, verbal response and/or speeded response. As such, standardised assessment may result in an underestimation of abilities for children with significant motor and/or speech impairment. The overall aim of the project is to examine and compare the psychometric properties of standardised cognitive assessment tools that have been accommodated for use with either a switch device or eye-gaze control technologies, with the specific aims to: (1) Examine the psychometric properties (measurement agreement and validity) of accommodated assessment tools by comparing the performance of typically developing children on six cognitive assessment tools administered via standardised versus accommodated (switch or eye-gaze control) administration; (2) Describe and compare the performance and user experience of children with cerebral palsy on six accommodated cognitive assessments administered via switch or eye-gaze control technologies. Secondary aims are to: (1) Describe the completion rates and time to complete assessments of participants in each group; (2) Within the group with cerebral palsy, examine the effects of condition-specific characteristics (type of cerebral palsy, functional levels, and pain) and demographics (age, socio-demographic) on participation. This protocol paper describes a two-phase validation and acceptability study that utilizes a mixed-model design. This study will collect concurrent data from 80 typically developing children and 40 children with cerebral palsy, who use switch or eye-gaze control technology as alternate access communication methods. The set of instruments will measure receptive vocabulary, fluid reasoning, sustained attention, vision perception, visuospatial working memory and executive functions. Data analyses will be conducted using SPSS v. 25 and R v 4.1.0. SPSS Sample Power 3 was used for power computation and allows for a 10% drop out rate. Quantitative descriptive statistics, measurement agreement data plotting, bivariate and multiple regressions analysis will be conducted using appropriate methods.

Aim: To review the epidemiology and outcomes of African children with cerebral palsy (CP) over a 21-year period., Method: The PubMed, Scopus, and Web of Science online databases were searched for original research on African children with CP aged 18 years and younger published from 2000 to 2021., Results: A total of 1811 articles underwent review against explicit criteria; 93 articles were selected for inclusion in the scoping review. The reported prevalence of CP ranged from 0.8 to 10 per 1000 children. Almost half had perinatal risk factors, but up to 26% had no identifiable risk factor. At least one-third of children with CP had one or more comorbidities, most commonly epilepsy, intellectual disability, and malnutrition. African children with CP demonstrated excess premature mortality approximately 25 times that of the general population, predominantly from infections. Hospital-based and younger populations had larger proportions of children with severe impairments. African children with CP had inadequate access to care and education, yet showed functional improvements compared to controls for all evaluated interventions., Interpretation: The prevalence of CP in Africa remains uncertain. African children with CP have different risk profiles, greater premature mortality, and more severe functional impairments and comorbidities compared to the Global North. Several barriers prevent access to optimal care. Larger African studies on validated and effective interventions are needed., (© 2024 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.)

Aim: To investigate clinicoradiological features associated with epilepsy, its resolution, and drug resistance in children with cerebral palsy (CP)., Method: Data were gathered from the New South Wales/Australian Capital Territory CP Register, encompassing children with CP born between 2003 and 2015 (n = 1916). Clinical features and the severity of impairments were compared among three groups: children with current epilepsy (n = 604), those with resolved epilepsy by age 5 years (n = 109), and those without epilepsy (n = 1203). Additionally, a subset of the registry cohort attending Children's Hospital Westmead (n = 256) was analysed to compare epilepsy and treatment characteristics between drug-responsive (n = 83) and drug-resistant groups (n = 147) using logistic regression and hierarchical cluster analysis., Results: Manual Ability Classification System levels IV and V, intellectual impairment, and vision impairment were found to be associated with epilepsy in children with CP on multivariable analysis (p < 0.01). Moderate to severe intellectual impairment and bilateral spastic CP were independent positive and negative predictors of epilepsy persistence at the age of 5 years respectively (p < 0.05). Microcephaly and multiple seizure types were predictors of drug-resistant epilepsy (area under the receiver operating characteristic curve of 0.83; 95% confidence interval 0.77-0.9). Children with a known genetic cause (14%) and CP epilepsy surgery group (4.3%) formed specific clinical subgroups in CP epilepsy., Interpretation: Our study highlights important clinical associations of epilepsy, its resolution, and treatment response in children with CP, providing valuable knowledge to aid in counselling families and identifying distinct prognostic groups for effective medical surveillance and optimal treatment., What This Paper Adds: Severe motor and non-motor impairments in cerebral palsy (CP) increase epilepsy risk. Epilepsy more likely resolves in bilateral spastic and milder CP impairments. Epilepsy in CP often manifests at an early age with multiple seizure types and high drug resistance. Children with a known genetic cause and CP epilepsy surgery group represent distinct clinical subgroups., (© 2023 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.)

Objective The participation of children in occupations, such as self-care, home environment, play, leisure, and educational and social environments, is significantly correlated with their health and wellbeing. Therefore, the aim of this study was to compare the children with cerebral palsy (CP) and their normally-developing counterparts in terms of their participation in each area of occupations. Materials & Methods This case-control study was conducted in 2015 with 50 children (aged 4-6 years) having CP and 50 normally-developing children (aged 4-6 years) in the Tehran city. The participants were chosen by a convenience sampling strategy and examined using the Persian version of Children Participation Questionnaire. The questionnaire was completed by the parents after the necessary explanations. SPSS (version 18) was used for statistical analysis, and independent t-test was used for the comparison. Results The mean ages of children with CP and normally-developing children were 5 years and 5.1 years, respectively. Significant differences (P0.05). Conclusion The results showed that the children with CP have a lower level of participation in occupations compared to their normally-developing counterparts. One of the reasons for the low participation level of children with CP could be the lack of goal-oriented and occupation-oriented interventions. Thus, this finding will help the healthcare providers to create and develop appropriate therapeutic and rehabilitation interventions so as to meet the needs of these children and promote their participation level and wellbeing.

Aim: To explore the ingredients of early interventions provided to young children with cerebral palsy (CP) who are classified in Gross Motor Function Classification System (GMFCS) levels IV and V, and to identify the 'F-words' addressed by the interventions., Method: Searches were completed in four electronic databases. Inclusion criteria were the original experimental studies that fitted the following PCC components: population, young children (aged 0-5 years, at least 30% of the sample) with CP and significant motor impairment (GMFCS levels IV or V, at least 30% of the sample); concept, non-surgical and non-pharmacological early intervention services measuring outcomes from any of the International Classification of Functioning, Disability and Health domains; and context, studies published from 2001 to 2021, from all settings and not limited to any specific geographical location., Results: Eighty-seven papers were included for review, with qualitative (n = 3), mixed-methods (n = 4), quantitative descriptive (n = 22), quantitative non-randomized (n = 39), and quantitative randomized (n = 19) designs. Fitness (n = 59), family (n = 46), and functioning (n = 33) ingredients were addressed by most experimental studies, whereas studies on fun (n = 6), friends (n = 5), and future (n = 14) were scarce. Several other factors (n = 55) related to the environment, for example, service provision, professional training, therapy dose, and environmental modifications, were also relevant., Interpretation: Many studies positively supported formal parent training and use of assistive technology to promote several F-words. A menu of intervention ingredients was provided, with suggestions for future research, to incorporate them into a real context within the family and clinical practice., What This Paper Adds: Family-centred care (including coaching and caregiver-delivered interventions) and formal parental training are effective strategies for children in GMFCS levels IV and V. Assistive technology ingredients (power, mobility, supported, sitting, stepping, and standing) may promote several 'F-words' (functioning, fitness, family, fun, friends, and future). The lowest level of evidence was found for fun, friends, and future. Other factors (service provision, professional training, therapy dose, environmental modifications) are relevant for young children in GMFCS levels IV and V., (© 2023 Mac Keith Press.)

Introduction: This study aimed to assess the relationship between the parent reports of gross motor function of children with Cerebral Palsy in activities of daily living. Materials and Methods: Sixty mothers of children with Cerebral Palsy (CP) who were recruited by convenience sampling method were participated in this cross-sectional study. Children were between 6 to 12 years old. For assessing the participation of children with CP in life areas, the Children Participation Assessment Scale-Parent version (CPAS-P) was used and for assessing the gross motor function level of these children, the Gross Motor Function Classification System-family report was used. For data analysis, the Pearson correlation coefficient, and ANOVA tests were used. All statistical analyses were done by SPSS v.21. Results: The mean age of children was 8.92 years (age range: 6-12 years). A total of 22 of them were males and 30 were females. The relationship between the Gross Motor Function Classification System (GMFCS) of children with CP and their participation in all objective aspects of Activities of Daily Livings (ADL) and Instrumental Activities of Daily Livings (IADL) were moderate to good and this relationship was significant P

Objectives: This study aimed at evaluating the correlation between mother-child relationship and the rate of participation of children and adolescents with cerebral palsy in leisure time activities. Methods: This study is a descriptive and correlational research. The statistical population included cerebral palsy children aged 7-17 years with a mother who is at least 25 years old. A sample size of 152 children was selected using systematic random sampling. The children filled the King's assessment of participation and enjoyment questionnaire, whereas the mothers responded to a survey of Roth's mother-child relationship evaluation. We collected the data and analyzed them (Spearman's correlation test, One-way ANOVA, Kruskal-Wallis, and Mann-Whitney) using SPSS 16 software. Results: The results showed that there is a correlation between mother-child relationship and the rate of participation of cerebral palsy children in leisure time activities. There was a significant correlation between acceptance of child and the increasing involvement in leisure activities in case of cerebral palsy children. Over protection, excessive ease, and child rejection in a mother-child relationship was associated with reduction in the participation rate of the cerebral palsy children and adolescents in leisure activities. In case of quadriplegic children, the acceptance of child and participation rate was low compared to hemiplegic and diplegic children. Excessive ease of a mother-child relationship in girls was more than boys, but boys experienced more child rejection of a mother-child relationship than girls. Discussion: Participation rate, frequency (how often), and the enjoyment of participation in leisure time activities were correlated with mother-child relationship. Participation differences were existed among CP groups. [ABSTRACT FROM AUTHOR]

Objectives: Children who have a disorder in motor function often suffer from disorders in other areas of their daily lives, such as social and communicative functions. The social function of children with cerebral palsy has so far been less studied than other aspects. The purpose of this study was to evaluate the social function of children with cerebral palsy of 2 to 6 years old. Methods: This (cross-sectional) descriptive-analytic study was performed on 100 children with cerebral palsy in two age groups of 2-4 and 4-6 years old who were selected through convenient sampling from the centers for occupational therapies in Isfahan city. Children's motor function was classified according to Gross Motor Function Classification System (hereafter, GMFCS). The social function was completed by filling in the Pediatric Evaluation of Disability Inventory (PEDI) by interviewing the parents. Statistical analysis was done. Results: The statistical analyses of this study showed that there was a significant difference between the mean score of social function in 5 levels of motor function of children with cerebral palsy (P<0.0001). There was also a significant relationship between the age of children and their social function score (r=0.265 and P=0.008). Moreover, the mean scores of social function in the first and second levels of GMFCS had a significant difference in both groups (P=0.002); however, this difference was not significant in the other three levels (0.053

Purpose: To systematically review the effectiveness of adaptive seating systems on sitting posture, postural control, and seated activity performance in children with cerebral palsy (CP)., Summary of Key Points: From 5 databases, 3 of 21 (14%) articles were of good quality based on the Downs and Black checklist. Commercial modular contoured seating and paper-based low-cost, and contoured foam seating were effective at improving sitting posture, postural control, and seated activity performance. Parents and service providers reported that seating systems reduced stress, burden and psychosocial well-being, and quality of life in children with CP., Conclusion: Limited evidence demonstrated that adaptive seating systems were effective at improving sitting ability and postural control. Randomized controlled trials with objective outcome measures of seating performance in children with CP are needed to evaluate effectiveness., Recommendations for Clinical Practice: Adaptive seating devices are preferred by parents and therapists for children with CP; however, objective measures of seating outcomes are needed., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)

Children cooled for HIE and who did not develop cerebral palsy (CP) still underperform at early school age in motor and cognitive domains and have altered supra-tentorial brain volumes and white matter connectivity. We obtained T1-weighted and diffusion-weighted MRI, motor (MABC-2) and cognitive (WISC-IV) scores from children aged 6-8 years who were cooled for HIE secondary to perinatal asphyxia without CP (cases), and controls matched for age, sex, and socioeconomic status. In 35 case children, we measured cerebellar growth from infancy (age 4-15 days after birth) to childhood. In childhood, cerebellar volumes were measured in 26 cases and 23 controls. Diffusion properties (mean diffusivity, MD and fractional anisotropy, FA) were calculated in 24 cases and 19 controls, in 9 cerebellar regions. Cases with FSIQ ≤ 85 had reduced growth of cerebellar width compared to those with FSIQ > 85 (p = 0.0005). Regional cerebellar volumes were smaller in cases compared to controls (p < 0.05); these differences were not significant when normalised to total brain volume. There were no case-control differences in MD or FA. Interposed nucleus volume was more strongly associated with IQ in cases than in controls (p = 0.0196). Other associations with developmental outcome did not differ between cases and controls., (© 2023. Springer Nature Limited.)

Cerebral palsy is a clinical descriptor covering a diverse group of permanent, non-degenerative disorders of motor function. Around one-third of cases have now been shown to have an underlying genetic aetiology, with the genetic landscape overlapping with those of neurodevelopmental disorders including intellectual disability, epilepsy, speech and language disorders and autism. Here we review the current state of genomic testing in cerebral palsy, highlighting the benefits for personalized medicine and the imperative to consider aetiology during clinical diagnosis. With earlier clinical diagnosis now possible, we emphasize the opportunity for comprehensive and early genomic testing as a crucial component of the routine diagnostic work-up in people with cerebral palsy., (© 2023. Springer Nature Limited.)

Aim: To describe the evidence, outcomes, and lived experience of supported standing for children and young adults with cerebral palsy aged 25 years or younger, classified in Gross Motor Function Classification System levels IV and V., Method: This scoping review included searches in eight electronic databases and manual searching from database inception to May 2020 and updated on 21st February 2022. Two of three reviewers independently screened titles and abstracts and extracted and appraised data. Methodological quality and risk of bias were appraised using tools appropriate to study type. Content analysis and frequency effect sizes were calculated for qualitative and descriptive evidence., Results: From 126 full-text references, 59 citations (one study was reported over two citations) were included: 16 systematic reviews, 17 intervention studies reporting over 18 citations, eight analytical cross-sectional studies, five descriptive cross-sectional/survey studies, five qualitative studies, and one mixed-methods study were identified, along with six clinical guidelines. Maintenance of bone mineral density and contracture prevention outcomes were supported by the most experimental studies and evidence syntheses, while evidence supporting other outcomes was primarily quasi-experimental or descriptive. Qualitative evidence suggests that programmes are influenced by attitudes, device, child, and environmental factors., Interpretation: Individualized assessment and prescription are essential to match personal and environmental needs. Although experimental evidence is limited due to many factors, lived-experience and cohort data suggest that successful integration of standing programmes into age-appropriate and meaningful activities may enhance function, participation, and overall health., What This Paper Adds: Supported-standing interventions may provide an important psychosocial and physical change of position. Supported standing is not passive for those classified in Gross Motor Function Classification System level IV or V. Supported standing may enhance social participation, functional abilities, and fitness. Children need choice in where and when to stand., (© 2022 Mac Keith Press.)

Aim: To test the efficacy of an integrated microfinance/livelihood and community-based rehabilitation (IMCBR) programme in improving health-related quality of life (HRQoL) and motor function of children with cerebral palsy (CP) and gain in social capital to their ultra-poor families in rural Bangladesh., Method: This was an open-label cluster randomized control trial. Children with CP aged 5 years or under were randomly allocated to three arms; Arm A: IMCBR; Arm B: community-based rehabilitation (CBR); and Arm C: care-as-usual. The CBR was modified with phone follow-up followed by home-based CBR at 2.5 months post-enrolment because of the COVID-19 pandemic. Intention-to-treat analysis was performed., Results: Twenty-four clusters constituting 251 children-primary caregivers' dyads were assigned to three arms (Arm A = 80; Arm B = 82; Arm C = 89). Between baseline and endline, the percentage mean change in the physical functioning domain of HRQoL was highest in Arm A (30.0%) with a significant mean difference between Arm A and Arm B (p = 0.015). Improvement in the mean social capital score was significantly higher in Arm A compared to Arm C (p < 0.001)., Interpretation: The findings suggest that IMCBR could improve the HRQoL of children with CP and the social capital of their ultra-poor families. Long-term follow-up of the trial participants and future exploration of such interventions are essential. The integrated livelihood and CBR programme holds potential to improve health and well-being of children with CP and their ultra-poor families., What This Paper Adds: Half of the families who received livelihoods were impacted by a cold-wave, suggesting the need for a more disaster-resilient livelihood asset. The integration of livelihood with community-based rehabilitation programme helps to improve health-related quality of life of children with cerebral palsy and the social capital of their ultra-poor families., (© 2022 Mac Keith Press.)

Objectives The purpose of this article is to determine how many of the current peer-reviewed studies of ankle foot orthoses (AFOs) on children with cerebral palsy (CP) have included adequate details of the design and material of the AFO, to enable the study to be reproduced and outcomes clearly understood. Methods A thorough search of studies published in English was conducted in March 2015, with no restriction on dates, within all major databases using relevant phrases. These searches were then supplemented by tracking all key references from the appropriate articles identified. Study selection The inclusion criteria were as follows: (1) population - children with CP; (2) intervention - AFOs; and (3) outcome measure. One reviewer extracted data regarding the characteristics of the included studies, with the extracted data checked for accuracy and completeness by a second reviewer. None of the studies reviewed gave adequate details of the AFOs. Only 3.6% (n = 2) of papers tested the stiffness. Many studies (54.5%) did not describe the material used nor the material thickness (72.7%). None of them gave any clinical justification for the chosen design of AFO. Conclusions There is a clear paucity of detail regarding the design and material used in AFOs on studies involving children with CP. Such a lack of detail has the potential to affect the validity of the reported outcomes, the ability to reproduce the studies and may misinform clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: To characterize and examine the variability in receipt of inpatient (IP) physical therapy after lower extremity (LE) orthopedic surgery for individuals with cerebral palsy (CP) across hospital-level (region, bed size) and individual characteristics (gender, age, race/ethnicity, insurance type, technology dependency, and surgical burden)., Methods: We retrospectively analyzed physical therapy billing data of children with CP who had LE orthopedic surgery from October 1, 2015, through September 30, 2017, from the Pediatric Health Information Services (PHIS) database., Results: Seventy-five percent of individuals received IP physical therapy during the hospital stay. Individuals from the South and West and those who were technology dependent were less likely to receive IP therapy. Those at large hospitals, aged 11 to 14 years, and with a high surgical burden were more likely to receive therapy., Conclusions: Results provide a starting point for future research on the discrepancies of acute physical therapy services in children diagnosed with CP. (Supplemental digital content video abstract available at: http://links.lww.com/PPT/A420)., Competing Interests: The authors have stated they have no conflicts of interest., (Copyright © 2022 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)

Despite the importance of knowing the cognitive capabilities of children with neurodevelopmental conditions, less than one-third of children with cerebral palsy participate in standardized assessments. Globally, approximately 50% of people with cerebral palsy have an intellectual disability and there is significant risk for domain-specific cognitive impairments for the majority of people with cerebral palsy. However, standardized cognitive assessment tools are not accessible to many children with cerebral palsy, as they require manual manipulation of objects, verbal response and/or speeded response. As such, standardised assessment may result in an underestimation of abilities for children with significant motor and/or speech impairment. The overall aim of the project is to examine and compare the psychometric properties of standardised cognitive assessment tools that have been accommodated for use with either a switch device or eye-gaze control technologies, with the specific aims to: (1) Examine the psychometric properties (measurement agreement and validity) of accommodated assessment tools by comparing the performance of typically developing children on six cognitive assessment tools administered via standardised versus accommodated (switch or eye-gaze control) administration; (2) Describe and compare the performance and user experience of children with cerebral palsy on six accommodated cognitive assessments administered via switch or eye-gaze control technologies. Secondary aims are to: (1) Describe the completion rates and time to complete assessments of participants in each group; (2) Within the group with cerebral palsy, examine the effects of condition-specific characteristics (type of cerebral palsy, functional levels, and pain) and demographics (age, socio-demographic) on participation. This protocol paper describes a two-phase validation and acceptability study that utilizes a mixed-model design. This study will collect concurrent data from 80 typically developing children and 40 children with cerebral palsy, who use switch or eye-gaze control technology as alternate access communication methods. The set of instruments will measure receptive vocabulary, fluid reasoning, sustained attention, vision perception, visuospatial working memory and executive functions. Data analyses will be conducted using SPSS v. 25 and R v 4.1.0. SPSS Sample Power 3 was used for power computation and allows for a 10% drop out rate. Quantitative descriptive statistics, measurement agreement data plotting, bivariate and multiple regressions analysis will be conducted using appropriate methods. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to standardize 1-repetition maximum (1-RM) testing procedures and evaluate the safety and feasibility of these procedures in youth with cerebral palsy (CP)., Methods: Youth with CP completed 1-RM testing on a leg press., Results: Mean absolute, adjusted, and normalized 1-RM loads were 262.4 ± 161.3 lb, 127.0 ± 80.2 lb, and 1.28 ± 0.51, respectively, and 67% were able to successfully lift the same or heavier load after a single failure. Cessation of testing after 1 failed attempt resulted in a 19.0% underestimation of the 1-RM., Conclusions: 1-RM testing in youth with CP is safe and feasible. Multiple attempts at a failed load should be provided to prevent underestimation in strength. The 1-RM test provides a more accurate strength assessment, which will improve the dosing for resistance training in youth with CP., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)

Purpose: This needs assessment survey identifies the priorities of the clinical and research communities involved with the use of instrumented gait analysis (IGA) for a clinical practice guideline on IGA use with children with cerebral palsy (CP)., Methods: Thirteen Likert scale questions asked about the importance of topics related to IGA. Other questions addressed respondents' demographics, experience with IGA, patient populations, and gait laboratory characteristics. Several open-ended questions were included and analyzed., Results: The survey was completed by 43 physical therapists and 53 non-physical therapists involved with IGA. More than 90% rated the following as critically or highly important: reliability and validity of IGA to identify gait pathology (94%); ability to longitudinally track gait pathology (93%); use in planning interventions (93%); use in evaluating outcomes (93%); and definition of IGA (90%)., Conclusions and Recommendations for Clinical Practice: This needs assessment survey identified the topic priorities of clinicians and practitioners who use IGA for the management of children with CP. These results will guide the development of a clinical practice guideline on the use of IGA for the management of CP., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)

Simple Summary: The present work presents a snapshot of the state of the art of Equine-Assisted Intervention (EAI) research, including published articles and the most cited research as well as the most used keywords, and prolific authors and co-authors and their countries. To our knowledge, no other bibliometric studies have been performed, so it can be a tool to support future research. Equine Assisted Interventions (EAIs) integrate the active participation of horses in therapeutic or educational interventions. A bibliometric analysis was carried out on this topic, using traditional bibliometric laws and recommendations. For this purpose, a search on the Web of Science (WoS) Core Collection database was carried out, obtaining 333 documents. Annual publications followed an exponentially increasing trend (R2 = 86%), pointing out that this topic is a growing interest among researchers, publishers, and journals. The USA was the most productive country worldwide and Jeong-yi Kwon and Ji Lee were the prolific co-authors. The WoS category with the highest number of papers was Rehabilitation (84 papers). The Journal of Alternative and Complementary Medicine, and Pediatric Physical Therapy were the journals with the highest number of publications. The most cited paper was "State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy". The most used author keywords were rehabilitation, balance, and those related to specific populations such as Cerebral Palsy and Autism Spectrum Disorder. These results suggest that EAIs is a topic of increasing interest for researchers, editors, and professionals. [ABSTRACT FROM AUTHOR]

A twice-exceptional student who is gifted but also has an additional exceptionality challenges teachers and educators to deliver the best teaching strategies. This paper reviews the current learning strategies, interventions and practices that specifically focused on twice-exceptional students. Research articles were obtained on online database of published articles. The scope is focused on intervention practices or instructions in the behavioral, developmental, emotional, or educational areas. By making a systematic review, this article summarizes 44 research studies on twice-exceptionality interventions between 2000 and 2018, regardless of the areas of disability. The findings are categorized into five main themes, preceded by the most used in studies which is academic or learning strategy, followed by support, strength or talent-based, art or music, and technology. An effective intervention must be tailored to their strengths and potentials as well as providing remediation and support for their social and emotional needs. This study is vital and meaningful for educators and parents to provide these twice-exceptional students the best intervention that suits their own strengths and needs.

Aim: To describe the major congenital anomalies present in children with postneonatally acquired cerebral palsy (CP), and to compare clinical outcomes and cause of postneonatally acquired CP between children with and without anomalies., Method: Data were linked between total population CP and congenital anomaly registers in five European and three Australian regions for children born 1991 to 2009 (n=468 children with postneonatally acquired CP; 255 males, 213 females). Data were pooled and children classified into mutually exclusive categories based on type of congenital anomaly. The proportion of children with congenital anomalies was calculated. Clinical outcomes and cause of postneonatally acquired CP were compared between children with and without anomalies., Results: Major congenital anomalies were reported in 25.6% (95% confidence interval [CI] 21.7-29.9) of children with postneonatally acquired CP. Cardiac anomalies, often severe, were common and present in 14.5% of children with postneonatally acquired CP. Clinical outcomes were not more severe in children with congenital anomalies than those without anomalies. Cause of postneonatally acquired CP differed with the presence of congenital anomalies, with cerebrovascular accidents predominating in the anomaly group. Congenital anomalies were likely associated with cause of postneonatally acquired CP in 77% of children with anomalies., Interpretation: In this large, international study of children with postneonatally acquired CP, congenital anomalies (particularly cardiac anomalies) were common. Future research should determine specific causal pathways to postneonatally acquired CP that include congenital anomalies to identify opportunities for prevention., What This Paper Adds: One-quarter of children with postneonatally acquired cerebral palsy (CP) have a major congenital anomaly. Cardiac anomalies, often severe, are the most common anomalies. Causes of postneonatally acquired CP differ between children with and without congenital anomalies., (© 2021 Mac Keith Press.)

Aim: To describe the frequency and types of major congenital anomalies present in children with pre- or perinatally acquired cerebral palsy (CP), and compare clinical outcomes for children with and without anomalies., Method: This multi-centre total population collaborative study between Surveillance of Cerebral Palsy in Europe, Australian Cerebral Palsy Register, and European Surveillance of Congenital Anomalies (EUROCAT) involved six European and three Australian regions. Data were linked between each region's CP and congenital anomaly register for children born between 1991 and 2009, and then pooled. Children were classified into mutually exclusive categories based on type of anomaly. Proportions of children with congenital anomalies were calculated, and clinical outcomes compared between children with and without anomalies., Results: Of 8201 children with CP, 22.8% (95% confidence interval [CI] 21.9, 23.8) had a major congenital anomaly. Isolated cerebral anomalies were most common (45.2%), with a further 8.6% having both cerebral and non-cerebral anomalies. Cardiac anomalies only were described in 10.5% of children and anomalies associated with syndromes were also reported: genetic (8.0%), chromosomal (5.7%), and teratogenic (3.0%). Clinical outcomes were more severe for children with CP and congenital anomalies, particularly cerebral anomalies., Interpretation: This large, international study reports major congenital anomalies in nearly one-quarter of children with pre- or perinatally acquired CP. Future research must focus on aetiological pathways to CP that include specific patterns of congenital anomalies., What This Paper Adds: Congenital anomalies were reported in 23% of children with pre- or perinatally acquired cerebral palsy. A higher proportion of children born at or near term had anomalies. The most common type of anomalies were isolated cerebral anomalies. Clinical outcomes were more severe for children with congenital anomalies (particularly cerebral)., (© 2020 Mac Keith Press.)

Purpose: To evaluate whether changes in lower-limb muscle strength explain changes in walking capacity during 14-week periods of usual care, power training and follow-up for children with spastic cerebral palsy., Methods: Secondary analysis of a previously conducted double-baseline controlled trial of 22 children with spastic cerebral palsy. Generalized estimating equations were used to evaluate the relationships between within-subject changes in isometric muscle strength and walking capacity over 3 periods., Results: Changes in hip abductor strength were associated with changes in the Muscle Power Sprint Test, changes in gastrocnemius and hip abductor strength were associated with changes in the Shuttle Run Test, and changes in gastrocnemius strength were associated with changes in the 1-minute walk test. All associations supported better walking capacity with increased strength., Conclusion: Walking capacity, especially sprint capacity, can be improved by increasing strength by functional power training in this population., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Academy of Pediatric Physical Therapy of the American Physical Therapy Association.)

This paper addresses the issue of integrating students with special needs into foreign language programs in the early childhood years. A partnership between a university and a charter school in central Florida began as a result of parent and teacher interest in providing a foreign language program for its prekindergarten students. Since 2014, prekindergarten students have been receiving French instruction twice per week in a typical foreign language exploratory (FLEX) program designed to introduce the French language and culture; however, this program is atypical because of the population of the charter school, United Cerebral Palsy (UCP). At UCP, approximately 50% of the students have special needs ranging from mild delays to significant physical and cognitive disabilities. Since the beginning of the French program, questions have been raised by various stakeholders (including some parents and other educational professionals) about students with special needs experiencing confusion in foreign language programs. The educators who started the French program designed a study to address questions raised about the suitability of foreign language programs for students with special needs. The purpose of this study is to examine the effects of a French language program on the first language skills of an inclusive prekindergarten population. This article presents the preliminary results from the ongoing research study.

Aim: To evaluate the effect of progressive resistance training of the ankle plantarflexors on gait efficiency, activity, and participation in adolescents with cerebral palsy (CP)., Method: Sixty-four adolescents (10-19y; 27 females, 37 males; Gross Motor Function Classification System [GMFCS] levels I-III) were randomized to 30 sessions of resistance training (10 supervised and 20 unsupervised home sessions) over 10 weeks or usual care. The primary outcome was gait efficiency indicated by net nondimensional oxygen cost (NNcost). Secondary outcomes included physical activity, gross motor function, participation, muscle strength, muscle and tendon size, and muscle and tendon stiffness. Analysis was intention-to-treat., Results: Median attendance at the 10 supervised sessions was 80% (range 40-100%). There was no between-group difference in NNcost at 10 (mean difference: 0.02, 95% confidence interval [CI] -0.07 to 0.11, p=0.696) or 22 weeks (mean difference: -0.08, 95% CI -0.18 to 0.03, p=0.158). There was also no evidence of between-group differences in secondary outcomes at 10 or 22 weeks. There were 123 adverse events reported by 27 participants in the resistance training group., Interpretation: We found that 10 supervised sessions and 20 home sessions of progressive resistance training of the ankle plantarflexors did not improve gait efficiency, muscle strength, activity, participation, or any biomechanical outcome among adolescents with CP., What This Paper Adds: Thirty sessions of progressive resistance training of the ankle plantarflexors over 10 weeks did not improve gait efficiency among ambulatory adolescents with cerebral palsy. Resistance training did not improve muscle strength, activity, or participation. Ninety percent of participants experienced an adverse event. Most adverse events were expected and no serious adverse events were reported., (© 2020 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press..)

Aim: To explore whether increasing parental education has a causal effect on risk of cerebral palsy (CP) in the child, or whether unobserved confounding is a more likely explanation., Method: We used data from Norwegian registries on approximately 1.5 million children born between 1967 and 2011. We compared results from a traditional cohort design with results from a family-based matched case-control design, in which children with CP were matched to their first cousins without CP. In addition, we performed a simulation study to assess the role of unobserved confounding., Results: In the cohort design, the odds of CP were reduced in children of mothers and fathers with higher education (adjusted odds ratio [OR] 0.67, 95% confidence interval [CI] 0.60-0.75 for maternal education, and adjusted OR 0.75, 95% CI 0.67-0.85 for paternal education). In the family-based case-control design, only an association for maternal education remained (adjusted OR 0.80, 95% CI 0.64-0.99). Results from a simulation study suggested that this association could be explained by unobserved confounding., Interpretation: A causal effect of obtaining higher education on risk of CP in the child is unlikely. Results stress the importance of continued research on the role of genetic and environmental risk factors that vary by parents' educational level., What This Paper Adds: Children of higher-educated parents had significantly lower odds of cerebral palsy (CP). There was no evidence of difference in risk of CP within first cousins whose mothers or fathers had different educational levels. Association between parental education and odds of CP did not reflect a causal effect., (© 2020 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.)

Aim: To explore how patients with cerebral palsy (CP) perceive their gait and evaluate associations between subjective gait perception and: objective gait parameters, endurance, pain, and fatigue., Method: Sixty-two patients (21 females and 41 males; mean [SD] age 20y [5y 1mo], range 15-29y) performed a clinical gait analysis. Self-selected walking speed, Gait Profile Score, and Gait Variable Score were calculated. Subjective gait perception was assessed with a visual analogue scale using the question: 'On a scale from 0 (worst) to 10 (optimal), how would you describe your walking today?'. A 6-minute walk test (6MWT) measured endurance; the 36-Item Short Form Health Survey (SF-36) evaluated quality of life. T-tests, Pearson correlations, and univariate and multiple linear regression models were used to compare and find associations between the data., Results: Overall mean (SD) subjective gait perception was 7.5 (1.8) and was significantly higher for patients in Gross Motor Function Classification System (GMFCS) level I (7.9 [1.5]) than for patients in GMFCS levels II and III (5.9 [2.0]). Positive correlations were found between subjective gait perception and gait scores, walking speed, 6MWT distance, and SF-36 score. Only walking speed was a significant predictor of subjective gait perception., Interpretation: Subjective gait perception was influenced by GMFCS level and linked partially with the walking speed. The gait quality did not explain subjective gait perception. It is important to combine subjective and objective gait scores to develop personalized therapeutic goals., What This Paper Adds: Subjective gait perception is influenced by the physical impairment levels of patients with cerebral palsy. Subjective gait perception and objective gait scores are associated. Walking speed is the only predictor of gait perception., (© 2020 Mac Keith Press.)