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Background: Cerebral palsy (CP) is the most common childhood physical disability. Early and evidence-based rehabilitation is essential for improving functional outcomes in children with CP. However, rehabilitation professionals face barriers to adopting evidence-based practices (EBP)s. The objective of this project is to develop a knowledge translation (KT) strategy to support CP-EBP among pediatric rehabilitation professionals. Methods: We follow an integrated KT approach by collaborating with clinicianand patient-partners. Partners engaged in co-design through team meetings and content review via email. The KT strategy comprises two components: (1) An electronic (e)-KT toolkit was created from summarized evidence extracted from randomized clinical trials on early rehabilitation for children with CP, and (2) a multifaceted online KT training program developed with guidance from a scoping review exploring effective KT strategies. Results: The e-KT toolkit summarizes twenty-two early interventions for children with or at risk for CP aged 0-5 years. Each module features an introduction, resources, parent/family section, and clinician information, including outcomes, intervention effectiveness, and evidence level. The KT training program includes three 10-15 min video-based training modules, text summaries, quizzes, and case studies. Site champions, identified as qualified rehabilitation professionals, were onboarded to support the site implementation of the training program. A champion-training booklet and 1-hour session were designed to equip them with the necessary knowledge/resources. Conclusion: The tailored, multifaceted, and co-designed KT strategy aims to be implemented in pediatric rehabilitation sites to support professional's uptake of CP-EBPs. Lessons learned from its development, including the co-development process and multifaceted nature, hold potential for broader applications in rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: To strengthen the translation of evidence to actionable policy, stakeholder engagement is necessary to synthesize, prioritize and contextualize the academic research content into accessible language. In this manuscript we describe a multi-level evidence-based stakeholder consultation process and related outcomes proposed to promote awareness of and foster cross-sectorial collaborations towards human rights-based approaches for children with disabilities. Methods: Mixed-methods participatory action research done in three steps: (1) A literature review of peer-reviewed evidence on rights-based approaches in childhood disabilities; (2) Consultation with researchers in diverse fields, grassroot organizations, caregivers, and youth with disabilities; (3) A constructive dialogue with decision makers at federal and provincial levels in Canada to discuss consultations results. Results: Stakeholders value human rights approaches that can have a direct impact on practical aspects of their daily living. Organizations give high importance to adopting rights-based approaches to measure policy outcomes, while parents value service provision and youth emphasize accessibility. Conclusion: The implementation of rights-based approaches in childhood disabilities can support policy, services, and daily lives of children with disabilities and the ecosystems around them. It can also guide research priorities, and create a common language to foster collaborations across sectors and interested parties. [ABSTRACT FROM AUTHOR]

This study examined the relationship between gross motor function and manual ability in 120 adolescents with cerebral palsy (CP) (15.2, SD 2.1 years, 59.8% male). Adolescents were evaluated using the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). A neurologist classified CP subtype. Most adolescents were ambulatory with or without utilization of aids (GMFCS level I: 35.0%, II: 30.0%, III: 5.8%, IV: 10.8%, and V: 18.3%). MACS levels were I: 34.2%, II: 25.8%, III: 16.7%, IV: 7.5%, and V: 15.8%. Correlations between GMFCS and MACS were strong in youth with quadriplegia (r = 0.89, p less than 0.001), moderate in individuals with diplegia (r = 0.58, p = 0.01), but weakly associated for adolescents with hemiplegia (r = 0.24, p = 0.23). The findings provide evidence for maintaining a clinical distinction between spastic quadriplegia and spastic diplegia. Manual ability may not be congruent with mobility in adolescents with CP and should be specifically evaluated given its importance to daily life functioning. (Contains 3 tables.)

This study examined the constructs underlying the Movement Assessment Battery for Children-2 (M-ABC-2), Bruninks-Oseretsky Test of Motor Proficiency (BOTMP) and Vineland Adaptive Behavior Scale-2 (VABS-2) using the framework of the International Classification of Functioning Disability and Health--Child Youth version (ICF-CY) and the diagnostic criteria of developmental coordination disorder (DCD). Two independent raters coded and matched items to ICF-CY codes as per the eight ICF linking rules developed by Cierza and colleagues. Content density and inter-rater reliability were also calculated. The majority of codes assigned to the M-ABC-2 and BOTMP related to body functions (54% and 64% respectively). For the VABS-2, 91% of codes pertained to activities and participation. The M-ABC-2, BOTMP, and the VABS-2 emphasize the ICF-CY constructs differently. The VABS-2 may be useful in the evaluation of performance of daily life activities and participation in children with DCD. (Contains 5 tables.)

Leisure participation has been associated with happiness and well-being in children. Individuals born preterm are at greater risk for motor, cognitive and behavioral difficulties which may contribute to difficulties participating in leisure activities. This systematic review examined the current knowledge on participation in leisure activities in individuals born preterm throughout the lifespan as compared to term born controls. An electronic search of eight databases for articles published up to October 2011 was conducted. The quality of each study was assessed using a standardized checklist. Thirteen studies met the selection criteria. In school-age children, no significant differences were found in activity levels between children born prematurely and term born controls. In adolescents, leisure scores in social activities, hobbies and sports were statistically significantly lower compared to controls. In young adults, differences in frequency and intensity of physical activity were reported compared to term controls. Promoting participation in leisure activities should be encouraged at a young age and continued to adulthood by minimizing the gaps between capabilities and the demands of the tasks and the environment. (Contains 1 figure and 2 tables.)

Motor difficulties are common in children with Attention Deficit Hyperactivity Disorder (ADHD). Although preliminary evidence has suggested that methylphenidate can improve the motor skills in children with ADHD and Developmental Coordination Disorder (DCD), the effect of stimulant medication on motor performance in children newly diagnosed with ADHD with or without motor impairment remains unclear. A cohort study of 49 medication-naive children (39 male; mean age 8.4 [plus or minus] 1.3 years) with ADHD was conducted. Children were evaluated using the Movement Assessment Battery for Children and the developmental test of visual motor integration at diagnosis and again three months following daily treatment with a stimulant medication. Motor difficulties were highly present at baseline (73.5%) but resolved in a subset after treatment with stimulant medication, suggesting that their motor difficulties may be attributed in part to their attentional problems. Nevertheless, motor impairment persisted in 55.1% of the sample. The severity of the behavioural symptoms was significantly associated with balance skills in children without motor impairments (r[squared] = 0.30, p less than 0.01) and with visual motor integration skills in children with persisting motor difficulties (r[squared] = 0.27, p less than 0.01). Attentional difficulties negatively affect the motor skills of children with ADHD. Following the use of stimulant medication, an important subset continued to demonstrate motor difficulties. The improvement in behaviour was insufficient to resolve motor problems and these children should therefore be targeted for rehabilitation services. (Contains 3 tables.)

Research on quality of life (QoL) of adolescents and young adults born preterm and those with congenital heart disease (CHD) was systematically reviewed, and factors associated with QoL were identified. Forty-five studies met the inclusion criteria for review. Although the majority of studies found that self-reported QoL of adolescents and young adults born preterm did not differ from term controls, several studies reported lower QoL among individuals born preterm, especially those who had additional impairments. Most studies on adolescents and young adults with CHD reported lower QoL compared with healthy peers, which may be in part due to real or perceived physical activity limitations of individuals with CHD. Overall, parents reported that their adolescents born at high risk had a less favorable QoL compared with those who served as controls. Encouraging age-appropriate, safe, and enjoyable physical activity and avoiding unnecessary restrictions and overprotection are considerations for optimizing QoL. (Contains 5 tables and 1 figure.)

Aim: To examine the evidence of the effectiveness of different feeding interventions for children with cerebral palsy. Methods: A search of 12 electronic databases identified all relevant studies. For each study, the quality of the methods was assessed according to the study design. A total of 33 articles were retrieved, and 21 studies were included in the final analysis. Results: Feeding interventions were separated into five main categories: oral sensorimotor facilitation, food consistency, positioning, oral appliances, and adaptive equipment. Five studies were randomized controlled trials. Outcomes were mainly reported on feeding safety and efficiency. One study documented positive results in height and weight change. Nineteen of the 21 studies presented positive outcomes in eating efficiency and/or safety. Interpretation: Feeding interventions demonstrate potential benefits for children with cerebral palsy. However, the current level of evidence is poor, and empirical data are lacking. Methodologically, rigorous studies are required particularly investigating multimodal approaches. (Contains 3 tables and 1 figure.)

Preliminary evidence suggests that children with Attention Deficit Hyperactivity Disorder (ADHD) may exhibit handwriting difficulties. However, the exact nature of these difficulties and the extent to which they may relate to motor or behavioural difficulties remains unclear. The aim of this study was to describe handwriting capacity in children newly diagnosed with ADHD and identify predictors of performance. Forty medication-naive children with ADHD (mean age 8.1 years) were evaluated with the Evaluation Tool of Children's Handwriting-Manuscript, the Movement Assessment Battery for Children (M-ABC), the Developmental Test of Visual Motor Integration (VMI) and the Conner Global Index. An important subset (85.0%) exhibited manual dexterity difficulties. Handwriting performance was extremely variable in terms of speed and legibility. VMI was the most important predictor of legibility. Upper extremity coordination, as measured by the M-ABC ball skills subtest, was also a good predictor of word legibility. Conclusion: Poor handwriting legibility and slow writing speed were common in children newly diagnosed with ADHD and were associated with motor abilities. Future studies are needed to determine whether interventions, including stimulant medications, can improve handwriting performance and related motor functioning. (Contains 4 tables.)

Aim: The aim of this study was to describe and identify factors associated with motivation in children with cerebral palsy (CP). Method: 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. Results: 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. Interpretation: 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

Aim: The objective was to describe leisure activity preferences of children with cerebral palsy (CP) and their relationship to participation. Factors associated with greater interest in leisure activities were identified. Method: Fifty-five school-aged children (36 males, 19 females; mean age 9y 11mo; range 6y 1mo-12y 11mo) with CP (Gross Motor Function Classification System [GMFCS]) level I 62%, level II 22%, level III-IV 16%; 33.3% hemiplegia, 29.6% diplegia, 25.9% quadriplegia, 11.2% other) who could complete the Preferences for Activities of Children (PAC) were recruited. Results: Social and recreational activities were most preferred, and self-improvement activities were least preferred. Younger age, higher motivation, and IQ predicted interest in active-physical activities (r[superscript 2] = 0.39). Negative reaction to failure was associated with less preference for social activities (r[superscript 2] = 0.16), whereas increased prosocial behaviours were related to greater preference for recreational (r[superscript 2] = 0.13) and self-improvement activities; the latter is also predicted by older age (r[superscript 2] = 0.24). Interest in skill-based activities was greater in females and in children who were highly motivated, younger, and had greater motor limitations (r[superscript 2] = 0.51). The findings suggest that personal factors and functional abilities influence leisure activity preferences. High preference for certain activities was not always associated with involvement in these activities. Interpretation: Determination of preferences is inherent to child-centred practice and should, therefore, be part of the evaluation process. Rehabilitation strategies can minimize barriers to leisure participation, such as fear of failure, low motivation, or environmental obstacles.