Hand function and habilitation services among young children with unilateral or bilateral cerebral palsy. A cohort study of performance, development, and current practice

Abstract

Limited hand function may restrict participation in everyday activities for children with cerebral palsy (CP). The general aims of this thesis were to describe aspects of hand function and development in young children with unilateral or bilateral CP, and to explore characteristics of current practice to enhance hand function. A cohort of 128 young children with CP was followed during preschool age. Hand function was classified with the Manual Ability Classification System (MACS) and assessed with the Assisting Hand Assessment or the Both Hands Assessment. Information on current practice was retrieved from a parent questionnaire and the CP follow-up program (CPOP). MACS levels distinguished between different developmental trajectories, and children with bilateral CP improved their performance less than children with unilateral CP. Performance at 18 months could coarsely predict development for children with unilateral CP. The parents reported large amounts of hand training, and variability in the organization of training enhanced their perception of child benefits. The limited development among children with bilateral CP needs further investigation, and more knowledge is warranted regarding the role of interventions and other factors on hand function development for children with CP.