Assessment & Research

Impact of social participation, motor, and cognitive functioning on quality of life in children with Cerebral Palsy.

Di Lieto et al. (2025) · Research in developmental disabilities 2025
★ The Verdict

For kids with CP, verbal IQ plus parent-rated social support predict quality of life more than gross motor level.

✓ Read this if BCBAs writing assessments or service plans for school-age clients with CP.
✗ Skip if Clinicians who only treat adults or purely motor goals.

01Research in Context

01

What this study did

Di Lieto et al. (2025) asked what shapes quality of life for kids with cerebral palsy.

They measured verbal IQ, gross motor level, and how helpful parents felt the social world was.

The team then looked at which of these best predicted life-quality scores.

02

What they found

Verbal smarts and a supportive social scene lifted quality of life across most areas.

Gross motor level mattered less than talking ability and parent-seen support.

In short, mind and social fit beat wheelchair skills alone.

03

How this fits with other research

Rapp et al. (2017) tracked the same kids as they became teens. They saw quality of life dip and named pain, mood, and parenting stress as the levers. Chiara’s new child data add verbal IQ and social ease to that list, so the full picture now spans body, mind, and context.

Shawler et al. (2021) and Marsack et al. (2017) show social involvement boosts parent well-being in IDD. Chiara flips the lens: when parents rate the social world as helpful, the child with CP feels it too.

Johnson et al. (2021) link higher verbal IQ to milder autism traits. Chiara finds the same cognitive factor lifts quality of life in CP, hinting that verbal ability is a cross-diagnosis asset.

04

Why it matters

You can’t fix brain injury, but you can screen verbal ability early and weave social supports into plans. When parents see clubs, schools, and peers as welcoming, kids live better right now. Target talk skills and engineer inclusive places—motor gains will still help, but these moves may pay bigger life-quality dividends.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add a quick verbal IQ probe and a parent social-support rating to your intake, then pick language-rich, peer-heavy activities before drilling gait.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
71
Population
other
Finding
positive

03Original abstract

BACKGROUND: Cerebral Palsy (CP) may impact the quality of life (QOL) and social.participation in different life situations and the discussion concerning the predictive.factors related is still open. The aim of the present study is to investigate the QOL in.Italian children with CP by a parent-reported questionnaire, evaluating the predictive.role of social participation and of motor and cognitive levels on the QOL dimensions. PARTICIPANTS AND METHODS: Seventy-one children with CP (31 males and 40 females) and with a mean age 8.9 years (SD 2.5 years) participated in this study and the Cerebral Palsy Quality of Life Questionnaire for Children (CP-QOL-Child) questionnaire was fulfilled by their parents. Type of CP, The Participation and Environment Measure for Children and Youth questionnaire (PEM-CY), functional motor level (described with GMFCS and MACS) and cognitive profile (Wechsler scales assessment) were collected. RESULTS: Significant differences within CP-QOL domains were found (X2(6) = 176.38,p < .001). The age and the level of environmental helpfulness in social participation impacted significantly the majority of CP-QOL domains (p < .001). The MACS and Verbal cognitive levels significantly influence CP-QOL domains, in terms of Feeling about functioning and Family health as Social wellbeing respectively(p < .001). The GMFCS level does not directly predict QOL but significantly impacts the environmental helpfulness in social participation (p < .001). DISCUSSION: Beside the known role of motor impairment in determining QOL, the verbal cognitive level and the parent-perception of environmental supports in social context,also represent significant co-predictive factors of QOL. Important implications in terms of multidimensional social and health care of children with CP may be proposed.

Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.105004