Sense of autonomy and daily and scholastic functioning among children with cerebral palsy.
Giving kids with CP real choices during daily tasks can double the payoff of your motor program.
01Research in Context
What this study did
Elad et al. (2018) looked at kids with cerebral palsy. They asked two questions: Does better motor skill help daily and school tasks? Does the child's sense of choice help too?
They gave standard tests of motor skill, autonomy, dressing, eating, and classroom work. Then they used stats to see which pieces predicted success.
What they found
Both motor skill and autonomy mattered. Kids who could move better did better at school and self-care. Kids who felt they had choices also did better.
Autonomy was not just extra credit. It partly carried the benefit of motor skill into real-life tasks. More choice meant more payoff from every gain in movement.
How this fits with other research
Taras et al. (1993) proved you can teach autonomy. They used behavioral skills training with blind students. The students kept new daily-living skills ten months later. Dina shows why that training is worth the time in CP.
Koritsas et al. (2009) tracked adults with CP. They saw stable limits in work and leisure. Dina’s child data hints that early autonomy work might bend that flat line before adulthood.
Sentenac et al. (2013) found that region, not just severity, decides if a European child with CP attends regular school. Dina adds a lever you can pull in any region: boost the child’s own voice in daily tasks.
Why it matters
Next time you write a plan for a child with CP, add a self-choice step. Let the learner pick the shirt color, the order of tasks, or the reward. This tiny move can lift ADL and classroom scores beyond what motor drills alone achieve. You do not need new gear or extra hours—just embed choice in the routine you already run.
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02At a glance
03Original abstract
BACKGROUND: There is growing evidence that children's sense of autonomy is an important psychological need closely linked with the development of self-esteem and motivation. Among children with physical disabilities, motor or cognitive limitations may negatively affect child's sense of autonomy (CSA) and competency. PURPOSE: To examine how sense of autonomy among children with cerebral palsy (CP) directly and indirectly relates to their activity of daily living (ADL) and scholastic performance. METHODS: Seventy-three children with CP and their mothers participated in this study. Child's ADL skills and scholastic performance were assessed using the Pediatric Evaluation Disability Inventory (PEDI) and the Scholastic Skills Rating Scale (SSRS), respectively. Level of impairment was assessed using the Gross Motor Function Measure-66 (GMFM-66). CSA was established via videotaped mother-child interactions. Regression analyses were conducted to examine factors predicting child's functional level (ADL and scholastic). The overall model was tested for goodness-of-fit and test of mediation. RESULTS: GMFM and CSA significantly predicted child's ADL and scholastic functioning. GMFM explained 15% of the variance for CSA, 84% for PEDI, and 24% for scholastic functioning. CSA positively mediated the association between GMFM and child's ADL skills. GMFM was positively associated with CSA. CONCLUSION: Motor impairment has a substantial impact on child's level of functioning. However, child's functioning is a complex construct that is also affected by her or his sense of autonomy. Therefore, sense of autonomy can serve as a potential point of intervention to improve functioning among children with CP.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.06.006