Stability of leisure participation from school-age to adolescence in individuals with cerebral palsy.
Leisure participation drops sharply as kids with CP become teens, so plan early to keep them engaged.
01Research in Context
What this study did
Majnemer et al. (2015) tracked the same kids with cerebral palsy for several years. They used a play survey called the CAPE to see how often, how many, and how much fun activities stayed the same from grade school to high school.
The team looked at recreation, skill, self-improvement, and social play. They wanted to know if leisure keeps steady or slips as these kids grow up.
What they found
Play dropped across the board. Kids tried fewer activities and did them less often. Enjoyment also sank, except for hanging out with friends, which held steady.
Recreation, skill, and self-improvement took the biggest hits. Social play stayed level, but overall leisure life shrank as they became teens.
How this fits with other research
Shikako-Dratsch et al. (2013) saw the same slide in a big one-time survey of 175 teens with CP. Both papers agree: participation dips with age, and non-ambulatory kids feel it most.
Badia et al. (2013) showed more play means better quality of life. Annette’s 2015 data now warn that this boost fades if we do not act early.
van Wely et al. (2020) stretched the lens into adulthood. Low teen participation predicted poor adult domestic and social life, so the teen drop carries long-term weight.
Why it matters
You can’t wait until high school to save leisure. Start in elementary years by writing participation goals into the IEP, scheduling club games, and training parents to book weekend slots. Check the CAPE each annual review. If diversity or intensity slips, add brief coached trials of new after-school clubs. Keeping play alive now protects adult independence later.
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02At a glance
03Original abstract
With increasing age, youth with disabilities are at risk for decreased participation in leisure activities, a key component for physical and mental health. This prospective study describes changes in leisure participation and leisure preferences from school-age to adolescence in children with cerebral palsy (CP). Participants were recruited at school-age (6-12 years) for a study on participation and reassessed for a second study on adolescents (12-19 years) if >12 years. Thirty-eight children (24 males) with CP who could actively participate in the completion of the Children's Assessment of Participation and Enjoyment (CAPE) and the Preferences for Activities of Children (PAC) comprised the sample. Average time between assessments was 5.0 ± 1.3 years. Most children were ambulatory (32/38 Gross Motor Function Classification System I-II). In addition to the CAPE and PAC, children were evaluated using the Gross Motor Function Measure-66 and parents completed a socio-demographic questionnaire. Paired t-tests revealed a significant decline in leisure participation diversity and intensity (CAPE) for recreation (p<.0001), skill-based (p<.0001) and self-improvement (p<.05) activities, whereas social participation remained stable (p>.05). Diversity of active-physical activities increased modestly (p=.06) although intensity of participation in this activity domain decreased (p=.003). There was also a decline in enjoyment of leisure activities. Preferences for these leisure activities remained unchanged between school-age and adolescence, except for recreational activities. Gender, maternal education, family income and gross motor ability were not related to differences in CAPE/PAC scores with increasing age. Findings suggest that over time, children with CP's participation in leisure activities diminishes, which is of concern to their functioning and well-being. Parents may be more involved in early childhood in facilitating participation whereas in adolescence, youth may be faced with more environmental barriers and a greater awareness of challenges to participation. Adolescents demonstrated a persisting desire to do these activities, challenging rehabilitation specialists to prioritize strategies to promote greater participation as children transition to adolescence.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.08.009