The determinants of self-determined behaviors of young children with cerebral palsy.
Family support for choice and low cognitive-behavioral load drive self-determined behaviors in preschool CP.
01Research in Context
What this study did
The team watched preschoolers with cerebral palsy during play and daily routines.
They asked parents how much they encourage choice and independence.
They also noted each child’s attention, memory, and behavior issues.
What they found
Kids whose families backed their choices showed more self-determined acts.
Fewer cognitive-behavioral problems added even more boost.
For children who could not move much, being playful gave an extra push.
How this fits with other research
Chien-Hu et al. (2013) seem to disagree: they saw higher motor severity and older age predict smaller gains. The gap is about what was counted. Chien-Min tracked broad developmental scores; Hui-Ju counted self-determined moves like picking toys.
Meral et al. (2022) widen the lens. They show parent habits shaped by region and income also color self-determination ratings across many disabilities.
Bassett-Gunter et al. (2017) carry the idea forward: adults with ID, ASD, or Down syndrome who report more daily choice are more likely to hold paid jobs.
Why it matters
You can grow self-determination long before school. Coach families to offer real choices during meals, play, and dressing. Pair this with plans that cut cognitive load—short cues, visual prompts, and calm spaces. Track choice-making as a goal on the IFSP; it may steer later employment and adult independence.
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02At a glance
03Original abstract
The purpose of this study was to identify determinants of self-determined behaviors of young children with cerebral palsy. The participants were 429 children (56% boys, 18-60 months) and their parents. Structural equation modeling was used to test two models of self-determined behaviors, one for children with walking mobility (Gross Motor Function Classification System, GMFCS levels I-II) and the other for children with limited self-mobility (GMFCS levels III-V). Cognitive-behavioral problems and the extent family supports their child's self-determined behaviors explained 60% of the variance in self-determined behaviors of children with walking mobility. Cognitive-behavioral problems, playfulness, and the extent family supports their child's self-determined behaviors explained 68% of the variance in self-determined behaviors of children with limited self-mobility. The less the child's cognitive-behavioral problems affect daily activities (p<.05) and the more the extent family supports their child's self-determined behaviors (p<.05), the more effective the child's self-determined behaviors. Playfulness only had an effect on self-determined behaviors of children with limited self-mobility (p<.05). Service providers are encouraged to assess and support children's daily functioning in cognition, communication, and emotional/behavioral regulation, playfulness, and family strategies in providing opportunity for children to practice self-determined behaviors.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.10.004