Development of social functioning and communication in school-aged (5-9 years) children with cerebral palsy.
Non-walking children with CP and low IQ can lose social and communication skills each year unless we intervene early.
01Research in Context
What this study did
Researchers followed a group of school-aged children with cerebral palsy for two years. They wanted to see how social and communication skills changed over time.
Kids who could not walk and had lower IQ scores made up most of the group. The team tested the same children at the start and again two years later.
What they found
Social and communication skills got worse for the non-walking children with lower IQ. The decline was steady, not sudden.
Children who could walk or had higher IQ scores did not show the same drop. The gap between groups widened each year.
How this fits with other research
Sawyer et al. (2014) tracked older children with early language delays. They also found that one in five shifted into social-communication deficits by middle childhood. Both studies warn that early language problems can snowball into social problems later.
Lecavalier et al. (2006) showed that social skills at school entry predict how well children with intellectual disability adapt. Their positive finding lines up with the CP study: kids with stronger skills at the start had better outcomes.
Capelli et al. (2025) saw social skill gaps in babies with visual impairment. That seems opposite to the CP study, but the babies were much younger and the cause was sensory, not motor. The shared message is to screen social skills early, no matter the diagnosis.
Why it matters
If you work with non-ambulatory children who have CP and low cognitive scores, do not wait for social skills to catch up on their own. Start joint-attention and turn-taking programs before age six. Add speech-language and occupational therapy early. Track progress every six months so you can adjust the plan before declines lock in.
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02At a glance
03Original abstract
The aim of this study was to examine determinants of the course and level of social functioning and communication in school-aged children with cerebral palsy (CP) over a 2-year period. A clinic-based sample of 5 and 7 years old children with CP (n=108; 72 males; mean age 6 y 3 mo, SD 12 mo; Gross Motor Function Classification System (GFMCS) level I-V) was followed longitudinally in three yearly assessments. Social functioning and communication were measured with the Vineland Adaptive Behavior Scales (VABS). Data were analyzed with generalized estimated equations. The results showed that social function followed a course of progressive restrictions over time in non-ambulatory children with CP aged 5-9 compared to children who could walk with or without walking aids. Overall lower levels of social functioning were found in children with GMFCS V, epilepsy, speech problems, lower intellectual capacity and older age at baseline. For communication more restrictions over time were found in children with lower intellectual capacity. Children with GMFCS V, speech problems and older age at baseline had overall greater restrictions in communication. It was concluded that motor functioning and intellectual ability can be used to identify children at risk for progressive restrictions in social functioning and communication. For children with CP and social and communicative restrictions, multidisciplinary assessment and treatment may be indicated to counteract an unfavorable development.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.09.033