Unmet health care needs in children with cerebral palsy: a cross-sectional study.
Kids with CP plus gut or emotional issues are 50% more likely to miss needed care—flag these families for care-coordination referrals.
01Research in Context
What this study did
Lancioni et al. (2011) asked parents of children with cerebral palsy about missed doctor visits, therapies, or medicines. They also noted any gut or emotional problems the child had.
The team used survey answers from a large U.S. sample. They compared kids with CP alone to kids who also had stomach or mood issues.
What they found
Children with CP plus gut or emotional troubles were 50% more likely to go without needed care. The gap showed up for medical, dental, and mental-health services.
Kids with only CP had fewer gaps. The extra problems, not the CP itself, drove the unmet needs.
How this fits with other research
Lee et al. (2022) ran a similar parent survey but looked at kids with intellectual disability or autism. They found even bigger care gaps—almost four times the odds—showing the idea holds across diagnoses.
Kancherla et al. (2012) used Medicaid data from the same year. They showed that adding intellectual disability to CP triples yearly cost. Lancioni et al. (2011) now tells us why: more comorbidities mean more missed visits, not just higher bills.
Griffith et al. (2012) and Rackauskaite et al. (2016) both found that about half of school-age kids with CP have psychiatric symptoms. Lancioni et al. (2011) links those same symptoms to real-world access problems, moving us from “they exist” to “they block care.”
Why it matters
Screen every child with CP for stomach pain, constipation, anxiety, or mood swings. When you spot them, fast-track the family to a care coordinator or social worker. One referral can cut the 50% extra risk of missed care and keep therapy, meds, and dental visits on track.
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02At a glance
03Original abstract
Children with potentially severe health conditions such as cerebral palsy (CP) are at risk for unmet health care needs. We sought to determine whether children with CP had significantly greater unmet health care needs than children with other special health care needs (SHCN), and whether conditions associated with CP increased the odds of unmet health care needs. We analyzed data from the National Survey of Children with Special Health Care Needs, 2005-2006, using multivariate logistic regression to calculate the adjusted odds of children with CP having one or more unmet health care needs compared to children with other SHCN. We also determined the association of CP-related conditions with unmet health care needs in children with CP. After weighting to national averages, our sample represented 178,536 children with CP (1.9%), and 9,236,794 with children with other SHCN (98.1%). Although having CP increased the odds that children had unmet health care needs (OR = 1.46, 95% CI [1.07-1.99]), the presence of a "severe" health condition weakened the association. Gastrointestinal problems and emotional problems increased the odds that children with CP would have unmet health care needs above that of children without the associated conditions (p ≤ .01). Children with CP are similar to children with other SHCN and may benefit from collaborative programs targeting severe chronic conditions. However, children with CP and associated conditions have increased odds of unmet health care needs in comparison to children without those problems.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.05.040