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Pediatrics. 2013 Oct;132(4):e915-23. doi: 10.1542/peds.2013-0499. Epub 2013 Sep 9.

Developmental trajectories of daily activities in children and adolescents with cerebral palsy.

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Department of Rehabilitation Medicine, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.



To describe the developmental trajectories of mobility performance and daily activities in children and young adults with cerebral palsy (CP). To explore the influence of gross motor function and intellectual disability on these trajectories.


Four hundred and twenty-four Dutch participants with CP (aged 1-20 years at study onset) were followed yearly over a period of 2 to 4 years. Developmental trajectories (from ages 1-16 years) were described for mobility performance and performance of daily activities, assessed by using the Vineland Adaptive Behavior Scale for gross motor function (classified by the Gross Motor Function Classification System) and intellectual disability (by IQ or school type). A subanalysis was done for performance of daily activities in a subgroup of participants without intellectual disability (aged 1-24 years).


The developmental trajectories of mobility performance differed according to levels of gross motor function but not levels of intellectual disability. Intellectual disability affected the performance of daily activities, with lower overall trajectory levels for participants with intellectual disabilities. For participants without intellectual disability, high-level developmental trajectories were found, with values similar to those of typically developing children despite differences in gross motor function level.


Mobility performance is determined mainly by levels of gross motor function. For performance of daily activities, intellectual disability was a more important determinant. Participants without intellectual disability showed developmental trajectories approaching values for typically developing participants. These estimated trajectories can guide rehabilitation interventions and future expectations for children and young adults with CP.


cerebral palsy; children and adolescents; developmental outcomes; longitudinal study; young adults

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