Association of functional and social factors with domain-specific quality of life profiles in children with cerebral palsy: findings from a low- and middle-income country

To evaluate domain-specific quality of life and its associations with functional severity, selected comorbidities, and social factors among children with cerebral palsy attending a tertiary referral centre in Sri Lanka. Among 223 children, 61.9% were male and the mean age was 6.99 years. Quality-of-life scores varied markedly across domains. Daily activities, school activities, movement and balance, eating activities, and speech and communication showed wide score dispersion, whereas pain and fatigue showed ceiling effects. Scores declined progressively with increasing Gross Motor Function Classification System level across analysed domains, with strong monotonic trends observed (Kendall’s τ − 0.57 to − 0.72; all p < 0.001). Epilepsy, cognitive impairment, cortico-visual impairment, hearing impairment, and gastro-oesophageal reflux disease were associated with lower overall or domain-specific scores in unadjusted analyses. In adjusted models focused on measured social factors, age, sex, living arrangement, and parental education were not independently associated with the analysed domain scores. Domain-level assessment may provide clinically informative quality-of-life profiles that are not captured by overall scores alone.