Activity and participation of children and adolescents with cerebral palsy: A cross‐sectional multicenter study in Brazil

Children and adolescents with cerebral palsy (CP) often face challenges in their daily activities (such as moving, dressing, eating, and hygiene) and participation (such as taking responsibility for daily tasks at home, routines, and engaging in age-appropriate roles). These challenges are influenced not only by the severity of their motor impairment but also by age, the parts of the body affected, and the environment in which they live, including the use of assistive technologies. This study included 190 Brazilian children and adolescents with CP aged 2 to 14 years. We examined how different factors affect their ability to perform daily activities, move around, interact socially and cognitively, and take responsibility for tasks in daily life. To do this, we used an assessment tool reported by families and analysed the relationships between motor function, age, body involvement, and environmental factors. The results showed that children with better gross motor function and older age generally performed better in daily activities, mobility, social and cognitive tasks, and assumed more responsibility. The distribution of motor impairment (e.g. whether one or both sides of the body were affected) also influenced those skills, mainly through its relationship with motor function level. A key finding was the important role of assistive technology for mobility, such as orthoses, walkers, wheelchairs, or other mobility devices. These technologies not only had a direct impact on performance and participation but also changed how motor impairment affected outcomes. Children with more severe motor limitations performed better in daily activities, mobility, social and cognitive functioning, and responsibility when they had access to more assistive technologies.