Work participation and employment in individuals with cerebral palsy: A scoping review

For many adults with cerebral palsy (CP), having a paid job is about much more than earning an income. Work can provide independence, purpose, social connections, and a sense of belonging. Yet adults with CP are much less likely to be employed than people without CP. To better understand why, we reviewed research on factors that have been examined to influence employment and employment dropout in adults with CP. We identified 29 studies including more than 33 000 adults with CP. The studies showed that employment is influenced by many interacting factors rather than by physical impairments alone. Most research has focused on physical functioning, such as manual ability or CP subtype, and personal factors such as age or sex. Better motor skills, communication abilities, independence in daily activities, and higher educational attainment were generally associated with better employment outcomes. Our review also found that environmental factors play an important role. Support from family or healthcare professionals, accessible transport, workplace accommodations, and access to assistive technology may all help individuals with CP to find employment and stay in it. At the same time, negative attitudes, inaccessible environments, pain, fatigue, and other health challenges can create barriers to work. Despite their importance, cognitive and psychosocial factors, and personal characteristics have received much less attention in research. Most studies also included relatively young adults, making it difficult to understand how employment changes across adulthood.