Cerebral Palsy Italian Network (ITA-NET-CP): a multidimensional assessment protocol and baseline results of a prospective study

International contributions to the study of children with cerebral palsy (CP) highlight the complexity of the disorder and its impact on various adaptive functions during development. Today, however, there is still little knowledge of the developmental trajectories of these functions and their interaction; moreover, the available studies often concern only neuromotor skills, specific ages, or specific forms of CP. The primary aim of this study was to develop a shared evaluation protocol to assess a comprehensive range of adaptive functions in a sample of Italian children with CP. In addition, we aimed to define the role of the examined adaptive functions in order to assess their evolution over time and their interaction. This multicenter prospective observational study (Italian Network of Cerebral Palsy - ITA-NET-CP) evaluated different adaptive functions at three time points (baseline, first follow-up after 12 months, and second follow-up after 24 months) using a multidimensional protocol. Children were classified according to international functional classification systems and underwent assessments covering gross motor, manipulative-praxic, visual, communicative, cognitive, emotional-behavioral functions, as well as their impact on autonomy and quality of life. Data reported in this paper are related only to the baseline assessment. A total of 143 patients were enrolled, representing all levels of severity according to functional classification systems. At baseline, our sample revealed distinct cognitive profiles across different age groups. Strong associations emerged between manipulative-praxic function and cognitive abilities. Behavioral difficulties, particularly internalizing problems, were prevalent even among those with milder forms of CP. Functional severity had a significant impact on autonomy, but not necessarily on gross motor, manipulative-praxic, communicative, and visual abilities. ITA-NET-CP is the first nationwide study in Italy to assess the adaptive functions in children with CP. Its findings will help inform integrated, family-centered care approaches and support the ongoing development of a national CP registry.