Social participation of youths with cerebral palsy differed based on their self‐perceived competence as a friend

BACKGROUND: Social participation with friends fosters development of meaningful relationships, life skills and psychosocial well-being. Youths with cerebral palsy (CP) face challenges to establishing social relationships with friends. The aim of this study was to explore whether social participation with friends differs among youths with CP based on their self-perceived competence as a friend. METHODS: A total of 135 youths with CP, 13-21 years old (mean age 16 years, 50% were male), completed the measures Fulfillment in Social Roles and Children's Assessment of Participation and Enjoyment. Youths were assigned to high, middle and low groups defined by their self-perceived competence as a friend. Differences among the three groups in the number, total frequency and enjoyment of activities done with friends was examined by Kruskal-Wallis one-way analyses of variance. Post hoc analysis of significant effects was performed using a Mann-Whitney U-test or Kolmogorov-Smirnov test. RESULTS: The number (χ(2) = 17.07, d.f. = 2, P < 0.001) and total frequency (χ(2) = 18.35, d.f. = 2, P < 0.001) of activities done with friends differed based on youths' self-perceived competence as a friend. Youths with high self-perceived competence as a friend did the greatest number of activities and participated most often with friends. Youths with low self-perceived competence did the fewest activities and participated least often with friends. No differences were found in the enjoyment of activities done with friends among the three groups (χ(2) = 1.86, d.f. = 2, P > 0.05). CONCLUSIONS: For youths with CP, the number and frequency of activities done with friends differed based on self-perceived competence as a friend, but not enjoyment of activities. The results suggest a positive link between social participation and self-perceived competence. Healthcare providers have a role to support youths' efforts to engage with friends by enhancing community opportunities, developing and providing interventions in natural social environments and incorporating peer support into service delivery.