Factors Related to Adaptive Behavior in Children With Cerebral Palsy

OBJECTIVE: The purpose of this study was to describe the adaptive behavior of children with cerebral palsy and identify the child, family, and service factors that are related to their adaptive behavior. METHODS: A convenience sample of 319 children with cerebral palsy (3 to <13 years), and their caregivers (81% were children's mothers) participated in the study. Caregivers completed the Coping Inventory, Family Environment Scale, Service Questionnaire, and demographic questionnaire. Children's Gross Motor Function Classification System levels were determined by assessors who met the criterion for reliability. A sequential multiple regression on 297 children with a complete data set was used to determine the factors that explain children's adaptive behavior. RESULTS: Children's mean Adaptive Behavior Index was 3.9 (SD = 0.7), indicating that, on average, their behavior was "effective more often than not." The Adaptive Behavior Index was lowest for children with severe limitations in gross motor function. The final regression model explained 45% of the variance in children's adaptive behavior. Children's behavioral/emotional problems, communication problems, health, learning problems, and family cohesion were significant factors in the model. CONCLUSIONS: Caregivers of children with cerebral palsy rated the children's behavior as effective in meeting personal needs, adapting to environmental demands, and interacting with others. The findings support the view that adaptive behavior of children with cerebral palsy is complex and multidimensional. Service providers can capitalize on children's adaptive behavioral strengths and promote their self-determination and support adaptation to optimize participation in daily life.