Children with cerebral palsy participate: A review of the literature

Purpose. To review research that examined the participation in activities of children who have cerebral palsy, in order to understand their extent of participation and the factors that influenced participation. Methods. A comprehensive search of seven databases retrieved 2,111 papers, 40 of which met criteria and were relevant for critique. As this paper intended to examine participation broadly, an ecological framework was used to organise the relevant papers into those studies that considered personal, environmental and occupational factors related to participation. Results. Children with cerebral palsy participated in a diverse array of activities across a range of occupational contexts. Their participation was not always a positive experience. Factors most commonly identified as barriers to participation were social attitudes and the physical environment. This review identified only emergent understandings of the naturally occurring changes in the participation of children with cerebral palsy that come with increasing age and, concurrently, with increasing social and environmental demands. Conclusions. Future research designs must accommodate the complexity of participation to further our knowledge and improve our ability to target therapeutic interventions at community, family and child levels.