The Mechanisms of Behaviour Problems in Children and Adolescents with Cerebral Palsy

Abstract

Cerebral palsy (CP) is an impairment of movement and posture derived from damage to the developing brain either before, during or after birth. There is evidence that children and adolescents with CP have high rates of behaviour problems. However, there have been very few attempts to understand the potential mechanisms for these behaviour problems. Elucidating these could help with prevention and intervention strategies. This thesis investigates eleven possible contributory variables to see if these correlate with behaviour problems in children and adolescents with CP. These are epilepsy, sleep, pain, executive function (EF), communication, type of CP, vision, hearing, gross and fine motor function and parent stress. The sample are split into two groups. These include children and adolescents with CP and intellectual disability (ID), and children and adolescents with CP and typical intellectual development. For both the ID and typical intellectual development cohort, the behaviour variables assessed include the levels of overall behaviour problems. For each cohort, the level of behaviour problems were measured with the Developmental Behaviour Checklist-Primary Carer Version and the Child Behaviour Checklist respectively. Participants include parents and their child aged 3–18 years with a confirmed diagnosis of CP. Of the possible contributory variables, sleep disturbance, deficits in EF and parent stress were significantly associated with behaviour problems for the ID cohort. Deficits in EF and parent stress were significantly associated with behaviour problems for the typical intellectual development cohort. The thesis describes possible intervention strategies for children with CP who experience the variables associated with behaviour problems. In addition, the thesis describes recommendations to overcome the existing limitations in pain and EF measurements in children with motor impairments.