Factors Affecting Initiation of Formal Education in Cerebral Palsy

Submitted by
Sivaram P
Seetha Mohandas
Archana

Guided by
Dr. Anish T S

Cerebral Palsy is the most common disability affecting about 2/1000 live born. It is a group of non progressive but often changing motor impairment syndromes secondary to lesions or abnormalities of the brain and arising in the early stages of development. Cerebral palsy can’t be cured, but thoughtful interventions including proper education will often improve a child’s capabilities. The aim of this paper is to study the factors affecting the initiation of formal education in children with Cerebral Palsy.

The study design was Case series. Study Subjects were 86 children with Cerebral Palsy in the age group 3 to 12 years. Study Setting was the Cerebral Palsy clinic, Department of P.M.R, Govt.Medical College, Trivandrum and conducted during a Study Period of Sep.1^st_Dec.30^th, 2008.The Study Variables were Educational status, Family, Economic, Social, Architectural and Clinical factors and Treatment. Study Tool used was a Semi structured interview schedule. Frequencies and proportions with 95% confidence limit and Significance of associations are analyzed statistically using Chi-square tests.

Of the total study population of 86 cerebral palsy children with a mean age of 5.7yrs(5.14-6.2), 54(66.5%) are receiving formal education.     On analyzing the factors that were found to be significantly associated with initiation of formal education are Ambulatory level, Drooling, Strabismus, Urinary incontinence, Mental retardation, Communication ability, Dysarthria, Delay in developmental milestones, Higher mental functions, Persistence of primitive reflexes, Severity of limb involvement and Physiotherapy. After analyzing the binary logistic regression, the following factors, with R²value =0.373,were found to be independently associated were Communication ability with sentences(odd’s.ratio-5.38,p=0.008), Ambulatory level (odd’s.ratio-4.40,p=0.019), Developmental milestone, transfer of object(odd’s.ratio-4.86,p=0.014

The knowledge of these factors will help in early spotting of children who are likely to have difficulties in initiating formal education. This can aid in proper channeling of resources and timely interventions which can lift them to the main stream world.