Retrospective study of factors affecting employability of individuals with cerebral palsy in Japan

Cognitive Functioning and Assessment in Adults with Cerebral Palsy: A Scoping Review

In this scoping review, we summarize the current knowledge of cognitive functioning in adults with cerebral palsy (CP), and identify the neuropsychological tests typically used in this population. 39 studies from the period January 1990 - August 2023 were included in the review, and they differ widely in their aims and approach to studying cognition. Very few studies have cognitive assessment as their core aim and use a neuropsychological test battery. The included studies show great variability in reported intelligence and cognitive functioning in adults with CP, and cognitive deficits have been reported in all cognitive domains. Most of the studies suffer from methodological limitations, and there is ample room for improvement within the field. We conclude by suggesting a number of recommendations that may contribute to increasing our understanding of cognitive impairments in adults with CP.

Evidence-Based Secondary Transition Predictors for Physical Therapists Working With High School Students

PURPOSE

Individuals with disabilities experience poorer postschool outcomes compared with their peers without disabilities. Youth with orthopedic or physical disabilities experience challenges during transition particularly in the areas of education and employment. Physical therapists should continue to become more involved in transition planning and providing services for transition-age students with physical disabilities. The purpose of this article is to clarify the role of physical therapists who work with students who have disabilities, as they transition from high school to postsecondary roles as well as provide the current evidence-based predictors of postschool success and recommended practices to school-based physical therapists who work with these students.

SUMMARY OF KEY POINTS

Evidence-based instructional practices for secondary students with disabilities and identified in-school predictors of postschool success for students with disabilities are aligned with effective practices for physical therapists. Additionally, suggestions for involving physical therapists in transition planning and increasing collaboration in providing transition services for students with disabilities are provided.

STATEMENT OF CONCLUSIONS

Physical therapists can provide critical expertise for many individuals with disabilities; however, they are not always included effectively in transition planning and services for students with disabilities.

RECOMMENDATIONS FOR CLINICAL PRACTICE

Recommendations for practice include ways to involve physical therapists in transition planning and services and increasing collaboration between teachers, physical therapists, and other members of the Individualized Education Program team to provide effective, comprehensive transition services.

Health, functioning, and participation of adolescents and adults with cerebral palsy: a review of outcomes research

With medical advances, more individuals with cerebral palsy (CP) syndromes who reside in developed countries are surviving to adolescence and adulthood. However, there continues to be a paucity of research examining long-term health, functional activities, and participatory outcomes over their life-course. This article reviews the current literature assessing adult outcomes for individuals with CP within the framework of the International Classification of Functioning (ICF), Disability, and Health model of enablement. Preliminary data over the last decade indicate that among adults with cerebral palsy without intellectual disability, 60-80% completed high school, 14-25% completed college, up to 61% were living independently in the community, 25-55% were competitively employed, and 14-28% were involved in long term relationships with partners or had established families. These outcomes occurred with biomedical advances in the management of spasticity, deformity, and medical co-morbidities, as well as with concurrent policy initiatives to increase access to a continuum of habilitative and education services. Although we have incomplete population data to inform comprehensive life-course planning, there are opportunities to create clinical and translational community networks with improved measures of functioning and participation that can better inform us about the factors influencing lifespan development of people with CP.

Relationship of therapy to postsecondary education and employment in young adults with physical disabilities

PURPOSE

The relationship of therapy services to postsecondary education and paid employment in young adults with physical disabilities was examined.

METHODS

A sample of 1510 youth from the National Longitudinal Transition Study 2 categorized with orthopedic impairment including cerebral palsy and spina bifida was analyzed using weighted sampling multivariate regression.

RESULTS

At follow-up, 48% participated in postsecondary education and 24% had paid employment. Receiving physical and/or occupational therapy at ages 13 to 16 years was significantly associated with higher levels of enrollment in postsecondary education at ages 19 to 21 years. Social interactions and expressive language skills but not therapy services were associated with paid employment.

CONCLUSIONS

Results suggest that therapy services that focus on improvement of upper extremity function, self-care skills, and social skills are associated with participation in postsecondary education. Longer follow-up is needed to effectively examine paid employment.