School outcomes of adolescents with cerebral palsy in Sweden.
Johan Jarl, Ann Alriksson-Schmidt
PMID 33325036WHAT IT FOUND
Adolescents with cerebral palsy had significantly lower school grades and were less likely to progress to secondary school or university compared to matched peers.
Communication ability was the strongest functional predictor of these poor outcomes, outweighing gross or manual motor skills.
Key findings
01Adolescents with cerebral palsy had substantially lower school outcomes, including receiving final grades and fulfilling requirements for secondary school, compared to a matched general population sample.
02When controlling for intellectual disability, a substantial negative association between cerebral palsy and school outcomes remained, though it was reduced.
03Communication ability (measured by CFCS) had a stronger association with schooling outcomes than manual or gross motor function in multivariable models.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study could not determine if grades reflect actual educational achievement, as standardized national test data were unavailable. Intellectual disability was identified via ICD-10 codes, which may over- or underestimate the true prevalence due to diagnostic hesitancy. Data on students in International Baccalaureate or Waldorf schools were excluded, potentially missing a subset of outcomes. The study did not assess other types of disabilities in the comparison group, which could influence outcomes. The association between intellectual disability and communication difficulties makes it difficult to disentangle their individual impacts on school outcomes. Disability-specific functional measures (CFCS, MACS, GMFCS) were only available for a subset of the CP population (31% and 27% of birth cohorts).
Declared interests
Funded by Stiftelsen Sunnerdahls Handikappfond and Forskningsrådet om Hälsa, Arbetsliv och Välfärd. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that improving gross motor or fine motor skills alone will lead to better school outcomes. The study found that communication ability was the strongest functional predictor of academic success, and motor function had weaker or non-significant associations when communication was controlled for.