Follow-up of developmental profiles in children with spastic quadriplegic cerebral palsy.

Background: The aim of this study was to investigate longitudinal changes in the developmental profiles of children with spastic quadriplegic (SQ) cerebral palsy (CP). Additionally, the relationship of developmental functions between the initial and final stages was determined. Methods: This prospective study enrolled forty-six children with SQ CP between 2-6 years old and assessed their developmental profiles using the Chinese Child Developmental Inventory on the initial and final assessments. The interval between two assessments was 1.0 0.3 years. Eight developmental domains, including gross motor, fine motor, expressive language, concept comprehension, situation comprehension, self help, personal social and general development, were evaluated and qualified by the development quotient (DQ). The DQ change index (%) was calculated to evaluate the differences in each domain between the two assessments. The paired t test was used to compare differences in each domain between the two assessments. Pearson’s correlation was used to analyze the relationship of each domain between the final and initial assessments. Results: Children with SQ CP had lower DQs than normal children in all developmental functions on both assessments (23 66%). The DQ distributions were lowest in the gross motor and self help domains, higher in the fine motor, situation comprehension, and personal social domains, and highest in the expressive language, concept comprehension, and general development domains. Except for the fine motor and concept comprehension domains, the DQs of the developmental functions were significantly decreased on the final assessment (p < 0.05). Conclusion: These findings suggest preschool children with SQ CP had impairments in the full spectrum of developmental profiles. The course of developmental profiles evolves with age. Most developmental functions did not increase proportionally with increasing age in children with SQ CP. (Chang Gung Med J 2009;32:628-35)