Queensland Cerebral Palsy and Rehabilitation Research Center

science, Australia

Queensland Cerebral Palsy and Rehabilitation Research Center

science, Australia
SEARCH FILTERS
Time filter
Source Type

Whittingham K.,Queensland Cerebral Palsy and Rehabilitation Research Center | Sanders M.,Parenting and Family Support Center | Boyd R.,Queensland Cerebral Palsy and Rehabilitation Research Center
Disability and Rehabilitation | Year: 2011

Purpose. To explore the unique parenting challenges that parents of children with cerebral palsy (CP) face and to explore the feasibility of a new parenting intervention, Stepping Stones Triple P (SSTP), for this population. Method. Focus groups were conducted with parents of children with CP (n = 8) and health professionals with experience in working with families of children with CP (n = 5). The discussion was transcribed verbatim and a descriptive thematic analysis was performed. Results. Parents stated that knowing whether a particular behaviour is the result of CP or a behavioural issue is challenging. Parents were also keen to promote communication, independence and socialisation in their child. In addition, parents also discussed the challenges of parenting under time pressure, with additional parenting tasks, under public scrutiny and with grief. Both parents and professionals found SSTP to be a feasible and appropriate intervention for parents of children with CP. Conclusions. The parents of children with CP in this study faced a range of parenting challenges that may be effectively targeted by a parenting intervention. In addition, parents and health professionals found SSTP content acceptable and feasible for use with parents of children with CP. © 2010 Informa UK, Ltd.


Brown F.L.,University of Queensland | Brown F.L.,Queensland Cerebral Palsy and Rehabilitation Research Center | Whittingham K.,University of Queensland | Whittingham K.,Queensland Cerebral Palsy and Rehabilitation Research Center | And 3 more authors.
Journal of Head Trauma Rehabilitation | Year: 2013

OBJECTIVE:: To evaluate the efficacy of parenting interventions on child and parent behavioral and emotional outcomes for parents of children with traumatic brain injury (TBI). METHODS:: Systematic searches of 5 databases. Included studies were assessed for quality, and relevant data were extracted and collated. RESULTS:: Eight articles met inclusion criteria, reporting 6 trials of interventions involving parent training for parents of children with TBI. Only 1 pre-post study trialed a version of a traditional parenting intervention. The remaining studies involved a multicomponent family problem-solving intervention. Each trial found a statistically significant intervention effect for at least 1 outcome measure. CONCLUSIONS:: Interventions that train parents may be a useful approach to alleviate behavioral and emotional disturbances after pediatric TBI. Some evidence suggests that these interventions may help to improve parenting skill and adjustment. However, all identified studies included interventions with multiple treatment components, so the effects attributable to parent training alone remain undetermined. Further quality trials are needed to assess the unique effectiveness of parenting interventions in this population. Copyright © 2013 Lippincott Williams & Wilkins.


Walker J.L.,University of Queensland | Walker J.L.,Queensland Cerebral Palsy and Rehabilitation Research Center | Bell K.L.,University of Queensland | Bell K.L.,Queensland Cerebral Palsy and Rehabilitation Research Center | And 6 more authors.
Annals of Nutrition and Metabolism | Year: 2012

Background/Aims: We aimed to determine the relationships between energy intake, macronutrient intake and body composition in preschool-aged children with cerebral palsy (CP) according to gross motor functional ability in comparison with typically developing children (TDC). Methods: Seventy-three children with CP (70% male) of all functional abilities and 16 TDC (63% male) aged 2.8 ± 0.9 years participated in this study. Dietary intake was measured via a validated 3-day weighed food record. Body composition was determined via isotope dilution techniques. Results: There was a significant relationship between energy intake and fat-free mass index, which was stronger in TDC compared to children with CP. There were no significant correlations between other dietary intake and body composition variables, despite differences in body composition as ambulatory status declined. Non-ambulant, tube-fed children had significantly lower protein intakes compared to orally fed children. No other differences in macronutrient intake between children with CP and TDC were apparent. Conclusions: Results suggest that relationships between dietary intake and body composition are not evident in this population, but develop over time. Physical activity levels may have a greater impact on body composition at this age. Longitudinal research is required to examine these factors. © 2012 S. Karger AG, Basel.


Whittingham K.,Queensland Cerebral Palsy and Rehabilitation Research Center | Whittingham K.,University of Queensland | Sanders M.,University of Queensland | McKinlay L.,Royal Childrens Hospital | Boyd R.N.,Queensland Cerebral Palsy and Rehabilitation Research Center
Pediatrics | Year: 2014

OBJECTIVE: To test Stepping Stones Triple P (SSTP) and Acceptance and Commitment Therapy (ACT) in a trial targeting behavioral problems in children with cerebral palsy (CP). METHODS: Sixty-seven parents (97.0% mothers; mean age 38.7 ± 7.1 years) of children (64.2% boys; mean age 5.3 ± 3.0 years) with CP (Gross Motor Function Classification System = 15, 22%; II = 18, 27%; III =12, 18%; IV = 18, 27%; V = 4, 6%) participated and were randomly assigned to SSTP, SSTP + ACT, or waitlist. Primary outcomes were behavioral and emotional problems (Eyberg Child Behavior Inventory [ECBI], Strengths and Difficulties Questionnaire [SDQ]) and parenting style (Parenting Scale [PS]) at postintervention and 6-month follow-up. RESULTS: SSTP with ACT was associated with decreased behavioral problems (ECBI Intensity mean difference [MD] = 24.12, confidence interval [CI] 10.22 to 38.03, P = .003; ECBI problem MD = 8.30, CI 4.63 to 11.97, P < .0001) including hyperactivity (SDQ MD = 1.66, CI 0.55 to 2.77, P = .004), as well as decreased parental overreactivity (PS MD = 0.60, CI 0.16 to 1.04, P = .008) and verbosity (PS MD = 0.68, CI 0.17 to 1.20, P = .01). SSTP alone was associated with decreased behavioral problems (ECBI problems MD = 6.04, CI 2.20 to 9.89, P = .003) and emotional symptoms (SDQ MD = 1.33, CI 0.45 to 2.21, P = .004). Decreases in behavioral and emotional problems were maintained at follow-up. CONCLUSIONS: SSTP is an effective intervention for behavioral problems in children with CP. ACT delivers additive benefits. Copyright © 2014 by the American Academy of Pediatrics.


Benfer K.A.,Queensland Cerebral Palsy and Rehabilitation Research Center | Benfer K.A.,University of Queensland | Weir K.A.,Queensland Cerebral Palsy and Rehabilitation Research Center | Weir K.A.,University of Queensland | And 2 more authors.
Developmental Medicine and Child Neurology | Year: 2012

Aim The aim of this study was to determine the psychometric properties and clinical utility of objective measures of oropharyngeal dysphagia (OPD) in children with cerebral palsy or neurodevelopmental disabilities aged 12months to 5years. Method Five electronic databases were searched to identify measures of OPD. The Consensus-based Standards for the Selection of Measurement Instruments (COSMIN) Checklist was used to assess psychometric properties and a Modified CanChild Outcome Rating Form was used for clinical utility. Results Nine measures of OPD from 27 papers were assessed: the Brief Assessment of Motor Function - Oral Motor Deglutition Scale; the Behavioral Assessment Scale of Oral Functions in Feeding; the Dysphagia Disorders Survey; the Feeding Behaviour Scale; the Functional Feeding Assessment, modified; the Gisel Video Assessment; the Oral Motor Assessment Scale; the Pre-Speech Assessment Scale; and the Schedule for Oral Motor Assessment. Interpretation The Schedule for Oral Motor Assessment and the Functional Feeding Assessment, modified, proved to be the strongest measures based on published psychometric properties of validity and reliability. The Schedule for Oral Motor Assessment and the Dysphagia Disorders Survey were found to have the strongest clinical utility. Further studies to test the psychometric properties of existing measures, in particular predictive validity, responsiveness, and test-retest reliability, would be beneficial for selecting an appropriate measure for both clinical and research contexts. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.


Klingels K.,Catholic University of Leuven | Demeyere I.,University Hospital Leuven | Jaspers E.,Catholic University of Leuven | De Cock P.,Catholic University of Leuven | And 3 more authors.
European Journal of Paediatric Neurology | Year: 2012

Background: Insights in upper limb impairments and their relationship with activity measures in children with unilateral cerebral palsy (CP) are important to optimize treatment interventions. Aims: (1) To investigate upper limb impairments and activity limitations in children with unilateral CP; (2) to compare these according to the Manual Ability Classification System (MACS), timing of lesion (congenital/acquired) and age; (3) to determine the impact of impairments on activity measures. Methods: Eighty-one children with unilateral CP aged 5-15 years (mean 9 years 11 months; congenital N = 69, acquired N = 12) were recruited. Body function measurements included passive range of motion (PROM), muscle tone, strength and sensibility. At activity level, the Melbourne Assessment, Assisting Hand Assessment (AHA) and Abilhand-Kids were assessed. Results: Most PROM limitations were found for elbow extension and supination. Increased tone and weakness were most prominent in distal muscles. Stereognosis and two-point discrimination were mostly affected. Children with a lower MACS level or acquired lesion had significantly more impairments and activity limitations. In children with congenital lesions, best predictors for unimanual capacity (Melbourne Assessment) were wrist strength, stereognosis and proprioception, and for bimanual performance (AHA) wrist strength and grip strength, explaining 76% of the variance. For the Abilhand-Kids, wrist strength and stereognosis predicted 46% of the variance. Conclusions: Classification according to MACS and timing of lesion is important to differentiate within the wide range of impairments and activity limitations. In children with congenital lesions, unimanual capacity and bimanual performance are highly determined by distal strength, supporting the additional use of impairment-based interventions. © 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.


Davies G.,University of Southern Queensland | Piovesana A.,University of Southern Queensland | Piovesana A.,Queensland Cerebral Palsy and Rehabilitation Research Center
Clinical Neuropsychologist | Year: 2015

Objective: This systematic review aims to identify, examine, and compare tests used to measure and assess verbal abstract reasoning (VAR). Method: Seven tests were identified through a systematic search of electronic databases, neuropsychological textbooks, and online catalogs. Clinical utility, normative data, and psychometric properties (internal consistency, test-retest reliability, and construct validity) of current test versions were evaluated using recent studies. A modified version of the CanChild Outcome Measures Rating Form, and structured quality assessment criteria were used in the evaluation process. Results: The WAIS-IV Similarities subtest was ranked the highest, followed by the Shipley-2 Abstraction test and Gorhams Proverbs test. These three tests had sufficient validity to recommend their use, however some caution is advised for the latter two in terms of construct purity, and age of normative data, respectively. Other tests reviewed were the Delis-Kaplan Executive Functioning System Proverbs subtest, the Stanford-Binet Intelligence Scale fifth edition Verbal Analogies subtests, the Conceptual Level Analogy Test, and the Verbal Concept Attainment Test. For the majority of tests, construct validity was lacking while reliabilities were sufficient. Conclusions: Lack of sound psychometric evidence limits the range of options for the practitioner to choose a test with confidence to assess VAR. While there is merit in the clinical utility of the majority of assessment instruments evaluated in this review, caution is recommended before deciding to use a test that does not carry sufficient psychometric evidence to support its use. Further research is recommended to improve the library of tests available to clinicians and researchers. © 2016 Taylor & Francis.


Auld M.L.,University of Queensland | Boyd R.N.,Queensland Cerebral Palsy and Rehabilitation Research Center | Moseley G.L.,University of South Australia | Moseley G.L.,Neuroscience Research Australia | And 3 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2012

Impact of tactile dysfunction on upper-limb motor performance in children with unilateral cerebral palsy. Objective: To determine the relationship between tactile function and upper-limb function in children with unilateral cerebral palsy (CP). Design: Cross-sectional study. Setting: Assessments were performed in community or hospital venues or in participants' homes. Participants: Recruitment information was sent to 253 possible participants with unilateral CP (aged 818y), and N=52 participated (median age [interquartile range], 12y [914y]; Gross Motor Functional Classification System level I=34; II=18; Manual Abilities Classification Scale level I=36; II=16). Interventions: Not applicable. Main Outcome Measures: Tactile assessment included 1 test of registration, 5 tests for spatial perception, and 1 test for texture perception. Upper-limb motor function was assessed using 2 unimanual tests, the Melbourne Unilateral Upper Limb Assessment (MUUL) and Jebsen-Taylor Test of Hand Function (JTTHF), and 1 bimanual test, the Assisting Hand Assessment (AHA). Results: Tactile registration and all tests of spatial perception were moderately related to the MUUL, JTTHF, and AHA (P<.001). Texture perception was not related to upper-limb motor function. Regression analysis showed that single point localization, a unilateral tactile spatial perception test, contributed most strongly to unimanual capacity (29% explained variance in MUUL and 26% explained variance in JTTHF), whereas double simultaneous, a bilateral tactile spatial perception test, contributed most strongly to bimanual performance (33% for the AHA). Conclusions: Spatial tactile deficits account for approximately 30% of the variance in upper-limb motor function in children with unilateral CP. This emphasizes the need for routine tactile assessment and targeted treatment of tactile spatial deficits in this population. © 2012 by the American Congress of Rehabilitation Medicine.


Whittingham K.,Queensland Cerebral Palsy and Rehabilitation Research Center | Whittingham K.,University of Queensland | Sanders M.,University of Queensland | McKinlay L.,Royal Childrens Hospital | Boyd R.N.,Queensland Cerebral Palsy and Rehabilitation Research Center
Brain Impairment | Year: 2013

This project aims to optimise outcomes for children with cerebral palsy (CP) and their families by testing the efficacy of two complementary interventions novel to the CP population: (1) parenting intervention (Stepping Stones Triple P, SSTP); and (2) parental stress management (Acceptance and Commitment Therapy, ACT) tailored for parents of children with CP. The efficacy of SSTP and the additional effects of ACT will be tested in a wait-list randomised controlled trial, with parents of children with CP (N = 110) randomised into three groups; SSTP, SSTP + ACT and wait-list control. Intervention delivery will combine group sessions with phone consultations. Outcomes will be assessed post-intervention with retention of effect examined at 6-month follow-up. Child outcomes will include: externalising behaviour (primary child outcome), functional performance, parent-reported child quality of life; and parent outcomes will include: dysfunctional parenting (primary parent outcome), parental confidence in performing disability-related parenting practices, degree of problems in performing disability-related parenting practices, parental adjustment, psychological flexibility and parental attitude to child emotions. The theoretical background, study design and study procedures are discussed. The validation of a parenting intervention and a parenting stress intervention for parents of children with CP is crucial to better support parents of children with CP in their parenting role and in providing evidence-based intervention for behavioural and emotional problems in children with CP. Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013.


PubMed | Royal Childrens Hospital, University of Queensland and Queensland Cerebral Palsy and Rehabilitation Research Center
Type: Comparative Study | Journal: Pediatrics | Year: 2014

To compare the patterns of motor type and gross motor functional severity in preschool-aged children with cerebral palsy (CP) in Bangladesh and Australia.We used comparison of 2 prospective studies. A total of 300 children with CP were aged 18 to 36 months, 219 Australian children (mean age, 26.6 months; 141 males) recruited through tertiary and community services, and 81 clinic-attendees born in Bangladesh (mean age, 27.5 months; 50 males). All children had diagnosis confirmed by an Australian physician, and birth and developmental history collected on the Physician Checklist. All children were classified by the same raters between countries using the Gross Motor Function Classification System (GMFCS), and motor type and distribution.There were more children from GMFCS I-II in the Australian sample (GMFCS I, P < .01; III, P < .01; V, P = .03). The patterns of motor type also differed significantly with more spasticity and less dyskinetic types in the Australian sample (spasticity, P < .01; dystonia, P < .01; athetosis, P < .01). Birth risk factors were more common in the Bangladesh sample, with risk factors of low Apgar scores (Australia, P < .01), lethargy/seizures (Australia, P = .01), and term birth (Bangladesh, P = .03) associated with poorer gross motor function. Cognitive impairments were significantly more common in the Bangladesh children (P < .01), and visual impairments more common in Australia (P < .01).Patterns of functional severity, motor type, comorbidities, etiology, and environmental risk factors differed markedly between settings. Our results contribute to understanding the patterns of CP in low-resource settings, and may assist in optimizing service delivery and prioritizing appropriate early interventions for children with CP in these settings.

Loading Queensland Cerebral Palsy and Rehabilitation Research Center collaborators
Loading Queensland Cerebral Palsy and Rehabilitation Research Center collaborators