Clinical profiles of ambulatory and non-ambulatory school-aged children and young people with cerebral palsy in Aotearoa New Zealand: implications for the health education interface.

AIM: In Aotearoa New Zealand, ambulatory ability impacts Ministry of Education - Te Tāhuhu o te Mātauranga therapy funding for school-aged children with cerebral palsy, yet demographic and clinical profiles across mobility groups remain poorly described. This study utilises data from the New Zealand Cerebral Palsy Register/Te Rēhita a Hōkai Nukurangi Aotearoa to compare ambulatory and non-ambulatory school-aged children, highlighting their distinct clinical needs.

METHOD: A correlational, observational analysis of 1,149 participants aged 5-21 years was conducted. Data were categorised into Gross Motor Function Classification System (GMFCS) I-III, and GMFCS IV and V, with significant associations identified using Chi-squared tests and univariate logistic regression.

RESULTS

Three hundred and forty-one (29.7%) children were classified as GMFCS IV and V. Compared to GMFCS I-III, those classified as GMFCS IV and V were more likely to have epilepsy (odds ratio [OR]=7.2 [5.2-10.0]), bilateral deafness (OR=5.4 [2.6-11.4]), moderate or severe intellectual impairment (OR=21.9 [13.3-35.9]) and be non-verbal (OR=89.1 [48.3-164.5]) or functionally blind (OR=63.4 [30.3-133.0]) (all 95% confidence interval [95% CI]). GMFCS levels corresponded with higher Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System levels.

CONCLUSION

Non-ambulatory children with cerebral palsy have more complex, co-occurring impairments that extend beyond physical limitations and require support outside of school-based service provision. The findings underscore the need for whole-of-life, transdisciplinary approaches to both funding and management in Aotearoa New Zealand.