The aim of this study is to investigate the relationship between upper extremity functionality and school-related outcomes, including academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy. The study specifically aims to evaluate how upper extremity motor function is associated with academic participation and school-based functional performance. The main hypotheses are: H0: There is no significant relationship between upper extremity functionality and academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy. H1: There is a significant relationship between upper extremity functionality and academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy.
Cerebral palsy (CP) is a group of permanent movement and posture disorders caused by non-progressive disturbances in the developing brain. It is one of the most common neurodevelopmental conditions in childhood and is frequently associated with upper extremity impairments that may affect functional independence, fine motor skills, and participation in daily and school-related activities. Upper extremity function plays a critical role in school participation, particularly in tasks such as writing, object manipulation, classroom material use, and task completion. Children with cerebral palsy often experience limitations in manual ability, which may directly or indirectly influence academic performance, school participation, and their perception of success in the school environment. Despite the known impact of motor impairments on functional outcomes, the relationship between upper extremity functionality and school-related outcomes such as academic achievement, school performance, and perceived academic success has not been sufficiently clarified in school-aged children with cerebral palsy. Existing literature generally focuses on either motor function or academic outcomes separately, and studies evaluating these domains together remain limited. In this context, a cross-sectional observational study will be conducted in school-aged children diagnosed with cerebral palsy who are actively attending school. Participants who meet the inclusion criteria and whose legal guardians provide informed consent will be included in the study. Sociodemographic and clinical data will be collected using a structured data form. Upper extremity functionality will be evaluated using the Manual Ability Classification System (MACS) and ABILHAND-Kids. Academic achievement will be assessed using school report card grades. School performance will be evaluated using a standardized academic performance assessment scale. Perceived academic success will be measured using a validated school success perception scale. All assessments will be performed in a single session under standardized conditions by trained physiotherapists. No intervention will be applied, and participants will continue their usual education and rehabilitation routines without any modification. The collected data will be analyzed to determine the relationship between upper extremity functionality and school-related outcomes in children with cerebral palsy.
Study Type
OBSERVATIONAL
Enrollment
10
Yeditepe University Faculty of Health Sciences
Istanbul, İ̇stanbul, Turkey (Türkiye)
Upper Extremity Functionality (MACS)
The Manual Ability Classification System (MACS) was used to evaluate upper extremity functional ability in children with cerebral palsy. MACS classifies how children use their hands to handle objects in daily activities. The system consists of five levels, ranging from Level I (handles objects easily and successfully) to Level V (does not handle objects and has severely limited ability). Scores range from 1 (minimum) to 5 (maximum). Lower levels indicate better manual ability and functional independence.The scale ranges from 1 (minimum) to 5 (maximum).
Time frame: [Time Frame: Baseline assessment (single session)]
Upper Extremity Functional Performance (ABILHAND-Kids)
The ABILHAND-Kids questionnaire was used to assess perceived manual ability in children with cerebral palsy. It evaluates the child's ability to perform daily activities involving upper extremity use, such as dressing, writing, and handling objects. The scale consists of 21 items, with total scores typically converted to a logits scale (or summed scores ranging from 0 to 42), where 0 represents the minimum and 42 represents the maximum ability. Higher scores indicate better manual ability and functional performance in daily life.The total score ranges from 0 (minimum) to 42 (maximum).
Time frame: [Time Frame: Baseline assessment (single session)]
Academic Achievement
Academic achievement was evaluated using students' official school report card grades. This measure reflects overall academic success in core subjects and provides an objective indicator of educational performance. Grades are reported on a scale from 0 (minimum) to 100 (maximum). Higher grades indicate better academic achievement.
Time frame: [Time Frame: Most recent academic term at baseline]
School Performance
School performance was assessed using the Academic Performance Evaluation Scale. This measure evaluates the child's participation, task completion, attention, and functional performance in the school environment. The scale consists of 19 items. Mean scores range from 1 (minimum) to 5 (maximum). Higher scores indicate better school functioning and academic participation.The total score ranges from 0 (minimum) to 42 (maximum).
Time frame: [Time Frame: Baseline assessment (single session)]
Perceived Academic Success
Perceived academic success was measured using the Perception of Success Scale. TIn this 24-item scale, for positive statements that support success, a score of 5 is given for "Strongly Agree" and 1 for "Strongly Disagree". For negative statements that hinder success, the scoring is reversed from 1 to 5 and then summed. A high total score indicates that the student has a strong and positive perception of success, high academic self-confidence, and effectively utilizes factors that support success. Conversely, a low total score indicates that the student feels significant obstacles to success (such as anxiety, lack of planning, lack of motivation, etc.) and may need support in academic processes.
Time frame: [Time Frame: Baseline assessment (single session)]
Sociodemographic and Clinical Data
Sociodemographic and clinical characteristics, including age, gender, diagnosis details, and functional level, were collected using a Structured Clinical Data Form to describe the study population. Age is measured in years, while categorical data such as gender and functional level are reported as frequencies and percentages. Each variable is aggregated as a single descriptive value (mean or frequency) to provide a baseline profile of the participants.
Time frame: [Time Frame: Baseline assessment (single session)]
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