Pain, fatigue, and school functioning in children with cerebral palsy: a path-analytic model.

OBJECTIVE This study tests a model of how pain and fatigue, independently or in combination, relate to school functioning in pediatric cerebral palsy (CP). METHODS One hundred eighty-nine parents of children with CP completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and the PedsQL 3.0 Cerebral Palsy Module. Seventy-three children with CP completed the PedsQL. Path-analytic and mediational techniques were utilized to test the a priori model. RESULTS Data from both parent proxy-report and child self-report were found to have acceptable model fit. Results supported the existence of an indirect relationship between diagnostic subtypes and school functioning that was partially mediated by both pain and fatigue. CONCLUSIONS Pain and fatigue represent potentially modifiable targets for interventions designed to improve school functioning in children with CP.