Comparison of developmental pattern change in preschool children with spastic diplegic and quadriplegic cerebral palsy.

BACKGROUND This study compares the longitudinal change of developmental patterns in preschool children with spastic diplegic (SD) and spastic quadriplegic (SQ) cerebral palsy (CP). METHODS Sixty children with spastic CP, aged 1-5 years (3.2 +/- 1.2 years), were classified into 2 groups: SD (n = 29) and SQ (n = 31). Gross Motor Function Classification System (GMFCS) levels were classified during the initial assessments. Developmental profiles, including development quotients (DQs) of gross motor, fine motor, expressive language, concept comprehension, situation comprehension, self help, personal social and general development, were evaluated on initial and final assessments and an average of one year later. The DQ change index (%) was calculated as 100% x (final DQ - initial DQ)/initial DQ. RESULTS Children with SQ had lower DQs in all developmental functions than those with SD on both assessments (p < 0.01). The DQ distributions of developmental profiles were different in SD and SQ groups, although both groups displayed the lowest DQs in the gross motor domain. As indicated by the DQ change index, most DQs increased with age in children with SD; however, most decreased with age in children with SQ (p < 0.05). CONCLUSION These findings suggest different CP subtypes demonstrate various development profiles. The evolvement of developmental patterns with age was different in children with various CP subtypes.