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Clinical condition complexity of 5-year-old children not included in regular school - Portuguese National Surveillance of Cerebral Palsy Registry 2005-2015 decade.

Teresa Folha, Daniel Virella, Ana João Santos, Ana Cadete, Rosa Gouveia, Joaquim Alvarelhão, Eulália Calado, Teresa Gaia, Maria da Graça Andrada.

- 31st European Academy of Childhood Disability 2019 Conference, 23 a 25 de Maio de 2019.

Introduction. For children with cerebral palsy (CP) attending kindergarten school promotes social and cognitive skills, which affects community participation. This study describes the association between complexity and inclusion in regular school (RS) for children with CP at 5 years old using the Portuguese National Surveillance of Cerebral Palsy Registry (PNSCPR).
Patients and methods. Children residents in Portugal between 2006 and 2016 were selected from PNSCPR database. The Surveillance of Cerebral Palsy in Europe definitions, classifications and instruments were used. Children not attending RS were considered. Clinical complexity included four indicators: GMFCS (III-V); cognitive function (IQ<50); active epilepsy and severe visual deficit. Univariate Chi-square test and logistic regression models were used to investigate association between complexity indicators and school inclusion.
Results. Of 1102 children 18.5% (n=204) were not in RS. The number of indicators was significantly associated with the increase of the proportion of children not attending school: 2.2% presenting zero indicators, 11.4% one; 19.8% two; 35% three and 45.2% of children presenting all four indicators. The highest risk of not attending RS at 5 years old was observed for children indicating worse global motor function (GMFCS III-V; OR=3.9; 95%CI=2.1-7.2; p<0.001), followed by children with cognitive deficit (IQ<50; OR=3.3; 95%CI=1.8-6.1; p<0.001) and active epilepsy (OR=1.9; 95%CI=1.1-3.3; p<0.05).
Conclusion. Clinical complexity indicators are significantly associated with attending RS at the pre-school level. This knowledge may potentiate better inclusion experiences, the development of children is potential, committing resources and supporting families in these processes.