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"Rosenbloom, Lewis"
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Survival in cerebral palsy in the last 20 years: signs of improvement?
This study investigated the possibility of improved survival in cerebral palsy (CP) over a 20‐year period. Participants were 47 259 persons with CP receiving services from the State of California between 1983 and 2002. The person–year approach was used. This asks whether the probability of dying in a given calendar year changes over the study period after age and severity of disability are taken into account. An appreciable improvement over time was found in children with severe disabilities and in adults who required gastrostomy feeding. In these groups, mortality rates fell by 3.4% per year. Therefore, life expectancies reported in earlier studies should be increased by approximately 5 years if adjustments to 2002 mortality rates are made. For other persons with CP there was, at most, a small improvement over the 20‐year period. The results suggest there have been improvements in the treatment and care of the most medically fragile children. Gastrostomy feeding has become much more widespread over the past two decades, and the improved survival of persons with gastrostomies may reflect better understanding of their requirements.
Journal Article
Developmental Disability and Ageing
This handbook is aimed at clinicians and others who are engaged in caring for ageing adults with developmental disabilities. It is intended to inform understanding, promote assessment, assist in care planning, and especially to improve everyday living for this needy but sadly often neglected group of vulnerable individuals. The authors base their guidance on evidence, focusing on important insights that are likely to be valuable to the clinician interested in the care of the individuals on whose behalf the book has been prepared.
eBook
Cerebral Palsy
This landmark title considers all aspects of cerebral palsy from the causes to clinical problems and their implications for individuals.An international team of experts provides clinicians and researchers with key information on the mechanisms underlying impairments in movement, development, cognition, communication, vision, feeding, behaviour, sexuality, and musculoskeletal deformities.They present a wide range of person-centred assessment approaches, including clinical evaluation, measurement scales, neuroimaging and gait analysis. The principles of multi-disciplinary management are presented, in terms of therapist intervention, medication and surgery. The perspective of the book spans the lifelong course of cerebral palsy, taking into account worldwide differences in socio-economic and cultural factors. Many chapters are illustrated with clinical vignettes enabling direct translation into practice. Full integrated colour, with extensive cross-referencing make this a highly attractive and useful reference.
eBook
Life expectancy in cerebral palsy: an update
This paper clarifies and updates some issues of life expectancy in cerebral palsy. These are: (1) the definition of life expectancy and how it is calculated; (2) the secular trends that have occurred since the data for the 1998 paper were collected; (3) revised estimates reflecting improvements of some of the analytical methods and statistics provided in that paper; (4) comparison of life expectancies among countries; (5) issues regarding quality of care; and (6) consideration of prospective life expectations in addition to current life expectancy.
Journal Article
Growth patterns in a population of children and adolescents with cerebral palsy
This study examined growth of children and adolescents with cerebral palsy (CP) who received services from the California Department of Developmental Services from 1987 to 2002. In all, 141 961 measurements of height and weight were taken from 24920 patients with CP (14103 males, 10817 females). Centiles of weight and height were determined by age, sex, and five levels of functional ability ranging from fully ambulatory to unable to walk, crawl, or feed self, and fed via gastrostomy tube. Resulting charts of height and weight centiles were compared with Centers for Disease Control and Prevention weight and height charts for the general population of the US. Centiles of height and weight of patients with CP were close to those of the general population for the highest functioning groups with CP, but lagged substantially for other groups. Presence of a feeding tube was associated with greater height and weight in the lowest functioning groups, with centiles for weight being 2 to 5kg higher for those with gastrostomy tubes. The charts may assist in early identification of nutritional or metabolic difficulties beyond what might be expected for patients with similar functional disabilities.
Journal Article