Background: Mothering handling plays an important role in the daily life of children with cerebral palsy (CP) and their mothers, so that the greatest amount of handling of children with CP is done by the mothers at home. The study aimed to explore the process of mothering handling in the children with CP at home.

Materials and Methods: This qualitative study was conducted using grounded theory methodology in Tehran. The purposeful sampling followed by theoretical sampling. Selecting participants continued to achieve theoretical saturation. The number of participants was 26 including 15 caregivers, 3 children with cerebral palsy, 5 occupational therapists, 1 physiotherapist, and 3 rehabilitation manegers. The main source for gathering data was in-depth, semi-structured interviews. Data were analyzed by Corbin & Straus method (2008).

Results: Six categories/themes emerged from the data, including: motherly care, confronting with unusual co-occupation, confusion in roles, effort to special care, dynamic management of handling, and continuing care. The central category, confrontation with unusual co-occupation, represented the main theme of the research, and all major categories had been related to it.

Conclusion: The results of this research could provide broad perspective to rehabilitation therapists, managers and policy makers for understanding the needs, meeting challenges and concerns of caregivers and children with CP and designing a comprehensive plan for handling process of children with CP and helping them to be empowered for achieving the proper management and effective handling.

Background: Determining the level of manual ability of children with cerebral palsy has significant role in scheduling care and providing supportive services by organizations such as the a social welfare office. Manual Ability Classification System (MACS) is responsible for this critical matter. In Mazandaran Province, the prediction of manual ability is intuitive and is done without tools. This study aimed to investigate the consistency between operational therapists prediction of future manual function of children with cerebral palsy and MACS scale.

Materials and Methods: This study was designed as a cross sectional trial. The study population consisted of 12 occupational therapists working in Mazandaran’s rehabilitation center under the social welfare office. Firstly, occupational therapists chose 100 children with cerebral palsy and classified their future manual ability into five levels according to their prediction. Then the researcher classified the children based on MACS scale. Finally, the amount of prediction consistency between therapists and researcher was statisticaly analyzed.

Results: The weighted kappa coefficients of MACS scale were 0.671 in first level and 0.747 in fifth level that show good agreement in these two levels. This coefficient was 0.417 in third level and 0.444 in forth level that shows fair agreement. The weighted kappa coefficient was 0.358 in second level that indicates slight agreement.

Conclusion: With prediction consistency between operational therapists and researcher, MACS is used as a suitable means for classifying the level of manual ability in children with cerebral palsy and predicting their needs to adaptive and auxiliary devices by occupational therapists in rehabilitation centers and social welfare offices.

Background: Understanding the real needs of children with cerebral palsy and their families  helps the therapists to provide adequate health care service for them. This study aimed to determine the needs  of  mothering handling training for family caregiving of children and youth with CP at home based on the level of gross motor function.

Materials and Methods: This research was a descriptive, analytical and cross sectional study that was performed on 186 children 4-12 year olds with CP from the rehabilitation clinics in the city of Arak. They were selected by simple and purposeful sampling. Clinical tests were Gross Motor Measure Function Classification System Expanded & Revised (GMFCS E&R) to assess the severity of gross motor function lesions and canadian Occupational performance measure (COPM) to determine the needs. Data were analyzed by descriptive tests such as: statistical test and two-way ANOVA.

Results:  The most important need of mothering handling training was self care training specially toileting, feeding, eating and functional mobility related to children with CP in the level of V of GMFCS E&R (transported in a manual wheelchair). There were no significant differences in needs of mothering handling training in areas of sex and severity of gross motor function lesions (p>0.05).

Conclusion: It seems that therapists should combine maternal handling trainings with other interventions in therapy programs, especially in the area of self- care.

Abstract

Background: One of the problems in children with cerebral palsy is impaired eating and drinking liquids. The purpose of this study is to compare the effect of oral motor stimulations on feeding function in the children with spastic cerebral palsy by two medical and family centered approaches.

Materials and Methods: This research was a descriptive-analytical cross sectional study that performed on 40 children 2-8 year olds with spastic Cerebral Palsy from the rehabilitation clinics in the city of Arak. They were selected by simple and purposeful sampling. Applied instruments were Gross Motor Measure Function Classification System Expanded & Revised (GMFCS E&R) and oral motor assessment scale(OMAS). Data were analyzed by statistical tests such as: Kolmogorov-Smirnov, reporting mean, standard deviation, data analysis frequncy distribution table, independent t-test, dependent t-test, chi-square and MANOVA.

Results: The difference of swallowing function assessed by OMAS in both groups managed by family centered and clinician centered approach prior and post management statistialy was meaningful (p=0.001(. The difference between swallowing function of both groups post intervention was not meaningful in view of first and second assessor, also it had no statistical significance(p=0.89 , p=0.07)

Conclusion: In general, we can conclude that oral motor stimulation is effective on swallowing function of cerebral palsy children in both treated groups. The effect of these stimulations on swallowing function in children with cerebral palsy between clinician centered and family centered approaches was equal.