Programa de Vigilância Nacional de Paralisia Cerebral aos 5 Anos de Idade em Portugal (PVNPC5A)
27th Annual Meeting of European Academy of Childhood Disability. Copenhaga, Dinamarca. 2015. Poster.
Inclusive schooling contributes to the integration of children with cerebral palsy (CP). Social and clinical factors affecting their effective early inclusive education are identified. A nested case-control analysis was performed, based on cross-sectional active surveillance data of 5-years-old children with CP born 2002-2005. Children living in Portugal were included. SCPE definitions and functional classifications (GMFCS, BFMF, MACS, IQ, vision and hearing) were used, as well as Portuguese scales for assessment of communication (as producer), feeding ability and drooling control. CP type was determined by the predominant clinical features. Education inclusion was graded in 5 levels, from full inclusion to segregated schooling and education at home (non-inclusion). Risk factors for non-inclusion were identified by logistic regression analysis (LRA) after preliminary bivariate analysis. Information about education inclusion was recorded in 387 of 641 registered CP children (60.4%). Non-inclusion was reported in 64 children (16.5%; 95%CI 13.17-20.56). LRA identified bilateral spastic CP, GMFCS or BMFM levels IV-V and severe epilepsy as associated to absence of reporting education inclusion. Full or partial inclusion was reported for 250 children (83.6%). The LRA model (n=244; Rsq=0.393) identified as main determinants of non-inclusion being foreign immigrant (adjusted OR 11.35; 95%CI 2.86-45.09), non-effective communicator (adjusted OR 5.25; 95%CI 1.37-20.12) and having severe feeding problems (adjusted OR 4.18; 95%CI 1.16-15.09). The odds for non-inclusion increase with the complexity and severity of CP. In Portugal, non-inclusive early education affects 13-20% of 5-years-old children with CP; it is significantly associated with severe communication and feeding problems and to immigration.
Palavras Chave: epidemiological surveillance, cerebral palsy, children, inclusion, early education, Portugal.