Clinical Profiles of Ambulatory and Non-Ambulatory School-Aged Children and Young People With Cerebral Palsy in Aotearoa New Zealand: Implications for the Health Education Interface

Abstract

Aim: In Aotearoa New Zealand, ambulatory ability impacts Ministry of Education – Te Tāhuhu o te Mātauranga therapy funding for school-aged children with cerebral palsy, yet demographic and clinical profiles across mobility groups remain poorly described. This study utilises data from the New Zealand Cerebral Palsy Register/Te Rēhita a Hōkai Nukurangi Aotearoa to compare ambulatory and non-ambulatory school-aged children, highlighting their distinct clinical needs.

Method: A correlational, observational analysis of 1,149 participants aged 5–21 years was conducted. Data were categorised into Gross Motor Function Classification System (GMFCS) I–III, and GMFCS IV and V, with significant associations identified using Chi-squared tests and univariate logistic regression.

Results: Three hundred and forty-one (29.7%) children were classified as GMFCS IV and V. Compared to GMFCS I–III, those classified as GMFCS IV and V were more likely to have epilepsy (odds ratio [OR]=7.2 [5.2–10.0]), bilateral deafness (OR=5.4 [2.6–11.4]), moderate or severe intellectual impairment (OR=21.9 [13.3–35.9]) and be non-verbal (OR=89.1 [48.3–164.5]) or functionally blind (OR=63.4 [30.3–133.0]) (all 95% confidence interval [95% CI]). GMFCS levels corresponded with higher Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System levels.

Conclusion: Non-ambulatory children with cerebral palsy have more complex, co-occurring impairments that extend beyond physical limitations and require support outside of school-based service provision. The findings underscore the need for whole-of-life, transdisciplinary approaches to both funding and management in Aotearoa New Zealand.</jats:p>