Peer-reviewed article
ICF Priorities and the Impact of Demographic Factors in a Paediatric Poststroke Population: An Observational Study.
Dreyer L, Fakoya I, Jauffret C, de Souza-Figueiredo N ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined the rehabilitation priorities of 59 children who had experienced stroke, using their medical records and structured classifications. Children and families raised an average of four priorities each, most commonly relating to behaviour and emotions, navigating health and education systems, fine hand control, and dealing with societal attitudes. The study found that priorities were distributed across physical, cognitive, environmental and social domains, and recommends that stroke services should be family-centered, involve multiple disciplines, and continue supporting children's participation in home and community life well beyond their acute illness.
Key points
- On average, four priorities were raised per child with post-stroke difficulties
- 47% of priorities related to activities and participation, 25% to body functions, 23% to environmental factors
- Key concerns included behaviour/emotion regulation, navigating health and education systems, fine hand use, and societal attitudes
- No significant differences in priorities were found by gender, ethnicity or deprivation level
- The study recommends longitudinal, integrated care across hospital, community and school settings focused on participation
Limitations
This is an observational study of existing clinic records from one UK stroke recovery clinic, so findings may not represent all children with stroke or other healthcare settings. The study does not evaluate an intervention to change outcomes, only describes current priorities and their associations with demographic factors.
Abstract
Background Common outcomes of childhood stroke include physical, cognitive, psychological and social difficulties. Evidence indicates young people with acquired brain injury have a range of community neuropsychological priorities impacting participation; however, less is known about priorities following childhood stroke specifically, and the demographic influences on these. This knowledge is essential to ensure rehabilitation services meet their needs. Methods Two-hundred twenty-two clinical priorities were extracted from the medical records of 59 children (66% male, 59% White, aged 1-17 years, median 7, all deprivation quintiles) attending an occupational therapy and neuropsychology Stroke Recovery Clinic: stroke type: 51% perinatal and 49% childhood. Priorities were coded using the International Classification of Functioning Disability and Health (ICF). Chi-square analysis identified associations between priorities and demographic factors. Results On average, four priorities were raised per patient. Priorities were distributed across ICF components, with 47% classified as activities and participation, 25% as body functions, 23% as environmental factors and 5% as body structures. Key concerns included behaviour/emotion, health/education navigation, fine hand use and societal attitudes. No significant demographic differences were found. A nonsignificant trend showed more body function and environmental priorities in primary and high school. Males and non-White patients continued clinic access into adolescence, with fewer non-White individuals in preschool. Discussion Children and their families have a range of priorities post-stroke, requiring patient and family centred, interdisciplinary and context specific approaches. These findings support longitudinal, integrated hospital, community and school care systems, which focus on children and young people's participation in their homes and communities well beyond the time of their stroke. Services must ensure interdisciplinary post-stroke care for children and young people is equitable and accessible, with priorities addressed in a timely manner.