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Journal of Pediatric Psychology Advance Access originally published online on July 3, 2006
Journal of Pediatric Psychology 2007 32(3):330-337; doi:10.1093/jpepsy/jsl017
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Pain, Fatigue, and School Functioning in Children with Cerebral Palsy: A Path-Analytic Model

Susan J. Berrin, MA1,*, Vanessa L. Malcarne, PhD1, James W. Varni, PhD2, Tasha M. Burwinkle, PhD3,4, Sandra A. Sherman, MS1,5, Kanela Artavia, BA6 and Henry G. Chambers, MD7

1 San Diego State University, 2 Texas A&M University, College Station, 3 The Children’s Hospital at Scott & White, 4 Texas A&M University Health Science Center, Temple, 5 University of California, San Diego, 6 University of California Los Angeles, and, 7 Children’s Hospital and Health Center, San Diego

All correspondence concerning this article should be addressed to Susan J. Berrin, 16 Fisk Circle, Annapolis, Maryland 21401. E-mail: sberrin1{at}umbc.edu.


  Abstract

Objective This study tests a model of how pain and fatigue, independently or in combination, relate to school functioning in pediatric cerebral palsy (CP). Methods One hundred eighty-nine parents of children with CP completed the Pediatric Quality of Life InventoryTM (PedsQLTM) 4.0 Generic Core Scales and the PedsQLTM 3.0 Cerebral Palsy Module. Seventy-three children with CP completed the PedsQLTM. Path-analytic and mediational techniques were utilized to test the a priori model. Results Data from both parent proxy-report and child self-report were found to have acceptable model fit. Results supported the existence of an indirect relationship between diagnostic subtypes and school functioning that was partially mediated by both pain and fatigue. Conclusions Pain and fatigue represent potentially modifiable targets for interventions designed to improve school functioning in children with CP.

Key words: cerebral palsy; children; fatigue; pain; PedsQLTM; school functioning.

* Susan J. Berrin is currently at the University of Maryland, Baltimore County.

Received November 29, 2005; revision received April 24, 2006; revision received June 5, 2006; accepted June 5, 2006


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