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Journal of Pediatric Psychology Advance Access published online on July 3, 2006
Journal of Pediatric Psychology, 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
Received November 29, 2005
Revised June 5, 2006
Accepted June 5, 2006

Article

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

Susan J. Berrin MA 1 *, Vanessa L. Malcarne PhD 2, James W. Varni PhD 3, Tasha M. Burwinkle PhD 4, Sandra A. Sherman MS 5, Kanela Artavia BA 6, and Henry G. Chambers MD 7

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

* To whom correspondence should be addressed.
Susan J. Berrin, 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.

Keywords: cerebral palsy; children; fatigue; pain; PedsQLTM; school functioning.
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