Description of Primary and Secondary Impairments in Young Children With Cerebral Palsy

Purpose: We describe primary and secondary impairments in young children with cerebral palsy (CP); report differences in impairments on the basis of Gross Motor Function Classification System (GMFCS), age, and sex; and examine the extent that individual impairments account for the construct of primary and secondary impairments. Methods: Participants included 429 children with CP (242 [56%] male; 1 1/2 to 5 years) representing all GMFCS levels. Reliable assessors collected primary and secondary impairment data using clinical measures. Analyses included descriptive statistics, comparisons among GMFCS, age, and sex, and factor analysis. Results: Young children with CP present with primary and secondary impairments. Significant differences in impairments occur among some GMFCS levels and age groups but not sex groups. Postural stability contributed most to primary impairments and strength to secondary impairments. Conclusion: Young children with CP across GMFCS levels may have already developed secondary impairments that should be addressed within therapy services.