Social Determinants of Health in Cerebral Palsy

J Clin Med. 2024 Nov 23;13(23):7081. doi: 10.3390/jcm13237081.

Abstract

Background/Objectives: To describe social and psychological needs, such as poverty, early trauma, or adverse childhood events, of caregivers with a child newly diagnosed with cerebral palsy (CP) or receiving a designation of high-risk for cerebral palsy (HRCP). Methods: Caregiver self-report questionnaires screening for unmet social needs, adverse childhood experiences (ACEs), depression symptoms, and trauma were collected from 97 caregivers of children with CP/HRCP seen in a high-risk infant follow-up clinic (adjusted age range 1-24 months). We compared their responses to those of 97 caregivers of age-matched controls seen in the same clinic with similar risk factors over the equivalent time period. Results: Income insecurity and positive screening rate for depressive and trauma symptoms were high for both groups (CP/HRCP, matched control group); no differences were found between CP/HRCP and control groups. Rates of food and housing insecurity and caregiver ACEs were not different between groups. All families received referrals to appropriate community support at the visit. Conclusions: Caregivers of children with CP/HRCP in high-risk infant follow-up clinics may face difficult conversations and decision-making in the context of high psychological and social adversity. Comprehensive support should be considered as early as possible.

Keywords: adverse childhood experiences; caregivers; cerebral palsy; depression; infants; social determinants of health; trauma.