Upper Extremity Function, School Performance, and Academic Success in Children With Cerebral Palsy (CP-SCHOOL)

June 23, 2026 updated by: Yeditepe University

Investigation of the Relationship Between Upper Extremity Functionality, Academic Achievement, School Performance, and Perception of Success in School-Aged Children With Cerebral Palsy

The aim of this study is to investigate the relationship between upper extremity functionality and school-related outcomes, including academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy. The study specifically aims to evaluate how upper extremity motor function is associated with academic participation and school-based functional performance.

The main hypotheses are:

H0: There is no significant relationship between upper extremity functionality and academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy.

H1: There is a significant relationship between upper extremity functionality and academic achievement, school performance, and perceived academic success in school-aged children with cerebral palsy.

Study Overview

Status

Completed

Conditions

Cerebral Palsy

Detailed Description

Cerebral palsy (CP) is a group of permanent movement and posture disorders caused by non-progressive disturbances in the developing brain. It is one of the most common neurodevelopmental conditions in childhood and is frequently associated with upper extremity impairments that may affect functional independence, fine motor skills, and participation in daily and school-related activities.

Upper extremity function plays a critical role in school participation, particularly in tasks such as writing, object manipulation, classroom material use, and task completion. Children with cerebral palsy often experience limitations in manual ability, which may directly or indirectly influence academic performance, school participation, and their perception of success in the school environment.

Despite the known impact of motor impairments on functional outcomes, the relationship between upper extremity functionality and school-related outcomes such as academic achievement, school performance, and perceived academic success has not been sufficiently clarified in school-aged children with cerebral palsy. Existing literature generally focuses on either motor function or academic outcomes separately, and studies evaluating these domains together remain limited.

In this context, a cross-sectional observational study will be conducted in school-aged children diagnosed with cerebral palsy who are actively attending school. Participants who meet the inclusion criteria and whose legal guardians provide informed consent will be included in the study.

Sociodemographic and clinical data will be collected using a structured data form. Upper extremity functionality will be evaluated using the Manual Ability Classification System (MACS) and ABILHAND-Kids. Academic achievement will be assessed using school report card grades. School performance will be evaluated using a standardized academic performance assessment scale. Perceived academic success will be measured using a validated school success perception scale.

All assessments will be performed in a single session under standardized conditions by trained physiotherapists. No intervention will be applied, and participants will continue their usual education and rehabilitation routines without any modification.

The collected data will be analyzed to determine the relationship between upper extremity functionality and school-related outcomes in children with cerebral palsy.

Study Type

Observational

Enrollment (Actual)

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Turkey (Türkiye)
- İ̇stanbul
  - Istanbul, İ̇stanbul, Turkey (Türkiye), 34755
    - Yeditepe University Faculty of Health Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Child
Adult

Accepts Healthy Volunteers

Sampling Method

Non-Probability Sample

Study Population

School-aged children diagnosed with cerebral palsy who meet the inclusion criteria and are actively attending school will be included in this cross-sectional observational study. Participants will be recruited from relevant clinical and educational settings. No intervention will be applied, and all participants will be assessed in a single evaluation session to examine the relationship between upper extremity functionality and school-related outcomes.

Description

Inclusion Criteria:

Diagnosis of cerebral palsy
Age between 6 and 18 years
Attending school (primary or secondary education)
Ability to understand and follow simple instructions
Consent from parents/guardians and assent from children when applicable

Exclusion Criteria:

Severe cognitive impairment preventing assessment participation
Severe visual or hearing impairments affecting test performance
Recent orthopedic surgery or botulinum toxin injection within the last 6 months
Other neurological or musculoskeletal conditions affecting upper extremity function
Inability to complete evaluation procedures

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
Cerebral Palsy Upper Extremity Function Group (CP-UEF-G) The study population consists of school-aged children diagnosed with cerebral palsy who meet the inclusion criteria and are actively attending school. The study is designed as a cross-sectional observational study and aims to evaluate the relationship between upper extremity functionality and school-related outcomes. Participants will not receive any experimental intervention. All participants will continue their routine medical care, rehabilitation programs, and school activities without any modification. All assessments will be conducted in a single session and will include evaluation of upper extremity functionality, academic achievement, school performance, and perceived academic success. Upper extremity functionality will be assessed using the Manual Ability Classification System (MACS) and ABILHAND-Kids. Academic achievement will be evaluated using school report card grades. School performance will be assessed using a standardized academic performance evaluation scale. Percei

Group / Cohort

Cerebral Palsy Upper Extremity Function Group (CP-UEF-G)

The study population consists of school-aged children diagnosed with cerebral palsy who meet the inclusion criteria and are actively attending school. The study is designed as a cross-sectional observational study and aims to evaluate the relationship between upper extremity functionality and school-related outcomes.

Participants will not receive any experimental intervention. All participants will continue their routine medical care, rehabilitation programs, and school activities without any modification.

All assessments will be conducted in a single session and will include evaluation of upper extremity functionality, academic achievement, school performance, and perceived academic success.

Upper extremity functionality will be assessed using the Manual Ability Classification System (MACS) and ABILHAND-Kids. Academic achievement will be evaluated using school report card grades. School performance will be assessed using a standardized academic performance evaluation scale. Percei

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Upper Extremity Functionality (MACS) Time Frame: [Time Frame: Baseline assessment (single session)]	The Manual Ability Classification System (MACS) was used to evaluate upper extremity functional ability in children with cerebral palsy. MACS classifies how children use their hands to handle objects in daily activities. The system consists of five levels, ranging from Level I (handles objects easily and successfully) to Level V (does not handle objects and has severely limited ability). Scores range from 1 (minimum) to 5 (maximum). Lower levels indicate better manual ability and functional independence.The scale ranges from 1 (minimum) to 5 (maximum).	[Time Frame: Baseline assessment (single session)]
Upper Extremity Functional Performance (ABILHAND-Kids) Time Frame: [Time Frame: Baseline assessment (single session)]	The ABILHAND-Kids questionnaire was used to assess perceived manual ability in children with cerebral palsy. It evaluates the child's ability to perform daily activities involving upper extremity use, such as dressing, writing, and handling objects. The scale consists of 21 items, with total scores typically converted to a logits scale (or summed scores ranging from 0 to 42), where 0 represents the minimum and 42 represents the maximum ability. Higher scores indicate better manual ability and functional performance in daily life.The total score ranges from 0 (minimum) to 42 (maximum).	[Time Frame: Baseline assessment (single session)]
Academic Achievement Time Frame: [Time Frame: Most recent academic term at baseline]	Academic achievement was evaluated using students' official school report card grades. This measure reflects overall academic success in core subjects and provides an objective indicator of educational performance. Grades are reported on a scale from 0 (minimum) to 100 (maximum). Higher grades indicate better academic achievement.	[Time Frame: Most recent academic term at baseline]

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
School Performance Time Frame: [Time Frame: Baseline assessment (single session)]	School performance was assessed using the Academic Performance Evaluation Scale. This measure evaluates the child's participation, task completion, attention, and functional performance in the school environment. The scale consists of 19 items. Mean scores range from 1 (minimum) to 5 (maximum). Higher scores indicate better school functioning and academic participation.The total score ranges from 0 (minimum) to 42 (maximum).	[Time Frame: Baseline assessment (single session)]
Perceived Academic Success Time Frame: [Time Frame: Baseline assessment (single session)]	Perceived academic success was measured using the Perception of Success Scale. TIn this 24-item scale, for positive statements that support success, a score of 5 is given for "Strongly Agree" and 1 for "Strongly Disagree". For negative statements that hinder success, the scoring is reversed from 1 to 5 and then summed. A high total score indicates that the student has a strong and positive perception of success, high academic self-confidence, and effectively utilizes factors that support success. Conversely, a low total score indicates that the student feels significant obstacles to success (such as anxiety, lack of planning, lack of motivation, etc.) and may need support in academic processes.	[Time Frame: Baseline assessment (single session)]
Sociodemographic and Clinical Data Time Frame: [Time Frame: Baseline assessment (single session)]	Sociodemographic and clinical characteristics, including age, gender, diagnosis details, and functional level, were collected using a Structured Clinical Data Form to describe the study population. Age is measured in years, while categorical data such as gender and functional level are reported as frequencies and percentages. Each variable is aggregated as a single descriptive value (mean or frequency) to provide a baseline profile of the participants.	[Time Frame: Baseline assessment (single session)]

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Yeditepe University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2026

Primary Completion (Actual)

June 22, 2026

Study Completion (Actual)

June 22, 2026

Study Registration Dates

First Submitted

April 25, 2026

First Submitted That Met QC Criteria