Self-Concept
Self-concept has been examined in children with cerebral palsy. This affects many different areas of life including social, athletic and academic competence. There is some debate whether young children with cerebral palsy have a lower overall self-concept than children without any impairment, but a recent study of children with mild-to-moderate spastic diplegia or hemiplegia at Gross Motor Function Classification System (GMFCS) levels 1, 2 or 3, generally had no difference in their global self-worth than children without disabilities. It has been proposed that children with mild or moderate degrees of cerebral palsy are expected to do more by their peers, so might be more vulnerable than children with more severe cerebral palsy.
It was found that children with cerebral palsy had a positive self image in areas of overall self-worth, physical appearance and behavioral conduct. Boys with cerebral palsy scored lower than boys without disability in scholastic and athletic competence, with girls scoring lower in areas of social acceptance and athletic competence. Young children with cerebral palsy scored lower in areas of scholastic and athletic competence. The fact that children with cerebral palsy generally score themselves as lower in athletic competence is possibly a sign of a realistic view of themselves with their physical challenges. Additionally, the fact that their overall sense of self-worth was not affected by this indicates that athletic competence is not strongly valued. There is also a question whether the boys and younger children scoring themselves lower on scholastic competence may be due to more frequent absenteeism with illness or visits to the doctor or therapist or possibly due to cognitive or communication deficits. These are important considerations in setting goals for each child.
Studies of social interaction and social adjustment in children generally show that children, particularly girls, tend to have a positive perception of other children based on physical similarities, social status and behavior. Girls tend to form small, homogeneous groups. Boys tend to form larger groups that are more heterogeneous with personal and social characteristics. The potential risk for girls with cerebral palsy having more social difficulties appears inherent in how young girls interact, particularly around the ages of 9 to 12.
There are, therefore, some who advocate working on particular social skills from a preschool level. This would include working on regulating emotions, interpreting intentions of others, positive reinforcement of desirable behaviors (such as sharing, helping and cooperating) which are associated with positive social status with peers in the general population. Therefore, theoretically, working on these skills before school age would enhance the ability for more positive social interactions with children.
It has also been shown that having at least one friend reduces the feeling of loneliness. It is also a protective factor against being picked on, unless the friend is a potential victim too, which then is an additional risk for rejection. The role of family, parents and teachers in maintaining positive social adjustment is important but not well defined. It has been suggested that having teachers or administrators monitor social situations several times a year could be helpful for promoting positive social interactions for children.
