Research Projects

Current Research Projects

Understanding the causes of cerebral palsy

The first part of this project has involved classifying and describing patterns of abnormality on MRI scans of the brain. In groups of children whose MRI scans show similar patterns, we are examining relationships between the abnormal MRI findings and the clinical characteristics of these children. The last part of the project is aimed at improving our understanding of the pathways to cerebral palsy and the timing of injury in the same groups. We are currently inviting families to participate in the study. The study inclusion criteria require children to be born in Victoria between 1999 and 2008 and have brain scans classified to one of four patterns of abnormality. Natural mothers of children are being invited to consent to the collection of additional data on risk factors from the Victorian Perinatal Data Collection and Birth Defects Register, complete a maternal questionnaire, and collect saliva samples from the child that will be stored for later use.

For more information on this study, please contact:
Angela Guzys
Tel: 03 9936 6089
Email: angela.guzys@mcri.edu.au  

 
Follow-up of children on the Victorian Cerebral Palsy Register at age five, ten and fifteen years

This research project aims to collect clinical information on children with cerebral palsy as they age, specifically at ages 5, 10 and 15 years. We are interested in learning about the number of children who develop epilepsy or other complications such as scoliosis as they get older, as well as recording any major medical or surgical interventions. Importantly, we want to understand if changes occur in children’s ability to move, communicate or complete everyday activities. It is anticipated that findings of this study will be used to guide future important research into cerebral palsy.

Seizures in children with cerebral palsy and white matter injury

The aim of this project is to learn more about different types of epilepsy in children with cerebral palsy and making decisions about treatment. Children with cerebral palsy who have already had an MRI of the brain demonstrating white matter injury are being invited to participate. Parents will be asked a range of questions about their child’s cerebral palsy and whether or not they are having seizures. This can be completed over the telephone.

For more information on this project, please contact:
Dr Monica Cooper
Tel: 03 9345 5898
Email: monica.cooper@rch.org.au

For more information about current project please visit the Developmental Disability and Rehabilitation Research page

Previous Research Studies:

In 2012, 86 parents of children with cerebral palsy completed a survey on the types of therapy their child receives. The study found that 83% of children had received occupational therapy; 88% had received physiotherapy; and 60% had received speech and language pathology services over the previous year. Children with more severe cerebral palsy received more therapy than children with mild cerebral palsy and children attending special schools received more therapy than those attending mainstream schools. Young children received more funding for therapy than older children. Overall, 40% of parents were dis-satisfied with the amount of therapy their child had received in the past year. This information may be useful for policy makers with the impending roll-out of the National Disability Insurance Scheme.

For further information on this study, please contact:

Adrienne Harvey
Tel: 03 9345 5522 ext 57540
Email:
adrienne.harvey@rch.org.au

During June, July and August 2014, a medical student from Monash University, Dhanu Giritharan, interviewed parents of children with CP who presented with a respiratory problem to the emergency department at the Royal Children’s Hospital. The study provided valuable information on current management strategies, the usefulness of a new measure of respiratory health, the Respiratory Health Questionnaire, in predicting the severity of respiratory illness, and ways to measure outcomes of treatment following illness. The results of the study will be used to inform further research and the development of management guidelines for the management of respiratory illness in children with cerebral palsy presenting to the emergency department with respiratory complaints.

For further information on this project, please contact:

Sue Reid
Tel: 03 9345 4807
Email:
sue.reid@mcri.edu.au

The aim of this project was to learn more about the clinical characteristics of children aged four to 12 years with cerebral palsy who have white matter changes on their MRI brain scans. We were interested in comparing the clinical characteristics for children who were born at or before 34 weeks gestation with those born after 34 weeks. Between January 2011 and June 2012, 109 children had an assessment with a physiotherapist and occupational therapist. Our results found that there was no difference in the type of movement problems experienced by children born at or before 34 weeks and those born after 34 weeks. However, more children born at or before 34 weeks had movement difficulties affecting both sides of their bodies compared with those born after 34 weeks. Children born after 34 weeks were found to have fewer problems with moving their bodies, using their hands and communicating than children born at or before 34 weeks gestation. These results provide important information about how this group of children communicate, use their hands and move their bodies.

For further information on this study, please contact:

Adrienne Harvey
Tel: 03 9345 5522 ext 57540
Email:
adrienne.harvey@rch.org.au

Sarah Sherwell looked at the thinking and learning abilities of young children with cerebral palsy as part of her PhD research. Between July 2008 and March 2011, 80 children had an assessment with a neuropsychologist as part of this project. We found that it was difficult for many children with cerebral palsy to take part in assessments that psychologists normally use to assess thinking and learning ability. Many children did not have the speech and movement ability to complete tasks and 38% of the children were unable to finish all of the assessment tasks. For the children who did complete the thinking and learning tasks, we found most of them scored within the range expected for their age, but lower than children who do not have cerebral palsy. Twenty-five percent of parents reported their child had some difficulty with emotional and behavioural problems. These results suggest that children with cerebral palsy may need extra support to help them with their thinking, learning and behaviour. Psychologists must consider a child’s movement and speech difficulties when they are assessing thinking and learning abilities so that a child’s results are a true indication of their ability.

For further information on this study, please contact:

Sue Reid
Tel: 03 9345 4807
Email:
sue.reid@mcri.edu.au

For most people, contact with the health system occurs intermittently following an acute illness or an injury. However, for children and adults with disabilities like cerebral palsy, their healthcare experiences are not so simple. Today, much is known about cerebral palsy, including the most common medical comorbidities, and how they are best managed in individual children. However, it is not clear if, as a group, children with cerebral palsy are receiving optimal medical care, from a healthcare delivery perspective.

For her PhD, Elaine Meehan linked the Victorian Cerebral Palsy Register with hospital admissions and emergency department data from the RCH and Monash Children’s initially, and then to statewide databases, the Victorian Admitted Episodes Dataset (VAED) and the Victorian Emergency Minimum Dataset (VEMD) to explore patterns of tertiary paediatric hospital use, and then all-hospital use, in this population. She also designed a survey and collected information directly from parents on their child’s use of other services, and on the financial implications of having a child with additional care needs.

Her thesis highlighted a number of issues, not previously reported in the literature, specifically the financial hardship being experienced by some families, the evidence that there may be more use of tertiary services than is needed among this group, the inadequate care coordination for those children that need it, and the fact that older children and adolescents with cerebral palsy continue to have high medical care needs. It is hoped that this information can be used to provide an evidence basis for future decisions around healthcare delivery for this group, so that ultimately, healthcare experiences for children with cerebral palsy can be improved on.

For more information on this research, please contact:
Elaine Meehan
Tel: 03 9345 4808
Email: elaine.meehan@mcri.edu.au