School attendance in individuals with cerebral palsy in Brazil

Abstract

Aim: To identify factors associated with school attendance among Brazilian children, adolescents, and young adults with cerebral palsy (CP) using population-based data from the Brazilian Cerebral Palsy Register (BrCPR).Method: This cross-sectional study analysed data from 774 individuals aged 4 to 21 years with CP registered in the BrCPR. Variables included sociodemographic and clinical characteristics (Gross Motor Function Classification System, Manual Ability Classification System, and speech limitations), and school attendance. Descriptive and bivariate analyses were conducted using χ2 tests; multivariable logistic regression models were applied to estimate adjusted odds ratios (aORs) with corresponding 95% confidence intervals (CIs).Results: Among participants, 76% attended school, although 62% could not read and write. Adolescents with CP aged 13 to 21 years were less likely to attend school compared to those aged 4 to 12 years (aOR = 0.49, 95% CI = 0.3-0.7), as were those classified in Gross Motor Function Classification System levels IV and V compared to levels I to III (aOR = 0.29, 95% CI = 0.1-0.4). Additionally, the presence of speech limitations was associated with reduced school attendance (aOR = 0.12, 95% CI = 0.1-0.3).Interpretation: Although school attendance rates for Brazilian individuals with CP are relatively high compared to other low- and middle-income countries, major barriers persist. Addressing speech support, and mobility-related inclusion, is essential to improve both school attendance and meaningful involvement.