{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:36:44Z","timestamp":1768876604054,"version":"3.49.0"},"reference-count":62,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P. (FCT) through the Portuguese State Budget","doi-asserted-by":"publisher","award":["UIDB\/01662\/2020"],"award-info":[{"award-number":["UIDB\/01662\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P. 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The severity and type of dysfunction depend on the brain injury. Movement and posture are the most affected areas. CP is a lifelong condition, and parenting a child with this disorder brings additional challenges (e.g., dealing with grief) and needs (e.g., information). Identifying and characterizing their challenges and needs are pivotal to enrich the knowledge in this field and help draw more suitable support for parents. Interviews with 11 parents of children with CP attending elementary school were conducted. The discourse was transcribed, and a thematic analysis was performed. Three themes emerged from the data: (i) challenges of parenting a child with CP (e.g., internal challenges), (ii) crucial needs for parents to cope with a child with CP (e.g., information), and (iii) the intersection between challenges and needs of parents of children with CP (e.g., unawareness). Regarding the challenges and needs characterization, lifespan was the most frequent period of child development, and the microsystem was the context of life most reported. The findings may inform the design of educational and remediation interventions to support families of children with CP attending elementary school.<\/jats:p>","DOI":"10.3390\/ijerph20053811","type":"journal-article","created":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T02:57:38Z","timestamp":1677034658000},"page":"3811","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Parenting in Cerebral Palsy: Understanding the Perceived Challenges and Needs Faced by Parents of Elementary School Children"],"prefix":"10.3390","volume":"20","author":[{"given":"Ana","family":"Guimar\u00e3es","sequence":"first","affiliation":[{"name":"Psychology Research Center, School of Psychology, University of Minho, 4710-057 Braga, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5009-8980","authenticated-orcid":false,"given":"Armanda","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Education and Psychology, School of Human and Social Sciences, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8112-8932","authenticated-orcid":false,"given":"Andr\u00e9","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Psychology Research Center, School of Psychology, University of Minho, 4710-057 Braga, Portugal"}]},{"given":"S\u00edlvia","family":"Lopes","sequence":"additional","affiliation":[{"name":"Psychology Research Center, School of Psychology, University of Minho, 4710-057 Braga, Portugal"}]},{"given":"Ana Rita","family":"Nunes","sequence":"additional","affiliation":[{"name":"School Psychology Office, Agrupamento de Escolas da Nazar\u00e9, 2450-284 Nazar\u00e9, Portugal"}]},{"given":"Cleia","family":"Zanatta","sequence":"additional","affiliation":[{"name":"Centro de Ci\u00eancias da Sa\u00fade, Catholic University of Petr\u00f3polis, Petr\u00f3polis, Rio de Janeiro 25685-100, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-1916","authenticated-orcid":false,"given":"Pedro","family":"Ros\u00e1rio","sequence":"additional","affiliation":[{"name":"Psychology Research Center, School of Psychology, University of Minho, 4710-057 Braga, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1136\/bmj.326.7396.970","article-title":"Cerebral palsy: What parents and doctors want to know","volume":"326","author":"Rosenbaum","year":"2003","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1017\/S0012162201002675","article-title":"Prevalence and characteristics of children with cerebral palsy in Europe","volume":"44","author":"Johnson","year":"2002","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_3","unstructured":"Australian Cerebral Palsy Register Group (2013). Report of the Australian Cerebral Palsy Register, Birth Years 1993\u20132006, February 2013, Australian Cerebral Palsy Register Group."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1017\/S001216220500112X","article-title":"Proposed definition and classification of cerebral palsy, April 2005","volume":"47","author":"Bax","year":"2005","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/j.1469-8749.2007.tb12610.x","article-title":"A report: The definition and classification of cerebral palsy April 2006","volume":"49","author":"Rosenbaum","year":"2007","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/S1474-4422(11)70176-4","article-title":"Cerebral palsy: Clinical care and neurological rehabilitation","volume":"10","author":"Aisen","year":"2011","journal-title":"Lancet Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/j.1469-8749.2004.tb00506.x","article-title":"Limb distribution, motor impairment, and functional classification of cerebral palsy","volume":"46","author":"Gorter","year":"2004","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1285","DOI":"10.1542\/peds.2012-0924","article-title":"Clinical Prognostic Messages from a Systematic Review on Cerebral Palsy","volume":"130","author":"Novak","year":"2012","journal-title":"Pediatrics"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/17518423.2017.1282054","article-title":"Neuropsychological profiles of children with cerebral palsy","volume":"21","author":"Stadskleiv","year":"2018","journal-title":"Dev. Neurorehabilit."},{"key":"ref_10","unstructured":"Cronin, A., and Mandich, M. (2016). Human Development and Performance throughout the Lifespan, Cengage Learning."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e626","DOI":"10.1542\/peds.2004-1689","article-title":"The Health and Well-Being of Caregivers of Children with Cerebral Palsy","volume":"115","author":"Raina","year":"2005","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1606\/1044-3894.4097","article-title":"Parents of Children with Mental Illness: Exploring the Caregiver Experience and Caregiver-Focused Interventions","volume":"92","author":"Mendenhall","year":"2011","journal-title":"Fam. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1365-2702.2008.02524.x","article-title":"The relationship between caregiver\u2019s strain and social support among mothers with intellectually disabled children","volume":"18","author":"Tsai","year":"2009","journal-title":"J. Clin. Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.3109\/09638288.2010.535090","article-title":"Responding to the challenges of parenting a child with cerebral palsy: A focus group","volume":"33","author":"Whittingham","year":"2011","journal-title":"Disabil. Rehabil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1007\/s10826-014-0016-3","article-title":"Psychosocial Challenges for Parents of Children with Cerebral Palsy: A Qualitative Study","volume":"24","author":"Alaee","year":"2015","journal-title":"J. Child Fam. Stud."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1097\/DBP.0000000000000880","article-title":"Experiences and needs of parents caring for children with cerebral palsy: A systematic review","volume":"41","author":"Elangkovan","year":"2020","journal-title":"J. Dev. Behav. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1365-2214.2009.01030.x","article-title":"Family needs of parents of children and youth with cerebral palsy","volume":"36","author":"Palisano","year":"2010","journal-title":"Child Care Health Dev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/j.1744-6155.2008.00176.x","article-title":"Family Needs Assessment in Cerebral Palsy Clinic","volume":"14","author":"Buran","year":"2009","journal-title":"J. Spec. Pediatr. Nurs."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s41252-019-00111-3","article-title":"Parents\u2019 Need-Related Experiences When Raising an Adolescent with Cerebral Palsy","volume":"3","author":"Dieleman","year":"2019","journal-title":"Adv. Neurodev. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1037\/0003-066X.55.1.68","article-title":"Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being","volume":"55","author":"Ryan","year":"2000","journal-title":"Am. Psychol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/dmcn.14321","article-title":"Prevalence of depression, anxiety, and substance-related disorders in parents of children with cerebral palsy: A systematic review","volume":"62","author":"Barreto","year":"2020","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.3109\/09638288.2011.638035","article-title":"Indicators of distress in families of children with cerebral palsy","volume":"34","author":"Majnemer","year":"2012","journal-title":"Disabil. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.pec.2005.07.006","article-title":"Parents\u2019 information needs about the treatment of their chronically ill child: A qualitative study","volume":"62","author":"Hummelinck","year":"2006","journal-title":"Patient Educ. Couns."},{"key":"ref_24","unstructured":"Papalia, D.E., Martorell, G., and Feldman, R.D. (2014). A Child\u2019s World: Infancy through Adolescence, McGraw-Hill Education. [13th ed.]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1037\/0003-066X.32.7.513","article-title":"Toward an experimental ecology of human development","volume":"32","author":"Bronfenbrenner","year":"1977","journal-title":"Am. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0140-6736(16)31389-7","article-title":"Early childhood development coming of age: Science through the life course","volume":"389","author":"Black","year":"2017","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3104\/reports.33","article-title":"The language development of children with Down syndrome: First words to two-word phrases","volume":"2","author":"Buckley","year":"1994","journal-title":"Down Syndr. Res. Pract."},{"key":"ref_28","unstructured":"Berk, L.E. (2009). Child Development, Pearson\/Allyn & Bacon. [8th ed.]."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.1016\/j.ridd.2011.07.039","article-title":"Developmental milestones in toddlers with atypical development","volume":"32","author":"Horovitz","year":"2011","journal-title":"Res. Dev. Disabil."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1080\/10911359.2012.747408","article-title":"Parenting Success and Challenges for Families of Children with Disabilities: An Ecological Systems Analysis","volume":"23","author":"Algood","year":"2013","journal-title":"J. Hum. Behav. Soc. Environ."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1111\/jocn.12124","article-title":"Quality of life and mental health among parents of children with cerebral palsy: The influence of self-efficacy and coping strategies","volume":"22","author":"Nieto","year":"2013","journal-title":"J. Clin. Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/j.1469-8749.2011.04068.x","article-title":"Family and quality of life: Key elements in intervention in children with cerebral palsy","volume":"53","author":"Rosenbaum","year":"2011","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1177\/1744987119880234","article-title":"An overview of the qualitative descriptive design within nursing research","volume":"25","author":"Doyle","year":"2020","journal-title":"J. Res. Nurs."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","article-title":"Whatever happened to qualitative description?","volume":"23","author":"Sandelowski","year":"2000","journal-title":"Res. Nurs. Health"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Crowe, S., Cresswell, K., Robertson, A., Huby, G., Avery, A., and Sheikh, A. (2011). The case study approach. BMC Med. Res. Methodol., 11.","DOI":"10.1186\/1471-2288-11-100"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1080\/14780887.2013.801543","article-title":"Sampling in Interview-Based Qualitative Research: A Theoretical and Practical Guide","volume":"11","author":"Robinson","year":"2014","journal-title":"Qual. Res. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"114523","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: A systematic review of empirical tests","volume":"292","author":"Hennink","year":"2022","journal-title":"Soc. Sci. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Jimerson, S.R., Burns, M.K., and Van DerHeyden, A.M. (2016). Handbook of Response to Intervention, Springer.","DOI":"10.1007\/978-1-4899-7568-3"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy","volume":"39","author":"Palisano","year":"1997","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_40","unstructured":"Diu, N.L., and Lockhart, K. (2023, February 01). Father\u2019s Days\u2014A Cartoonist\u2019s Journey into First-Time Fatherhood. Available online: https:\/\/s.telegraph.co.uk\/graphics\/projects\/fathers-days\/index.html."},{"key":"ref_41","first-page":"117","article-title":"A theoretical agenda for entertainment education","volume":"12","author":"Singhal","year":"2002","journal-title":"Commun. Theory"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/10810730903528017","article-title":"A model of effects of narrative as culture-centric health promotion","volume":"15","author":"Larkey","year":"2010","journal-title":"J. Health Commun."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/j.1460-2466.2006.00017.x","article-title":"Television Dramas and Support for Controversial Public Policies: Effects and Mechanisms","volume":"56","author":"Slater","year":"2006","journal-title":"J. Commun."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Cooper, H., Camic, P.M., Long, D.L., Panter, A.T., Rindskopf, D., and Sher, K.J. (2012). APA Handbook of Research Methods in Psychology, Vol 1: Foundations, Planning, Measures, and Psychometrics, American Psychological Association.","DOI":"10.1037\/13619-000"},{"key":"ref_45","first-page":"1408","article-title":"Are We There Yet? Data Saturation in Qualitative Research","volume":"20","author":"Fusch","year":"2015","journal-title":"Qual. Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qual. Res. Sport Exerc. Health"},{"key":"ref_48","unstructured":"QSR International Pty Ltd. (2014). NVivo, QSR International Pty Ltd.. (Version 10)."},{"key":"ref_49","unstructured":"Bazeley, P., and Jackson, K. (2013). Qualitative Data Analysis with NVivo, SAGE Publications. [2nd ed.]."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"222","DOI":"10.5502\/ijw.v2i3.4","article-title":"The challenge of defining wellbeing","volume":"2","author":"Dodge","year":"2012","journal-title":"Int. J. Wellbeing"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/j.1365-2214.2006.00643.x","article-title":"Parents of children with cerebral palsy: A review of factors related to the process of adaptation","volume":"33","author":"Rentinck","year":"2007","journal-title":"Child. Care Health Dev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.3109\/09638281003649920","article-title":"The psychosocial well-being of parents of children with cerebral palsy: A comparison study","volume":"32","author":"Cheshire","year":"2010","journal-title":"Disabil. Rehabil."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/13284207.2020.1829945","article-title":"Risk factors for mental health difficulties in parents of children with cerebral palsy: A systematic review and meta-analysis","volume":"25","author":"Sivaratnam","year":"2021","journal-title":"Clin. Psychol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.3109\/09638288.2012.748840","article-title":"The effect of the environment on participation of children and youth with disabilities: A scoping review","volume":"35","author":"Anaby","year":"2013","journal-title":"Disabil. Rehabil."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.yebeh.2011.12.003","article-title":"Perceptions, social life, treatment and education gap of Tanzanian children with epilepsy: A community-based study","volume":"23","author":"Mushi","year":"2012","journal-title":"Epilepsy Behav."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/dmcn.13681","article-title":"Health-related quality of life of children and adolescents with cerebral palsy in low- and middle-income countries: A systematic review","volume":"60","author":"Power","year":"2018","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"101020","DOI":"10.1016\/j.dhjo.2020.101020","article-title":"Mental health risks of parents of children with developmental disabilities: A nationally representative study in the United States","volume":"14","author":"Hoyle","year":"2021","journal-title":"Disabil. Health J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.3109\/09638288.2012.737081","article-title":"Sorrow, coping and resiliency: Parents of children with cerebral palsy share their experiences","volume":"35","author":"Whittingham","year":"2013","journal-title":"Disabil. Rehabil."},{"key":"ref_60","unstructured":"Ronen, G.M., and Rosenbaum, P.L. (2013). Life Quality Outcomes in Children and Young People with Neurological and Developmental Conditions: Concepts, Evidence and Practice, Mac Keith Press. Clinics in developmental medicine."},{"key":"ref_61","first-page":"314","article-title":"Parents\u2019 experiences and needs regarding physical and occupational therapy for their young children with cerebral palsy","volume":"53","author":"Verschuren","year":"2016","journal-title":"Res. Dev. Disabil."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"210","DOI":"10.3109\/09638288.2013.783123","article-title":"Predictors of needs for families of children with cerebral palsy","volume":"36","author":"Almasri","year":"2014","journal-title":"Disabil. Rehabil."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/5\/3811\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:38:09Z","timestamp":1760121489000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/5\/3811"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,21]]},"references-count":62,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["ijerph20053811"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20053811","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,21]]}}}