How children with cerebral palsy master bimanual activities from a parental perspective.

Background: During childhood, children learn the daily life activities they want and need to do. Children with unilateral spastic cerebral palsy often have difficulties performing activities requiring two hands.Aim: To describe parental reasoning on how children with unilateral spastic cerebral palsy learn to master the performance of bimanual activities in everyday life.Material and methods: Sixteen parents participated in focus groups, a qualitative research approach with its own methodological criteria and research methods.Results: One overall theme emerged from the analysis: Finding harmony between pleasure and effort is the key to learning'. This overall theme arose as a synthesis of four themes: awakening of the inner drive', trying on one's own', enabling things to work' and it must be worth the effort. The parents described when an activity woke their children ' s inner drive to perform. Their children also strived to develop their own way to perform an activity, sometimes with the support of others, still, some activities were not possible to learn.Conclusions: Occupational therapists and others in the children's environment have an important mission to support the children to find their own harmony between pleasure and effort and their individual key to success in learning bimanual everyday activities.