Early predictors of psychosocial functioning 5 years after paediatric stroke
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Published on: February 22, 2020
Mardee Greenham1,2, Vicki Anderson1,2,3, Anna Cooper1,4
1Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
Insights
Children with paediatric stroke experience poorer psychosocial outcomes 5 years later. Early cognitive function, age at stroke, and lesion size predict these long-term effects, suggesting early screening is vital.
Area of Science:
- Pediatric Neurology
- Child Psychology
- Neurorehabilitation
Background:
- Paediatric stroke is a significant cause of acquired childhood disability.
- Psychosocial outcomes following paediatric stroke are not well understood.
- Early identification of risk factors is crucial for timely intervention.
Purpose of the Study:
- To evaluate psychosocial outcomes in children 5 years after paediatric stroke.
- To explore early presenting factors that predict long-term psychosocial function.
- To inform early screening and intervention strategies.
Main Methods:
- Prospective, longitudinal study of 31 children with arterial ischemic stroke.
- Intellectual assessment at 12 months poststroke.
- Parent-reported questionnaires on child functioning and parental mental health at 12 months and 5 years poststroke.
Main Results:
- Children exhibited significantly poorer psychological and social function at 5-year follow-up compared to normative data.
- Poorer cognitive and psychological function at 12 months poststroke predicted worse 5-year outcomes.
- Older age at stroke onset and larger lesion size were associated with poorer psychosocial function at 5 years.
Conclusions:
- Early poststroke cognitive and psychological assessments, along with age at onset and lesion size, are important predictors of long-term psychosocial outcomes.
- Screening children within the first year after stroke can identify those at higher risk for later difficulties.
- Early intervention based on identified risk factors may improve psychosocial trajectories in paediatric stroke survivors.
Aim:
Little is known about psychological and social outcomes after paediatric stroke. This study aimed to evaluate psychosocial outcomes in children 5 years after paediatric stroke and explore the contribution of early presenting factors.
Method:
Thirty-one children (19 males, 12 females) with arterial ischemic stroke were involved in this prospective, longitudinal study. Children underwent intellectual assessment at 12 months poststroke and parents completed questionnaires rating their own mental health and their child's functioning at 12 months and 5 years poststroke.
Results:
At 5-year follow-up, psychological and social function were significantly poorer than normative expectations. Exploration of early predictive factors showed poorer cognitive and psychological function at 12 months poststroke and older age at stroke onset was associated with poorer psychosocial function at 5 years. Larger lesion size was also associated with poorer psychological function at 5 years poststroke.
Interpretation:
These early predictors of poorer psychosocial outcome suggest that screening children within the first year after stroke may identify children most at risk of later problems and facilitate early intervention.
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