Cognitive functioning in children with cerebral palsy
1Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.
Insights
Children with cerebral palsy (CP) often experience cognitive impairments. Many studies fail to assess cognition, particularly in severe motor impairment cases, potentially overestimating intellectual disability prevalence.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Children with cerebral palsy (CP) face a higher risk of cognitive impairments.
- Understanding cognitive function in this population is crucial for effective intervention.
- Existing literature often lacks comprehensive assessment, especially for severe motor impairments.
Purpose of the Study:
- To review the literature on cognitive assessment in children with CP.
- To characterize cognitive functioning across different CP subtypes.
- To explore the links between brain injury, development, and intervention.
Main Methods:
- A narrative review of original studies on cognitive functioning in children with CP subtypes.
- Literature search yielding 81 unique hits.
- Analysis of assessment methodologies and reported cognitive characteristics.
Main Results:
- Few studies utilized representative samples or individual cognitive assessments.
- Cognition in children with severe motor impairments was frequently assumed, not formally assessed.
- Conflation of low IQ scores with intellectual disability may inflate prevalence estimates.
Conclusions:
- There is a significant need for longitudinal neuropsychological studies in children with CP, including those with severe speech and motor impairments.
- Intervention studies are essential to improve cognitive outcomes.
- Accurate cognitive assessment is vital to avoid overestimating intellectual disability in CP.
Abstract:
Children with cerebral palsy (CP) have an increased risk of cognitive impairments. This narrative review of the literature discusses assessment of cognition in children with CP, presents the most salient characteristics of cognitive functioning pertaining to each subtype, and discusses the relationships between brain injury, functioning, and intervention from a developmental perspective. A search for original studies of cognitive functioning in children with different subtypes of CP was performed. The search resulted in 81 unique hits. There were few studies with a representative sample of children with CP where all participants were individually assessed. Cognitive functioning in children with the most severe motor impairments were often assumed and not assessed. Furthermore, there was a confounding of IQ below 70 and intellectual disability, possibly leading to an overestimation of the prevalence of intellectual disability. Longitudinal neuropsychological studies, including also very young children and those with the most severe speech and motor impairments, as well as intervention studies, are called for. WHAT THIS PAPER ADDS: Few studies have assessed cognition in a representative sample of children with cerebral palsy. Cognition in children with severe motor impairment is often assumed, not assessed. Lack of assessment may lead to overestimating the prevalence of intellectual disability. Lowered cognitive functioning in older children highlights the need for longitudinal studies.
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