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Daily-life executive functions and bimanual performance in children with unilateral cerebral palsy

Alexandra Kalkantzi1,2, Lize Kleeren1,2,3, Dieter Baeyens2,4

  • 1Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.

Developmental Medicine and Child Neurology
|March 29, 2025
PubMed

Insights

Children with unilateral cerebral palsy (CP) often have poorer executive functions, particularly when autism spectrum disorder (ASD) is present. Manual ability impacts inhibition, and executive function deficits correlate with bimanual performance issues.

Area of Science:

  • Pediatric Neurology
  • Developmental Psychology
  • Rehabilitation Medicine

Background:

  • Unilateral cerebral palsy (CP) affects motor function and can impact cognitive abilities.
  • Executive functions are crucial for daily-life activities and goal-directed behavior.
  • Understanding the interplay between executive functions and bimanual performance in unilateral CP is important for targeted interventions.

Purpose of the Study:

  • To investigate daily-life reported executive functions in children with unilateral CP.
  • To examine the relationship between executive functions and bimanual performance in this population.
  • To explore the influence of comorbidities like autism spectrum disorder (ASD) and manual ability on executive functions.

Main Methods:

  • A cross-sectional study involving 46 children with unilateral CP (mean age ~11 years).
  • Executive functions assessed using the Behavior Rating Inventory of Executive Function (BRIEF).
  • Bimanual performance evaluated with the Assisting Hand Assessment (AHA) and Children's Hand-use Experience Questionnaire (CHEQ).
  • Statistical analyses included one-sample z-tests, regression analysis, and non-parametric correlations.

Main Results:

  • Children with unilateral CP generally showed poorer executive functions compared to norms (p ≤ 0.024).
  • Executive function differences were primarily linked to ASD comorbidity (p ≤ 0.001).
  • Manual ability significantly affected inhibition (p = 0.042).
  • Significant correlations were found between BRIEF and CHEQ (rs = -0.50 to -0.29), and BRIEF inhibition with AHA (rs = -0.35).

Conclusions:

  • Executive function difficulties are common in unilateral CP, often associated with ASD.
  • Manual ability is a key factor in inhibition-related challenges.
  • Impaired executive functions appear related to reduced bimanual performance.
  • Further research, including performance-based executive function assessments, is recommended.
Abstract

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