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Cognitive and Executive Function Profiles in School‑Age Children with Obstetric Brachial Plexus Injury
Elif Cimilli1, Ilkem Ceren Sigirtmac2, Tüzün Fırat3
1Faculty of Health Sciences, Occupational Therapy Department Sıhhiye, Hacettepe University, Ankara, Turkey.
Insights
Children with obstetric brachial plexus injury (OBPI) show lower cognitive function but not executive function (EF) compared to typically developing peers. These findings highlight the need for cognitive assessments in managing OBPI.
Area of Science:
- Pediatric neurology
- Neurodevelopmental disorders
- Rehabilitation medicine
Background:
- Obstetric brachial plexus injury (OBPI) can impact child development.
- Cognitive and executive functions (EF) are crucial for daily functioning.
- Understanding these impacts is vital for effective intervention.
Purpose of the Study:
- To assess cognitive and executive function (EF) in children with OBPI.
- To investigate the influence of injury severity and surgical treatment on these functions.
Main Methods:
- Assessed 30 children with OBPI (aged 6-12) and 22 controls.
- Used Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch) for cognition.
- Employed Childhood Executive Functioning Inventory (CHEXI) for EF via parent reports.
- Applied non-parametric tests and FDR correction for analysis.
Main Results:
- Children with OBPI demonstrated significantly lower cognitive function scores on DOTCA-Ch (p=0.002).
- No significant differences in executive function (EF) composite scores were observed between groups.
- Subgroup analyses revealed no significant impact of surgery or Narakas classification on outcomes.
Conclusions:
- Children with OBPI exhibit deficits in cognitive function compared to typically developing children.
- Executive function (EF) appears unaffected in this OBPI cohort.
- Integrating cognitive assessments into OBPI management is recommended.
Aims:
To evaluate cognitive and executive function (EF) in children with obstetric brachial plexus injury (OBPI), and the potential effects of injury severity and surgical intervention.
Methods:
Fifty-two children aged 6-12 years were assessed: 30 with OBPI (Type IIa: n = 10, Type IIb: n = 11, Type III-IV: n = 9) and 22 children with typical development. Cognitive function was measured using the Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch), and EF was assessed via parent-reported Childhood Executive Functioning Inventory (CHEXI). Non-parametric tests and subgroup analyses were conducted, with false discovery rate (FDR) correction applied for multiple comparisons.
Results:
Children with OBPI scored significantly lower on total and domain-specific DOTCA-Ch measures (median [IQR]: 85 [72-95] vs. 125 [115-135]; q = 0.002), with large effect sizes (Cliff's δ = -0.82 to -0.90). No significant differences were found in CHEXI EF composites. Subgroup analyses showed no statistically significant effects of surgery or Narakas classification, although trends indicated potentially poorer cognitive outcomes in children with Narakas type III-IV.
Conclusion:
Children with OBPI had lower cognitive function than children with typical development but there was no difference in EF. Findings support integrating cognitive assessments into management of children with OBPI.
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