Effects of Cerebral Palsy on Neuropsychological Function

  • Kathryn Straub
  • John E. ObrzutEmail author
Review Article


Cerebral Palsy (CP) is a muscle and movement disorder that affects children and is the result of early brain injury. The causes and nature of the brain damage may vary considerably, which renders children with cerebral palsy a heterogeneous group. Only recently has research begun to utilize technology to determine the nature of the brain injury and the relation to clinical observations. This paper reviews neuropsychological findings on children with a diagnosis of CP with regard to the spastic, dyskinetic, and ataxic types. Specifically, areas of sensorimotor functioning, language and verbal skills, visual-spatial and perceptual skills, learning and memory, and executive functioning are reviewed. Implications for learning as well as a neurobiological cause of executive function deficits are discussed.


Cerebral palsy Neuropsychological function Spastic cerebral palsy Dyskinetic cerebral palsy Ataxic cerebral palsy Pediatric cerebral palsy Neuropsychological function in cerebral palsy Subtypes of cerebral palsy 


  1. Bax, M., Goldstein, P., Rosenbaum, P., Leviton, A., & Paneth, N. (2005). Proposed definition and classification of cerebral palsy. Developmental Medicine and Child Neurology, 47, 571–576. doi: 10.1017/S001216220500112X.PubMedCrossRefGoogle Scholar
  2. Bax, M., Tydeman, C., & Flodmark, O. (2006). Clinical and MRI correlates of cerebral palsy. Journal of the American Medical Association, 296, 1602–1608. doi: 10.1001/jama.296.13.1602.PubMedCrossRefGoogle Scholar
  3. Card, R., & Dodd, B. (2006). The phonological awareness abilities of children with cerebral\ palsy who do not speak. Augmentative and Alternative Communication, 22, 149–159. doi: 10.1080/07434610500431694.PubMedCrossRefGoogle Scholar
  4. Carlsson, G. (1997). Memory for words and drawings in children with hemiplegic cerebral palsy. Scandinavian Journal of Psychology, 38, 265–273. doi: 10.1111/1467-9450.00036.PubMedCrossRefGoogle Scholar
  5. Carlsson, G., Uvebrant, P., Hugdahl, K., Arvidson, J., Wiklund, L. M., & Von Weendt, L. (1994). Verbal and non-verbal function of children with right versus left hemiplegic cerebral palsy of pre and perinatal origin. Developmental Medicine and Child Neurology, 36, 503–512.PubMedGoogle Scholar
  6. Cheney, P. D., & Palmer, F. B. (1997). Overview: Cerebral palsy. Mental Retardation and Developmental Disabilities, 3, 109–111. doi: 10.1002/(SICI)1098-2779(1997)3:2<109::AID-MRDD1>3.0.CO;2-M.CrossRefGoogle Scholar
  7. Christ, S. E., White, D. A., Brunstrom, J. E., & Abrams, R. A. (2003). Inhibitory control following perinatal brain injury. Neuropsychology, 17, 171–178. doi: 10.1037/0894-4105.17.1.171.PubMedCrossRefGoogle Scholar
  8. Courbois, Y., Coello, Y., & Bouchard, I. (2004). Mental imagery abilities in adolescents with spastic diplegia cerebral palsy. Journal of Intellectual & Developmental Disability, 29, 226–338. doi: 10.1080/13668250412331285154.CrossRefGoogle Scholar
  9. Dahlgren-Sandberg, A. (2006). Reading and spelling abilities in children with severe speech impairments and cerebral palsy at 6,9, and 12 years of age in relation to cognitive development: A longitudinal study. Developmental Medicine and Child Neurology, 48, 629–634. doi: 10.1017/S0012162206001344.PubMedCrossRefGoogle Scholar
  10. Dahlgren-Sandberg, A., & Hjelmquist, E. (1997). Language and literacy in nonvocal children with cerebral palsy. Reading and Writing: An Interdisciplinary Journal, 9, 107–133. doi: 10.1023/A:1007958705625.CrossRefGoogle Scholar
  11. Dellatolas, G., Filho, G. N., Souza, L., Nunes, L. G., & Braga, L. W. (2005). Manual skill, hand skill asymmetry, and neuropsychological test performance in schoolchildren with spastic cerebral palsy. Laterality, 10, 161–182. doi: 10.1080/13576500442000012.PubMedGoogle Scholar
  12. Dorman, C. (1987). Verbal, perceptual, and intellectual factors associated with reading, achievement in adolescents with cerebral palsy. Perceptual and Motor Skills, 64, 671–678.PubMedGoogle Scholar
  13. Dorman, C., Hurley, A. D., & Laatsch, L. (1984). Prediction of spelling and reading performance in cerebral palsied adolescents using neuropsychological tests. International Journal of Clinical Neuropsychology, 6, 142–144.Google Scholar
  14. Fennell, E., & Dikel, T. N. (2001). Cognitive and neuropsychological functioning in children with cerebral palsy. Journal of Child Neurology, 16, 58–63.PubMedCrossRefGoogle Scholar
  15. Fedrizzi, E., Inverno, M., Bruzzone, M. G., Botteon, G., Saletti, V., & Farinotti, M. (1996). MRI features of cerebral lesions and cognitive functions in preterm spastic diplegic children. Pediatric Neurology, 15, 207–212. doi: 10.1016/S0887-8994(96)00174-9.PubMedCrossRefGoogle Scholar
  16. Himmelmann, K., Beckung, E., Hagberg, G., & Uvebrant, P. (2006). Gross and fine motor function and accompanying impairments in cerebral palsy. Developmental Medicine and Child Neurology, 48, 417–423. doi: 10.1017/S0012162206000922.PubMedCrossRefGoogle Scholar
  17. Hoon, A. H. (2005). Neuroimaging in cerebral palsy: Patterns of brain dysgenesis and injury. Journal of Child Neurology, 20, 936–939. doi: 10.1177/08830738050200120201.PubMedCrossRefGoogle Scholar
  18. Kozeis, N., Anogeianaki, A., Mitova, D. T., Anogianakis, G., Mitov, T., & Klisarova, A. (2007). Visual function and visual perception in cerebral palsied children. Ophthalmic & Physiological Optics, 27, 44–53. doi: 10.1111/j.1475-1313.2006.00413.x.CrossRefGoogle Scholar
  19. Kozeis, N., Anogeianaki, A., Mitova, D. T., Anogianakis, G., Mitov, T., Felekidis, A. (2006). Visual function and execution of microsaccades related to reading skills, in cerebral palsied children. The International Journal of Neuroscience, 116, 1347–1358. doi: 10.1080/00207450500514011.PubMedCrossRefGoogle Scholar
  20. Krägeloh-Mann, I., & Horber, V. (2007). The role of magnetic resonance imaging in elucidating the pathogenesis of cerebral palsy: a systematic review. Developmental Medicine and Child Neurology, 49, 144–151.PubMedCrossRefGoogle Scholar
  21. Krigger, K. W. (2006). Cerebral Palsy: An overview. American Family Physician, 73, 91–100.PubMedGoogle Scholar
  22. Laraway, L. (1985). Auditory selective attention in cerebral-palsied individuals. Language, Speech, and Hearing Services in Schools, 16, 260–266 Abstract.Google Scholar
  23. Lidzba, K., Staudt, M., Wilke, M., & Krägeloh-Mann, I. (2006). Visuospatial deficits in patients with early left-hemispheric lesions and functional reorganization of language: Consequence of lesion or reorganization? Neuropsychologia, 44, 1088–1094. doi: 10.1016/j.neuropsychologia.2005.10.022.PubMedCrossRefGoogle Scholar
  24. Melherm, E. R., Hoon, A. H., Ferrucci, J. T., Quinn, C. B., Reinhartd, E. M., & Demetrides, S. W. (2000). Periventricular Leukomalacia: Relationship between lateral ventricular volume on brain MR images and severity of cognitive and motor impairment. Radiology, 214, 199–203.Google Scholar
  25. Odding, E., Roebroeck, M. E., & Stam, H. (2006). The epidemiology of cerebral palsy: Incidence, impairments and risk factors. Disability and Rehabilitation, 28, 183–191. doi: 10.1080/09638280500158422.PubMedCrossRefGoogle Scholar
  26. Østensjø, S., Carlberg, E., & Vøllestad, N. K. (2003). Everyday functioning in young children with cerebral palsy: functional skills, caregiver assistance, and modifications of the environment. Developmental Medicine and Child Neurology, 45, 603–612. doi: 10.1017/S0012162203001105.PubMedCrossRefGoogle Scholar
  27. Pirila, S., van der Meere, J., Korhonen, P., Ruusu-Niemi, P., Kyntaja, M., Nieminen, P., (2004). A retrospective neurocognitive study in children with spastic diplegia. Developmental Neuropsychology, 26, 679–690. doi: 10.1207/s15326942dn2603_2.PubMedCrossRefGoogle Scholar
  28. Pirila, S., van der Meere, J., Pentikainen, T., Ruusu-Niemi, P., Korpela, R., Kilpinen, J. (2007). Language and motor speech skills in children with cerebral palsy. Journal of Communication Disorders, 40, 116–128. doi: 10.1016/j.jcomdis.2006.06.002.PubMedCrossRefGoogle Scholar
  29. Pueyo, R., Junque, C., & Vendrell, P. (2003). Neuropsychologic differences between bilateral dyskinetic and spastic cerebral palsy. Journal of Child Neurology, 18, 845–850. doi: 10.1177/088307380301801204.PubMedCrossRefGoogle Scholar
  30. Reddihough, D. (2006). Measurement tools: New opportunities for children with cerebral palsy. Developmental Medicine and Child Neurology, 48, 548–548. doi: 10.1017/S0012162206001150.PubMedCrossRefGoogle Scholar
  31. Sabbadini, M., Bonanni, R., Carlesimo, G. A., & Caltagirone, C. (2001). Neuropsychological assessment of patients with severe neuromotor and verbal disabilities. Journal of Intellectual Disability Research, 45, 160–179. doi: 10.1046/j.1365-2788.2001.00301.x.CrossRefGoogle Scholar
  32. Sankar, C., & Mundkur, N. (2005). Cerebral palsy-definition, classification, etiology and early diagnosis. Indian Journal of Pediatrics, 72, 865–868. doi: 10.1007/BF02731117.PubMedCrossRefGoogle Scholar
  33. Schatz, J., Craft, S., Koby, M., & Park, T. S. (1997). Associative learning in children with perinatal brain injury. Journal of the International Neuropsychological Society, 3, 521–527.PubMedGoogle Scholar
  34. Schatz, J., Craft, S., White, D., Park, T. S., & Figiel, G. S. (2001). Inhibition of return in children with perinatal brain injury. Journal of the International Neuropsychological Society, 7, 275–284. doi: 10.1017/S1355617701733012.PubMedCrossRefGoogle Scholar
  35. Stiers, P., & Vandenbussche, E. (2004). The disassociation of perception and cognition in children with early brain damage. Brain & Development, 26, 81–92. doi: 10.1016/j.braindev.2003.09.005.CrossRefGoogle Scholar
  36. Stiers, P., Vanderkelen, R., Vanneste, G., Coene, S., de Rammelaere, M., & Vandenbussche, E. (2002). Visual-perceptual impairment in a random simple of children with cerebral palsy. Developmental Medicine and Child Neurology, 44, 370–382. doi: 10.1017/S0012162201002249.PubMedCrossRefGoogle Scholar
  37. van der Weel, F. R., van der meer, A., & Lee, D. N. (1996). Measuring dysfunction of basic movement control in cerebral palsy. Human Movement Science, 15, 253–283. doi: 10.1016/0167-9457(95)00046-1.CrossRefGoogle Scholar
  38. Vohr, B. R., Msall, M. E., Wilson, D., Wright, L. L., McDonald, S., & Poole, K. (2005). Spectrum of gross motor function in extremely low birth weight children with cerebral palsy at 18 months of age. Pediatrics, 116, 123–129. doi: 10.1542/peds.2004-1810.PubMedCrossRefGoogle Scholar
  39. Wann, J. P. (1991). The integrity of visual-proprioceptive mapping in cerebral palsy. Neuropsychologia, 26, 1095–1106. doi: 10.1016/0028-3932(91)90079-N.CrossRefGoogle Scholar
  40. White, D. A., & Christ, S. (2005). Executive control of learning and memory in children with bilateral spastic cerebral palsy. Journal of the International Neuropsychological Society, 11, 920–924. doi: 10.1017/S1355617705051064.PubMedCrossRefGoogle Scholar
  41. White, D. A., Craft, S., Hale, S., & Park, T. S. (1994). Working memory and articulation rate in children with spastic diplegic cerebral palsy. Neuropsychology, 8, 180–186. doi: 10.1037/0894-4105.8.2.180.CrossRefGoogle Scholar
  42. Wu, Y., Croen, L. A., Shah, S. J., Newman, T. B., & Najjar, D. V. (2006). Cerebral palsy in a term population: Risk factors and neuroimaging findings. Pediatrics, 118, 690–698. doi: 10.1542/peds.2006–0278.PubMedCrossRefGoogle Scholar
  43. Yeargin-Allsopp, M., Van Naarden Braun, K., Doernberg, N. S., Benedict, R. E., Kirby, R. S., & Durkin, M. S. (2008). Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: A Multisite Collaboration. Pediatrics, 121, 547–554. doi: 10.1542/peds.2007-1270.PubMedCrossRefGoogle Scholar
  44. Yin, R., Reddihough, D. S., Ditchfield, M. R., & Collins, K. J. (2000). Magnetic resonance imaging findings in cerebral palsy. Journal of Paediatrics and Child Health, 36, 139–144. doi: 10.1046/j.1440-1754.2000.00484.x.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Special Education, Rehabilitation and School Psychology, College of EducationThe University of ArizonaTucsonUSA

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