Structure of Executive Functioning in Children with Cerebral Palsy: an Investigation of Anderson’s Developmental Model

  • Kristine StadskleivEmail author
  • Reidun Jahnsen
  • Stephen von Tetzchner


To investigate the factor structure of executive functioning (EF) in children with cerebral palsy (CP) and whether this can be described by the four-component model of EF described by Anderson (2002, 2008). Participants were 73 children with CP with various degrees of speech and motor impairment. Mean age was 9;10 years (range 5;1 to 17;7 years) and 39 were girls. EF was investigated with neuropsychological assessment, parent evaluation, and structured tasks. The neuropsychological tests used were Wisconsin Card Sorting Test and Forward and Backward Memory tasks from Leiter-R. Parents evaluated the children’s working memory capacity, attentiveness, ability to plan, impulsivity, and task efficiency. The structured tasks comprise instruction and description, and tap planning ability, monitoring, and impulsivity. In the instruction task, the child instructed the parent to construct a figure similar to a model that was only visible to the child. In the description task, the child described a picture of an object without naming it, and the parent guessed what was depicted. The mean test scores of the group were within the normal range, with considerable individual variation. Measures from different sources – neuropsychological tests, parental evaluations, and structured tasks – correlated significantly. Principal component analysis indicated a one-factor solution. EF has a unitary structure in school-aged children with CP and is not well described by the four-component model of EF.


Executive functioning Cognition Cerebral palsy Speech Motor impairment Development 


Compliance with Ethical Standards

Ethical Approval

All procedures performed were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards and the study was approved by the Norwegian Regional Committees for Medical and Health Research Ethics (#2012/1409).

Informed Consent

Informed consent was obtained from all individual participants included in the study. All parents were given written information about the project and gave consent for the children aged between six and 16 years. Adolescents older than 16 years, who were not intellectually disabled, gave consent themselves. The participants were not compensated economically for participating in the project, but travel expenses were refunded. As the participants were recruited from a hospital clinic, care was made in the written information to emphasize that consent could be withdrawn at any time and that this would not affect the clinical services provided by the hospital.

Conflict of Interest

The authors declare that we have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Child NeurologyOslo University HospitalOsloNorway
  2. 2.Department of PsychologyUniversity of OsloOsloNorway
  3. 3.Department of ResearchSunnaas Rehabilitation HospitalNesoddenNorway

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