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Executive Functioning in Children Aged 6–18 Years with Cerebral Palsy

Abstract

Executive functioning (EF) is necessary for purposeful and goal-directed activity. Deficits in EF have been related to prematurity, low birth weight and early acquired brain lesions. Cerebral palsy (CP) is a condition where all these factors might be present and therefore suited to explore the relative contribution of each. The aim is to investigate factors that may contribute to variability in EF in children with CP. Participants were 68 children with CP, with various degrees of speech and motor impairment. Mean age 10;2 years (range 6;0 to 17;7 years), 38 were girls. EF was investigated with tests, Backward memory from Leiter-R and Wisconsin Card Sorting Test, which were adapted so that the children could respond regardless of their level of motor functioning. The mean standardized scores on tests of EF were within the normal range (89.5–105.9). The considerable individual variation (55–145) is explained by age and cognitive ability. Of the 68 participants, a measure of EF was available for 57 (83.8%). The 11 who did not complete the tests all had an intellectual disability. Variability in EF in children with CP was explained by age and cognitive ability, and not by prematurity, type of brain lesion or epilepsy. There was a developmental trend towards an increase in EF with age. However, the delay in EF may have consequences for overall cognitive and everyday functioning. The large variability in EF suggests that cognition should be assessed in all children with CP.

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Correspondence to Kristine Stadskleiv.

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Ethical Approval

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

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Informed consent was obtained from all individual participants included in the study; parents gave consent for the children aged between six and 16 years and 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.

Conflicts of Interest

Authors Kristine Stadskleiv, Reidun Jahnsen, Guro L. Andersen and Stephen von Tetzchner declare that there are no conflicts of interest.

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Stadskleiv, K., Jahnsen, R., Andersen, G.L. et al. Executive Functioning in Children Aged 6–18 Years with Cerebral Palsy. J Dev Phys Disabil 29, 663–681 (2017). https://doi.org/10.1007/s10882-017-9549-x

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Keywords

  • Executive functioning
  • Assessment
  • Development
  • IQ
  • Neuropsychology
  • Cerebral palsy