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Cognitive and academic profiles in children with cerebral palsy: A narrative review - 16/05/20

Doi : 10.1016/j.rehab.2020.01.005 
Joel Fluss a, , Karen Lidzba b
a Pediatric Neurology Unit, Pediatrics Subspecialties Service, Geneva Children's Hospital, 6, rue Willy-Donzé, 1211 Genève 4, Switzerland 
b Clinic of Paediatric Medicine, Department of Paediatric Neurology, Development, Rehabilitation, University Children's Hospital Berne, Switzerland 

Corresponding author.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 16 May 2020
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Highlights

Cerebral palsy is often associated with a range of cognitive impairments that are crucial to identify during early school years.
The type of cerebral palsy and the observable associated brain lesions seen on MRI can predict to some extent specific patterns of neuropsychological dysfunction that might ease early recognition and intervention.
Despite being mostly integrated in mainstream school and showing preserved intellectual abilities, many ambulatory children with mild forms of cerebral palsy demonstrate learning disabilities and educational underachievement that are likely to affect their current and future social participation.
Despite a strong correlation between motor function, speech expression and cognition, some severely affected children demonstrate normal intelligence and receptive language skills.
Neuropsychological assessment might ideally serve to guide and implement adequate school support service and assistive technology tailored to the child's needs in close collaboration with education professionals.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

Considerable effort has recently been made to improve the accurate diagnosis of cerebral palsy (CP) in childhood and to establish early intervention aiming to improve functional outcome. Besides the visible motor impairments, cognitive abilities are frequently affected but might remain unrecognised in children with mild forms. On the other hand, some severely disabled children with presumed intellectual disabilities might demonstrate normal-range reasoning capacities. Most studies on this topic have emphasized a variety of cognitive profiles (cognitive level) related to the type of cerebral palsy and the underlying brain lesions (biological level). However, little is known at the behavioural level, namely learning skills and educational achievement.

Objective

This narrative review aimed to discuss cognitive and scholastic skills typically affected in children with CP.

Methods

Online literature research for studies of cerebral palsy, cognition and academic achievement, extracting all relevant articles regardless of article type.

Results

In children with CP, intellectual disability is frequent and correlated with the degree of motor impairment and early epilepsy. Speech and language problems are prevalent in all forms of CP and might hamper everyday participation on varying levels depending on the degree of motor disability. Most children with CP have neuropsychological deficits affecting predominantly visuospatial functions, attention, and/or executive functions. These problems relate to academic performance and social participation.

Discussion

An adequate interdisciplinary follow-up of children with CP requires a sensitization of clinicians to the complex topic of cognitive and academic problems in this population and a better synergy between the medical and educational worlds.

Le texte complet de cet article est disponible en PDF.

Keywords : Cerebral palsy, Cognition, Neuropsychology, Learning disabilities, Intelligence


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