Executive Function in Children and Adolescents with the Congenital Hemiplegia Type of Cerebral Palsy

Miss Harriet Bodimeade (). Executive Function in Children and Adolescents with the Congenital Hemiplegia Type of Cerebral Palsy Professional Doctorate, School of Psychology, The University of Queensland.

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Author Miss Harriet Bodimeade
Thesis Title Executive Function in Children and Adolescents with the Congenital Hemiplegia Type of Cerebral Palsy
School, Centre or Institute School of Psychology
Institution The University of Queensland
Thesis type Professional Doctorate
Supervisor Dr Koa Whittingham
Professor Roslyn Boyd
Mr Owen Lloyd
Total pages 194
Language eng
Abstract/Summary Background: Cerebral Palsy is a heterogeneous neurodevelopmental condition that is well-recognised as the leading cause of childhood physical disability in Australia and worldwide (Stanley, Blair, & Alberman, 2000). It is caused by non-progressive damage to the foetal or infant brain that results in motor and postural difficulties (Rosenbaum, Paneth, Leviton, Coldsteinm, & Bax, 2007). In addition to movement impairments, children with cerebral palsy can also experience cognitive and psychological difficulties (Goodman & Yude, 2000; Straub & Obrzut, 2009). This dissertation focuses on children and adolescents with a unilateral distribution of motor impairments and includes children with both left and right-sided congenital hemiplegia. Early injury to the brain can cause deficits in higher-order cognitive tasks, such as executive functions (Long et al., 2011). Executive dysfunction can derail normal development by disrupting the child’s ability to effectively interact with their environment and acquire new skills. Given that early brain injury can result in executive function difficulties and the fact that by definition, children with congenital hemiplegia have sustained injury to the developing foetal or infant brain, it is surprising that there is a lack of research examining executive abilities in this population. Study Aims: The primary aim of the current study was to investigate executive function in children and adolescents with congenital hemiplegia. A further aim was to ascertain whether children and adolescents with left congenital hemiplegia and right congenital hemiplegia exhibit the same executive function profile. The relationship between executive abilities and psychological functioning was also explored. Method: A total of 46 children with congenital hemiplegia and 20 typically developing children, who served as a control group, were recruited (N = 66). Executive function was operationalised according to P. Anderson’s (2002) developmental model of executive function that incorporates four components: attentional control; cognitive flexibility; goal setting; and information processing. Nine neuropsychological assessments were chosen to assess these components of executive function based on previous research (e.g., V. Anderson, Spencer-Smith, et al., 2010). A brief measure of intellectual functioning was also administered. Questionnaire data was collected from the child’s parents and schoolteacher on the behavioural manifestations of executive function in everyday life, as measured by the Behaviour Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000) and on emotional, behavioural, and social functioning, as measured by the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997, 1999). Results: Children with congenital hemiplegia showed a significantly lower overall IQ score and more executive function difficulties than controls. There was no difference between children with left and right congenital hemiplegia on any of the IQ or executive function measures, with the exception of Inhibition/Switching total errors. On both the parent and teacher-rated versions of the BRIEF questionnaire, children with congenital hemiplegia showed significantly more difficulties across all scales. Similarly, on the SDQ questionnaire, children with congenital hemiplegia demonstrated significantly more difficulties on all scales, with the exception of the Prosocial Behaviour scale. On both the BRIEF and SDQ, there was no difference between children with left and right congenital hemiplegia. Finally, among children with congenital hemiplegia, those with higher (i.e., better) levels of executive function scored significantly lower on the majority of problem scales from the BRIEF and SDQ, with the exception of the Emotional Symptoms and Peer Problem scales from the SDQ. Conclusions: This study showed that children and adolescents with congenital hemiplegia experience difficulties across multiple executive function domains. Also, a higher level of executive function was associated with fewer psychological difficulties among children and adolescents with congenital hemiplegia. Theoretical and clinical implications of the results are discussed and directions for future research are recommended.
Keyword cerebral palsy
congenital hemiplegia
executive function
psychological functioning

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Created: Wed, 08 Feb 2012, 18:51:15 EST by Miss Harriet Bodimeade on behalf of Faculty of Social & Behavioural Sciences