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

Abstract

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.