Child Cognitive Outcomes Research Articles

Quantifying the contribution of poverty and family adversity to adverse child outcomes in the UK: evidence from the UK Millennium Cohort Study

BackgroundAdolescent health is poor in the UK, with higher prevalence of adverse outcomes in adolescents exposed to family adversities that cluster with poverty from early life. However, little evidence exists to quantify the contribution of these exposures to poor child health in the UK to inform policy. The aim of this study was to estimate the proportion of child physical, mental, cognitive, and behavioural outcomes that could be prevented if exposure to poverty and family adversity during childhood were eliminated. MethodsWe used nationally representative birth cohort data from the UK Millennium Cohort Study to calculate population attributable fractions. Exposure trajectories were characterised using previously developed group-based multi-trajectory models of childhood adversities up to age 14 years, including low poverty and family adversity, persistent poverty, persistent parental alcohol use, persistent domestic violence and abuse, and persistent poverty and poor parental mental health trajectory; and we assessed the effect of these trajectories on adolescent outcomes using regression models. These models were used to calculate population attributable fractions by contrasting a hypothetical scenario in which all children were in a low poverty and family adversity trajectory with the real-world scenario. FindingsThe identified exposure trajectories contributed substantially to the burden of childhood developmental problems. Compared with the low poverty and family adversity trajectory, the overall percentage of socioemotional behavioural problems at age 14 years attributable to persistent poverty and family adversity trajectories was 54% (95% CI 45–60). A percentage of 36·1% (95% CI 21·8–46·2) was reported for drug experimentation, 32·6% (18·8–40·7) for cognitive disability, and 27·4% (12·9–34·9) for obesity (appendix). InterpretationPoverty and family adversity contribute to a substantial burden of adverse child health and developmental outcomes in the UK population. FundingThe National Institute for Health Research (NIHR) Policy Research Programme, NIHR Applied Research Collaboration South London at King's College Hospital NHS Foundation Trust, and the UK Medical Research Council.

Exploring proximal mechanisms behind intergenerational association between maternal childhood abuse and Chinese preschool children's executive function

BackgroundMaternal personal history of childhood abuse has been found to predict child social-emotional problems; however, little is known about the intergenerational associations between maternal childhood abuse and child cognitive outcomes. ObjectiveThis study aims at examining the intergenerational associations of maternal childhood emotional abuse and physical abuse with child executive functions among Chinese families with preschoolers, and exploring how these associations are mediated by maternal perspective-taking skills and mother-child conflict. MethodsParticipants were 309 preschoolers (152 boys) aged 2–6 years and their mothers. Mothers reported on their childhood abuse histories, perspective taking, and mother-child conflict at baseline (T1). Five months later (T2), child executive functions including working memory, inhibitory control, and cognitive flexibility were assessed using five computerized tasks. ResultsAfter controlling for child gender and age, associations with child executive functions were found for maternal childhood emotional abuse, but not physical abuse. Specifically, severer childhood emotional abuse directly predicted lower levels of child cognitive flexibility. Furthermore, chained mediation paths were found from maternal childhood emotional abuse to lower levels of child working memory and inhibitory control through worse maternal perspective taking skills and then more mother-child conflicts. ConclusionsOur findings provide evidence for less optimal executive functions among preschoolers with emotionally abused mothers. Developing strategies to resolve the long-lasting impacts of maternal childhood emotional abuse may be important for reducing the risks of being unable to fully achieve the cognitive potentials of the next generation.

Peripapillary retinal nerve fibre layer thickness and macular ganglion cell layer volume in association with motor and cognitive outcomes in 11-year-old children born very preterm.

The purpose of the study was to study the association between retinal parameters and motor and cognitive outcomes in children born very preterm. This study is part of a prospective cohort study of very preterm infants (birth weight ≤ 1500 grams/gestational age < 32 weeks). At 11 years of age, the ophthalmological assessment included a retinal optical coherence tomography (OCT) examination of the peripapillary retinal nerve fibre layer (PRNFL) and the macular ganglion cell layer (GCL). The motor performance was assessed with the Movement Assessment Battery for Children-Second Edition (Movement ABC-2), and the cognitive outcome with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). A total of 141 children were included. The mean (SD) average PRNFL was 95 μm (10.2μm). The mean (SD) macular GCL volume was 0.34 mm3 (0.03 mm3 ). Higher PRNFL thickness associated with higher percentiles for total scores in the motor assessment (b=0.5, 95% CI 0.1-0.8, p=0.01) and higher macular GCL volume with higher scores in the cognitive assessment (b=1.4, 95% CI 0.5-2.3, p=0.002), also when adjusted for gender, birth weight z-score (birth weight in relation to gestational age) and major brain pathology at term. The associations between higher average PRNFL thickness and better motor performance as well as higher macular GCL volume and better cognitive performance refer to more generalized changes in the brain of 11-year-old children born very preterm. Retinal OCT examinations might provide a deeper insight than mere eyesight in long-term neurodevelopmental follow-up of children born very preterm.

Predictive validity of the Westmead Post-Traumatic Amnesia Scale for functional outcomes in school-aged children who sustained traumatic brain injury.

The Westmead Post-Traumatic Amnesia Scale (WPTAS) is routinely used for the assessment of post-traumatic amnesia (PTA) in children who sustained traumatic brain injury (TBI). Yet, the WPTAS' predictive validity for functional outcomes is largely unknown. We aimed to determine whether PTA duration measured by the WPTAS (i) differentially predicts functional outcomes and (ii) contributes to predictions of outcomes beyond the Glasgow Coma Scale (GCS) in children who sustained TBI. Participants were children and adolescents with moderate-to-severe TBI (n=55) aged 8-15 years. PTA duration was assessed with the WPTAS. Outcomes at the first outpatient follow-up were scored on the Kings Outcome Scale for Childhood Head Injury (KOSCHI) and the TBI Outcome Domain Scale-Extended (ODS-E). Longer PTA and lower GCS were both significantly correlated with worse (i) global outcomes: presence of disability on the KOSCHI and lower score on the ODS-E and (ii) select specific outcomes on the ODS-E: mobility, mood and cognition. PTA duration predicted cognitive outcome on the ODS-E independently, beyond GCS. Together, PTA duration and GCS, predicted the global KOSCHI outcome, as well as the ODS-E mobility and mood outcomes. Neither GCS nor PTA duration correlated with the ODS-E communication, impulsivity/disinhibition, headache, fatigue, sensory impairments or somatic complaints outcomes. PTA duration measured by the WPTAS is a significant unique predictor of functional cognitive outcomes in children who sustained moderate-to-severe TBI, and in combination with the GCS, a significant predictor of global, and several specific functional outcomes.

Longitudinal Cognitive Outcomes in Children With HIV in Zambia: 2-Year Outcomes From the HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) Study.

To describe longitudinal outcomes and predictors of cognitive outcomes in children with HIV in Zambia. Multiple studies have shown that children with HIV are at risk for impaired cognition. However, there are limited data on longitudinal cognitive outcomes in children with HIV. We conducted a prospective cohort study of 208 perinatally infected children with HIV ages 8-17 years, all treated with antiretroviral therapy, and 208 HIV-exposed uninfected controls. Participants were followed for 2 years. Cognition was assessed with a custom NIH Toolbox Cognition Battery, and tests were combined to generate a Summary Cognition Score (SCS). The contribution of potential risk factors to outcomes was explored using regression models and group-based trajectory modeling. HIV was strongly associated with lower SCS at baseline [β-14, 95% confidence interval (CI): -20 to -7, P < 0.001]. Change scores over time were similar between groups, but poorer average performance in children with HIV persisted at the 2-year follow-up visit (adjusted β = -11, 95% CI: -22 to -0.3, P = 0.04). Other than HIV, the strongest predictors of baseline SCS included socioeconomic status index (β =3, 95% CI: 1, 5, P = 0.004), history of growth stunting (β=-14, 95% CI: -23 to -6, P = 0.001), history of CD4 count below 200 (β = -19, 95% CI: -35 to -2, P = 0.02), and history of World Health Organization stage 4 disease (β = -10, 95% CI: -19 to -0.2, P = 0.04). In the group-based trajectory model, HIV+ status predicted membership in the lowest performing trajectory group (odds ratio 2.5, 95% CI: 1.2 to 5.1, P = 0.01). Children with HIV are at risk of poor cognitive outcomes, despite chronic treatment with antiretroviral therapy.

Exposure to greenspace and bluespace in relation to cognitive functioning in children and adolescents - A systematic review

BACKGROUND AND AIM The field of green- and bluespace research including studies in relation to cognitive functioning is rapidly growing. Thus, there is a strong need to systematically review the existing studies. Several systematic reviews have been already published on this topic but none of them is specific to cognitive outcomes in children of the entire age range. Moreover, only few of them examined the effects of bluespace in addition to greenspace. Also, previous reviews were focused either only on observational studies or on experimental studies. Our systematic review focuses on cognition in relation to green- and bluespace in children and adolescents between birth and 18 years old and captures both observational and experimental studies. METHODS We followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Searches were conducted in two databases – PubMed and PsychInfo. Free-text terms related to outcome, exposure, and population as well as MeSH terms for outcome and population were used. Further, the reference lists of publications identified as eligible for full-text review were &amp;#x22;snowball” searched to detect additional studies. RESULTS Records identified from PubMed (n=2030) and PsycINFO (n=1168) were deduplicated and screened. 22 publications were selected. 13 additional publications were identified through „snowball” search. The extration of data revealed heterogeneity among studies. Methodological flaws and differences between studies should be considered. First, various methods of exposure and outcome assessment were used. Second, risk of bias assessment revealed inappriopriate use of statistical methods including the confounding and modifying variables, and mediating methods, exclusion data from analysis and selective reporting of outcomes, and inappriopriate assessment of cognition. CONCLUSIONS Improvement regading the methodological quality of future studies is required: expertise from several domains such as environmental epidemiology, statistics, and psychology should be involved in conducting future studies. KEYWORDS: green space, blue space, cognitive development

Mental health around pregnancy and child development from early childhood to adolescence

Mental health problems during pregnancy affect around 20% of mothers and may have lasting impacts on children’s health, cognitive and socio-emotional skills, educational attainment, and future labour market outcomes. We identify the causal effect of mothers’ prenatal mental health on a range of child psychological, socio-emotional and cognitive outcomes. Our methodology exploits shocks to mothers’ mental health that are induced by illness of the mother’s friends or relatives, whilst accounting for the non-randomness of exposure to illness. We find that mothers’ mental health problems negatively affect children’s psychological and socio-emotional skills in early childhood, but these fade-out between the ages of 11-13. There is no effect on children’s cognitive outcomes. Hence, our findings suggest that maternal prenatal mental health may have a limited direct effect on children’s future labour market outcomes.

Associations between maternal exposure to surgery or pregnancy exposure to fluorinated anesthetics and children's cognitive development and educational outcomes.

A transgenerational, epigenetic effect of anesthesia, particularly fluorinated agents, has been examined in rat models, but translation to humans is unclear. This study examined associations of maternal lifetime exposure to anesthesia and pregnancy exposure to fluorinated anesthetics with child cognitive and educational outcomes. Women in the US Collaborative Perinatal Project (1959-1963) reported lifetime history of surgeries, and the obstetric record captured pregnancy exposure to anesthetics. Children were followed to age 7 for global cognitive ability and educational outcomes (n=47,977). Logistic and linear regressions were adjusted for maternal and child birth years, race and ethnicity, smoking, education, parity, study site. Many outcomes were not associated with exposure to maternal surgery that occurred at various life stages. However, maternal surgery in early childhood was associated both with being in a special school or not in school (adj OR=1.42; 95% CI 1.02, 1.98) and with slightly better cognitive ability across childhood (e.g., WISC IQ (adj β=0.59; CI 0.13, 1.04) (especially among boys)). Maternal surgery in puberty was associated with slightly lower IQ (adj β= -0.42; CI -0.79, -0.05) and poorer spelling at age 7. Children's prenatal exposure to fluorinated anesthetics was associated with slightly better spelling ability (adj β = 1.20; CI 0.02, 2.38) but lower performance IQ at age 7 (only among boys, adj β=-1.97; CI -3.88, -0.06). This study shows inconsistent evidence of effects of maternal exposure to surgery or prenatal exposure to fluorinated agents on child developmental and educational outcomes Residual confounding by indication and socioeconomic status may explain observed associations.

Integrating Maternal Depression Screening Into an Early Intervention Program: An Implementation Evaluation.

Background:In all 50 states, early intervention (EI) services to improve long-term child cognitive and academic outcomes are provided to infants and toddlers with suspected or diagnosed developmental delays. When mothers of EI-enrolled children experience depressive symptoms, uptake of EI services can be compromised.Aims:The purpose of the article is to present a depressive symptom screening intervention for mothers consisting of toolkit development for EI staff and families, symptom screening for mothers and follow-up protocol. To formally evaluate the implementation of the intervention, our research team followed the consolidated framework for implementation research (CFIR).Methods:Participants were 12 EI service coordinators across two offices. Focus groups and individual interviews were used to develop the toolkit and education module. Through the five CFIR domains, we evaluated the implemented intervention in order to allow other teams to learn from our experiences.Results:Our team successfully partnered with SCs to develop the intended deliverables. Still, the SCs found it challenging to conduct the screenings and reported mixed success.Conclusions:Preparation of EI SCs to integrate mental health screenings into their existing skillsets requires a high level of support from the research team, resulting in a rich understanding of the barriers—and potential rewards—for staff and families.

Opioid Exposure During Pregnancy and Child Cognitive Outcomes—The Importance of Defining the Study Base

Opioid Exposure During Pregnancy and Child Cognitive Outcomes—The Importance of Defining the Study Base

A mediation analysis to disentangle relations between maternal education and early child development

Maternal education is associated with early child outcomes. However, the several mechanisms that may explain this relationship remain underexplored. Using data from 1,097 children aged 12–15 months in Chile, we estimate the maternal education gap across child cognitive and language outcomes. Following a bioecological perspective, we explore potential pathways by which maternal education might influence child development, such as child characteristics, the quantity and quality of mother–child interactions, and the availability of home stimulation. We found an average maternal education gap between children with mothers with the lowest and the highest educational levels of 0.36, 0.31, and 0.25 standard deviation in child cognition, expressive language, and receptive language, respectively. The mediational analysis showed that maternal stress and depression and the quality of the home environment mediated the relation between maternal education and child language and cognitive development.

Relationships between maternal body mass index and child cognitive outcomes at 3 years of age are buffered by specific early environments in a prospective Canadian birth cohort.

Fetal and child development are shaped by early life exposures, including maternal health states, nutrition and educational and home environments. We aimed to determine if suboptimal pre-pregnancy maternal body mass index (BMI; underweight, overweight, obese) would associate with poorer cognitive outcomes in children, and whether early life nutritional, educational and home environments modify these relationships. Self-reported data were obtained from mother-infant dyads from the pan-Canadian prospective Maternal-Infant Research on Environmental Chemicals cohort. Relationships between potential risk factors (pre-pregnancy maternal BMI, breastfeeding practices and Home Observation Measurement of the Environment [HOME] score) and child cognitive development at age three (Weschler's Preschool and Primary Scale of Intelligence, Third Edition scale and its subcategories) were each evaluated using analysis of variance, multivariable regression models and moderating analyses. Amongst the 528 mother-child dyads, increasing maternal pre-pregnancy BMI was negatively associated with scores for child full-scale IQ (β [95% CI]; -2.01 [-3.43, -0.59], p = 0.006), verbal composite (-1.93 [-3.33, -0.53], p = 0.007), and information scale (-0.41 [-0.70, -0.14], p = 0.003) scores. Higher maternal education level or HOME score attenuated the negative association between maternal pre-pregnancy BMI and child cognitive outcome by 30%-41% and 7%-22%, respectively, and accounted for approximately 5%-10% greater variation in male children's cognitive scores compared to females. Maternal education and higher quality home environment buffer the negative effect of elevated maternal pre-pregnancy BMI on child cognitive outcomes. Findings suggest that relationships between maternal, social and environmental factors must be considered to reveal pathways that shape risk for, and resiliency against, suboptimal cognitive outcomes in early life.

Distributional effects on children's cognitive and social-emotional outcomes in the Head Start Impact Study: A quantile regression approach

Heterogeneity in treatment effects of the Head Start, a federally funded early childhood development program in the United States, has previously been found in the Head Start Impact Study (HSIS), a nationally representative randomized controlled trial. While individual characteristics have been extensively examined as sources of effect heterogeneity, treatment effects may vary as a function of outcome distribution (i.e., distributional effect). Using quantile regressions, we investigated distributional effects of the Head Start on eight child developmental outcomes for first year, second year, third year, and the 3rd grade year follow-up in the HSIS data. For PPVT and Applied Problems, the effects varied substantially across quantiles in the first follow-up, but they were positive overall. The effects at the lower quantiles were larger and were sustained beyond the first follow-up (PPVT [95% CI] at 10th and 90th quantiles: 8.74 [6.22, 11.27], 3.32 [0.82, 5.81]) in the first follow-up and 5.72 [2.66, 8.77], −1.66 [-3.69, 0.37] in the second follow-up). For Behavior Problems, the effects were only positive for the lower quantiles in the first follow-up, but they became null in the latter follow-ups. For Letter-Word Identification, Spelling, and Pre-Academic, the effects were positive in the first follow-up with moderate variation across quantiles. In the second follow-up, only the effects at the lower quantiles were statistically significant, although they faded in the latter follow-ups. For Oral Comprehension and Social Skills, effects were null for all follow-ups. The Head Start had meaningful distributional effects for a range of child developmental outcomes, and distributional effects should be routinely assessed for better understanding of child developmental programs.

An Analysis of Behaviour Change Techniques used in the Care for Child Development Parenting Program

Care for Child Development (CCD) is one of several parenting programs implemented in low- and middle-income countries to improve child cognitive development outcomes by increasing responsive stimulation practices in caregivers of young children. Broadly, these programs have been demonstrated to be effective. However, there is markedly little high-quality evidence for the effectiveness of CCD. Despite this, CCD is promoted by UNICEF and the World Health Organisation as an evidence-based program and is implemented in many countries. We conducted a scoping review, including grey literature and a systematic search of published literature, to obtain an overview of the available evidence. We also performed an analysis of two quantitative outcomes, child cognitive development and caregiver behaviour, to investigate their correlation with behaviour change techniques used in CCD program implementation. We found no significant correlation between any behaviour change techniques and child cognitive development outcomes. There was a significant correlation between the techniques of performance and social support, as well as the total number of techniques used, and caregiver behaviour outcomes. This analysis was limited by the quality of reported data available about the program; of 27 total identified papers, only 14 reported quantitative data regarding either child cognitive development or caregiver behaviour change. Inconsistent reporting of this data required us to use a rating system to perform our analysis; we consequently lost specificity. Even those papers that did report quantitative data were subject to methodological flaws; the measures and study designs used did not always inspire confidence in their results. We concluded that CCD is not one single, well-defined program, and that there is an important distinction to be made between CCD-based and CCD-informed programs. The generic Care for Child Development Package (2012) is a framework that contains too many gaps to be easily adaptable. Not enough high-quality studies of this program are available to draw concrete conclusions concerning its effectiveness, in whole or in part.

Association of maternal depression and anxiety with toddler social-emotional and cognitive development in South Africa: a prospective cohort study

ObjectiveA robust literature has identified associations between prenatal maternal depression and adverse child social-emotional and cognitive outcomes. The majority of prior research is from high-income countries despite increased reporting of...

Fronto-Parietal and White Matter Haemodynamics Predict Cognitive Outcome in Children with Moyamoya Independent of Stroke.

Moyamoya disease is a major arteriopathy characterised by progressive steno-occlusion of the arteries of the circle of Willis. Studies in adults with moyamoya suggest an association between abnormal fronto-parietal and white matter regional haemodynamics and cognitive impairments, even in the absence of focal infarction. However, these associations have not been investigated in children with moyamoya. We examined the relationship between regional haemodynamics and ratings of intellectual ability and executive function, using hypercapnic challenge blood oxygen level-dependent magnetic resonance imaging of cerebrovascular reactivity in a consecutive cohort of children with confirmed moyamoya. Thirty children were included in the final analysis (mean age: 12.55 ± 3.03years, 17 females, 15 idiopathic moyamoya and 15 syndromic moyamoya). Frontal haemodynamics were abnormal in all regardless of stroke history and comorbidity, but occipital lobe haemodynamics were also abnormal in children with syndromic moyamoya. Executive function deficits were noted in both idiopathic and syndromic moyamoya, whereas intellectual ability was impaired in syndromic moyamoya, even in the absence of stroke. Analysis of the relative effect of regional abnormal haemodynamics on cognitive outcomes demonstrated that executive dysfunction was predominantly explained by right parietal and white matter haemodynamics independent of stroke and comorbidity, while posterior circulation haemodynamics predicted intellectual ability. These results suggest that parietal and posterior haemodynamics play a compensatory role in overcoming frontal vulnerability and cognitive impairment.

Maternal depressive symptoms and children's cognitive school readiness: the role of gene-environment interplay.

Maternal depressive symptoms are a robust risk factor for poor cognitive outcomes in children, yet the role of gene-environment interplay in this association is not well understood. The objective of this study was to evaluate gene-environment interaction in the association between maternal depressive symptoms and children's cognitive school readiness. Data come from a population-based birth cohort of 538 twin pairs. Maternal depressive symptoms were self-reported (Centre for Epidemiologic Studies Depression Scale) when children were aged 6 and 18 months (a mean score was used). Children's cognitive school readiness was assessed using the Lollipop Test when children were aged 5 years. Analyses were conducted with structural equation modeling. Maternal depressive symptoms were correlated with children's cognitive school readiness (r = -0.10). Shared environmental factors explained most of the variance in children's cognitive school readiness (52%). The remaining variance was accounted for by genetic (30%) and nonshared environmental factors (18%). As the level of maternal depressive symptoms increased, the relative contribution of nonshared environmental factors to the variance in children's cognitive school readiness increased (0.14 [95% CI: 0.04 to 0.24]), whereas the relative contribution of genetic factors decreased (-0.28 [-0.64 to 0.08]). In contexts of elevated maternal depressive symptoms, environmental - and potentially modifiable - factors may be especially important for shaping children's cognitive outcomes. This suggests that interventions to improve the early childhood environment of children exposed to maternal depressive symptoms may improve their cognitive outcomes.

Changes in Cognitive Outcomes in Early Childhood: The Role of Family Income and Volatility.

Associations between family income and child developmental outcomes are well documented. However, family income is not static but changes over time. Although this volatility represents income shocks that are likely to affect children’s lives, very few studies have so far examined its effect on early cognitive development. This study investigated associations between family income, volatility, and changes in cognitive outcomes in early childhood and examined whether these associations are dependent on a family’s overall income position. Data for the study spanned five waves of the Growing Up in Scotland longitudinal survey (N = 3,621). Findings indicate that income volatility was more prevalent among disadvantaged sociodemographic groups. In addition to average income, short-term volatility was associated with changes in child cognitive outcomes from ages 3 to 5. While upward volatility was associated with gains in expressive vocabulary, downward and fluctuating volatility were associated with declines in child problem-solving abilities. The association between volatility and changes in cognitive outcomes was similar for both children living in poverty and those from medium–high-income households. Our results suggest that policies aiming to cushion all families from negative income shocks, boost family income to ensure stability, and take low-income families out of poverty will have a significant impact on children’s cognitive development. Additionally, a more nuanced conceptualization of income is needed to understand its multidimensional impact on developmental outcomes.

Multidimensional Family-Centred Early Intervention in Children with Hearing Loss: A Conceptual Model.

At least two per thousand newborns are affected by hearing loss, with up to 40% with an additional disability. Early identification by universal newborn hearing screening and early intervention services are available in many countries around the world, with limited data on their effectiveness and a lack of knowledge about specific intervention-related determinants of child and family outcomes. This concept paper aimed to better understand the mechanisms by which multi-dimensional family-centred early intervention influences child outcomes, through parent behaviour, targeted by intervention by a review of the literature, primarily in the field of childhood hearing loss, supplemented by research findings on physiological and atypical child development. We present a conceptual model of influences of multi-disciplinary family-centred early intervention on family coping/functioning and parent–child interaction, with effects on child psycho-social and cognitive outcomes. Social communication and language skills are postulated as mediators between parent–child interaction and non-verbal child outcomes. Multi-disciplinary networks of professionals trained in family-centred practice and the evaluation of existing services, with respect to best practice guidelines for family-centred early intervention, are recommended. There is a need for longitudinal epidemiological studies, including specific intervention measures, family behaviours and multidimensional child outcomes.

From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy

Recent neuroimaging studies allowed us to explore abnormal brain structures and interhemispheric connectivity in children with cerebral palsy (CP). Behavioral researchers have long reported that children with CP exhibit suboptimal performance in different cognitive domains (e.g., receptive and expressive language skills, reading, mental imagery, spatial processing, subitizing, math, and executive functions). However, there has been very limited cross-domain research involving these two areas of scientific inquiry. To stimulate such research, this perspective paper proposes some possible neurological mechanisms involved in the cognitive delays and impairments in children with CP. Additionally, the paper examines the ways motor and sensorimotor experience during the development of these neural substrates could enable more optimal development for children with CP. Understanding these developmental mechanisms could guide more effective interventions to promote the development of both sensorimotor and cognitive skills in children with CP.