Executive function in school-aged children with cerebral palsy: Relationship with speech and language.
Every school-aged client with CP, even those who speak well, is at high risk for executive-function deficits.
01Research in Context
What this study did
Sakash et al. (2018) looked at executive function in kids with cerebral palsy. They split the kids by speech and language profiles. Then they checked if some groups had bigger EF problems than others.
It was a small case-series study. Every child with CP joined, no matter how they talked.
What they found
All groups scored worse than average on every EF task. Kids who spoke well still had clear deficits. Kids who needed devices had them too.
Speech and language level did not predict EF score. The main message: expect EF trouble in every school-aged client with CP.
How this fits with other research
Tseng et al. (2011) showed that daily skills in CP hinge on motor and prosocial factors, not EF. Ashley adds that EF is still globally weak, so you must assess it even when daily skills look fine.
Chevalère et al. (2015) found global EF deficits in Prader-Willi syndrome after IQ was held constant. Ashley mirrors this pattern in CP, widening the warning beyond genetic syndromes to motor disorders.
Danielsson et al. (2012) found selective EF weaknesses in intellectual disability: fluency and switching kept pace with mental age, but inhibition and planning lagged. Ashley shows a broader, flatter EF hit in CP, so you cannot use mental-age matching to explain away the scores.
Why it matters
If you work with school kids who have CP, do not skip EF testing just because they speak clearly. Build supports like visual schedules, task chunking, and self-monitoring scripts into their plans. Share the EF profile with teachers so classroom demands can be adjusted before problem behavior starts.
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02At a glance
03Original abstract
BACKGROUND AND AIMS: Although children with cerebral palsy (CP) are at an increased risk for developing speech, language, and executive function (EF) impairments, little is known regarding the relationship among these risk factors. The current study examined how different profiles of speech and language impairment might be associated with impairments in EF skills in school-aged children with CP. METHODS AND PROCEDURES: Forty-seven school-aged children with CP were included. Each child contributed between one and four data points for a total of 87 data points. Children were classified into speech and language profile groups at each data point. EF skills were examined using the Behavior Rating Inventory of Executive Function questionnaire. OUTCOMES AND RESULTS: Compared to a mean of 50 from a normative population of children, mean scores on all measures of EF were significantly elevated for all groups (p<.05). The proportion of children with CP with elevated EF scores was significantly higher for all groups compared to the expected proportion in a normal population of children (p<.05). CONCLUSIONS AND IMPLICATIONS: Children with CP who do not have impairments in speech or language may be at risk for EF difficulties which may negatively affect social communication, academic performance, and functional independence.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.05.015