Assessment & Research

Motor imagery in congenital hemiplegia: Impairments are not universal.

Williams et al. (2021) · Research in developmental disabilities 2021
★ The Verdict

Test motor imagery in each child with hemiplegia before assuming they need imagery training—some already think in motion like their peers.

✓ Read this if BCBAs working on motor or daily-living goals with school-age clients who have hemiplegic cerebral palsy.
✗ Skip if Practitioners serving adults with stroke or purely cognitive programs with no motor component.

01Research in Context

01

What this study did

Williams et al. (2021) asked kids with hemiplegia to imagine moving an arm without actually moving it.

They watched each child one by one to see who could form a clear mental picture of the action.

02

What they found

About half the kids pictured the move as well as their peers. The rest ranged from a little off to very poor.

The team says this means hemiplegia is not one-size-fits-all; you must test each child before training.

03

How this fits with other research

Conson et al. (2016) found that teens with autism always struggled with motor imagery when their body was in an awkward pose. Jacqueline’s kids with hemiplegia sometimes did fine, showing the trouble is not universal across diagnoses.

Wagels et al. (2020) pooled nineteen imaging studies and linked weak brain motor tracts to poor hand use in cerebral palsy. Jacqueline’s work adds a quick picture-in-your-mind test that can flag the same risk without a scanner.

Coceski et al. (2021) showed teens with CP score lower on motor-free IQ tests. Together, these papers push the same message: remove motor demands first, then test the skill you really want to know.

04

Why it matters

If you plan to use motor imagery drills to boost limb use, run a one-minute imagery check first. Kids who already picture motion well can skip the step and move straight to active practice. Those who fail get the imagery primer they actually need, saving precious therapy minutes.

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Open your session with a quick 'imagine reaching for the toy' trial—if the child can describe speed and path, jump straight to real reaches; if not, insert brief imagery cues first.

02At a glance

Intervention
not applicable
Design
case series
Sample size
20
Population
other
Finding
mixed

03Original abstract

BACKGROUND: Motor imagery (MI) training may benefit children with congenital hemiplegia, but reports on MI ability are mixed. This study considered individual patterns of performance to better understand MI ability in children with hemiplegia. METHOD: Twenty children with hemiplegia (7-13 years; 10 with right hemiplegia), completed a MI task, IQ estimate and functional tests. Children with hemiplegia scoring above chance on the MI task were compared to a group of age-matched peers. The performance patterns of those scoring below chance were considered individually. RESULTS: Three children with right hemiplegia were excluded due to low IQ. Seven of 10 children with left hemiplegia and three of seven with right hemiplegia performed MI at an equivalent level to peers without hemiplegia. The seven children with hemiplegia who scored significantly below chance scored lower on functional tests, but differences here failed to reach an adjusted significance level. Four of the seven appeared engaged in MI, but performed very poorly. The remaining three had unique performance patterns explored in more detail. CONCLUSION: Motor imagery deficits are not universally observed in children with congenital hemiplegia and individual performance should be examined before completing group analyses. Recommendations for exclusions and reporting in future studies are made.

Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2021.103991