The development of anticipatory action planning in children with unilateral cerebral palsy.
The sword task hides planning deficits in school-age kids with unilateral CP—use real-life actions instead.
01Research in Context
What this study did
Krajenbrink et al. (2019) watched kids with unilateral cerebral palsy do a sword task.
The task checks if the child flips the sword before handing it over.
They wanted to see if older kids plan better and if planning links to hand use.
What they found
Planning scores stayed flat across ages.
Scores also did not match how well the child used one hand or two.
The sword task gave no useful signal.
How this fits with other research
Cavézian et al. (2010) saw preschoolers with the same diagnosis improve on a similar task after eight weeks of constraint plus bimanual training.
The kids in that study were younger and got therapy, so the task could show change when training is given.
Janssen et al. (2011) also found no age gain in grasp planning for kids with CP, backing the idea that the sword result is real but the tool is dull.
Why it matters
Skip the sword test in your next upper-limb eval. Pick daily tasks like reach-grasp-eat or add bimanual play to see true planning limits and track change.
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02At a glance
03Original abstract
Background Previous studies suggest that compromised bimanual performance experienced by children with unilateral cerebral palsy (CP) is not only due to difficulties in action execution but may also be a result of impaired anticipatory action planning. Aims The effect of age and side of hemiplegia were examined and the relationship between anticipatory action planning, unimanual capacity and bimanual performance was explored. Methods and procedures Using a multi-centre, prospective, cross-sectional observational design, anticipatory action planning was analyzed in 104 children with unilateral cerebral palsy, aged 6-12 years, using the sword task. Outcomes and results Anticipatory action planning did not improve with age in children with unilateral CP, aged between 6-12 years. No differences were found between children with left or right hemiplegia. Finally, anticipatory action planning was not related to unimanual capacity or bimanual performance. Conclusion and implications This study demonstrates anticipatory action planning, measured using the sword task, does not improve with age in children with unilateral CP and is not related to bimanual performance or laterality. Future studies of anticipatory action planning in children with unilateral CP should consider using measures that require effective anticipatory action planning for successful task completion rather than end state comfort.
Research in developmental disabilities, 2019 · doi:10.1016/j.ridd.2018.12.002