Cognitive Strategy Use in Children with Unilateral Cerebral Palsy

Abstract

Unilateral cerebral palsy is the most common presentation of cerebral palsy. Although cerebral palsy is a neurocognitive disorder, research emphasises motor manifestations which is reflected in the prevalence of motor based assessments and interventions. However, researchers and clinicians are becoming increasingly aware that cerebral palsy can also involve cognitive deficits, and social emotional difficulties.

This study investigates how children with unilateral cerebral palsy perform everyday tasks, how they utilise cognitive strategies during task performance and how this compares to their peers without cerebral palsy. A standardised, criterion-referenced assessment the Perceive, Recall, Plan and Perform System of Task Analysis (PRPP-A) was used to explore task performance and cognitive strategy use of 18 children with unilateral cerebral palsy, aged 3 to 6 years, and 18 peers without cerebral palsy.

The results of the study demonstrated that children with unilateral cerebral palsy present with significant difficulties in task performance and application of all cognitive strategies when compared to their peers. Although children with unilateral cerebral palsy presented with significantly more difficulties than their peers, key trends and patterns emerged in their ability to utilise cognitive strategies to support more successful task performance, including relative strengths utilising memory and knowledge when compared with other areas. The least efficient cognitive strategies applied related to planning and evaluating behaviours, impacting the child’s ability to adapt as the task progresses.

By increasing this understanding of cognitive strategy use for children with unilateral cerebral palsy, therapists will be able to use more targeted assessment and intervention techniques to address difficulties with cognitive strategy use during occupational performance, with the aim of improving functional outcomes for children with unilateral cerebral palsy.