Executive Functioning in Children Aged 6–18 Years with Cerebral Palsy

Executive functioning (EF) is necessary for purposeful and goal-directed activity. Deficits in EF have been related to prematurity, low birth weight and early acquired brain lesions. Cerebral palsy (CP) is a condition where all these factors might be present and therefore suited to explore the relative contribution of each. The aim is to investigate factors that may contribute to variability in EF in children with CP. Participants were 68 children with CP, with various degrees of speech and motor impairment. Mean age 10;2 years (range 6;0 to 17;7 years), 38 were girls. EF was investigated with tests, Backward memory from Leiter-R and Wisconsin Card Sorting Test, which were adapted so that the children could respond regardless of their level of motor functioning. The mean standardized scores on tests of EF were within the normal range (89.5–105.9). The considerable individual variation (55–145) is explained by age and cognitive ability. Of the 68 participants, a measure of EF was available for 57 (83.8%). The 11 who did not complete the tests all had an intellectual disability. Variability in EF in children with CP was explained by age and cognitive ability, and not by prematurity, type of brain lesion or epilepsy. There was a developmental trend towards an increase in EF with age. However, the delay in EF may have consequences for overall cognitive and everyday functioning. The large variability in EF suggests that cognition should be assessed in all children with CP.