Cognitive impairment is frequent in cerebral palsy (CP) and there is a lack of multiprofessional screening instruments.OBJECTIVE:The aim of this study was to investigate the utility of the Mini-Mental State Examination for Children (MMC), an adapted version of the Mini-Mental State Examination, in screening for cognitive impairments in children with CP.METHODS:We assessed 397 Brazilian children, 310 with typical development and 87 with CP (hemiplegic and quadriplegic forms), aged 5-16 years. Association between the MMC and general intelligence was assessed by the Colored Progressive Matrices instrument.RESULTS:Psychometric indexes for the MMC were adequate. ROC analyses revealed effective diagnostic accuracy in all ages assessed. Cut-off values are reported. Major difficulties on the MMC were observed in children with CP, particularly individuals with the quadriplegic form. Moreover, the MMC showed moderate correlation with the intelligence test, and was reliable in discriminating, among clinical cases, those with poorer cognitive abilities.CONCLUSION:The MMC could be useful as a multiprofessional screening instrument for cognitive impairment in children with hemiplegic CP. Results of the MMC in quadriplegic CP children should be interpreted with caution. Diagnosis should be confirmed by further psychological testing.

Clinical observations indicate that many children with hemiplegic cerebral palsy (HCP) exhibit a lack of use or disregard of the affected upper limb. The aim of the present study was to develop, adapt, and verify the psychometric properties of a neuropsychological battery to assess body perception and representation disturbances in children with HCP. Three groups of children participated in this study, who took part in different phases of the validation process: one group of typically developing children (TD; n = 30; aged 4-6 years) and two groups of HCP children (HCP1: n = 12, aged 5-10 years; HCP2: n = 49, aged 5-13 years). Because no cognitive-neuropsychological model of body representation has been specifically developed for children, the tasks were designed based on a cognitive-neuropsychological model developed for adults. The chosen model comprises three levels of body representation: body schema, body structural description, and body image. The following steps were adopted in developing the instrument: development and choice of the tasks, selection and preparation of stimuli, adequacy and improvement of the instrument, semantic analysis of items, internal consistency, and feasibility and acceptability of application for TD and HCP children. The final set of tasks and items was chosen to balance the levels of difficulty and internal consistency. We concluded that the final battery was adequate and can be used to assess body representation disturbances in children with HCP.

Although motor imagery has been pointed as a promising strategy for the rehabilitation of children with neurological disorders, information on their development throughout childhood and adolescence is still scarce. For instance, it is still unclear at what age they reach a development comparable to the motor imagery performance observed in adults. Herein we used a mental rotation task to assess motor imagery in 164 typically developing children and adolescents, which were divided into four age groups (6-7, 8-9, 10-11, and 12-13 years) and 30 adults. The effects of biomechanical constraints, accuracy, and reaction time of the mental rotation task were considered. ANOVA showed that all groups had the effect of biomechanical restrictions of the mental rotation task. We found a group effect for accuracy [F (4, 180) = 17,560; p < 0.00; η² = 3.79] and reaction time [F (4, 180) = 17.5; p < 0.001, η² = 0.615], with the results of children groups 6-7 and 8-9 years being significantly lower than the other groups (p < 0.05). In all the analyses, there were no differences regarding accuracy and reaction time among the participants of the age groups 10-11 and 12-13 years and adults (p > 0.05). Concluding, children aged 6-7 years were able to perform motor imagery, motor imagery ability improved as the participants' ages increased, and children aged 10 and over-performed similarly to adults.