Evaluation of body representation in children with hemiplegic cerebral palsy: Toward the development of a neuropsychological test battery.

Abstract

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.

Action and Non-Action Oriented Body Representations: Insight from Behavioural and Grey Matter Modifications in Individuals with Lower Limb Amputation

“…BS was assessed using a mental rotation of feet task (adapted from [ 17 ]). Tasks that involve the mental rotation of body parts are considered to assess BS being tasks in which the mentally simulated kinematic configuration of the body matches the actual current kinematic configuration of one's body (for studies in which mental rotation tasks were used to assess BS see for example [ 7 , 11 , 14 , 28 ]. In other words, they are tasks that can be solved by imagining performing the actual movement, thus involving the use of the body schema, as for the actual movements [ 11 , 14 , 17 ].…”

Children with unilateral cerebral palsy show diminished implicit motor imagery with the affected hand

“…Previous studies have suggested that implicit motor imagery depends (in part) on the imagers' body scheme. 7,8 For example, it has been reported that hemiplegic post-stroke participants rely on visual strategies to compensate deficient access to their body schema. 7,8 Although previous research has reported a diminished motor imagery capacity in general in both children and adolescents with CP and children with developmental coordination disorder, 21,22 the current study is the first study, to our knowledge, that reveals a hand-specific decrease in motor imagery capacity.…”

“…During explicit motor imagery, a specific motor act is internally simulated, whereas implicit motor imagery refers to the ability to engage into the projection and manipulation of the body schema from a first-person perspective. [6][7][8] An often used paradigm to test the implicit motor imagery ability is Parsons' hand laterality judgement (HLJ) task. 6,9 In this forced choice task, participants judge the laterality of displayed hands as quickly as possible by determining whether a left or right hand is depicted.…”

“…18,19 Unlike stroke patients, adolescents and children with unilateral CP lack a typical early development of the body schema. 8 Moreover, their internal body representation might be less accurate with respect to the affected side of the body than the less-affected side. Because implicit motor imagery relies on the ability to engage into the projection and manipulation of the body schema from a firstperson perspective, we hypothesize that in unilateral CP, implicit motor imagery is especially compromised when the affected hand is involved, but less so when the lessaffected hand is involved.…”

Critical Analysis of Children’s Drawings as a Diagnostic Tool for Body Schema and Body Image Disorder in Cerebral Palsy

“…Individuals with Cerebral Palsy (CP) may have issues with perception, cognition and behavior, in addition to their motor disorder [1] [2] [3]. In children with CP, motor impairments are often accompanied by deficits in body schema and body image [4].…”