Behavioral Differences in School Age Children after Perinatal Stroke

Abstract

Little is known about the influence of the right hemisphere (RH) on social and emotional development in children. In order to examine the effect of RH damage on behavioral function, the Personality Inventory for Children was administered to parents of 17 children who had suffered perinatal strokes and 23 control children. Children with focal brain lesions, regardless of hemisphere, had higher T scores (indicating greater abnormality) than controls on scales measuring social competence, emotional behavior, cognitive and academic development. Children with lesions involving the frontal lobe obtained higher T scores than did those with nonfrontal lesions or controls on scales related to cognitive function. The nonfrontal group had higher T scores than those with frontal lesions on measures of social competence and behavior. The data suggest that any focal brain lesion of early onset may predispose one to social and cognitive deficits. The site of the lesion within the hemisphere may be of importance in determining what difficulties the child may experience (i.e., frontal lobe lesions are more likely to result in cognitive deficits, whereas posterior lesions are more likely to be associated with social problems). These findings further suggest that brain localization for cognitive and social skills may be determined very early in development.

Effect of side of lesion on neuropsychological performance in childhood stroke

“…Past studies that have examined the effect of childhood stroke on a single cognitive domain (e.g., IQ: Ballantyne et al, 1994;Goodman & Yude, 1996;Hogan et al, 2000), language skills (Bates & Roe, 2001;Bates et al, 1997bBates et al, , 1999bReilly et al, 1998), visuospatial skills (Akshoomoff et al, 2002;Schatz et al, 2000;Stiles, 2000b), and behavioral profiles (Goodman & Yude, 1997;Max et al, 2002aMax et al, , 2002bTrauner et al, 1996Trauner et al, , 2001. The strength of the current study lies in its breadth.…”

The clinical outcomes of neonatal and childhood stroke: review of the literature and implications for future research

“…Whereas earlier studies suggested a negative impact of neonatal stroke on emotional expression, comprehension and social skills (Reilly et al. , 1995; Goodman and Graham, 1996; Goodman and Yude, 1996; Trauner et al. , 1996a,b; Goodman, 1998), Trauner et al.…”

Social competence following pediatric stroke: Contributions of brain insult and family environment

“…However, current evidence suggests that age at stroke onset is unrelated to social outcomes (Hurvitz et al, 2004). Rather, the risk of social deficits appears to be elevated following stroke at any age during childhood (Anderson et al, , 2009Greenham, SpencerSmith, Anderson, Coleman, & Anderson, 2010;Trauner et al, 1996). Little is known regarding the impact of focal brain insult on social competence and, of interest, studies attempting to identify brain-behavior links for other cognitive and functional outcomes following pediatric stroke have been disappointing (Ganesan, Ng, Chong, Kirkham, & Connelly, 1999;Westmacott, Askalan, Macgregor, Anderson, & Deveber, 2010).…”

“…Little is known regarding the impact of focal brain insult on social competence and, of interest, studies attempting to identify brain-behavior links for other cognitive and functional outcomes following pediatric stroke have been disappointing (Ganesan, Ng, Chong, Kirkham, & Connelly, 1999;Westmacott, Askalan, Macgregor, Anderson, & Deveber, 2010). Trauner et al (1996) describe elevated risk of social impairment with pediatric stroke involving extra-frontal structures, while report that children with stroke involving subcortical brain regions may be vulnerable, particularly with respect to emotional regulation. Studies conducted by Max et al (2002Max et al ( , 2010 also link lesion location, particularly frontal pathology, to elevated risk of attention deficit 472 ANDERSON ET AL.…”

“…The bulk of research examining social competence after pediatric stroke has taken a global view, reporting poor "socialization" and emphasizing children's difficulties in implementing social skills in real-life situations (Friefeld, Westmacott, Macgregor, & Deveber, 2011;Mosch, Max, & Tranel, 2005;Neuner et al, 2011;O'Keeffe, Ganesan, King, & Murphy, 2012;Trauner, Panyard-Davis, & Ballantyne, 1996). Recent advances in theoretical models in the social domain challenge researchers to take a more fine-grained approach to examining social competence.…”