Cognition and bimanual performance in children with unilateral cerebral palsy: Protocol for a multicentre, cross-sectional study

© 2018 The Author(s). Background: Motor outcomes of children with unilateral cerebral palsy are clearly documented and well understood, yet few studies describe the cognitive functioning in this population, and the associations between the two is poorly understood. Using two hands together in daily life involves complex motor and cognitive processes. Impairment in either domain may contribute to difficulties with bimanual performance. Research is yet to derive whether, and how, cognition affects a child's ability to use their two hands to perform bimanual tasks. Methods/Design: This study will use a prospective, cross-sectional multi-centre observational design. Children (aged 6-12 years) with unilateral cerebral palsy will be recruited from one of five Australian treatment centres. We will examine associations between cognition, bimanual performance and brain neuropathology (lesion type and severity) in a sample of 131 children. The primary outcomes are: Motor - the Assisting Hand Assessment; Cognitive - Executive Function; and Brain - lesion location on structural MRI. Secondary data collected will include: Motor - Box and Blocks, ABILHAND- Kids, Sword Test; Cognitive - standard neuropsychological measures of intelligence. We will use generalized linear modelling and structural equation modelling techniques to investigate relationships between bimanual performance, executive function and brain lesion location. Discussion: This large multi-centre study will examine how cognition affects bimanual performance in children with unilateral cerebral palsy. First, it is anticipated that distinct relationships between bimanual performance and cognition (executive function) will be identified. Second, it is anticipated that interrelationships between bimanual performance and cognition will be associated with common underlying neuropathology. Findings have the potential to improve the specificity of existing upper limb interventions by providing more targeted treatments and influence the development of novel methods to improve both cognitive and motor outcomes in children with unilateral cerebral palsy

Everyday psychological functioning in children with unilateral cerebral palsy: Does executive functioning play a role?

Aim: To identify whether executive functioning mediates the effect of having unilateral cerebral palsy (CP) on executive functioning in everyday life, psychological functioning, and social functioning. Method: A cross-sectional cohort of 46 children with unilateral CP (25 males, 21 females; mean age 11y 1mo, SD 2y 5mo; 24 right-sided, 22 left-sided) and 20 children with typical development (nine males, 11 females; mean age 10y 10mo, SD 2y 4mo). Cognitive executive functioning was tested using a neuropsychological battery. Executive functioning in everyday life was measured with the Behavior Rating Inventory of Executive Function (BRIEF; teacher and parent reports) and psychological and social functioning by the Strengths and Difficulties Questionnaire (SDQ). Analysis included analysis of covariance and bootstrapping. Results: Children with unilateral CP were found to have significantly decreased functioning, compared with children with typical development, on the BRIEF Behavioral Regulation Index, the BRIEF Metacognition Index, and on the SDQ emotion, conduct, hyperactivity, and peer problems subscales. Group differences were mediated by cognitive executive functioning for the BRIEF Metacognition Index (teacher and parent report), the BRIEF Behavioral Regulation Index (parent report only), the SDQ conduct subscale, and the SDQ hyperactivity subscale. Interpretation: This study suggests that the increased risk of children with unilateral CP experiencing executive functioning difficulties in everyday life, conduct problems, and hyperactivity can be partly explained by decreased cognitive executive functioning abilities relative to children with typical development. © 2014 Mac Keith Press

Testing the direct, indirect, and interactive roles of referent group injunctive and descriptive norms for sun protection in relation to the theory of planned behavior

This is the peer reviewed version of the article, which has been published in final form at DOI: 10.1111/jasp.12264. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.The theory of planned behavior was used to predict participants' (n=219) sun protection intentions and (longitudinally) self-reported behavior from attitudes, perceptions of control, and subjective norms. Norm focus theory was incorporated by distinguishing injunctive and descriptive norms. In turn, subjective descriptive and injunctive norms were examined in relation to the norms of a salient referent group: university students. Referent group norms were found to be associated with subjective norms, and to influence intentions indirectly. A marginal interaction of referent group descriptive and injunctive norms was also observed on behavior. Results highlight the importance of examining indirect effects in order to capture the effect of group-level processes when multiple sources and levels of normative influence are examined.Australian Research Council Discovery schem

Robot Programming to Empower Higher Cognitive Functions in Early Childhood

This chapter describes a new approach of educational robotics (ER) aimed at empowering higher cognitive functions in school. As robot programming requires mentally planning complex action sequences before the motor act, ER may promote several crucial cognitive processes underlying learning. During robot programming, the child has to first set the target, second sequentially think through the steps needed to achieve that target, then verify the goal, and eventually reset the plan. All these mental acts involve executive functions (EFs), which are complex higher cognitive processes, crucial in early development because they are the base for abstraction and logical reasoning, decision-making, sequential thinking, and maintaining and updating information in memory and problem-solving. Robot programming may empower EFs not only by improving top-down cognitive control, working memory, and inhibition skills but also by placing the child, more than other passive thought technologies, in front of “objects to think with” in a group setting that stimulates the use of EFs for social and emotional purposes. Recent studies demonstrating, through a rigorous and scientific approach, the effect of ER on EFs in typical and atypical development will be discussed