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

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