Visuospatial Perception in Prematurely Born Children Without Cerebral Palsy or Retinopathy but With Scholar Complaints.

In the absence of any complaints in early childhood, preterm children remain more at risk of encountering academic difficulties, but their clinical picture remains not well characterized. We screened visuospatial perception in 70 children born preterm consulting for scholar complaints. Developmental Coordination Disorder (with or without comorbidities) was associated with high prevalence (27%) of impaired perception of spatial relationship. Prematurely born children who obtained no diagnosis of Neuro-Developmental Disorder exhibited a high prevalence (31%) of impaired perception of object magnitude. Regression revealed that low gestational age and fetal growth restriction significantly predicted the magnitude but not the spatial relationship perception.

Alteration of body representation in typical and atypical motor development.

Developmental coordination disorder (DCD) impacts the quality of life and ability to perform coordinated actions in 5% of school-aged children. The quality of body representations of individuals with DCD has been questioned, but never assessed. We hypothesize that children with DCD have imprecise body representations in the sensory and motor domains. Twenty neurotypical children, seventeen children with DCD (8-12 years old) and twenty neurotypical adults (25-45 years old) performed both sensory and motor body representation tasks: a limb identification and a limb movement task. We observed lower accuracy in the sensory task but not in the motor task. In both tasks, we observe a larger amplitude of errors, or synkinesis, in children with DCD than in neurotypical children. In neurotypical children, accuracy was lower than in neurotypical adults in the motor and sensory task, and the amplitude of sensory errors and synkinesis was higher than in neurotypical adults. Using a linear regression model, we showed that sensory accuracy is a good predictor of synkinesis production, and that synkinesis production is a good predictor of sensory accuracy, as can be expected by the perception-action loop. Results support the hypothesis of an imprecision of body representation in DCD. We suggest that this imprecision arises from noise in the body representation used at the level of internal models of action. Future studies may assess whether slower plasticity of body representations, initial imprecision, or both may account for this observation. At the clinical level, prevention strategies targeting body representation in early childhood are strategically important to limit such impairments. RESEARCH HIGHLIGHTS: Body representation is impaired in children with DCD and has a significant cost in terms of the accuracy of sensory identification of body parts and associated movements. Inaccuracies in the body representation measured in perception and in action (error amplitude and synkinesis) are related in both NT children and adults. In typical development, we provide evidence of a strong link between body schema and body image.

Elementary visuospatial perception deficit in children with neurodevelopmental disorders.

AIM: To assess the prevalence of elementary visuospatial perception (EVSP) deficit in children with neurodevelopmental disorders. METHOD: Using a screening test designed and validated to measure dorsal EVSP ability, 168 children (122 males, 46 females; mean age 10y [SD 1y 10mo], range 4y 8mo-16y 4mo) diagnosed with developmental coordination disorder (DCD), specific learning disorder (SLD), attention-deficit/hyperactivity disorder (ADHD), and/or oral language disorder were compared with a group of 184 typically developing children. We also tested 14 children with binocular vision dysfunction and no neurodevelopmental disorder. RESULTS: Children with SLD scored below the interquartile range of typically developing children as frequently (59%) as children with DCD, but only 5% were severely impaired (i.e. scored as outliers). Children with DCD were the most severely impaired (22% of outliers), even more so when they exhibited a co-occuring disorder. Children with language disorder and those with binocular vision dysfunction scored similarly to the group of typically developing children. INTERPRETATION: These results confirm the importance of assessing EVSP in the clinical evaluation of children with neurodevelopmental disorders, in particular those presenting with DCD or SLD. What this paper adds More than half of children with developmental coordination disorder (DCD) scored below the normal interquartile range on the elementary visuospatial perception (EVSP) test. More than half of children with specific learning disorder (SLD) scored below the normal interquartile range on the EVSP test. Twenty-two percent of children with DCD performed as outliers on the EVSP test. Children with language disorder and those with binocular vision dysfunction scored similarly to typically developing children.

Validation of a simple screening test for elementary visuo-spatial perception deficit.

OBJECTIVE: The reliability and validity of a screening test for a deficit in elementary visuo-spatial perception (EVSP) were evaluated. METHOD: This prospective study collected performance from 210 typically developing individuals and evaluated the internal consistency of the EVSP screening test. Test-retest reliability was examined with 25 individuals. Validity also involved retrospective clinical data collected from 223 non-typically developing children coming to the hospital for outpatient consultation. Since EVSP matures through childhood, we standardized the EVSP screening test scores by age category and performed Pearson correlations with standardized clinical tests scores. RESULTS: Test-retest reliability (intraclass correlation coefficient=0.76) and internal consistency (Cronbach's alpha=0.76) were satisfactory. Construct validity included correlation with the subtests of the Wechsler Intelligence Scale IV (WISC-IV) involving visuo-spatial analysis (Matrix Reasoning and Block Design, P<0.01; Symbol Search and Coding, P<0.05) and was reinforced by the expected non-correlation between the Verbal Comprehension Index and EVSP scoring class. The EVSP scoring class was correlated with Manual dexterity of the M-ABC (P<0.05) and the Working Memory Index (P<0.05) of the WISC-IV including the subtest Arithmetic (P<0.01). CONCLUSION: This screening test is reliable and valid to evaluate EVSP before more complex cognitive or motor assessment.

Don't speak too fast! Processing of fast rate speech in children with specific language impairment.

BACKGROUND: Perception of speech rhythm requires the auditory system to track temporal envelope fluctuations, which carry syllabic and stress information. Reduced sensitivity to rhythmic acoustic cues has been evidenced in children with Specific Language Impairment (SLI), impeding syllabic parsing and speech decoding. Our study investigated whether these children experience specific difficulties processing fast rate speech as compared with typically developing (TD) children. METHOD: Sixteen French children with SLI (8-13 years old) with mainly expressive phonological disorders and with preserved comprehension and 16 age-matched TD children performed a judgment task on sentences produced 1) at normal rate, 2) at fast rate or 3) time-compressed. Sensitivity index (d') to semantically incongruent sentence-final words was measured. RESULTS: Overall children with SLI perform significantly worse than TD children. Importantly, as revealed by the significant Group × Speech Rate interaction, children with SLI find it more challenging than TD children to process both naturally or artificially accelerated speech. The two groups do not significantly differ in normal rate speech processing. CONCLUSION: In agreement with rhythm-processing deficits in atypical language development, our results suggest that children with SLI face difficulties adjusting to rapid speech rate. These findings are interpreted in light of temporal sampling and prosodic phrasing frameworks and of oscillatory mechanisms underlying speech perception.

Visual-perceptual impairment in children with cerebral palsy: a systematic review.

AIM: Visual perception is one of the cognitive functions often impaired in children with cerebral palsy (CP). The aim of this systematic literature review was to assess the frequency of visual-perceptual impairment (VPI) and its relationship with patient characteristics. METHOD: Eligible studies were relevant papers assessing visual perception with five common standardized assessment instruments in children with CP published from January 1990 to August 2011. RESULTS: Of the 84 studies selected, 15 were retained. In children with CP, the proportion of VPI ranged from 40% to 50% and the mean visual perception quotient from 70 to 90. None of the studies reported a significant influence of CP subtype, IQ level, side of motor impairment, neuro-ophthalmological outcomes, or seizures. The severity of neuroradiological lesions seemed associated with VPI. The influence of prematurity was controversial, but a lower gestational age was more often associated with lower visual motor skills than with decreased visual-perceptual abilities. INTERPRETATION: The impairment of visual perception in children with CP should be considered a core disorder within the CP syndrome. Further research, including a more systematic approach to neuropsychological testing, is needed to explore the specific impact of CP subgroups and of neuroradiological features on visual-perceptual development.

A 7-year longitudinal follow-up of intellectual development in children with congenital hemiplegia.

AIMS: Our aim was to examine intellectual development in children with congenital hemiplegia from early childhood to adolescence. METHOD: Full-scale IQ (FIQ), Verbal IQ (VIQ), and Performance IQ (PIQ) scores were measured in 32 participants (19 males, 13 females) with congenital hemiplegia at mean ages of 4 years 6 months (SD 7mo; 31 participants), 7 years (SD 6mo; 23 participants), and 14 years (SD 1y 5mo; 26 participants). RESULTS: The FIQ and VIQ scores did not change with age, but the PIQ declined significantly (0.7 points per year; p=0.004). The estimated mean (95% confidence intervals) scores in males born at term with right-sided lesions without epilepsy were FIQ 106.5 (95.29-117.74), VIQ 105.9 (95.57-116.24), and PIQ 103.7 (93.19-114.31). Those means were negatively associated with preterm birth. PIQ was negatively associated with epilepsy. VIQ increased more quickly in males and in children with right-sided lesions. INTERPRETATION: The results confirm previous findings of FIQ stability, PIQ decline, the impact of epilepsy, and the status of females with left-sided lesions, and also reveal the effect of gestational age at birth. They underline the importance of management focused on nonverbal functions and further the debate about the early lateralization of language, the 'crowding effect', and the difference in brain plasticity between males and females.