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

Abstract

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.

Whole-brain structural connectivity in dyskinetic cerebral palsy and its association with motor and cognitive function

“…This pattern of involvement, which mainly comprises parieto‐occipital areas, coincides with previous findings on spastic CP [Ceschin et al, ; Nagae et al, ]. Ceschin et al [] identified several parieto‐occipital nodes with a reduced nodal efficiency, local efficiency and clustering coefficient, and suggested that an altered occipito‐parietal network of disordered connectivity may underlie visuoperceptual dysfunction, an impairment that is estimated to occur in 40–50% of CP cases [Ego et al, ] and that has also been found in our sample (Table ). A possible explanation for the involvement of sensorimotor areas could be related to the high metabolic rate of the primary sensory and motor cortex in the newborn period [Chugani, ; Rennie et al, ] becoming, among other structures, a target region in the event of acute brain asphyxia, which is a common cause of dyskinetic CP [Himmelmann et al, ].…”

Visual perception, visual-spatial cognition and mathematics: Associations and predictions in children with cerebral palsy

“…Many children with CP have visual-spatial perceptual impairments despite typical or near-typical visual acuity (Akhutina, Foreman, Krichevets, & Vahakuopus, 2003;Ego et al, 2015;Menken, Cermak, & Fisher, 1987;Reed & Drake, 1990;Ortibus, Lagae, Casteels, Demaerel, & Stiers, 2009;Stadskleiv, Jahnsen, Andersen, & von Tetzchner, 2017). Ego et al (2015), in a systematic review of visual-perceptual impairments in children with CP, identified 15 studies which included one of five standardised tests that assessed visual perception.…”

“…Ego et al (2015), in a systematic review of visual-perceptual impairments in children with CP, identified 15 studies which included one of five standardised tests that assessed visual perception. The review indicated that the proportion of children with visual-perception impairments ranged from 40% to 50%, with no study reporting a significant effect of CP subtype or IQ level, although the severity of neurological lesions appeared to be associated with visual perception abilities.…”

“…Children with CP have lower scores on Raven's Progressive Matrices (RPM or Raven's Progressive Coloured Matrices [RCPM], Raven et al, 2008) than chronologically age matched TD children (Jenks et al, 2012;Peeters, Verhoeven, Van Balkom, & De Moor, 2008). This is usually interpreted as indicating that the children have lower non-verbal intelligence as the task involves non-verbal reasoning, but matrices tasks have an important visual-spatial component and notably Ego et al (2015) in their systematic review included the RPM as a visual-perceptual assessment. Consequently, we were interested in investigating whether matrices tasks had similar relationships to mathematical abilities as other visualspatial tasks.…”

Anticipatory control and spatial cognition in locomotion and navigation through typical development and in cerebral palsy

“…Top-down disorders, instead, are those of spatial cognition and perception, and are very frequent in CP as well. 22 Our preliminary results, from 15 individuals aged 5 to 23 years, show that head anticipation was lacking in a subgroup of patients and highly variable in the whole sample. Trajectory curvature and variability were significantly higher in spastic diplegia than in controls.…”