Cerebral palsy (CP) is defined as non-progressive damage to the brain at or around birth, which leads to varying symptoms depending on the extent and location of damage. The leading symptom is sensory-motor impairment of varying expression, but additional perceptual, cognitive, and socio-emotional symptoms are common. CP can be divided into four types, with bilateral spastic being by far the most frequent, followed by the unilateral spastic, the dyskinetic, and the ataxic variants. The intellectual, linguistic, and cognitive profile of CP is extremely variant, but all qualities correlate more or less with CP type and motor impairment. Early diagnosis is important since early intervention may promote all developmental dimensions. Generally, individuals with unilateral spastic CP have the best (almost normal) intellectual, linguistic, and cognitive outcomes, while those with bilateral spastic CP fare the worst. Language perception is often an individual strength, while language expression, and particularly speech, may be heavily impaired. Attention and executive functions are often impaired as compared to typically developing controls, even in those children with normal intellectual functioning. The same holds true for visual perceptual functions, which are impaired in almost half of all children and adolescents with CP. The potential neuropsychological dysfunctions are a risk factor for arithmetic functions and literacy. Obstacles to participate in society are high for individuals with CP and heavily dependent on their motor, language, intellectual, and cognitive functions. However, quality of life is good for most children and adolescents, and they develop a sound self-concept. On the other side, bully experience is more common than amongst typically developing children and is associated with behavior problems and executive dysfunction. The development of children and adolescents with CP is determined by a complex interplay between physical, intellectual, and neuropsychological functions.
Karen Z. H. Li, Halina Bruce, and Rachel Downey
Research on the interplay of cognition and mobility in old age is inherently multidisciplinary, informed by findings from life span developmental psychology, kinesiology, cognitive neuroscience, and rehabilitation sciences. Early observational work revealed strong connections between sensory and sensorimotor performance with measures of intellectual functioning. Subsequent work has revealed more specific links between measures of cognitive control and gait quality. Convergent evidence for the interdependence of cognition and mobility is seen in patient studies, wherein cognitive impairment is associated with increased frequency and risk of falling. Even in cross-sectional studies involving healthy young and older adults, the effects of aging on postural control and gait are commonly exacerbated when participants perform a motor task with a concurrent cognitive load. This motor-cognitive dual-task method assumes that cognitive and motor domains compete for common capacity, and that older adults recruit more cognitive capacity than young adults to support gait and posture. Neuroimaging techniques such as magnetic resonance imaging (MRI) have revealed associations between measures of mobility (e.g., gait velocity and postural control) and measures of brain health (e.g., gray matter volumes, cortical thickness, white matter integrity, and functional connectivity). The brain regions most often associated with aging and mobility also appear to subserve high-level cognitive functions such as executive control, attention, and working memory (e.g., dorsolateral prefrontal cortex, anterior cingulate). Portable functional neuroimaging has allowed for the examination of neural functioning during real-time walking, often in conjunction with detailed spatiotemporal measures of gait. A more recent strategy that addresses the interdependence of cognitive and motor processes in old age is cognitive remediation. Cognitive training has yielded promising improvements in balance, walking, and overall mobility status in healthy older adults, and those with age-related neurodegenerative conditions such as Parkinson’s Disease.