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Performance of Visual Spatial Attention and Visual Perceptual Skills in Children with Hemiplegic Cerebral Palsy in Taiwan
Cerebral Palsy,visual spatial attention,visual perceptual skills,computerized assessment,hemiplegia,
|Publication Year :||2019|
Introduction: In hemiplegic cerebral palsy (CP), the most common type of CP, unilateral motor disability is caused by a non-progressive lesion of the immature brain. The performances of visual spatial attention (VSA) and visual perceptual skills (VPS) have often been reported to be impaired in children with hemiplegic CP, and they require comprehensive investigation.
Objective: The aims of this study were (1) to compare the performances of VSA and VPS between children with hemiplegic CP and typically developing children (TDC) in Taiwan, as well as to compare the performances of VSA between the contralesional and ipsilesional fields in children with hemiplegic CP; (2) to examine the relationships of VSA and VPS in children with hemiplegic CP and TDC; and (3) to investigate the performance differences of VSA and VPS between children with left and right hemiplegic CP.
Methods: Thirty children with hemiplegic CP (15 males and 15 females, mean age 9 y 7 mo ± 2y 0 mo) and 30 TDC (9 males and 21 females, mean age 8 y 6 mo ± 1y 9 mo) were recruited in this current study. In the CP group, 15 children with left hemiplegic CP (mean age 10 y 5 mo ± 1 y 11 mo) and 15 children with right hemiplegic CP (mean age 8 y 9 mo ± 1y 10 mo). VSA and VPS were measured with the Random Visual Stimuli Detection Task (RVSDT) and the Computerized Visual Perceptual Skills Assessment (CVPSA), respectively. Each participant was assessed with the RVSDT and CVPSA within one week.
Results: Significant differences were found between the CP and TD groups in VSA and VPS, as analyzed by one-way mixed analysis of covariance (ANCOVA). In the CP group, there was no significant difference in VSA between dominant and non-dominant field as analyzed by paired t-test. The correlation of VSA and VP in the CP and TD group was analyzed by pearson’s correlation test. In the CP group, moderate to high correlations between the miss rates of VSA and total visual perceptual scores were observed (Peripheral Non-dominant r = -.66, p < .001; All peripheral r = -.66, p < .001), while the miss rates of VSA did not reach a moderate relation to total visual perceptual scores in the TD group. In the TD group, moderate to high correlations between the reaction times of VSA and total visual perceptual scores were found (Peripheral Non-dominant r = -.66, p < .001; All peripheral r = -.63, p < .001), while the relationship between the reaction times and total visual perceptual scores was relatively low in the CP group. Performance on visual spatial attention and visual perceptual skills did not differ between children with left hemiplegic CP and those with right hemiplegic CP as analyzed by ANCOVA.
Conclusion: This study demonstrates that children with hemiplegic CP have difficulties in VSA and VPS. Children with hemiplegic CP seem not to perceive visual stimuli in both contralesional and ipsilesional space. The VSA problems appear to be accompanied by VPS impairment in this population. In addition, VSA and VPS might not be lateralized in children with hemiplegic CP, for children with right and left hemiplegia performed at equal levels. This study highlights the importance of considering both VSA and VPS in this population. Specialized and tailored treatments should be provided for both right and left hemiplegic CP.
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