Cognitive correlates of mathematical achievement in children with cerebral palsy and typically developing children

Background. Remarkably few studies have investigated the nature and origin of learning difficulties in children with cerebral palsy (CP). Aims. To investigate math achievement in terms of word-problem solving ability in children with CP and controls. Because of the potential importance of reading for word-problem solving, we investigated reading as well. Sample. Children with CP attending either special (n = 41) or mainstream schools (n = 16) and a control group of typically developing children in mainstream schools (n = 16). Method. Group differences in third grade math and reading, controlled for IQ, were tested with analyses of co-variance (ANCOVAs). Hierarchical regression was used to investigate cognitive correlates of third grade math and reading. Predictors included verbal and non-verbal IQ measured in first grade, components of working memory (WM) and executive function (EF) measured in second grade, and arithmetic fact fluency and reading measured in third grade. Results. Children with CP in special schools performed significantly worse than their peers on word-problem solving and reading. There was a trend towards worse performance in children with CP in mainstream schools compared to typically developing children. Conclusions. Impairments of non-verbal IQ and WM updating predicted future difficulties in both word-problem solving and reading. Impairments of visuospatial sketchpad and inhibition predicted future word-problem, but not reading difficulty. Conversely, deficits of phonological loop predicted reading but not word-problem difficulty. Concurrent arithmetic fact fluency and reading ability were both important for word-problem solving ability. These results could potentially help to predict which children are likely to develop specific learning difficulties, facilitating early intervention.