title: Arithmetic difficulties in children with cerebral palsy are related to executive function and working memory.
abstract: BACKGROUND
  Although it is believed that children with cerebral palsy are at high risk for learning difficulties and arithmetic difficulties in particular, few studies have investigated this issue.
  
  
  METHODS
  Arithmetic ability was longitudinally assessed in children with cerebral palsy in special (n = 41) and mainstream education (n = 16) and controls in mainstream education (n = 16). Second grade executive function and working memory scores were used to predict third grade arithmetic accuracy and response time.
  
  
  RESULTS
  Children with cerebral palsy in special education were less accurate and slower than their peers on all arithmetic tests, even after controlling for IQ, whereas children with cerebral palsy in mainstream education performed as well as controls. Although the performance gap became smaller over time, it did not disappear. Children with cerebral palsy in special education showed evidence of executive function and working memory deficits in shifting, updating, visuospatial sketchpad and phonological loop (for digits, not words) whereas children with cerebral palsy in mainstream education only had a deficit in visuospatial sketchpad. Hierarchical regression revealed that, after controlling for intelligence, components of executive function and working memory explained large proportions of unique variance in arithmetic accuracy and response time and these variables were sufficient to explain group differences in simple, but not complex, arithmetic.
  
  
  CONCLUSIONS
  Children with cerebral palsy are at risk for specific executive function and working memory deficits that, when present, increase the risk for arithmetic difficulties in these children.
authors.affiliation: Behavioral Science Institute, Radboud University Nijmegen, P.O. Box 9104, Nijmegen 6500 HE, The Netherlands. k.jenks@pwo.ru.nl
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Jenks
authors.forename: Jan
authors.initials: J
authors.lastname: de Moor
authors.forename: Ernest C D M
authors.initials: EC
authors.lastname: van Lieshout
mesh_terms: D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008433:Mathematics; D008569:Memory Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D008570:Memory, Short-Term; D009426:Netherlands / Q000453:epidemiology; D011930:Reaction Time; D013647:Task Performance and Analysis