title: Measuring intellectual ability in children with cerebral palsy: can we do better?
abstract: Standard intelligence tests such as the WPPSI-III have limitations when testing children with motor impairment. This study aimed to determine the proportion of children with cerebral palsy with sufficient verbal and motor skills to complete the WPPSI-III, to determine their comparative ability to complete tasks with and without a significant motor component, and to investigate short forms of the WPPSI-III as alternatives. Participants were 78 of 235 eligible 4-5 year old children with cerebral palsy resident in the Australian state of Victoria. Verbal IQ (VIQ), Performance IQ (PIQ), and Full-scale IQ (FSIQ) were determined using the WPPSI-III. Initial screening for pointing and verbal abilities determined which tests were attempted. The impact of speed was investigated by comparing scores on the Block Design subtest with and without an imposed time limit. FSIQ scores were calculated from two short forms of the WPPSI-III and compared to the full form. On screening, 16 children had inadequate pointing (14) and verbal abilities (2). FSIQ was obtained in 62 (82%) children. Strong associations were seen between completion of the entire test battery and topographical pattern, level of manual ability and level of gross motor function. Scores on subtests requiring manual ability were depressed relative to other scores. Children performed better using short forms of the WPPSI-III and, for a minority, when time limits were disregarded. In summary, children with cerebral palsy often lack the fine and gross motor skills necessary to complete the WPPSI-III, scoring relatively poorly on tasks requiring a fine motor response. Using short-form estimations of FSIQ comprised of subtests without a significant fine motor component has the potential to increase a child's FSIQ by approximately 5 points. These findings have important clinical implications when assessing a child with both motor and cognitive limitations.
authors.affiliation: Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Psychological Science, LaTrobe University, Melbourne, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sherwell
authors.affiliation: Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia. Electronic address: sue.reid@mcri.edu.au.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Reid
authors.affiliation: Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia; Department of Developmental Medicine, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Dinah S
authors.initials: DS
authors.lastname: Reddihough
authors.affiliation: Department of Psychology, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Jacquie
authors.initials: J
authors.lastname: Wrennall
authors.affiliation: Psychological Science, LaTrobe University, Melbourne, Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Ong
authors.affiliation: Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia; Psychological Science, LaTrobe University, Melbourne, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Stargatt
mesh_terms: D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D007361:Intelligence Tests; D007807:Language Tests; D008297:Male; D009048:Motor Skills; D014739:Victoria; D014888:Wechsler Scales
keywords: Cerebral palsy; Child; Cognition; Intelligence tests; Motor skills; Wechsler scales