A neurocognitive perspective on developmental disregard in children with hemiplegic cerebral palsy

A common problem in children with hemiplegic cerebral palsy (CP) is the asymmetrical development of arm and hand capacity caused by the lack of use of the affected upper limb, or developmental disregard. In this paper, we provide a neuropsychological model that relates developmental disregard to attentional processes and motor learning. From this model, we hypothesize that high attentional demands associated with the use of the affected upper limb might hinder its use in daily life, and therefore may be a factor in developmental disregard. This can be assessed with a dual-task paradigm. However, until now, this has not been applied to children with CP. We provide recommendations for using a dual-task paradigm in children with CP based on empirical studies in typically developing children and children with developmental coordination disorder. Ultimately, these dual-task studies may be used to improve interventions aimed at reducing developmental disregard.

► This review gives a neurocognitive account of developmental disregard in children with hemiplegic cerebral palsy. ► Lack of automaticity of movement, which can be assessed using a dual-task paradigm, is discussed in relation to developmental disregard. ► Recommendations are provided for future studies using a dual-task paradigm in children with hemiplegic cerebral palsy to investigate automaticity of movement of the upper limb.