A stroke is something we tend to associate with old age, often together with smoking or poor diet. The outcome and long-term implications for these patients are relatively well-known. We expect and prepare for cognitive decline [1], or some leftover deficits that need appropriate management.[2]

There is, however, one less common circumstance worth considering: pediatric ischemic stroke. While it is a rare occurrence, it is one of the most important causes for brain injury in youth, leaving behind sequelae across multiple cognitive domains and affecting academic outcome in a manner that has yet to be properly determined.

Several studies do, however, point out that pediatric stroke can reach a mortality rate of up to XNUMX% and leave behind long-term neurological deficits in up to XNUMX% of survivors. These deficits may include verbal and nonverbal reasoning, processing speed, reading or mathematics, as well as socio-emotional skills. Altogether, they make these children particularly vulnerable to academic difficulties and more likely to be diagnosed with a learning disability [XNUMX]

Naturally, the extent of this deficit may depend on a variety of factors, including the location and extent of the lesion, as well as the age at the time of stroke. Particularities of the young brain, such as its remarkable plasticity, but also its vulnerability, need to be taken into account.

A recent study published in Child Neuropsychology by Claire M. Champigny et. al. [XNUMX] examined the academic outcome of XNUMX post-stroke children compared to a control group of XNUMX of their peers. Participants, aged between XNUMX and XNUMX, completed a series of neuropsychological assessments, but also brought in their latest report cards and evaluations from their caregivers regarding learning difficulties and social relationships.

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Before testing, a questionnaire evaluated the parents’ most significant concerns regarding their children’s educational difficulties. Results reported significant concerns regarding reading and verbal expression deficits, as well as problem-solving, math, handwriting and remembering information on tests.

It is also worth noting that many of the post-stroke patients were receiving some form of assistance during their studies, such as an individual educational plan, support, extra help or even access to assistive technologies (laptop, iPad). Children in the post-stroke group were, also, as expected, more likely to be diagnosed with a learning disability (XNUMX% vs XNUMX% in the control group).

Compared to the neuropsychological assessment, children with a history of stroke showed a slowdown in processing information it's a less verbal reasoning skills, albeit without major compromises in reasoning is not verbal.

Regarding school learning (reading, sentence comprehension, writing and mathematics), the researchers highlighted that subjects with stroke obtained scores significantly lower than their comrades. Further analyzes showed that these deficits they were not related to the hemispheric location of the lesion (right or left).

Surprisingly, despite challenges with their academic skills, post-stroke children received similar grades with their peers, although this may be a result of having a specialized curriculum.

In the end, this insightful overview of the effects pediatric stroke may have on academic performance concludes that post-stroke patients do, indeed, face difficulties compared to their peers, although that may not be well reflected by their grades. Despite its limitations, such as the small sample size, it provides interesting preliminary results that deserve further investigations.

What is, for example, the situation for children in less developed areas, where individualized support plans and assistive resources are not available?

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Large-scale, systematic studies are awaited to properly elucidate what impact pediatric stroke has on learning abilities, as well as how to properly manage it.

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Working memory and phonological awareness