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Spatial and motor neglect in children

From Service de rééducation des pathologies neurologiques acquises de l’enfant (Drs. Laurent-Vannier and Chevignard and G. Abada), Hôpital National de Saint Maurice; Service de médecine physique et de readaptation (Drs. Pradat-Diehl and Chevignard), Hôpital de la Salpêtrière, Paris; and U 472 INSERM Villejuif (Dr. De Agostini), France.

Address correspondence and reprint requests to Dr. Anne Laurent-Vannier, Service de rééducation des pathologies neurologiques acquises de l’enfant, Hôpital National de Saint Maurice, 14 rue du Val d’Osne, 94415 Saint Maurice Cedex, France; e-mail: a.laurentvannier{at}hopital-saint-maurice.fr

Objective: To determine if unilateral spatial neglect can be found in very young children with acquired brain lesions.

Methods: A retrospective study was carried out over a 10-year period in a pediatric rehabilitation department specializing in acquired brain lesions. Twelve cases were selected involving children aged 7 months to 14 years. Neglect was assessed by behavior observation for all children and, depending on age, by drawing, copying, reading, writing, and arithmetic tasks. Seven patients underwent the experimental "Teddy Bear" cancellation task, specially adapted to children.

Results: All children exhibited spatial and motor neglect in daily activities. In addition, children who were over 2 years of age made lateralized omissions in paper and pencil tasks as well as in the "Teddy Bear" cancellation task. Nine of the 12 children exhibited left spatial and motor neglect, whereas the other three, all of whom were very young (under 4 years), exhibited right spatial neglect. In three cases, cortical lesions were restricted to one lobe, either the parietal, frontal, or temporal. In eight children, lesions extended over more than one lobe, and one child sustained only subcortical lesions.

Conclusion: Unilateral spatial and motor neglect occurs even in very young children. Right spatial neglect described in very young children may be related to the development of hemispheric specialization.

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