Sequence memory skills in Spastic Bilateral Cerebral Palsy are age independent as in normally developing children

Abstract

Purpose: To study the development of sequence memory skills in a group of participants with Spastic Bilateral Cerebral Palsy (CP) and their matched controls (TD). Sequence memory skills are defined as a blend of implicit and explicit competences that are crucial for the acquisition and consolidation of most adaptive skills along the lifespan. Method: A computerized sequence learning task was administered to 51 participants with CP (age range: 4.1–14.7) and their controls. General performance, accuracy and learning strategy were analyzed, as well as cognitive competencies (IQ and explicit visual spatial memory). Results: Explicit learning developed along with age in all participants. Sequence learning skills were age independent and unevenly distributed among CP participants: most TD (96.1%) and only about half (58.8%) of CP participants succeeded in sequence learning, in dynamic relation with cognitive and manipulation abilities. Conclusion: Sequence memory skills should be verified to plan therapeutic strategies. Therapeutic plans based on implicit learning (more resistant to disruption and stress) could be effective and highly advantageous for most but not for all CP children. Independently from age, many CP children could fix sequences more efficiently by explicit strategies, a more effortful but probably more effective way.

Implications for Rehabilitation

“Sequence memory skills in Spastic Bilateral Cerebral Palsy (CP) are age-independent as in normally developing children”

• Sequence memory skills (a blend of explicit and implicit components) represent a basic competence whose impairment could in a dynamic perspective affect multiple motor and non-motor developmental features.

• The prevalence and importance of implicit learning as a point of strength in therapeutic choice has been formerly emphasized: implicit learning is far more resistant to disruption and stress during rehabilitation and therefore potentially far reaching.

• Sequence memory skills are unevenly distributed in our clinical group.

• A majority of CP participants (58.8%) can rely on efficient sequence learning and therefore may specifically benefit from therapeutic programs privileging implicit learning (that is, relying on progressive and not necessarily explicit consolidation of sequences).

• In those children failing to fix sequences, sequence learning skills need to be specifically supported and explicit strategies (such as for example verbal and visual guides along the task) could be helpful to support consolidation.

Keywords::

• Cerebral palsy
• development
• Sequence learning
• spatial memory

Declaration of Interest: The Authors report no conflicts of interest.