Academic Outcome in Pediatric Stroke: A Multifaceted Approach to Exploring Challenges and Achievements

An important cause of acquired brain injury in children, pediatric stroke causes sequelae across a wide range of cognitive domains, including expressive language, attention, memory, and processing speed. As a result, survivors are especially vulnerable to academic difficulties and face unique challenges compared to their peers. Despite this knowledge, pediatric stroke remains an understudied neurological condition, and its impact on school functioning poorly understood. The present thesis addresses academic outcome in pediatric stroke with two manuscripts. The first, a systematic review, explores the tools chosen by researchers to measure academic outcome in this population. An examination of the limitations of research methodologies paves the way for discussions and recommendations for improvement. The second manuscript, a clinical research study, assesses academic outcome using a multifaceted approach. Patients in the Childrens Stroke Program at the Hospital for Sick Children were recruited for participation. Results indicate that, compared to their peers, youth with stroke exhibit deficits in processing speed and basic academic skills, require more school accommodations, and are more likely to receive a learning disability diagnosis. Analyses suggest that processing speed and reading ability predict grades for youth with stroke over and above the effects of intelligence. Finally, school grades, school-related quality of life, and symptoms of Attention Deficit Hyperactivity Disorder were all comparable between groups. Ending with an overarching discussion connecting both studies, the present thesis makes a meaningful contribution to the field of pediatric stroke and promotes a more nuanced understanding of the academic struggles and achievements that survivors experience.