Executive Functioning and its Relationship to Academic and Social - Emotional Outcomes in Children with a History of Arterial Ischemic Stroke

Thirty-two pediatric patients with stroke and 32 demographically equivalent, healthy controls were tested on standardized measures of working memory, arithmetic, and spelling. EF and social-emotional behavioural data were collected via standardized parent questionnaires. Relative to controls, working memory performance of stroke participants was significantly lower across all tasks. Stroke participants demonstrated poorer functioning in both metacognitive and behavioural regulatory EF domains and significantly lower achievement on tests of math and spelling. Untimed pencil and paper arithmetic was an area of particular concern, as math impairment was documented in 40% of the tested stroke participants. Metacognitive EF abilities predicted academic achievement, and behavioural regulatory EF predicted social-emotional functioning. Furthermore, increased time since stroke and larger stroke lesions were associated with poorer academic outcomes, as indicated by retrospective analysis of a large patient database. Findings assist with accurate prognosis and indicate need for early post-stroke cognitive intervention in affected children and youth.