Social Information Processing and Working Memory Following Pediatric Stroke

There is a dearth of research examining social competence following pediatric arterial ischemic stroke (AIS). Previous studies suggest that working memory (WM) and social information processing (SIP), two related individual characteristics that are critical for this construct, are compromised following pediatric AIS. However, research is limited and little is known about the effects of age at stroke and lesion location. Study 1 assessed the WM and SIP patterns of 32 children, aged 6 to 14, with histories of unilateral AIS and 32 controls using paradigms based on Baddeley and Hitch’s three-component WM model and Crick and Dodge’s six-step SIP model. Study 2 investigated the effects of age at stroke (i.e., perinatal, 1 month-5 years, 6-14 years) and lesion location (i.e., cortical, subcortical, and combined) on WM and social outcomes as rated by parents using a large, retrospective sample of children with unilateral AIS. Evidence was found for isolated, subtle difficulties in social cue encoding and decoding in children with AIS compared to controls. Children with AIS also consistently scored significantly lower than controls across WM indices and performance correlated with many SIP measures. Children who suffered a stroke between 1 month and 5 years were rated more favourably by parents on social skills than children who suffered a stroke between 6 and 14 years. No evidence was found for an effect of lesion location on WM and social outcomes, nor was there an effect of age at stroke on WM. These findings suggest that social competence in children with AIS may be compromised by subtle, interrelated difficulties in WM and SIP. Continual follow-up is recommended, as the subtle nature of these challenges increases the likelihood that they will go undetected. Moreover, the long-term trajectories of WM and social outcomes in the pediatric stroke population remains unknown.