Abstract

Objectives: Children with perinatal stroke may show evidence of contralateral spatial neglect. The goal of this study was to determine whether a clock drawing task commonly used in adults to identify neglect would be effective in detecting neglect in children with perinatal stroke. Methods: Thirty-eight individuals (age range 6-21 years) with left hemisphere (LH) or right hemisphere (RH) focal lesions and one hundred and seventy-nine age-matched controls were given the free-drawn Clock Drawing Task (CDT) in a cross-sectional design. An adapted scoring system with emphasis on evaluation of right- and left-sided errors was developed as part of the investigation. Results: Children with LH lesions made a greater number of errors on both the right and left sides of the clock drawing throughout all age subgroups (6-8 years, 9-14 years, and 15-21 years) compared to controls. Children with RH lesions showed greater left and right errors in the younger groups compared to controls, with significantly poorer performance on the left at 6-8 years, suggestive of contralateral neglect. However, at ages 15-21, the RH lesion subjects no longer differed from controls. Conclusions: Children with LH lesions demonstrate bilateral inattention, which is a pattern that is not seen in adults with LH lesions. The performance of RH lesion subjects suggests that contralateral neglect may be present at early ages, but diminishes at older ages. Our findings demonstrate the efficacy of the clock drawing test for comparing the performance of children with focal brain lesions to controls.