Development of executive functions in children with frontal lobe lesions

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Executive functions (EF), refer to the ability to problem solve, think flexibly and in abstract terms and pay attention. EFs are essential for managing daily life activities. The frontal lobes of the brain are believed be important in coordinating EFs. In childhood, frontal areas are developing rapidly and damage may affect ongoing development due to impairments in a child's capacity to function normally within their environment, interfering with adaptive functions such as new learning and reasoning. Executive dysfunction in children manifests as disorganisation, impulsivity, inattention and inappropriate behaviour. Such problems are often masked in early chilhood, due to highly structured environments and support of parents and care-givers in day-to-day activities. However, as children mature, expectations of indepence increase and executive deficits become more apparent (ie. child 'grows into' these problems). Appropriate treatment and management is dependent on (i) improvement in early identification of patients at risk for such sequelae; (ii) establishing long-term consequences of executive deficits to ongoing development. This research aims to advance our understanding of EFs and their development through childhood, both in healthy children and children with cerebral lesions to regions believed to subsume EFs(ie the frontal lobes). While anecdotal case data is available, to our knowledge, no other study has attempted to do this using a longitudinal group design. Specific predictions include; (i) Children with frontal lobe damage will perform more poorly on EF measures, in comparison to children with damage to other cerebral areas and healthy children; (ii) Children with frontal lobe damage will show increasing deficits on EF tasks over time, reflecting an inability to acquire executive skills in the expected time frame, when compared with children with localised damage to cerebral areas excluding the frontal lobes, and healthy children.