We investigated attentional outcome after childhood stroke and
orthopedic diagnosis in medical controls. Twenty-nine children with
focal stroke lesions and individually matched children with clubfoot or
scoliosis were studied with standardized attention and neuroimaging
assessments. Stroke lesions were quite varied in location and commonly
involved regions implicated in Posner's model of attention
networks. Children with stroke lesions performed significantly more
poorly regarding attention function compared with controls. Performance
on the Starry Night, a test demanding alerting and sensory-orienting
but not executive attention function, was significantly associated with
lesion size in the alerting and sensory-orienting networks but not the
executive attention network. Furthermore, earlier age at lesion
acquisition was significantly associated with poorer attention function
even when lesion size was controlled. These findings support the theory
of dissociable networks of attention and add to evidence from studies
of children with diffuse and focal brain damage that early insults are
associated with worse long-term outcomes in many domains of
neuropsychological function. In addition, these results may provide
clues towards the understanding of mechanisms underlying attention in
children. (JINS, 2004, 10, 976–986.)