Attentional skills and executive functions in children with early hydrocephalus

Measures of executive functions (Tower of London, Wisconsin Card Sorting Test), focused attention (cancellation tasks), and selective attention (Stroop test) were administered to 116 school-age children with shunted hydrocephalus, arrested (unshunted) hydrocephalus, and no hydrocephalus. The results revealed that children with shunted hydrocephalus solved fewer problems on the Tower of London task and achieved fewer categories on the Wisconsin Card Sorting Test than children with arrested and no hydrocephalus. However, most indices of executive functions derived from these two measures did not significantly differentiate the three groups. Children with shunted hydrocephalus also performed more poorly on the focused and selective attention tasks. However, their poorer performance was related to brain defects influencing motor speed and the transfer of information across the corpus callosum and not to specific effects of hydrocephalus. Children with hydrocephalus do demonstrate problems with attention and problem-solving skills. These differences are not as large as those observed on measures of spatial cognition and are not readily explained by hypotheses involving frontal lobe control of executive functions.