Spatial grouping activity in young children with congenital right or left hemisphere brain injury

Spatial grouping abilities were examined in 20 preschool-aged children with right or left hemisphere congenital focal brain injury, and a group of age-matched normal control children. Children were presented with a series of spontaneous grouping tasks in which they were given small sets of blocks and asked to play with them. Although the children with focal brain injury played as actively with the blocks as normal children, the constructions they produced differed systematically. Across eight measures of spatial grouping both children with right and left hemisphere injury were delayed compared to normal children. In addition, the behavioral profiles for the two groups of children with focal brain injury were qualitatively different. Data for the children with RH injury suggested difficulty organizing objects into coherent spatial groupings, while data from the children with LH injury suggested difficulty with local relations within the spatial arrays. These findings are consistent with data reported for adults on spatial construction tasks. Developmental trajectories in the 3- to 4-year age period suggest, further, that the spatial integrative deficits observed in the children with RH injury are persistent. When the children began to produce spatial constructions using complex grouping procedures, those constructions were heaps or disordered clusters. In contrast, when children with LH injury began to use complex procedures, they generated the types of constructions usually associated with those procedures in normal children, e.g., arches, enclosures, and symmetries. These data were found within a cross-sectional study of 20 children and confirmed in a series of six longitudinal case study reports of three children with RH and three with LH injury. The data confirm our previous reports of spatial integrative deficit associated with early RH injury and present the first indication of spatial encoding deficits in children with LH injury.