Pediatric unilateral spatial neglect: A systematic review.
Emerson Hart, Emily Grattan, Michelle Woodbury and 3 others
PMID 34459422WHAT IT FOUND
Pediatric unilateral spatial neglect often persists for years but is missed by simple paper-and-pencil tests.
Clinicians should use challenging functional tasks, eye tracking, or age-appropriate tools like the Teddy Bear Cancellation Test to detect it, as standard assessments frequently fail to identify the condition.
Key findings
01Standard paper-and-pencil tests often fail to detect pediatric unilateral spatial neglect, whereas functional and clinician-created assessments are more sensitive.
02Unilateral spatial neglect in children frequently persists long-term, requiring repeated assessment as the child ages and faces more complex daily demands.
03There is insufficient evidence to recommend specific treatments, as only three studies addressed intervention and none provided robust efficacy data.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The evidence base is very small and consists mostly of case studies and low-quality reports. No psychometric properties (reliability or validity) were reported for any of the 70 assessments used. The review included heterogeneous brain lesions (stroke, CP, TBI), so findings may not apply specifically to stroke survivors. Search terms for 'neglect' may have missed relevant studies due to confusion with child abuse neglect. Treatment studies were too few and poorly designed to support any clinical recommendations.
Declared interests
The study received support from the National Institutes of Health (N.I.H.) and non-U.S. government sources. No commercial conflicts of interest are reported in the provided text.
The easy way to misread this
Do not assume a child has recovered from unilateral spatial neglect because they pass a standard paper-and-pencil test. The review found that simple tests often fail to detect persistent neglect, which may only become apparent during complex, fatiguing, or functional daily activities.