Over the past ten years, we have made significant progress in addressing key questions concerning deficit and development after early stroke. We found evidence of subtle early impairment and subsequent development in each domain examines. However, the profiles of impairment and development differed across domains. Deficits of language acquisition are initially pervasive in that they are observed following injury to widely distributed brain areas. Spatial analytic deficits exhibit more specific patterns of brain-behavior association, similar to those observed among adults with injury to comparable brain regions. We have to look for ways to resolve the apparent disparity in our cross-domain findings. The model that best fit our data focuses on redefining the nature of early plasticity. Recent animal studies provide strong evidence that plasticity plays a central role in brain development. Brain organization is to a large extent defined by the changes in patterns of connectivity that occur as a result of input to the maturing system. Early injury constitutes a perturbation of normal development. Specific neural resources are lost, and there is consequent impairment of the system. However, it is also a developing system and therefore a system with an exuberance of resources the fate of which are determined in large measure by input. Thus, the magnitude and duration of the initial impairment may well depend on a range of factors such as the timing of insult, extent and location of injury, and specificity of the neural substrate for athe function under consideration. In the next phase of the injury, and specificity of the neural substrate for the function under consideration. In the next phase of the project, we will extend our investigation of the long-term effects of early injury on development. We have made considerable headway in defining developmental profiles in the preschool and early school-age period. Less is known about change in the later school years. One goal for the next phase will be the focused examination of development within and across these domains. We will also initiate a full-scale study of two other important domains, spatial attention and executive functioning. We have initiated a collaboration with Eric Courchesne at UCSD who has an international reputation for studies of attention of normal and impaired populations. He has proposed studies focused on the basic mechanisms of attention which are important to our understanding of performances in other domains. Finally, we will begin to examine the development of executive functioning ina the FL population. Planning is key to a wide range of problem solving activities. Limitations on the initiation or flexibility of planning skills could have serious consequences for the development of children with early injury.
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