Language and cognitive outcomes after pediatric ischemic stroke: The role of linguistic diversity and age at stroke onset
Leung, K. I.; Westmacott, R.; Dlamini, N.; Rochon, E.; Molnar, M.
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Pediatric stroke disrupts ongoing neurodevelopment and often results in long-term cognitive challenges. For bilingual children navigating healthcare systems that underserve linguistically diverse families, these impacts raise critical health equity considerations. While bilingualism has historically been framed as a burden, research suggests it may support development in clinical populations. This cross-sectional study investigated how linguistic diversity relates to language and cognitive outcomes following arterial ischemic stroke, examining moderation by age at stroke onset. Twenty-nine children completed language and executive function assessments; caregivers reported language exposure and socioeconomic information. Analyses showed no main effect of linguistic diversity, but significant interactions with age at stroke. In the neonatal group, greater linguistic diversity was associated with better expressive language, whereas the presumed perinatal group showed the inverse pattern; childhood-onset stroke showed minimal associations. Findings suggest that bilingual environments do not impede, and may support, language following stroke, underscoring the importance of culturally/linguistically responsive care.
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