Intellectual Profiles in Children with Unilateral and Bilateral Cerebral Palsy: A Multilevel Analysis of the Wisc-Iv Scale

Objective Cerebral palsy (CP) is a neurodevelopmental disorder primarily affecting motor functioning and often accompanied by cognitive impairments. Although intellectual profiles in children with CP are known to be heterogeneous, standard intelligence assessments often rely on a single global IQ score, which may obscure important intra-individual differences and limit clinical usefulness. This study aimed to explore intellectual functioning in children with unilateral and bilateral spastic cerebral palsy using a detailed multi-level analysis to examine how motor impairments may influence performance on WISC-IV indices and subtests. Method A cross-sectional study was conducted on 48 children aged 6-15 years with spastic cerebral palsy (24 unilateral, 24 bilateral). Inclusion required at least one WISC-IV index score above 80. Intellectual functioning was assessed through Full Scale IQ, four cognitive indices (verbal comprehension, perceptual reasoning, working memory, processing speed), and individual subtests. Participants were classified by cerebral palsy type and gross motor function level. Descriptive and comparative statistics identified significant group differences. Results Intellectual profiles showed marked heterogeneity. Over half of the children showed marked discrepancies among WISC-IV index scores, making the Full Scale IQ difficult to interpret as a representation of their overall cognitive functioning. Working Memory and Processing Speed were the most frequently impaired indices. Processing Speed deficits were consistent across CP types and motor levels, while Working Memory impairments were more pronounced in children with bilateral CP. Perceptual and verbal reasoning differences were more evident in bilateral cases. Greater motor impairment correlated with lower Perceptual Reasoning and Processing Speed scores, highlighting the influence of motor functioning on performance. Conclusions Detailed, multi-level assessments of WISC-IV performance provides a clearer understanding of cognitive functioning in children with CP. Considering indices and subtests in relation to motor constraints helps distinguish true cognitive abilities from motor-related limitations, supporting accurate diagnosis and targeted interventions.