Assessing Cognitive Impairment in Children


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As children grow, there is a certain standard of cognitive development that is expected to take place, based on various accepted norms on the level of cognitive functioning that should be reached by certain ages or milestones.


Examples of cognitive functioning include language skills, motor skills, interpersonal skills, memory, and more. When a child demonstrates a delay in development or a lack of ability in one of these areas they may be suffering from cognitive impairment.

Cognitive impairment is defined as struggling in one of the major areas of cognitive functioning (as mentioned above) to the point where it affects an individual’s everyday life; it can be mild to severe depending on the person.

Most often, symptoms of cognitive impairment show up in early childhood and can become more pronounced as the child grows older. This is especially true and significant for children who suffered from a serious illness or injury that could have affected the ability of their cognition to development normally.

Signs and Symptoms of Cognitive Impairment in Children Are:

  • Difficulty focusing or short attention span
  • Poor memory recall
  • Struggling to communicate (either verbally or in writing)
  • Poor or delayed motor skills
  • Difficulty following directions
  • Difficulty learning or keeping up with peers
  • Trouble organizing or expressing thoughts or emotions

These symptoms aren’t exclusive and cognitive impairment can manifest itself differently child to child, but these are general symptoms that can be watched for to indicate potential cognitive impairment in children and its level of severity.

Tools for Assessment

When it comes to assessing cognitive impairment, there are a few well-accepted measures clinicians use to evaluate how well a child’s cognition is developing based on comparisons to established standards.

These measures include general intelligence, non-verbal intelligence, academic achievement (for school age children), attention and executive functioning, memory and learning, visual-motor skills and general motor functioning, and language. For each of these individual measures you will find various clinical assessments to use for evaluating a patient.

However, it’s important to note that when selecting an assessment to evaluate a child’s cognitive functioning you should properly vet it for its reliability, accuracy and level of acceptance amongst other professionals in your field.

To help guide your assessment selection, a third party clinical assessment partner can be an invaluable resource. They’ve already vetted the assessments they offer, which means that you’ll have to do less personal research into an assessment to assure it’s an acceptable evaluation tool.


One such tool that works well for evaluating children for cognitive impairment is the SDMT – Symbol Digit Modalities Test. This assessment can be used to evaluate both children and adults for cognitive impairment in fewer than five minutes and is comprised of simple substitution tasks that children and adults should be able to complete if their cognitive functioning is normal.

Responses to the tasks can be given orally or in writing. When they are unable to do this, the SDMT is able to detect even subtle changes, delays in, or difficulties with cognition. With this information you will then be able to determine a treatment plan that will work best for a given patient or determine if current treatment is working or needs to be adjusted.


This article is for informational/educational purposes only. Healthtian does not provide medical advice, diagnosis, or treatment, read more.


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