Quality of life and psychosocial functioning in childhood stroke

Stroke in childhood is rare but can have long-lasting significant consequences. This chapter shows that approximately three quarters of children with stroke have resulting functional and physical disabilities. Physical and psychosocial problems have been ranked by young people who have experienced childhood stroke as the biggest source of impairment, while parents have indicated that the emotional domain is the most affected. Approximately 50% of children with stroke have a psychological, behavioral, or psychiatric diagnosis (most commonly attention deficit hyperactivity disorder, anxiety or mood disorders), and one in five receive more than one diagnosis. A significant proportion of children with stroke have long-term difficulties in many psychosocial domains, and an estimated 50% require additional educational assistance. Childhood stroke is associated with higher levels of emotional, behavioral, and social problems, and fatigue is also commonly reported. Health-related quality of life (HR-QoL) is often significantly reduced following childhood stroke. Parental well-being and sibling HR-QoL can also be affected. Clinical assessment of psychosocial difficulties in children with stroke is vital, to develop tailored interventions and improve HR-QoL for children with stroke and their families.