The posterior fossa region of the brain is a frequent site for tumour development in children, with over half of all childhood tumours occurring at this site. The principal brain structure implicated at this site is the cerebellum. Children treated for posterior fossa tumours can have a wide range of neurological and psychosocial problems. This paper describes the literature to date that addresses the neuropsychological impact of tumour and treatment in children with posterior fossa tumours. This paper reviews the literature on the causes of morbidity in this group. It discusses the recent research on the role of the cerebellum in outcomes and the studies that identify variables that interact with radiation effects.

Children with frontal lobe damage often appear to demonstrate remarkable recovery with few apparent signs of impairment immediately after injury. Over time, however, many develop increasing deficits in self-regulation, attention, and executive function, as well as in other higher functions. Current literature suggests that, in particular, these children seem to experience worsening socio-behavioural problems. Some case studies (Grattan & Eslinger, 1992; Anderson et al., 1999) describe individuals with childhood frontal lesions who developed severe social problems, deficits in executive functions and who also had lower than expected levels of moral reasoning. In the present study, social-adaptive behaviour and maturity of moral reasoning were measured in 16 children with focal frontal lesions and in 12 age-matched controls. Children with frontal lobe lesions had poorer adaptive behaviour ratings and lower levels of moral maturity than controls. These results support previous research suggesting that children with frontal lobe lesions have reduced social understanding and typically experience ongoing sociobehavioural problems.

Previous studies have indicated an increased likelihood of intellectual and memory impairments in children with epilepsy. It has been argued that early surgical intervention in children with intractable seizures might be advantageous to their development. We conducted a retrospective review of pre- and postoperative IQ and verbal memory scores in 16 paediatric patients who underwent temporal (N = 10) or extra-temporal (N = 6) focal surgery for epilepsy. Patients with an extratemporal seizure focus performed significantly worse than patients with a temporal lobe seizure focus on Full Scale IQ and Verbal IQ before surgery. Postoperatively a statistically significant decline in verbal memory, but not in any of the IQ indices was noticed in the extratemporal group. Individual outcome analyses revealed a significant decline in verbal memory in 22% of temporal lobectomy and 60% of extratemporal cases. Our review suggests that verbal memory but not IQ is vulnerable to postoperative decline in children who undergo focal extratemporal surgery for intractable epilepsy. The findings raise the possibility that extratemporal regions play a role in anterograde memory in children. Given the small number of subjects in this study, further investigations into the cognitive effects of paediatric surgical intervention are recommended.

Findings are reported from the first examination of the Beardsworth Memory for Children's Faces Test (BMCFT) (Beardsworth & Zaidel, 1994) tested on a selected sample of 10 left (LATL) and 7 right (RATL) anterior temporal lobectomy patients an average of 7 years post surgery. No differences between LATL and RATL groups were found on immediate or delayed memory trials of the BMCFT. Verbal memory was assessed with a verbal analogue of this test, the Extended Verbal Paired Associates Test (EVPAT) specifically constructed for this study. Differences were obtained on the immediate (F = 5.17; p < .01) and delayed (F = 6.55; p < .01) memory trials of the EVPAT with LATL patients learning and retrieving fewer verbal associations than their right ATL counterparts. No differences were found on the memory decline to delayed recall scores on the EVPAT. The findings suggest that people who have left or right ATL in childhood cannot be distinguished on the basis of their immediate or delayed memory for paired faces an average of 7 years post-surgery. These results are consistent with the immediate memory performance of children 6 months post-surgery as reported by Beardsworth and Zaidel (1994), but are not consonant with the delayed memory performance of their children on this task. This indicates that left-right dissociations found in children on measures of delayed memory for faces 6 months post-surgery may represent a component of memory that is still in a state of recovery. The findings for the immediate memory trials of the EVPAT conformed to expectations and underscore the dependability of simple rote verbal memory tasks in dissociating left from right ATL 7 years post-surgery. The study addresses the issue of the recovery of immediate versus delayed memory and time of assessment post-surgery.

Functional magnetic resonance imaging (fMRI) has been recognised as a neuroimaging technique suitable for examination of higher cognitive function in children. It has been used to elucidate cognitive neural networks associated with various aspects of language function in several group and case studies of school-aged children. Language function has been lateralised and localised with fMRI in clinical samples, neurologically normal children and children with developmental language disorders. Issues of plasticity of language function during development and following injury have also been considered. Several paediatric case studies have also raised questions with respect to the interpretation of fMRI language activation. In spite of methodological challenges, fMRI has proved a useful technique for examination of the brain-behaviour relationship in developmental language functions. This paper reviews fMRI studies of language, including reading, in children.