With respect to language, it has long been observed that children who experience early unilateral brain injury do not show the same irreparable damage as do adults with homologous late-onset strokes. Neural plasticity has been proposed as the explanation for such differential linguistic profiles; that is, the plasticity of the young, developing brain allows the possibility for extensive adaptation and organization following a neural insult. Recent research, however, suggests that there are limits to this ability to adapt and organize. Results from a another communicative system, affect, suggest that children with unilateral pre- or perinatal stroke show similar (albeit subtler) effects to adults with homologous late-onset injuries. This chapter presents findings on language development in children who sustained a pre- or perinatal unilateral stroke, and complements these studies with a discussion of affective expression in these same children. These prospective studies of children with perinatal stroke provide a unique window into the development of the neural substrates for language and affect. Specifically, they afford a context to investigate the degree to which particular brain regions may be privileged for specific behavioral functions, as well as how the developing brain adapts to organize alternative pathways in the wake of an early insult.
