A prospective examination of neuropsychological functioning in preschool-age children with sickle cell disease and its association with psychosocial factors.

摘要

There is limited research involving neuropsychological functioning in preschool-age children with SCD; research on older children with SCD has found inconsistent deficits across domains of neuropsychological functioning. The present study prospectively examined neuropsychological functioning in preschool-age children with SCD. Current neuropsychological functioning, as well as change in functioning over a 1-year period was assessed; psychosocial factors at baseline were used to predict current neuropsychological functioning.; Participants included children with SCD who participated in the baseline study (N = 18; Mage = 67.5 months, range = 54--85 months) and completed a neuropsychological battery assessing the following domains of functioning: General Intelligence, Language, Motor Skill, Memory/Attention, Visuospatial Skill, and Reasoning. Illness-related risk factors were assessed through research/medical chart review. Psychosocial risk factors were assessed through parent report measures; a semi-structured interview was also conducted to examine the family's ability to follow treatment recommendations from the baseline assessment and to obtain details about daycare/preschool placement.; Results indicated that our sample performed significantly below the normative mean on all measured areas. No significant changes were noted between performance at baseline compared to the present when standard scores were examined (greatest non-significant decline noted in the Reasoning Domain of 4.6 points). Maternal income/education (baseline) was the strongest predictor of present functioning, however, disease severity was the sole predictor of the Memory/Attention domain. Furthermore, parent report indicated that the Metacognition Index (Working Memory and Plan/Organize subscales) from the BRIEF-P was of greatest concern.; Findings add to the limited literature on neuropsychological functioning in preschool-age children with SCD and indicate performance significantly below the normative sample in several areas of functioning, associated primarily with maternal and socioeconomic factors. Although these children were progressing slower than the normative sample, they were making gains and are capable of learning. Therefore, early intervention and support surrounding specific strengths and weaknesses may help children with SCD develop at an age-appropriate pace. Furthermore, information from the present study highlight memory/attention and reasoning skills in children with SCD as an area that may be screened to identify those children at greatest academic/developmental risk.