The neuropsychological and behavioural sequelae of children with myelomeningocele and hydrocephalus.

摘要

Thirty-six myelomeningocele children with hydrocephalus (between 9-16 years of age) were evaluated on a battery of neuropsychological tests and behavioural measures. The children obtained a FSIQ on the WISC-R of greater than 60 and all were attending school on a regular basis.;Results showed that the myelomeningocele children, as a group, performed as well as the normative sample on measures of auditory comprehension, fine motor speed, accuracy on a visuomotor speeded task, stereognosis, and single-word reading.;The myelomeningocele group performed below the level expected for their age on the remaining measures in the neuropsychological test battery (83.63% of tests administered).;The mean composite scores on the WISC-R (FSIQ, VIQ, and PIQ) fell within the low average range of psychometric intelligence (IQ 80-89).;The measures that presented the most difficulty were: (1) those requiring perceptual-motor skill and processing speed, (2) those requiring attention, and (3) those involving learning and memory of verbal and visually presented material. Poor performance on a measure of computational mathematics as well as a measure of verbal fluency (reflecting word-finding difficulties) were also characteristic of this group. These results were compared with findings obtained from studies of other groups of brain-injured children.;Information obtained from the behavioural measures showed delayed achievement in social competence skills. These findings are not surprising in light of the neuropsychological deficits in this sample. The myelomeningocele children as a group did not exhibit a negative self-concept.;Results showed that the degree of neuropsychological and adaptive impairment was related to a number of factors: the level of lesion, a history of ocular abnormalities and/or intrauterine hydrocephalus. That is, the pattern of neuropsychological impairments was similar for the myelomeningocele children as a group, but the degree of impairment appeared to be related, in parts to medical factors.;With regard to socioeconomic status, results showed that in general children from families with more education and income were doing better in terms of cognitive abilities and daily living skills. Children from the lower socio-economic group exhibited significant impairment on measures of verbal ability. (Abstract shortened with permission of author.)