ASSESSMENT OF SCHOOL READINESS IN SICKLE CELL CHILDREN

Abstract

Patients with sickle cell disease express a myriad of clinical signs and symptoms to varying degrees which affect their lifestyle and academic performance. Certain psycho-educational and psycho-social factors have been shown to influence the academic achievement of sickle cell patients, but no one has investigated the potential effects of pre-school development. We examined 5 children with sickle cell disease ages 4-6 and 5 age, sex and race matched controls for school readiness using the PEER (Pediatric Examination of Educational Readiness). The PEER assesses a child's performance in such areas of developmental attainment as visual input, verbal output, etc. The child's selective attention, adaptive behavior and processing efficiency were also measured. The sickle cell group scored significantly lower than their normal counterparts (p<0.025, t-test for paired variates) particularly in the areas of visual motor integration, motor sequential tasks, selective attention and processing efficiency. Four of the children with sickle cell disease were also tested with a standardized psychometric test (McCarthy Scales of Children's Abilities). There was a good correlation (r=0.8) between the PEER scores and the perceptual/performance component of the McCarthy Scales. Magnetic resonance imaging studies performed on 3 of the children with sickle cell disease for the detection of cerebral vascular accidents revealed no infarctions. These preliminary studies show that sickle cell children are developmentally less ready to enter school and this may contribute to their future academic underachievement.