Diagnosis Of Specific Learning Disabilities Research Articles

Intellectual functioning and executive functions in children and adolescents with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD)

Several studies have shown neuropsychological deficits across multiple domains in attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD), but differences and similarities between these disorders have been little considered. We were interested in analyzing the intellectual and executive profiles in a sample of children and adolescents, divided according to the diagnosis into the ADHD group and the SLD group, and in identifying the differences and similarities between these disorders. The sample included two clinical groups: the first included 36 children and adolescents with a diagnosis of ADHD (5-15years; mean=9.42; SD=2.22) while the second included 36 children and adolescents with a diagnosis of SLD (7-15years; mean=9.43; SD=2.25). The WISC-IV was used to measure intellectual ability and the NEPSY-II was employed to measure executive functions. The results showed that the SLD group had significantly higher scores than the ADHD group on the NEPSY-II in the inhibition, cognitive flexibility, short-term verbal memory and verbal working memory domains. The ANCOVA showed differences regarding the FSIQ of WISC-IV, in that the SLD group obtaining higher scores than ADHD group. Findings showed that ADHD children are more impaired than SLD children, in particular in cognitive inhibition, cognitive flexibility, verbal memory, working memory and intellectual functioning. The recognition of the strengths and weaknesses of children and adolescents with ADHD and SLD allows to outline an educational and clinical intervention focused on their specific executive and intellectual functioning.

The discrepancy between verbal and visuoperceptual IQ in children with a specific learning disorder: An analysis of 1624 cases

Children with a specific learning disorder (SLD) are often characterized by marked intellectual strengths and weaknesses. In the last few years, research has focused on a common discrepancy between low working memory and processing speed on the one hand, and high verbal and visuoperceptual intelligence on the other. SLD profiles featuring a specific discrepancy between verbal and visuoperceptual abilities have been only marginally considered, however, and their systematic comparison vis-à-vis typically-developing (TD) populations has yet to be conducted. The present study examined a dataset of 1624 WISC-IV profiles of children with a diagnosis of SLD. It emerged that the proportion of children with a Verbal Comprehension Index (VCI) at least 1.5 SD (22 standardized points) lower than their scores on the Perceptual Reasoning Index (PRI) was larger than the proportion of SLD children with the opposite discrepant profile; it was also larger than the same proportion found among TD children. Comparing the two discrepant profiles revealed that the children also differed by type of learning difficulty, gender, and performance in the WISC-IV Symbol search task. Further examination suggested that children who were discrepant and also distinctly poor in visuoperceptual intelligence were particularly slow in general processing.

Perception of Families of Children with Specific Learning Disorder: An Exploratory Study.

Background:Parents have a tremendous influence on their children's academic and social success. Unfortunately, a majority of them do not have a concrete idea on how to assist their children, impacting negatively on both the parents and the child. Currently, there is sparse research on parents' experiences in dealing with children with specific learning disorders (SLD). The current study was planned to explore the perception of families of children with SLD.Materials and Methods:Five focus group discussions (FGDs) including 30 parents of children with SLD aged between 8 and 14 years were carried out. Each group composed of five − seven participants. A format to guide FGDs was made to bring uniformity across groups. The transcripts were analyzed using the content analysis method to extract key conceptual themes.Results:The parents showed lack of conceptual knowledge with regard to the SLD symptomatology as well as proper guidelines to deal with their child's problem. They displayed negative attitudes and reactions toward their child's diagnosis of SLD, such as rejection, denial, over-protection, and loss of hope. Their caregiving was also perceived to place physical, personal, social, financial, and emotional burden by the majority of parents.Conclusion:The study highlights the experiences of parents dealing with SLD in terms of their inadequate knowledge, adaptational difficulties, and burden. The findings also reiterate the need to focus on family perspective and experiences when working with a learning-disabled child. Various supportive strategies are required to empower families, which would help alleviate their burden. Moreover, parents' training to strengthen child's learning skills is also warranted.

Daily motor characteristics in children with developmental coordination disorder and in children with specific learning disorder.

An association between learning disorders and coordination problems has been reported in several studies over the last few decades. In this study, we have investigated daily motor characteristics in children with a diagnosis of specific learning disorder (SLD) and compared them with those of children with developmental coordination disorder (DCD) and those of typically developing controls. Ninety-six children aged 5 to 12years were included: 29 with a diagnosis of SLD, 33 of DCD, and 34 controls. The Italian version of the Developmental Coordination Disorder Questionnaire 2007 (DCDQ-Italian) was used to measure children's coordination in everyday functional activities. The mean DCDQ-Italian total score was significantly lower in both SLD and DCD groups as compared with controls. Regarding subscores, both clinical groups scored significantly lower than controls on "Fine motor/handwriting" skills and on "General coordination." The DCD group scored also significantly lower than controls on "Control during movement." Moreover, clinical groups differed from each other, with SLD children scoring significantly higher on "Control during movement" and "General coordination" subscores. SLD children diverged from typically developing children in some motor skills during ordinary activities, and although this discrepancy was not as severe as in DCD children, it could have an impact on self-esteem and sport inclusion.

Neuropsychological profile in Italian children with neurofibromatosis type 1 (NF1) and their relationships with neuroradiological data: Preliminary results.

Neurofibromatosis type 1 is a genetic disorder associated with cognitive deficits, learning disabilities and behavioral problems. These domains appear to have a still controversial debated association with local areas of T2-hyperintensities on MRI images, called unidentified bright objects (UBOs). A cohort of 36 children (aged 7-11 years) included consecutively, underwent neuropsychological and behavioral assessment to determine their cognitive and neuropsychological profile, and the frequency of specific learning disabilities. MRI examination was used to determine the impact of UBOs' presence, number, and location on the cognitive, neuropsychological and behavioral profile, and also the presence of optic glioma. The mean full intelligence quotient was 104.6; only one child had mild intellectual disability. Forty one percent of children had a diagnosis of specific learning disabilities and reading was mainly involved. Twenty per cent had attention problems. All children had normal scores in visuo-motor and visuo-perceptual tests. UBOs were present in 94.0% of the MRI examinations. Two children had optic glioma. Children with UBOs in a specific location and children with UBOs elsewhere were statistically compared, no one of the location seemed to have an impact on general cognition measured with full intelligence quotient. The thalamus was associated with problems in calculation and striatum with behavioral problems. An inverse relationship between the number of UBOs and the full intelligence quotient was present, but without a statistical significance. In this study, the specific location of UBOs did not seem to influence the general cognitive profile and also the relationship between their number and the full intelligence quotient was not significant; these results are still controversial in literature. Finally, the presence of UBOs in the thalamus and striatum may represent a neuroradiological pattern that influences performances in calculation and behavior respectively in children with Neurofibromatosis type 1.

Qualitative and quantitative revaluation of specific learning disabilities: a multicentric study.

Specific learning disabilities are disorders that affect the instrumental skills of academic learning, leaving intact the general intellectual functioning. It is possible to distinguish: dyslexia, dysorthography, dysgraphia, and dyscalculia. The diagnosis is made according to DSMV. The aim of this study is to evaluate the implementation of Law N° 170 following a diagnosis of specific learning disabilities in children and their evolution over time. The sample under examination consists of 75 children, 56 males and 18 females aged 7,8 to 16 years, with a diagnosis of specific learning disabilities; a revaluation was carried outthrough the use of standardized instruments according to age and school attended. A twopart questionnaire was proposed: the first part turned to the parents/carers of the child and the second part turned to the boy himself. The improvement parameter has been linked, through a statistical analysis of univarianza with intelligence quotient, age, application of the law 10 October 2010 n 170, rehabilitative paths and attending afterschool program. Most of the guys are followed at school by the application of the law 170 and, outside school, by attending speech and neuropsychological therapy and after school. Going to investigate the actual use of the measures put in place by the school, it is evident a partial and incomplete application of Law 170. The most suitable measures for these children are pedagogical measures in order to make them integrate with the group class and strengthen their capacities through specific measures provided by a specific legislative decree.

P.3.023 - Efficacy of an omega-3/6 combination on specific learning abilities in children with mild to moderate inattentive ADHD - preliminary results

Background Attention Deficit Hyperactivity Disorder (ADHD) is a common child psychiatric disorder with a significant global functional impairment. Learning disorders represent a frequent comorbid condition in ADHD patients and recent research has investigated the effects of non pharmacological treatments for ADHD on learning abilities [1]. During the last two decades, there has been a growing interest in the role of essential fatty acids (EFA), based on the hypotheses that Omega-3/6 fatty acids seem to be deficient in ADHD individuals [2] and moderately effective in reducing inattention [3] and improving learning abilities [4]. Objectives Whitin a multicentric study the efficacy of a specific Omega-3/6 combination supplement was evaluated in a population of Italian children with predominantly Inattentive Type of ADHD (ADHD-I). The primary efficacy measure was the ADHD Rating Scale (ADHD-RS-IV) score for clinical symptoms. Among the secondary objectives we evaluated the efficacy of Omega3/6 supplement on learning abilities. Methods The study was a randomised, double-blind, placebo-controlled efficacy trial of Omega-3/6 combination in mild/moderate ADHD-I children (6-12 y), conducted in 4 Italian sites (Cagliari, Roma, Pisa and Messina), and including a screening and baseline assessment, a double blind evaluation phase of Omega-3/6 supplement vs placebo (6 months) and a following open label treatment phase of futher 6 months during which all subjects were on the Omega3/6 supplement. Learning abilities were assessed at baseline and at 6 and 12 months, by the Sartori reading and writing tests (Battery for the Evaluation of Dyslexia and Written Expression Disorder-lists 4,5,6,10,11 and 12) and the Cornoldi Reading Tests MT, using the number of errors as measure of accuracy and syllables/sec or total time as measure of reading speed. Results 160 drug naive ADHD Italian children (118 M; 42 F) were enrolled. Scores were analysed at baseline visit and after 6 and 12 months. Statistical significance was calculated by ANOVA for repeated measures, Friedman’s and Wilcoxon’s Test for non parametric data. In the total sample, 91 have a diagnosis of Specific Learning Disorder (SLD): in the PL group 47 have a SLD (35 with impairment in reading, 44 with impairment in written expression); in the OM group 44 have a SLD (32 with impairment in reading, 40 with impairment in written expression). The prevalence of SLD was not significantly different in the PL and OM groups. No significant effect was found in improving learning abilities within and between the two groups. A significant improvement was found at 6 and 12 months visits, in both groups, for ADHD-RS total score, ADHD-RS-Inattentive, and functioning, with no difference comparing the two groups. Further analysis are in due course. Discussion Preliminary results suggest no significant effect of Omega-3/6 supplementation on learning abilities but only a mild improvement in global functioning and in clinical symptoms, especially inattention, was found after at least 6 months without significant differences between Omega-3/6 dietary supplementation and placebo.

Computer-Assisted Mathematics Instruction for Students With Specific Learning Disability

This review was conducted to evaluate the current body of scholarly research regarding the use of computer-assisted instruction (CAI) to teach mathematics to students with specific learning disability (SLD). For many years, computers are utilized for educational purposes. However, the effectiveness of CAI for teaching mathematics to this specific group of students is unclear. First, a brief review of the diagnosis of SLD, the importance of mathematics instruction for these students, and the use of computers in the classroom is provided. Next, a review of the current body of research is presented. Finally, suggestions for future research are discussed. Since 1981, a total of 25 research studies have been published, focusing exclusively on using CAI for teaching mathematics to students with SLD. This review examines the current body of research for this area. In addition, the author provides recommendations for future research on this important subject for this category of students.

Case Vignettes on Life Span Approach to Diagnosis of Specific Learning Disability in India

Case Vignettes on Life Span Approach to Diagnosis of Specific Learning Disability in India

The effect of educational therapy on self-esteem and problem behaviors in children with specific learning disability

Objective: The purpose of this study is to investigate the effectiveness of educational therapy on the level of self-esteem and problem behaviors in children diagnosed with specific learning disability (SLD). Methods: A total of 150 children between 9-11 years of age were included in the study. Wechsler Intelligence Scale for Children-Revised (WISC-R) and SLD test battery was administered to all children who were diagnosed with SLD. Piers-Harris Children’s Self-Concept Scale, Child Behavior Checklist (CBCL 6-18) and Teacher’s Report Form were also used. The scales were administered again to children in the educational therapy group when the therapy was completed and to children in the control group after three months. Results: The level of self-esteem in children with a diagnosis of SLD was found to be lower than the normal developing children. Scores related to behavioral problems in CBCL 6-18 and TRF 6-18 were found higher in children with a diagnosis of SLD than the normal developing children. In the evaluations performed after the therapy, a significant difference was found in the SLD test battery scores of the children who were diagnosed with SLD and were administered educational therapy compared to the SLD test battery scores of those on the waiting list. In the evaluations performed after the educational therapy, an increase in the level of self-esteem and a decrease in problem behavior scores were found in the group that were diagnosed with SLD and received educational therapy. Discussion: Educational therapy was found to increase the level of self-esteem and to decrease behavioral problems and symptoms of SLD in children. However, other psychosocial factors are thought to play a role in children’s better detection themselves except improvement signs of SLD with education. More specific studies are needed on the impact of these factors.

Cognitive Clusters in Specific Learning Disorder

The heterogeneity among children with learning disabilities still represents a barrier and a challenge in their conceptualization. Although a dimensional approach has been gaining support, the categorical approach is still the most adopted, as in the recent fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The introduction of the single overarching diagnostic category of specific learning disorder (SLD) could underemphasize interindividual clinical differences regarding intracategory cognitive functioning and learning proficiency, according to current models of multiple cognitive deficits at the basis of neurodevelopmental disorders. The characterization of specific cognitive profiles associated with an already manifest SLD could help identify possible early cognitive markers of SLD risk and distinct trajectories of atypical cognitive development leading to SLD. In this perspective, we applied a cluster analysis to identify groups of children with a Diagnostic and Statistical Manual–based diagnosis of SLD with similar cognitive profiles and to describe the association between clusters and SLD subtypes. A sample of 205 children with a diagnosis of SLD were enrolled. Cluster analyses (agglomerative hierarchical and nonhierarchical iterative clustering technique) were used successively on 10 core subtests of the Wechsler Intelligence Scale for Children–Fourth Edition. The 4-cluster solution was adopted, and external validation found differences in terms of SLD subtype frequencies and learning proficiency among clusters. Clinical implications of these findings are discussed, tracing directions for further studies.

Utility of KTEA-3 Error Analysis for the Diagnosis of Specific Learning Disabilities

Through the use of excerpts from one of our own case studies, this commentary applied concepts inherent in, but not limited to, the neuropsychological literature to the interpretation of performance on the Kaufman Tests of Educational Achievement–Third Edition (KTEA-3), particularly at the level of error analysis. The approach to KTEA-3 test interpretation advocated here parallels the cognitive process-oriented approach used by McCloskey and colleagues in their interpretation of the Wechsler scales. This approach is also advocated by Hale and Fiorello as part of their cognitive hypothesis testing model and is inherent in the neuropsychological assessment and interpretation frameworks proposed by Miller and Dehn. For the purpose of this commentary, we describe how this approach to KTEA-3 test interpretation fits within our own Cattell-Horn-Carroll (CHC)-based approach to specific learning disabilities (SLD) identification. To derive maximum benefit from error analysis, practitioners must pay careful attention to the manner in which students respond to test items and copiously document their observations during test administration.

Using Neuropsychometric Measurements in the Differential Diagnosis of Specific Learning Disability.

The aim of this study was to develop a neuropsychometric battery for the differential diagnosis of specific learning disability (SLD), with specific respect to attention deficit hyperactivity disorder (ADHD), and to help resolve the conflicting results in the literature by an integrative utilization of scores on both the Bannatyne categories and neuropsychological tests. The sample included 168 primary school boys who were assigned to SLD (n=21), ADHD (n=45), SLD and ADHD (n=57), and control groups (n=45). The exclusion criteria were a neurological or psychiatric comorbidity other than ADHD, a level of anxiety and/or depression above the cutoff score, medication affecting cognitive processes, visual and/or auditory disorders, and an intelligence level outside the IQ range of 85-129. Psychometric scores were obtained from the SLD Battery and Wechsler Intelligence Scale for Children-Revised in the form of Bannatyne category scores. Neuropsychological scores were from the Visual-Aural Digit Span Test-Form B, Serial Digit Learning Test, Judgment of Line Orientation, and Mangina Test. The battery was called the Integrative Battery of SLD. The correctness of estimation for classifying cases into the diagnostic dyads (SLD/ADHD, SLD/SLD+ADHD, and SLD+ADHD/ADHD) by an integrative utilization of both the Bannatyne category scores (n=4) and scores from the four neuropsychological tests (n=10) was 92.4%, 81.4%, and 71.8%, respectively. These proportions were generally higher than those obtained using the Bannatyne category scores alone (86.4%, 75.5%, and 73.1%, respectively). The same trend was seen in the classification of children into diagnostic and control groups. However, the proportion of the correctness of estimation was higher than that obtained for the diagnostic dyads. When conducted using appropriately chosen research designs and statistical techniques and if confounding variables are sufficiently controlled, a neuropsychometric battery that includes capacities that relate to intelligence (Bannatyne categories) and those that relate to neurocognitive processes (neuropsychological tests) can be useful in the differential diagnosis of SLD.

The structure of intelligence in children with specific learning disabilities is different as compared to typically development children

Children with specific learning disabilities (SLDs) are characterized by a poor academic achievement despite an average intelligence. They are therefore typically assessed not only with achievement tests, but also with intelligence tests, usually the Wechsler Intelligence Scale for Children (WISC). The assumption of a discrepancy between IQ and achievement in children with SLD has been questioned, however, and the implications of using different measures in batteries of intellectual subtests have not been thoroughly investigated. The present study examined these issues, taking advantage of a large database of scores obtained in the ten core subtests of the WISC-IV by a group of 910 Italian children with a clinical diagnosis of SLD, who were compared with the children considered for national standardization purposes. Our results support the doubts raised concerning the IQ-achievement discrepancy model, showing that relevant discrepancies can emerge even within the WISC profile. The four main WISC-IV indexes were found differently related to intelligence (measured by means of the g-factor) and the g content of many subtests differed in children with SLD vis-à-vis typically-developing children. These results have important implications both theoretical, indicating that the g-factor is weakly identified in children with SLD children, and practical, indicating that the QI obtained with the WISC-IV may not be a good measure of intellectual functioning for children with SLD, which are discussed.

WISC-IV Intellectual Profiles in Italian Children With Specific Learning Disorder and Related Impairments in Reading, Written Expression, and Mathematics

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders grouped specific learning disabilities in the single diagnostic category of specific learning disorder (SLD), with specifiers for impairments in reading, written expression, and mathematics. This study aimed at investigating the intellectual profile, assessed with the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV), of 172 children with a diagnosis of SLD, compared to 74 clinical referral controls. WISC-IV intellectual functioning in children with SLD was characterized by a significant discrepancy between general ability and cognitive proficiency (General Ability Index [GAI] > Cognitive Proficiency Index [CPI]), and worse performances on the Similarities, Digit Span, Letter–Number Sequencing, and Coding subtests, supporting models of multiple cognitive deficits at the basis of neurodevelopmental disorders as SLD. GAI was the best and more conservative measure provided by the WISC-IV to identify intellectual functioning in children with SLD, and the intellectual discrepancy between GAI and CPI could be considered a “cognitive sign” for the presence of SLD in a single diagnostic category. Cognitive deficits differed in subtypes of impairment (reading, written expression, and mathematics), supporting their distinction for empirical, educational, and rehabilitative purposes. These findings need further replication in larger samples and in comparison to typically developing children.

Specific learning disabilities - from DSM-IV to DSM-5

The publication of the DSM-5 means changes in the classification and recommendations for diagnosis of specific learning disabilities. Dyslexia and dyscalculia have been reintroduced into the DSM. Three specific learning disorders - impairment in reading, impairment in the written expression, and impairment in mathematics, described by subskills - are now part of the DSM-5. Three subcomponents of the reading disorder are expressly differentiated: word reading accuracy, reading rate, and fluency and reading comprehension. Impaired subskills of the specific learning disorder with impairment in written expression are spelling accuracy, grammar and punctuation accuracy, and clarity and organization of written expression. Four subskills are found in the mathematics disorder: number sense, memorization of arithmetic facts, accurate or fluent calculation, and accurate math reasoning. Each impaired academic domain and subskill should be recorded. A description of the severity degree was also included. The diagnosis is based on a variety of methods, including medical history, clinical interview, school report, teacher evaluation, rating scales, and psychometric tests. The IQ discrepancy criterion was abandoned, though that of age or class discrepancy criterion was retained. The application of a discrepancy is recommended by 1 to 2.5 SD. All three specific developmental disorders are common (prevalence 5 %-15 %), occur early during the first years of formal schooling, and persist into adulthood.

Study of a Sample of Preadolescents with Specific Learning Disorder (SLD) through a Global Functioning Scale (C-GAS)

The aim of this study was to evaluate the overall functioning, through the C-GAS scale, of a sample of 100 preadolescents with a diagnosis of Specific Learning Disorder (SLD). Were searched correlations between this functioning and specific factors of the SLD as reading speed(measured byMT test) and intellective level (measured by the intellective scale WISC-III)and aspecific factors of the SLD as emotional-behavioral problems (measured by CBCL and YSR scales) and socio-economic level(measured by the Hollingshead scale). The results seem to show that children with SLD present a comprehensive framework of functioning (C-GAS) described in most cases to moderately low scores (with an average of 58.71 at the C-GAS). Statistical analysis showed significant correlations between scores obtained with the C-GAS scale and the scores of the CBCL scales relating to skills, internalizing, externalizing and total problems, the scores obtained with the scale of YSR on the aggressive component, the values determined by the evaluation of socio-economic status. There is no correlation between the scores obtained to the C-GAS and MT tests (speed) and between C-GAS and the values of IQ (except for a low correlation with the Total IQ)

Caracterización de las funciones cognitivas de un grupo de estudiantes con trastornos específicos del aprendizaje en un colegio de la ciudad de Cali, Colombia

Los Trastornos Específicos del Aprendizaje (TEA) son dificultades que se manifiestan en el ámbito escolar interfiriendo de manera significativa en las actividades que implican habilidades de lectura, cálculo y escritura, descartando como causa de estos, las alteraciones neurológicas, emocionales y conductuales. El presente estudio tuvo como objetivo describir las funciones cognitiva de un grupo de estudiantes con TEA que se encontraban asistiendo a un colegio privado de la ciudad de Cali. Los instrumentos que se utilizaron para recolectar la información fueron: Cuestionario de problemas de aprendizaje CEPA, Subescalas de la Mini entrevista neuropsiquiátrica internacional para niños y adolescentes (M.I.N.I.- N-A), Escala de inteligencia de Wechsler para niños WISC-R y Subtareas de la Evaluación Neuropsicológica Infantil (ENI). Los resultados mostraron que los estudiantes con diagnóstico de TEA presentaron fallas cognitivas, específicamente de atención y memoria para información auditivo verbal y visual, acompañadas de falencias para la discriminación fonológica, que se encontraron asociadas a dificultades de la percepción fonémica. Del mismo modo, presentaron fallas en las habilidades espaciales, construccionales y dificultades en la planeación de estrategias para llevar a cabo un plan de manera eficaz. Las falencias cognitivas que subyacen el aprendizaje de la lectura, la escritura y el cálculo de los sujetos estudiados, exponen la necesidad de un adecuado desarrollo de funciones cognitivas para conseguir un exitoso aprendizaje pedagógico, así como también la importancia de ser incluidas en las estrategias de intervención en este tipo de población.

Long-term neurodevelopmental outcomes of congenital diaphragmatic hernia survivors not treated with extracorporeal membrane oxygenation

Background/Purpose Although there has been a marked improvement in the survival of children with congenital diaphragmatic hernia (CDH) in the past 2 decades, there are few reports of long-term neurodevelopmental outcome in this population. The present study examined neurodevelopmental outcomes in 10- to 16-year-old CDH survivors not treated with extracorporeal membrane oxygenation (ECMO). Methods Parents of 27 CDH survivors completed questionnaires assessing medical problems, daily living skills, educational outcomes, behavioral problems, and executive functioning. Fifteen CDH survivors and matched full-term controls completed standardized intelligence, academic achievement, phonological processing, and working memory tests. Results Non–ECMO-treated CDH survivors demonstrated high rates of clinically significant difficulties on standardized academic achievement measures, and 14 of the 27 survivors had a formal diagnosis of specific learning disability, attention deficit hyperactivity disorder, or developmental disability. Specific problems with executive function, cognitive and attentional weaknesses, and social difficulties were more common in CDH patients than controls. Perioperative hypocapnia was linked to executive dysfunction, behavioral problems, lowered intelligence, and poor achievement in mathematics. Conclusions Non–ECMO-treated CDH survivors are at substantial risk for neurodevelopmental problems in late childhood and adolescence.

Intelligence structure in children with hyperkinetic disorders

The Wechsler Intelligence Scale for Children – Third edition (WISC-III) has been widely used to assess the intellectual abilities of children with hyperkinetic disorders by both researchers and practitioners. The characteristic features of the WISC-III profile of this clinical group have been described by several authors (Anastopoulos et al., 1994; Assessmany et al., 2001; Snow and Sapp, 2000; Mayes and Calhoun, 2006; Ek et al., 2007). However, the issue of the WISC-III construct validity in this particular clinical group was scarcely addressed. It remains possible that in hyperkinetic children with poor attention this long and attention-demanding test measures other constructs than in general population. The objective of this study was to examine the structure of intelligence in primary school children diagnosed with hyperkinetic disorders. 29 children (23 boys and 6 girls) aged seven to ten years, participated in the study. All the children were diagnosed with a hyperkinetic disorder, and ten of them had a comorbid diagnosis of specific learning disabilities. The participants of the study completed the Lithuanian version of the Wechsler Intelligence Scale for Children – Third edition (WISC-III) (2002). The Confirmatory factor analysis confirmed the construct validity of WISC-III when used in hyperkinetic children: one factor model (general intelligence) fits the data satisfactorily, while two factor (Verbal IQ, Performance IQ) and four factor (Verbal Comprehension, Perceptual Organisation, Freedom from Distractibility, Processing Speed) models fit the data very well. However, the exploratory factor analysis revealed a different factor structure without the Processing Speed factor, more similar to WISC-R. It also showed that Object Arrangement is a problematic subtest when used with hyperkinetic children as it does not fit with any of the three factors. We suggest that its performance could be determined by emotional variables rather than by cognitive ones. The WISC-III profile of hyperkinetic children as a group was characterized by the low Freedom from Distractibility score and ACID profile (low Arithmetic, Coding, Information and Digit span scores). The mean scores of these subtests and factors were significantly lower than the standardization sample mean, which is 10 for subtest scores and 100 for factor scores: M = 8.4, t = –3.215, p < 0.01 for Information; M = 8.5, t = –5.998, p < 0.01 for Coding; M = 8.4, t = –3.194, p < 0.01 for Arithmetic; M = 6.9, t = –5.998, p < 0.01 for Digit Span; M = 86.17, t = –5.393, p < 0.01 for Freedom from Distractibility. These peculiarities of hyperkinetic children’s WISC-III performance are explained by difficulties in attention, short-term memory, sequential auditory processing and factual knowledge. Satisfactory results of Similarities, Picture Completion and Block Design suggest relative strengths of using concepts, ability to analyse and synthesize information, and fluid intelligence. It has been proposed that comorbid specific learning disabilities may affect the cognitive performance of hyperkinetic children. For this reason, the effect of a comorbid learning disability was also assessed. The results showed that, although the intellectual abilities of hyperkinetic children with a comorbid learning disability are lower, the comorbid learning disability does not change the hyperkinetic children’s intelligence profile.