Low Average IQ Research Articles

Quality of life and late therapy effects in pediatric non-Hodgkin lymphoma survivors: Insights from a single-institution study.

The survival outcomes of pediatric patients with mature B-non-Hodgkin lymphoma (NHL) have improved due to advances in treatment. We aimed to assess the frequency and severity of late effects and their impact on quality of life among pediatric NHL survivors. This retrospective study included patients diagnosed with mature B-NHL at Children's Cancer Hospital of Egypt (CCHE) 57357 from January 2012 through December 2015. Patients received treatment according to the modified LMB 96 protocol. The minimum follow-up period was 5years. Assessments for toxicity and quality of life were conducted at regular intervals during and after treatment. Patients were assessed for toxicity including pulmonary dysfunction, cardiac dysfunction, lipid profile abnormalities, endocrine dysfunction (thyroid function, vitamin D levels, growth curves), and cognitive function (intelligence quotient [IQ] level using Stanford-Binet Intelligence Scales-5th Edition, and quality of life (QoL) assessment (PedsQoL). A total of 273 patients were eligible, and 206 were evaluable. Median age was 5.45 (range: 2.4-18), with a male-to-female ratio 4:1. Pulmonary function abnormalities were detected in 119/203 (58.6%); most had mild dysfunction (72/119, 60.5%), while 17% had severe dysfunction. Cardiac toxicity occurred in 10% of the patients (n=20). IQ testing showed that 52 patients had a low average IQ score, while 151 patients had either average or above average scores. The total mean QoL score was 99±0.058 classified as "satisfactory." However, significant impairment of the physical domain of quality of life was observed among group C patients compared to A/B (p=.033), older age at diagnosis (p=.042), and those with pulmonary dysfunction (p<.001). Total score of quality of life was significantly impaired among patients with pulmonary dysfunction (p=.009), likewise older age at diagnosis (p=.017) and those with low average IQ scores (p=.033). Childhood mature B-NHL survivors are at significant risk for late effects; pulmonary dysfunction and low average IQ that can subsequently impact QoL.

A - 45 Duchenne and Becker Muscular Dystrophy: Sibling Case Studies

Abstract Objective Duchenne Muscular Dystrophy (DMD) is an X-linked recessive neuromuscular condition primarily affecting males. Progressive proximal muscle wasting and weakness is seen and a shortened life span can occur due to cardiac involvement. Becker Muscular Dystrophy (BMD) is a milder form of DMD. Non-progressive cognitive impairment (e.g., lower IQ) in DMD has been well established, while the cognitive profile in BMD is less known. DMD/BMD are caused by mutations in the dystrophin protein. Research suggests that mutations downstream of exon 63 in the DMD gene are associated with poorer cognitive outcomes compared to upstream 1–30. Our cases explore the association between genetic/medical factors upon cognitive and behavioral outcomes, and neuropsychological similarities/differences between DMD and BMD. Method The current sibling case studies include one BMD set (mutations at exon 45–49) and two DMD sets (exon 61–74, and 13, respectively). They are part of a larger IRB-approved research dataset. Notably in DMD set two, the siblings have different biological fathers. Results The BMD siblings have comparable neuropsychological profiles (e.g., below average IQ, academic challenges, attention/executive problems). In DMD set one, one sibling has average intelligence with no academic challenges, while the other sibling has a low average IQ with challenges in math and spelling. In DMD set two, one sibling has intact cognitive functioning, while the other sibling performs well below average across neurocognitive domains. Conclusions Our results indicate variabilities in DMD/BMD, highlighting the contributing role of established factors (e.g., mutation location) and additional non-DMD influences (e.g., genetic contributions from biological father) to understand neuropsychological profiles.

Istikhdām al-Lugah al-‘Arabiyyah Ladā al-Aṭfāl zāwi al-Iḥtiyājāt al-Khāssah; ‘Alā Naẓri ‘Ilm al-Lugah al-Nafsī

This study aims to measure psychological gestures and language acuity (linguistics) from sensory integration barriers or disorders in a child with Down syndrome named Muhammad Syauqi, with an IQ below 45, a child with special needs from QIS Surabaya. The purpose of this study was to determine linguistic ability (language ability related to pronunciation sharpness, duration of memorizing Arabic vocabulary, and language regularity), psychological resilience in the process of speaking Arabic, and to identify pronunciation barriers that are owned by the cognitive abilities of children with Down syndrome IQ in below 45. This study uses qualitative research with observation methods, namely field observations, accompanied by analysis and distribution methods, namely listening, taking notes, changing, and replacing. The descriptive analysis method is used to present information and data. Data collection techniques were obtained through observation, interviews, and documentation. Data analysis used descriptive analysis by describing and summarizing the data obtained statistically. The analysis results show that language use in children with Down syndrome, namely Muhammad Syauqi, is very different because apart from the lower average IQ, obstacles to pronunciation acuity also occur due to physical disorders in the mouth to the throat. Down syndrome children can only say one word because of the lack of vocabulary. Children with Down syndrome will point to the object they want when asking for something. Children with Down syndrome have difficulty pronouncing the vowels /alif/, /fa'/, /syin/, /shod/, /hot/ /'ain/, and /groin/, as well as the vibration of the sound /ro'/. Children with Down syndrome also experience difficulties pronouncing the correct articulation, even sounds that sound unclear, and sometimes make faint sounds without meaning that cannot be understood.

Clinical characteristics of children and adolescents with ADHD with or without methylphenidate prescription at their first diagnostic assessment.

Attention Deficit/Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder diagnosed in the scholar age. It is associated with significant impairment in global functioning, and in moderate/severe presentations the outcome is critically dependent on pharmacological optimization of the multi-modal treatment. Methylphenidate (MPH) is the first-choice pharmacological treatment in children and adolescents with ADHD, with substantial evidence of significant efficacy and effectiveness on global functioning and symptoms' severity. There is some evidence supporting a few clinical and socio-demographic variables as predictors of pharmacological treatment prescription in children with ADHD independently of ADHD symptoms severity. However, it is warranted to investigate clinical and general psychopathological characteristics potentially associated with negative outcomes and the need for pharmacological treatment to inform appropriate prescription strategies. In this context, we compared 268 children and adolescents who were prescribed MPH (ADHD/MPH) for the first time after their first diagnostic assessment at our center, and 444 children and adolescents with ADHD (ADHD/noMPH) who were recommended non-pharmacological evidence-based interventions alone. ADHD/MPH group had higher severity of non-ADHD psychopathological symptoms compared to the ADHD/noMPH group, as documented by higher scores on the Child Behavior Checklist (CBCL) subscales, higher severity of ADHD symptoms, lower average IQ and lower adaptive levels independently of IQ. More specifically, beside externalizing symptoms, also internalizing symptoms were significantly higher in the ADHD/MPH group. The presence of significant non-ADHD psychopathology should be considered as a clinical factor associated with the need for MPH prescription in children and adolescents with ADHD.

Are there differences in performance validity test scores between African American and White American neuropsychology clinic patients?

ABSTRACT Objective The purpose of the present study was to compare performance on a wide range of PVTs in a neuropsychology clinic sample of African Americans and White Americans to determine if there are differences in mean scores or cut-off failure rates between the two groups, and to identify factors that may account for false positive PVT results in African American patients. Method African American and White American non-compensation-seeking neuropsychology clinic patients were compared on a wide range of standalone and embedded PVTs: Dot Counting Test, b Test, Warrington Recognition Memory Test, Rey 15-item plus recognition, Rey Word Recognition Test, Digit Span (ACSS, RDS, 3-digit time, 4-digit time), WAIS-III Picture Completion (Most discrepant index), WAIS-III Digit Symbol/Coding (recognition equation), Rey Auditory Verbal Learning Test, Rey Complex figure, WMS-III Logical Memory, Comalli Stroop Test, Trails A, and Wisconsin Card Sorting Test. Results When groups were equated for age and education, African Americans obtained mean performances significantly worse than White Americans on only four of 25 PVT scores across the 14 different measures (Stroop Word Reading and Color Naming, Trails A, Digit Span 3-digit time); however, FSIQ was also significantly higher in White American patients. When subjects with borderline IQ (FSIQ = 70 to 79) were excluded (resulting in 74 White Americans and 25 African Americans), groups no longer differed in IQ and only continued to differ on a single PVT cutoff (Trails A). Further, specificity rates in African Americans were comparable to those of White Americans with the exception of the b Test, the Dot Counting Test, and Stroop B. Conclusions PVT performance generally does not differ as a function of Black versus White race once the impact of intellectual level is controlled, and most PVT cutoffs appear appropriate for use in African Americans of low average IQ or higher.

Preference for biological motion is reduced in ASD: implications for clinical trials and the search for biomarkers

BackgroundThe neurocognitive mechanisms underlying autism spectrum disorder (ASD) remain unclear. Progress has been largely hampered by small sample sizes, variable age ranges and resulting inconsistent findings. There is a pressing need for large definitive studies to delineate the nature and extent of key case/control differences to direct research towards fruitful areas for future investigation. Here we focus on perception of biological motion, a promising index of social brain function which may be altered in ASD. In a large sample ranging from childhood to adulthood, we assess whether biological motion preference differs in ASD compared to neurotypical participants (NT), how differences are modulated by age and sex and whether they are associated with dimensional variation in concurrent or later symptomatology.MethodsEye-tracking data were collected from 486 6-to-30-year-old autistic (N = 282) and non-autistic control (N = 204) participants whilst they viewed 28 trials pairing biological (BM) and control (non-biological, CTRL) motion. Preference for the biological motion stimulus was calculated as (1) proportion looking time difference (BM-CTRL) and (2) peak look duration difference (BM-CTRL).ResultsThe ASD group showed a present but weaker preference for biological motion than the NT group. The nature of the control stimulus modulated preference for biological motion in both groups. Biological motion preference did not vary with age, gender, or concurrent or prospective social communicative skill within the ASD group, although a lack of clear preference for either stimulus was associated with higher social-communicative symptoms at baseline.LimitationsThe paired visual preference we used may underestimate preference for a stimulus in younger and lower IQ individuals. Our ASD group had a lower average IQ by approximately seven points. 18% of our sample was not analysed for various technical and behavioural reasons.ConclusionsBiological motion preference elicits small-to-medium-sized case–control effects, but individual differences do not strongly relate to core social autism associated symptomatology. We interpret this as an autistic difference (as opposed to a deficit) likely manifest in social brain regions. The extent to which this is an innate difference present from birth and central to the autistic phenotype, or the consequence of a life lived with ASD, is unclear.

Longer term outcomes following serogroup B invasive meningococcal disease.

To characterise the physical, psychological, and quality of life burden associated with serogroup B invasive meningococcal disease (IMD) in children. Children aged up to 14 years at the time of serogroup B IMD, who were admitted to intensive care units of two tertiary paediatric hospitals in New South Wales, Australia between January 2009 and December 2013 were recruited. Children underwent clinical and neuropsychological assessments up to 6 years post-disease. Eleven children were assessed, with a median age of 16 months (range 4-46 months) at time of disease. The median follow-up time was 50 months (range 10-67 months). Seven (63.6%) cases had one or more long-term sequelae involving permanent and evolving physical disability. Three cases had ongoing medical conditions including two with seizures and one with ataxia and hypermetropia. Five required ongoing medical and allied health care. Other complications identified included anxiety, speech delay, low average full-scale IQ score (median 85, interquartile range 89-103) and borderline memory impairment. Serogroup B IMD is associated with significant long-term morbidity and burden on the child and family with substantial economic implications. The impact of this on the total cost of IMD needs to be further quantified, and better considered in vaccine cost-effectiveness analyses.

RETRACTED: Declines in Religiosity Predict Increases in Violent Crime—but Not Among Countries With Relatively High Average IQ

Many scholars have argued that religion reduces violent behavior within human social groups. Here, we tested whether intelligence moderates this relationship. We hypothesized that religion would have greater utility for regulating violent behavior among societies with relatively lower average IQs than among societies with relatively more cognitively gifted citizens. Two studies supported this hypothesis. Study 1, a longitudinal analysis from 1945 to 2010 (with up to 176 countries and 1,046 observations), demonstrated that declines in religiosity were associated with increases in homicide rates-but only in countries with relatively low average IQs. Study 2, a multiverse analysis (171 models) using modern data (97-195 countries) and various controls, consistently confirmed that lower rates of religiosity were more strongly associated with higher homicide rates in countries with lower average IQ. These findings raise questions about how secularization might differentially affect groups of different mean cognitive ability.

Rushton, Jensen, and the Wealth of Nations: Biogeography and Public Policy as Determinants of Economic Growth

This paper offers a review of some of the empirical literature on economic growth and discusses its recent evolution in light of developments in intelligence research and genomics. The paper also undertakes the first regression analysis of economic growth to use the most up-to-date version (VI.3.2) of David Becker’s data set of international IQ scores. The analysis concerns the growth of 94 countries from 1995-2016. The new regression analysis replicates the results of Jones and Schneider (2006) in finding IQ to have a robust impact on economic growth. Political and economic institutions are represented in the regressions via a country’s “degree of capitalism” (aka “economic freedom”), which is found to have an impact that is positive and statistically significant. A change from communism to a market economy does much to increase growth, but the paper finds diminishing returns to free markets. Countries whose people are mostly of sub-Saharan African descent have low average IQ scores, but the paper finds that other factors also have lessened economic growth not only in Africa, but in Haiti and Jamaica as well. Rushton and Jensen (2005, 2010) put forth the hypothesis that average IQ differences across ethnic groups are 50% due to genetic differences, and 50% due to differences in natural and social environments. Applied to international IQ scores, the paper finds the hypothesis to be very reasonable.

Vers un rapprochement du syndrome de Klinefelter et de la psychopathie en psychiatrie légale

Klinefelter syndrome (KS) (47,XXY) is the most common aneuploidy (1/650) of sexual chromosome among male (0,1 à 0,2 % of male population) (Hong and Reiss, 2014). Because its large physical phenotypic variability (high tall, sparse hairiness, gynecomastia), this syndrome is largely underdiagnosed (less than 25 % of affected persons) (Samango-Sprouse et al., 2018). Nevertheless, cognitive variability is smaller. Normal to low average total IQ, low verbal IQ, social problems and high levels of psychiatric comorbidities including early aggressiveness are commonly described (Hong and Reiss, 2014). In Denmark, higher risks of committing sexual crime and arson (compared to criminal controls) was recently reported (Stochholm et al., 2012). Quite a few clinically relevant cases reports scattered in the literature, suggests the presence of a pattern of a specific subtype of KS inpatients among forensic population (Bénézech, 1975). However, very few studies provide quantitative or qualitative pertaining to robust results. KS well-documented neurobiological (van Rijn, 2018) (e.g. low levels of testosterone), neuropsychological (Bénézech, 1975; Hong and Reiss, 2014; Samango-Sprouse et al., 2018; Savic, 2012; Seara-Cardoso et al., 2016; Senon, 2005; Stochholm et al., 2012; van Rijn, 2018; van Rijn et al., 2008; van Rijn et al., 2018; van Rijn et al., 2014; van Rijn et al., 2012) [29] (e.g. alterations of both complex cerebral — attention, empathy — and behavioral regulation functions - inhibition, mental flexibility, emotional response modulation, control of own actions) and neuroanatomical (Hong and Reiss, 2014; Itti et al., 2003; Savic, 2012; van Rijn et al., 2008; van Rijn et al., 2012) [29] (e.g. limbic system and temporal lobe abnormal volume, hemispheric specialization shortcoming) features may be helpful to understand comorbid symptoms psychopathology. Numbers of recent studies conduct on KS pediatric or adult population provide interesting results on conduct, anxiety, psychotic and autism spectrum disorders. In addition, some authors use genetic and epigenetic specific features of sex chromosome aneuploidies (e.g. X genes neurodevelopmental role; imprinting) in order to clarify genotype-phenotype links of comorbid symptoms (Bruining et al., 2011; Zitzmann et al., 2004;). With Belgian colleagues from the Social Defense Research Center (CRDS, Tournai, Belgium), we are currently recruiting KS inpatients from security hospitals or psychiatric units in Belgium and France. We aim to assess psychopathic traits with the Psychopathy Checklist Revised (PCL-R, Hare) (Hare, 2003). Our first results concerning 3 KS males outline that PCL-R is useful for the characterization of clinical phenotype among KS forensic sample. While three of them present psychopathic traits, two of them present categorical double diagnose “psychopathy-KS” (total PCL-R score>=30/40 (Delannoy et al., 2017)). Moreover, dimensional analysis support our hypothesis of a higher prevalence of “explosive profile” in comparison to other psychopathic profiles in our sample (Delannoy et al., 2017). The present article summarizes historic background (e.g. “psychopathy” disappearance of mental disorder reference classification schemes, “crime chromosome” (Bénézech, 1975)) and current context argues (e.g. French psychiatrists court experts widely refer to psychopathy concept despite a lack of consensual definition (Senon, 2005), weak knowledge and training of PCL-R and its related biopsychological recent findings (Blair, 2013; de Oliveira-Souza et al., 2008; Dotterer et al., 2017; Glenn and Raine, 2014; Hosking et al., 2017; Korponay et al., 2017; Pham, 1995; Pham, 2005; Raine, 2008; Raine et al., 2003); stigma and discrimination apprehensions of KS and psychopath) that motivate our research project. Finally, we discuss the advantages of our research protocol on KS participants assessed with PCL-R, such as tackling stigma and discrimination, better understanding psychopathology, and clarifying murky interactions of biological, psychological and social factors entangled in the development of these two fascinating troubles.

Exploring the Neuropsychological Profile of a Clinically Referred Sample of Children in Mexico

Abstract Objective The Wechsler Scale of Intelligence for Children (WISC-IV) is one of the most commonly used intelligence tests for children. A Spanish version of the WISC-IV exists, but a limited amount of published information is available on its utility when assessing pediatric clinical populations. Furthermore, little published research utilizes the WISC-IV in Spanish speaking populations residing outside the US. This study seeks to present the neuropsychological profile of a clinically referred sample of children residing in Mexico. Participants and Method The present study included 35 participants (15 females and 20 males, M age of 9.26 years, SD = 1.69). Participants were referred to clinic sites affiliated with the neuropsychology master’s program at Benemérita Universidad Autónoma de Puebla (BUAP). Participants were referred for assessment due to persistent academic/behavior difficulties and were included in this study if they were between the ages of 7 and 12, with no history of a psychiatric disorder. All participants were administered the WISC-IV. Procedures were approved by the ethics committee at BUAP. Informed consent was obtained prior to evaluation. Results Descriptive statistics show a Full-Scale IQ average (FSIQ) mean of 75.40 (SD = 12.42). Highest index scores were on Perceptual Reasoning (PRI) (M = 84.94, SD = 16.22) and Processing Speed (PSI) (M = 81.34, SD = 12.96) and lowest index score were on working memory (WMI) (M = 76.97, SD = 14.64) and Verbal Comprehension (VCI) (M = 76.54, SD = 12.42). Independent T-Tests showed no significant differences between genders. Conclusions Our results show a low average IQ for the sample but also identifies strengths in certain indices and specific subtests within the WISC-IV that can add rich details in the comprehension of cognitive functioning in this sample. In the future, we plan to continue the growth of our study via the utilization of a control group to compare with the clinical sample.

C-44 Exploring the Criterion Validity of the WISC-IV in a Clinically Referred Sample of Children in Mexico

Abstract Objective The Weschler Scale of Intelligence (WISC-IV) is one of the most commonly used measures in the neuropsychological evaluation of children. Little published research utilizes the WISC-IV in diverse populations outside the US. The objective of this study was to examine the criterion validity of the WISC-IV’s subtests and index scores in a clinically referred sample in Mexico. Methods The present study included 86 participants, 35 clinical patients referred for neuropsychological evaluation for persistent learning difficulties at a public clinic and 51 healthy control children enrolled in public school with a GPA of 3.0-4.0 in Puebla, Mexico. Participants were between the ages of 7-12. None of the children in our clinical group had a formal diagnosis of any learning or behavior disorder, this was the first experience seeking neuropsychological evaluation. The WISC-IV was administered to all participants as part of the evaluation process. Informed consent was obtained prior to evaluation. Results Independent sample T-Tests show no significant differences in Full-Scale IQ average (FSIQ) between the clinical sample (M = 75.40, SD = 11.81) and control group (M = 79.73, SD = 10.36). Descriptive statistics for indices and subtests can be found in Table 1. Conclusions Our results demonstrate low average IQ for both groups, indicating further research is needed in understanding the criterion validity of the WISC-IV when applied to clinical populations in Mexico. Furthermore, because we were unable to explain below average scores in the control group by any confounding variable, future studies comparing the Mexican standardization of the WISC-IV with our data before utilizing as clinical evaluation tool is recommended.

Neuropsychological profile of pedophilic child sexual offenders compared with an IQ-matched non-offender sample – Results of a pilot study

Child sexual offenders have been found to have a lower average IQ than the general population. Several studies indicate that they also exhibit executive dysfunction, but the specificity of this dysfunction is unclear; the inconclusive results have been attributed to methodological problems and the heterogeneity of the population. Our study aimed to describe the neuropsychological profiles of convicted child sexual offenders with pedophilia (n = 15). To control for IQ-related effects on neuropsychological performance, we compared the sample with an IQ-matched control group (n = 15). Test scores in both groups were significantly lower than the norms, but we did not find significant differences between the two study groups. The findings of our pilot study indicate that the neuropsychological deficits of pedophilic sexual offenders are unspecific rather than the result of a pedophilia-specific brain dysfunction.

Reliable Digit Span: Does it Adequately Measure Suboptimal Effort in an Adult Epilepsy Population?

Assessment of performance validity is a necessary component of any neuropsychological evaluation. Prior research has shown that cutoff scores of ≤6 or ≤7 on Reliable Digit Span (RDS) can detect suboptimal effort across numerous adult clinical populations; however, these scores have not been validated for that purpose in an adult epilepsy population. This investigation aims to determine whether these previously established RDS cutoff scores could detect suboptimal effort in adults with epilepsy. Sixty-three clinically referred adults with a diagnosis of epilepsy or suspected seizures were administered the Digit Span subtest of the Wechsler Adult Intelligence Scale (WAIS-III or WAIS-IV). Most participants (98%) passed Trial 2 of the Test of Memory Malingering (TOMM), achieving a score of ≥45. Previously established cutoff scores of ≤6 and ≤7 on RDS yielded a specificity rate of 85% and 77% respectively. Findings also revealed that RDS scores were positively related to attention and intellectual functioning. Given the less than ideal specificity rate associated with each of these cutoff scores, together with their strong association to cognitive factors, secondary analyses were conducted to identify more optimal cutoff scores. Preliminary results suggest that an RDS cutoff score of ≤4 may be more appropriate in a clinically referred adult epilepsy population with a low average IQ or lower. Preliminary findings indicate that cutoff scores of ≤6 and ≤7 on RDS are not appropriate in adults with epilepsy, especially in individuals with low average IQ or below.

Net opposition to immigrants of different nationalities correlates strongly with their arrest rates in the UK

Public beliefs about immigrants and immigration are widely regarded as erroneous. For example, members of the public typically overestimate the immigrant fraction of the population by ~10–15 percentage points. On the other hand, consensual stereotypes about the respective characteristics of different groups (e.g., sexes, races, nationalities) are generally found to be quite accurate. The present study shows that, in the UK, net opposition to immigrants of different nationalities (n = 23) correlates strongly with the log of immigrant arrests rates (r = .69; p = 0.0003; 95% CI = [.39, .86]) and with the log of their arrest rates for violent crime (r = .68; p = 0.0003; 95% CI = [.38, .85]). This is particularly noteworthy given that Britons reportedly think that an immigrant’s criminal history should be one of the most important characteristics when considering whether he or she should be allowed into the country. In bivariate models, the associations are not wholly accounted for by a general opposition to non-Whites, non-Westerners, foreigners who do not speak English, Muslims, or those from countries with low average IQ. While circumstantial in nature, the study’s findings suggest that public beliefs about the relative positions of different immigrant groups may be reasonably accurate.

Investigating Discrepancies between Predicted and Observed Wechsler Adult Intelligence Scale‐Version IV Full‐Scale Intelligence Quotient Scores in a Non‐Clinical Sample

ObjectiveIn neuropsychological assessment estimates of how a client was performing prior to an injury is achieved by using instruments that have been developed to predict premorbid abilities, such as the National Adult Reading Test (NART), the re‐standardised NART (NART‐2), the Wechsler Test of Adult Reading (WTAR), and the Test of Premorbid Functioning (TOPF), and comparing these to scores from tests of current ability, such as the Wechsler Adult Intelligence Scale‐Fourth Edition (WAIS‐IV). These instruments have been criticised, however, due to concerns regarding the accuracy of their predictions.MethodThis study evaluated the ability of the NART, NART‐2, WTAR and TOPF to accurately estimate current full scale intelligence quotient (FSIQ) as measured by the WAIS‐IV in an unimpaired Australian sample.ResultsFor the sample as a whole, the NART significantly over‐estimated FSIQ, whilst the TOPF significantly underestimated FSIQ. In the low average IQ group, scores were over‐estimated by the NART‐2 and WTAR. In the average group, the predicted FSIQ scores produced by each measure were relatively accurate. In the high average group, NART was the best predictor of FSIQ, while the other tests all significantly underestimated IQ.ConclusionsIt was concluded that reading tests may not be the most accurate method for predicting IQ, and that other approaches which include demographic correction the should be further explored.

Executive functioning deficits in children with neurofibromatosis type 1: The influence of intellectual and social functioning.

The aim of this study was to provide a broad picture of Executive Functioning (EF) in NF1 children, while taking into account their lower average IQ and increased Autism Spectrum Disorder (ASD) symptoms. This was done by administering an extended battery of tasks and questionnaires, designed to reduce task impurity, that measures five EF domains (inhibition, cognitive flexibility, working memory, generativity and planning) in a laboratory setting and in daily life. Data are presented for 42 age- and gender-matched NF1, 52 typically developing, and 52 ASD children (8-18 years). Our results indicated that although EF is highly influenced by IQ and severity of ASD symptoms, EF deficits seem to be a core feature of NF1 and not merely a secondary effect of a lower IQ and/or increased ASD symptoms. However, additional research is needed to confirm these findings.

Intellectual Function among Epileptic Children: The Role of Epilepsy Related-Factors in Nigeria

This study evaluated the role of epilepsy-related factors, such as etiological variability, sex and age, on general intellectual functions among Nigerian children with epilepsy. Sixty epileptic children (38 males and 22 females) with a mean age of 12.9 years (SD= 2.9 years) were randomly selected from a population of epileptic children attending the Outpatient Neurology Clinic at Neuropsychiatric Hospital, Aro, Abeokuta. The Wechsler Intelligence Scale for Children (WISC-R) was administered. The result showed that 73.4% of the epileptic children had mental retardation, borderline and low average IQ level which, in some way, corresponded to general intellectual impairment. Multiple regression analysis revealed that etiological variability independently predicted Verbal IQ, Performance IQ and Full Scale IQ among the epileptic children. Furthermore, sex independently predicted Performance IQ of the epileptic children. This study emphasised a significant joint prediction of etiological variability, sex and age on Verbal IQ, Performance IQ and Full Scale IQ among the epileptic children. In conclusions, etiological variability and sex are important predictors of general intellectual functions. This research will enhance the understanding of those epileptic children who are in danger of developmental impairment so that treatment methods can be developed.

Longitudinal neuroimaging and neuropsychological profiles of frontotemporal dementia with C9ORF72 expansions.

IntroductionFrontotemporal dementia (FTD) is a common cause of early-onset dementia with a significant genetic component, as underlined by the recent identification of repeat expansions in the gene C9ORF72 as a major cause of FTD and motor neuron disease. Understanding the neurobiology and clinical phenomenology of this novel mutation is currently a major research focus. However, few data are available concerning the longitudinal evolution of this genetic disease. Here we present longitudinal neuropsychological and neuroimaging data on a cohort of patients with pathological repeat expansions in C9ORF72.MethodsFollowing a review of the University College London FTD DNA database, 20 cases were retrospectively identified with a C9ORF72 expansion. Twelve cases had longitudinal neuropsychology data available and six of these cases also had longitudinal volumetric brain magnetic resonance imaging. Cortical and subcortical volumes were extracted using FreeSurfer. Rates of whole brain, hemispheric, cerebellar and ventricular change were calculated for each subject. Nonlinear fluid registration of follow-up to baseline scan was performed to visualise longitudinal intra-subject patterns of brain atrophy and ventricular expansion.ResultsPatients had low average verbal and performance IQ at baseline that became impaired (< 5th percentile) at follow-up. In particular, visual memory, naming and dominant parietal skills all showed deterioration. Mean rates of whole brain atrophy (1.4%/year) and ventricular expansion (3.2 ml/year) were substantially greater in patients with the C9ORF72 mutation than in healthy controls; atrophy was symmetrical between the cerebral hemispheres within the C9ORF72 mutation group. The thalamus and cerebellum showed significant atrophy whereas no cortical areas were preferentially affected. Longitudinal fluid imaging in individual patients demonstrated heterogeneous patterns of progressive volume loss; however, ventricular expansion and cerebellar volume loss were consistent findings.ConclusionDisease evolution in C9ORF72-associated FTD is linked neuropsychologically with increasing involvement of parietal and amnestic functions, and neuroanatomically with rather diffuse and variable cortical and central atrophy but more consistent involvement of the cerebellum and thalamus. These longitudinal profiles are consistent with disease spread within a distributed subcortical network and demonstrate the feasibility of longitudinal biomarkers for tracking the evolution of the C9ORF72 mutation phenotype.

Surgical Diagnosis Is an Important Variable to Consider in Postanesthesia Exposure–associated Learning Disabilities

*Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada. ddoherty@cheo.on.caWe commend Dr. Wilder et al. 1for their work titled “Early Exposure to Anesthesia and Learning Disabilities in a Population-based Birth Cohort.” In their article, they report that patients younger than 4 yr, with two or more exposures to general anesthesia, had a greater proportion of learning disabilities (LDs) compared with children who had one or no exposure to general anesthesia. This represents a clinically important epidemiologic correlate to compliment the worrying animal observations demonstrating the detrimental effects of general anesthesia on the developing brain.A primary assumption in cohort analyses is that the groups observed are the same before exposure. However, children requiring anesthesia for surgical treatment may be inherently different from those who do not; these differences may present unique factors that predispose to LDs independent of anesthesia per se . In particular, we are concerned that a subpopulation at risk for learning disabilities—children undergoing ears, nose, and throat surgery—is overrepresented. Typical ears, nose, and throat surgeries in this age group include adenotonsillectomy and bilateral myringotomy with tympanostomy tube placement. The former is associated with obstructive sleep apnea, which can result in neurocognitive defects2; the latter may be associated with otitis media with effusions, which can yield poor performance in expressive speech and math testing in younger children.3These coexisting conditions may have skewed the diagnosis of LD in this population. This is relevant because children tested within a short period of time from their ears, nose, and throat surgery may not have had sufficient time to “catch up” with their peers in terms of testing, should the surgery have improved their condition. Furthermore, given the frequency of achievement tests administered to the cohort population, is it possible to find children who no longer met LD definitions at some time point during follow-up testing? This would be of particular interest for those children undergoing ears, nose, and throat surgeries.In addition, we are concerned that the third definition of LD included patients in the low-average IQ range versus average intelligence. Moreover, using a cutoff of 1.75 SDs below their predicted standard score, as opposed to the conventional 2 SDs, might be an oversensitive method of identifying patients with LDs.We are interested to know whether the authors could remove patients who underwent adenotonsillectomy and bilateral myringotomy with tympanostomy tube surgeries from the analysis and apply conventional definitions of LD to determine whether a relation between general anesthesia and LD persists.*Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada. ddoherty@cheo.on.ca