Standard Score Mean Research Articles

A - 116 A Neuropsychological Testing Protocol for Assessing Lecanemab Eligibility for Alzheimer’s Disease: the First Fifty Patients

Abstract Objective Since the FDA approved lecanemab for Alzheimer’s disease (ad) treatment in 2023, neuropsychology’s role in the treatment eligibility determination process has become increasingly important. Not only is objective evidence of cognitive impairment required for the diagnosis of mild cognitive impairment (MCI) and mild dementia, but testing can be used to measure treatment efficacy and monitor for adverse effects. Our center developed a specialized protocol to assess cognitive and behavioral functioning for assisting in the eligibility determination process. Method Fifty adults (Mean Age = 73.8 years) underwent neuropsychological testing, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), as a part of their eligibility workup. Caregiver questionnaires were used to assess behavioral functioning. Test scores and patient outcomes were explored. Results Thirteen patients (26%) were prescribed lecanemab. Another 13 patients were deemed ineligible (five due to their cognitive results), eight patients (16%) were undecided, and 16 patients (32%) had not yet completed their workup. Of those who initiated lecanemab, eight patients (62%) had a diagnosis of MCI and six were diagnosed with mild dementia. Of these patients, eight (82%) showed an amnestic pattern on testing (RBANS Delayed Recall Standard Score Mean = 46.8). Additional analyses involving ad biomarkers, neuroimaging, and APOE status, were conducted. Conclusion Over one quarter of patients referred for neuropsychological testing as a part of their eligibility determination initiated lecanemab treatment for ad. Cognitive testing was directly related to determining ineligibility in 10% of patients. This review of an initial lecanemab treatment cohort highlights the importance of neuropsychology in the eligibility determination process.

Changes in verbal and visuospatial working memory from Grade 1 to Grade 3 of primary school: Population longitudinal study.

Adaptive working memory training is being implemented without an adequate understanding of developmental trajectories of working memory. We aimed to quantify from Grade 1 to Grade 3 of primary school (1) changes in verbal and visuospatial working memory and (2) whether low verbal and visuospatial working memory in Grade 1 predicts low working memory in Grade 3. The study design includes a population-based longitudinal study of 1,802 children (66% uptake from all 2,747 Grade 1 students) at 44 randomly selected primary schools in Melbourne, Australia. Backwards Digit Recall (verbal working memory) and Mister X (visuospatial working memory) screening measures from the Automated Working Memory Assessment (M=100; SD=15) were used to assess Grades 1 and 3 (ages 6-7 and 8-9years) students. Low working memory was defined as ≥1 standard deviation below the standard score mean. Descriptive statistics addressed Aim 1, and predictive parameters addressed Aim 2. One thousand seventy (59%) of 1802 Grade 1 participants were reassessed in Grade 3. As expected for typically developing children, group mean standard scores were similar in Grades 1 and 3 for verbal, visuospatial, and overall working memory, but group mean raw scores increased markedly. Compared to "not low" children, those classified as having low working memory in Grade 1 showed much larger increases in both standard and raw scores across verbal, visuospatial, and overall working memory. Sensitivity was very low for Grade 1 low working memory predicting Grade 3 low classifications. Although mean changes in working memory standard scores between Grades 1 and 3 were minimal, we found that individual development varied widely, with marked natural resolution by Grade 3 in children who initially had low working memory. This may render brain-training interventions ineffective in the early school year ages, particularly if (as population-based programmes usually mandate) selection occurs within a screening paradigm.

Longitudinal Analysis of Receptive Vocabulary Growth in Young Spanish English–Speaking Children From Migrant Families

The authors of this study described developmental trajectories and predicted kindergarten performance of Spanish and English receptive vocabulary acquisition of young Latino/a English language learners (ELLs) from socioeconomically disadvantaged migrant families. In addition, the authors examined the extent to which gender and individual initial performance in Spanish predict receptive vocabulary performance and growth rate. The authors used hierarchical linear modeling of 64 children's receptive vocabulary performance to generate growth trajectories, predict performance at school entry, and examine potential predictors of rate of growth. The timing of testing varied across children. The ELLs (prekindergarten to 2nd grade) participated in 2-5 testing sessions, each 6-12 months apart. The ELLs' average predicted standard score on an English receptive vocabulary at kindergarten was nearly 2 SDs below the mean for monolingual peers. Significant growth in the ELLs' receptive vocabulary was observed between preschool and 2nd grade, indicating that the ELLs were slowly closing the receptive vocabulary gap, although their average score remained below the standard score mean for age-matched monolingual peers. The ELLs demonstrated a significant decrease in Spanish receptive vocabulary standard scores over time. Initial Spanish receptive vocabulary was a significant predictor of growth in English receptive vocabulary. High initial Spanish receptive vocabulary was associated with greater growth in English receptive vocabulary and decelerated growth in Spanish receptive vocabulary. Gender was not a significant predictor of growth in either English or Spanish receptive vocabulary. ELLs from low socioeconomic backgrounds may be expected to perform lower in English compared with their monolingual English peers in kindergarten. Performance in Spanish at school entry may be useful in identifying children who require more intensive instructional support for English vocabulary growth. Findings substantiate the need for progress monitoring across the early school years.

Changing Expectations for Neurological Outcomes After the Neonatal Arterial Switch Operation

Expectations for outcomes after the neonatal arterial switch operation (ASO) continue to change. This cohort study describes neurodevelopmental outcomes at age 12 months after neonatal ASO, and analyzes both modifiable and nonmodifiable factors for association with adverse outcomes. Patients who underwent an ASO (n=30) were enrolled in a prospective outcome study, with comprehensive clinical data collection during the first 12 months of life. Brain magnetic resonance imaging was done preoperatively and 7 days postoperatively, and the Bayley Scales of Infant Development III was performed at age 12 months. Ten of 30 patients (33%) had preoperative magnetic resonance imaging injury; 13 of 30 patients (43%) had new postoperative magnetic resonance imaging injury. Twenty patients (67%) had Bayley Scales of Infant Development III: Cognitive Composite standard score mean was 104.8±15.0, Language Composite standard score median was 90.0 (25th to 75th percentile, 83 to 94), and Motor Composite standard score mean was 92.3±14.2. Best subsets multivariable analysis found associations between lower preoperative and intraoperative cerebral oxygen saturation, preoperative magnetic resonance imaging brain injury, total bypass time, and total midazolam dose and lower Bayley Scales of Infant Development III scores at age 12 months. At 12 months after ASO, neurodevelopmental outcome means were within normal population ranges. The new associations reported in this study between potentially modifiable perioperative factors and outcomes require investigations in larger patient cohorts. Beyond survival, which was 100% in this cohort, factors influencing quality of life including neurodevelopmental outcomes should be routinely investigated in studies of ASO patients.

Intelligence test scores and birth order among young Norwegian men (conscripts) analyzed within and between families

The present paper reports the results of a within and between family analysis of the relation between birth order and intelligence. The material comprises more than a quarter of a million test scores for intellectual performance of Norwegian male conscripts recorded during 1984–2004. Conscripts, mostly 18–19 years of age, were born to women for whom almost complete reproductive histories were obtained. Women with single births only 1967–1998 and first birth 1967–1976 were selected for analyses. The grand mean stanine score for intellectual performance standardized for age and calendar year was 5.05 (SD = 1.80). The mean standardized score decreased with size of sibship and with higher birth orders in all sibship sizes. These patterns as well as the size of the difference between birth orders 1 and 3 were rather similar between and within families. Among 63 951 adjacent sibling pairs the mean standardized scores were 5.18 (95% confidence interval [CI]: 5.16, 5.19) for the elder and 4.93 (95% CI: 4.91, 4.94) for the younger brother. The difference in mean of standardized scores between adjacent siblings was − 0.251 (95% CI: − 0.270, − 0.231). The difference in mean standardized scores between brothers of adjacent birth orders increased with higher maternal level of education, was highest between brothers of married women, higher with paternal income and decreased with sibship size and longer spacing between births.

A Comparison of the Long and Short Forms of the Bruininks-Oseretsky Test of Motor Proficiency

The relationship between the long and short forms of the Bruininks-Oseretsky Test of Motor Proficiency was investigated. Forty-eight regular education students, who had been referred to adapted physical education, were administered the long form of this test. Short form scores were subsequently derived from the long form items. Pearson product-moment r values generally indicated strong relationships between long and short form scores when the data were converted to standard and percentile scores. T-test analyses, however, indicated that long and short form standard score mean differences were significant at the .01 level (conventional .05 alpha level was reduced to .01 by the Dunn Test) for the two younger age groups and the all-subjects group. These results indicate that placement decisions in adapted physical education may vary depending upon which form of the test is used.