Function In School-aged Children Research Articles

Neuropsychological Function in School-Age Children with Concurrent Mercury Exposures

Neuropsychological Function in School-Age Children with Concurrent Mercury Exposures

Renal volume and function in school-age children born preterm or small for gestational age

Impaired renal development during foetal life is a proposed mechanism for adult hypertension in people born small. Whether preterm birth contributes to such adverse development is still unclear. We investigated the selective contributions from foetal growth restriction or preterm birth to renal function and volume in children with low birth weight. Three groups of 9 to 12-year-old children were studied: those born at < 32 gestational weeks (preterm, n = 39), those born at term but small for gestational age (SGA, n = 29) and those born at the term appropriate for gestational age (controls, n = 37). We estimated renal function by calculating glomerular filtration rate (GFR) and by measuring urinary proteins. Volumetric ultrasound of the kidneys was performed in 86 children (preterm, n = 33; SGA, n = 25; controls, n = 29). Estimated glomerular filtration rate (eGFR) and urinary protein patterns were similar between the groups. Kidney volume (preterm 162 ml (31); SGA 163 ml (26) and controls 182 ml (47)) was smaller in the preterm group than in the controls, but the difference was not significant when adjusted for body surface area, gender and age (P = 0.25). Total renal volume correlated to birth weight (r = 0.23, P = 0.03). No significant differences were found in renal function or volume between the three groups at school age.

Vitamin B-12 Status Is Associated with Socioeconomic Level and Adherence to an Animal Food Dietary Pattern in Colombian School Children 3

Vitamin B-12 is related to neurocognitive function in school-age children, yet sociodemographic and dietary correlates of vitamin B-12 status in this age group are not well characterized. The prevalences of vitamin B-12 or folate deficiencies in Colombia are unknown. We conducted a cross-sectional study in a representative sample of 2800 low- and middle-income children aged 5–12 y from Bogotá’s public schools. Plasma vitamin B-12 and erythrocyte folate concentrations (mean ± SD) were 327 ± 106 pmol/L and 858 ± 256 nmol/L, respectively. The prevalence of vitamin B-12 deficiency (<148 pmol/L) was 1.6% and the prevalence of marginal status (148–221 pmol/L) was 15.0%. Only 2 children had folate deficiency (<305 nmol/L). In multivariate analysis, mean vitamin B-12 concentrations significantly decreased with age and were 15 pmol/L higher in girls than boys (95%CI = 8, 23). Vitamin B-12 was inversely related to the mother’s parity and positively associated with the amount of money spent on food per person per day at home and the household’s neighborhood socioeconomic status (SES) classification. Folate concentrations were lower in girls than in boys and significantly increased with the household’s SES. We identified 4 dietary patterns with principal components analysis of a FFQ in a random subsample (n = 972). Plasma vitamin B-12 was strongly, positively associated with a pattern that included frequent intake of beef, chicken, and dairy products in a dose-response manner (P-trend, adjusted, = 0.008). Low vitamin B-12 status is not negligible in Colombian school children and is associated with poverty and marginal intake of animal food sources.

Tests for screening olfactory and gustatory function in school-age children

Determine the suitability of three tests based on the identification of familiar odors and tastes for the clinical assessment of olfaction and gustation in children. A total of 232 children aged 5 to 7 years from Sydney public schools and 56 adults aged 18 to 51 years participated in a cross-sectional study. The children demonstrated they can identify the majority of the 16 test odorants and 4 common tastes that describe gustatory function. The response distributions obtained for each test provide the basis for a set of normative data for young children. Olfactory and gustatory function can be determined in school-age children using the three tests described. Currently no satisfactory clinical tests of olfaction and gustation for children or normative data are available. The present study resolves these shortcomings and provides normative data that can be used in the diagnosis of olfactory and gustatory impairment in school-age children.

Predictors of performance on three developmentally sensitive neuropsychological tests in children with and without traumatic brain injury

Objective: To determine the effect of age and vocabulary as predictors of performance on neuropsychological tests in children with and without traumatic brain injury (TBI).Setting and participants: In the first study, 213 school-age children were evaluated in their public school environment. In the second study, 65 children with a history of TBI were examined in a medical centre.Major outcome measures: Age of the child and two estimates of intellectual functioning (Vocabulary and Block Design) were used to predict performance on the Barrow Neurological Institute Screen for Higher Cerebral Functions in School-Age Children (BNIS-C), a verbal fluency task and the Halstead Finger Tapping Test (HFTT).Results: In study 1, the exact age of the child was the strongest predictor of performance (e.g. 47.5% of the variability on the BNIS-C) in normal school-age children. Vocabulary level accounted for less than 10% of the variability across the three measures. In children with TBI (study 2; n= 65) age effects remained strong, but a greater vocabulary effect was observed on two of the three measures (i.e. 29.2% on the BNIS-C and 18.8% on verbal fluency).Conclusions: While age is an important predictor of neuropsychological test performance in children, post-injury vocabulary level appears to be an important moderator variable.

Sleep Disturbances in School-age Children with Chronic Pain

To examine associations between pain, functional outcomes, and sleep disturbances in children with chronic pain, specifically juvenile idiopathic arthritis (JIA), sickle cell disease (SCD), and headache (HA). Sleep disturbances were tested as a risk factor for increased functional disability and decreased health-related quality of life (HRQOL). One hundred children (JIA n = 30, SCD n = 26, HA n = 44; 8-12 years; 56% female) and their caregivers participated. Children completed questionnaires regarding pain, depression, and functional disability. Caregivers completed questionnaires regarding sociodemographics, child sleep habits, functional disability, and HRQOL. Levels of overall sleep disturbances were above the clinical cutoff for 53% of children with chronic pain. Sleep disturbances predicted lower physical HRQOL and higher functional disability, according to parent report. Sleep disturbances are common and associated with daytime functioning in school-age children with chronic pain, suggesting that assessment and treatment of sleep problems is clinically relevant.

Neuropsychological Performance in School-Aged Children with Surgically Corrected Congenital Heart Disease

As surgical management of children with congenital heart disease (CHD) advanced, developmental outcome became the main focus of contemporary research. In this study, we specify the cognitive profile of children with CHD, 6 to 12 years postoperatively. Patients with CHD (n = 43, mean age 8 years, 8 months) and healthy controls (n = 43, mean age 8 years, 11 months), were examined with an abbreviated intelligence scale (Wechsler Intelligence Scale for Children-3rd edition, Dutch version) and a developmental neuropsychological assessment battery (NEPSY [a developmental NEuroPSYchological assessment]). We identified significantly lower scores for the CHD group on Estimated Full Scale IQ (P < .01). Neuropsychological assessment revealed lower scores for the CHD group on the cognitive domains of Sensorimotor Functioning (P < .001), Language (P < .001), Attention and Executive Functioning (P < .05), and Memory (P < .05). Children with CHD displayed more impulsive test behavior than healthy peers. No differences on IQ or cognitive domains were found between the cyanotic and the acyanotic CHD group. Six to 12 years postoperatively, children with CHD display a neuropsychological profile with mainly mild motor deficits and subtle difficulties with language tasks. Attention/executive functioning and memory also appear involved but to a lesser degree. Long-term follow-up of children with surgically corrected CHD, even when hemodynamically successful, is warranted, as they are at risk for neurodevelopmental delay at school age.

Assessing Social Communication in the Classroom

This article describes a new construct for coding the social communicative performance of school-aged children as they interact with peers and teachers in the classroom. The Social Communication Coding System (SCCS) allows clinicians a way of describing how children actually spend their time during

Learning Disabilities and Intellectual Functioning in School-Aged Children With Prenatal Cocaine Exposure

Risk for developing a learning disability (LD) or impaired intellectual functioning by age 7 was assessed in full-term children with prenatal cocaine exposure drawn from a cohort of 476 children born full term and enrolled prospectively at birth. Intellectual functioning was assessed using the Wechsler Intelligence Scale for Children–Third Edition (Wechsler, 1991) short form, and academic functioning was assessed using the Wechsler Individual Achievement Test (WIAT; Wechsler, 1993) Screener by examiners blind to exposure status. LDs were categorized based on ability-achievement discrepancy scores, using the regression-based predicted achievement method described in the WIAT manual. The sample in this report included 409 children (212 cocaine-exposed, 197 non-cocaine-exposed) from the birth cohort with available data. Cumulative incidence proportions and relative risk values were estimated using STATA software (Statacorp, 2003). No differences were found in the estimate of relative risk for impaired intellectual functioning (IQ below 70) between children with and without prenatal cocaine exposure (estimated relative risk = .95; 95% confidence interval [CI] = 0.65, 1.39; p = .79). The cocaine-exposed children had 2.8 times greater risk of developing a LD by age 7 than non-cocaine-exposed children (95% CI = 1.05, 7.67; p = .038; IQ ≥ 70 cutoff). Results remained stable with adjustment for multiple child and caregiver covariates, suggesting that children with prenatal cocaine exposure are at increased risk for developing a learning disability by age 7 when compared to their non-cocaine-exposed peers.

Cognitive Functioning in School-Aged Children With Vertically Acquired HIV Infection Being Treated With Highly Active Antiretroviral Therapy (HAART)

In today's era of highly active antiretroviral therapy (HAART), few children with HIV-1 infection experience severe central nervous system (CNS) manifestations indicative of encephalopathy. However, little is known about the neurocognitive strengths and weaknesses of HIV-infected children treated with HAART. This cross-sectional study is the first to systematically investigate the relation between cognitive functioning and medical markers in HIV-infected children and adolescents treated with HAART with varying levels of computed tomography (CT) brain scan abnormalities. The Wechsler Intelligence Scale for Children–Third Edition was administered to 41 vertically infected children (mean age = 11.2 years) treated with HAART for at least 1 year. Other procedures at the time of testing included CT brain scans and collection of CD4 cell counts and plasma HIV–1 RNA PCR. Although global cognitive functioning among participants was in the Average range, children with minimal to moderate CT brain scan abnormalities scored significantly lower than children with normal scans on composite measures of cognitive functioning and five specific subtests, especially tasks involving executive functions. Furthermore, children with worse immune status (CD4+ counts ≤ 500) scored lower on subtests measuring processing speed. Viral load was unrelated to cognitive test scores. Thus, children with HIV being treated with HAART remain at risk for developing CNS disease. Findings emphasize the importance of conducting neuropsychological assessments in this population, particularly for children with cortical atrophy and absolute CD4+ cell counts ≤ 500.

Higher-order theory of mind and social competence in school-age children

Theory of mind, or the ability to make inferences about the mental states of other people, is thought to be the proximate mechanism underlying humans' ability to function in complex, collaborative social networks. Here we present a set of stories and questions for investigating higher-order theory of mind functioning in school-age children and also a scale for obtaining ratings of children's social competence. Ten and eleven year old children master first and second level theory of mind problems, are slightly above chance on third level problems and perform at chance on fourth level. Theory of mind performance is positively correlated with teacher ratings of the child's social competence. We also find poorer performance in a relatively deprived school than a relatively affluent one.

Executive functions in school-age children born very prematurely

Background School-age preterm children are at risk for cognitive difficulties including Executive Dysfunction and low average IQ. Aim The aim of this study was to determine the performance of very preterm, school-age children on three components of Executive Function (EF), two components of Executive Attention and a measure of IQ. Study design Cross-sectional, independent samples comparison. Methods A UK sample of 40 very preterm (< 32 weeks gestational age, Mean 28.43, SD 2.41) children and 41 term born control children aged between 6 and 12 years (mean ages 8 years 5 months in both groups) was assessed on IQ, EF (inhibition, working memory and set shifting) and attention (sustained and selective). Between group comparisons were made using multivariate analysis of variance and covariance. Results Multivariate analyses indicated that preterm children scored significantly lower than their term born peers across Executive Function and executive attention tasks. As expected, the preterm group achieved IQ scores at the low end of the average range. Univariate analyses indicated some difficulties with shifting and inhibition components of EF, although covariate analysis revealed that only shifting was independent of IQ. Conclusions Preterm children showed mild executive function and executive attention difficulties in the context of average IQ scores. The findings highlight the benefit of using multivariate assessments of executive skills rather than general intellectual outcome alone, to obtain a better distinction of the specific cognitive weaknesses associated with preterm birth.

Anatomical and Behavioral Effects of in Utero Exposure to Antiepileptic Drugs

Anatomical and Behavioral Effects of in Utero Exposure to Antiepileptic Drugs

Dietary Fat Intake Is Associated with Psychosocial and Cognitive Functioning of School-Aged Children in the United States

Using cross-sectional data from the Third National Health and Nutrition Survey, 1988-1994, we examined whether dietary fat intake is associated with cognitive and psychosocial functioning in school-aged children. Based upon 24-h diet recall interviews, dietary intakes of total fat, SFA, monounsaturated fatty, PUFAs, and cholesterol were estimated in 3666 participants aged 6 to 16 y. Psychosocial functioning was evaluated in interviews of each child's mother. Cognitive functioning was measured using achievement and intelligence tests. Overall, total fat and saturated fat were unrelated to measures of cognitive and psychosocial functioning. Compared with equivalent energy intake from saturated fat or carbohydrate, each 5% increase in energy intake from PUFAs was associated with lower risks of poor performance on the digit span test (replacing SFA, OR = 0.58, 95% CI = 0.37-0.91; replacing carbohydrate, OR = 0.61, 95% CI = 0.43-0.88). Cholesterol intake was associated with an increased risk of poor performance on the digit span test (OR = 1.25, 95% CI = 1.11-1.42 for each 100-mg increment intake of cholesterol). The associations were independent of socioeconomic status, maternal education and marital status, and children's nutrition status and were consistent across different methods of energy adjustment in regression models. We conclude that high intake of PUFAs may contribute to an improved performance on the digit span test. In contrast, increased intake of cholesterol may be associated with a poorer performance.

Cognitive Deficits in Children Exposed to Valproate in Utero

The long-term effects on cognitive functioning of school-aged children exposed to antiepileptic drugs (AEDs) in utero were investigated at Alder Hay Hospital and Walton Centre for Neurology and Neurosurgery, Liverpool, UK.

Writing and Drawing Performance of School Age Children

The aim of our study was to investigate possible relationships between writing and drawing performance of school-aged children, in order to compare the two skills at the within-individual level. The sample consisted of 182 right- and left-handed children, aged 8 to 12 years. Children were examined by the Greek adaptation of the Luria-Nebraska neuropsychological battery in spontaneous writing, copying and writing to dictation and they were asked to complete four different drawing tasks. The results produced significant correlations between drawing scores and scores in all three writing tasks. Significant differences in drawing performance among proficient and poor hand writers were also found. On the other hand, there were no significant differences between right- and left-handers’ performance on the above tasks, despite the overrepresentation of left-handed amongst between poor writers. Our findings create a fruitful ground for the further study of early drawing as a means to predict later handwriting problems.

Neuropsychological effects of exposure to anticonvulsant medication in utero

To investigate the long-term differential drug effects on cognitive functioning in school-aged children exposed to antiepileptic drugs (AEDs) in utero. Mothers with epilepsy were recruited from specialist epilepsy clinics and obstetric clinics from the Liverpool and Manchester region. The mothers and their children were recruited without prior knowledge of their AED treatment during pregnancy or the health of the offspring. A battery of neuropsychological tests was applied to each mother-child pair in order to obtain a neuropsychological profile for each child. Neuropsychological investigation was performed on 249 children between the ages of 6 and 16. Children exposed to sodium valproate had a significantly lower verbal IQ when compared to children exposed to other antiepileptic drugs or not exposed at all. The same children were more likely to have an IQ below 69 and more likely to have memory impairment when compared to the other groups. The mothers' IQ, exposure to sodium valproate, and the number of tonic-clonic seizures during pregnancy were significant predictors of verbal IQ in this population. This retrospective study highlights the potential harmful effects of sodium valproate exposure in utero on neuropsychological development.

Family Functioning in School-Age Children With Cystic Fibrosis: An Observational Assessment of Family Interactions in the Mealtime Environment

To examine, using direct observation methodology, differences in family functioning at mealtime between families of school-age children with cystic fibrosis (CF) and families of school-age children without a chronic illness. Family functioning was rated using the McMaster Mealtime Interaction Coding System (MICS) during a videotaped dinner among 28 families of children with CF and 27 families of non-ill, age-matched peers. Families were rated on overall family functioning and on six dimensions of the MICS: task accomplishment, communication, affect management, interpersonal involvement, behavior control, and role allocation. Ratings for families of a child with CF were significantly lower than they were for comparison families on overall family functioning and on four of the six MICS dimensions: communication, affect management, interpersonal involvement, and behavioral control. Moreover, a significantly greater percentage of families of children with CF were rated in the unhealthy range on overall family functioning and on five of six MICS dimensions. There was no relationship between family functioning and child weight status for children with CF. The current study suggests that for families of school-age children with CF, the family system is negatively affected during mealtime. Dietary interventions need to address family-centered, as well as child-centered, interventions to help families manage challenges presented during the family meal.

Abnormal cognitive function in treated congenital hypopituitarism

Aims: To assess cognitive function in school age children with congenital pituitary hormone deficiency (PHD). Methods: Ten children with PHD (aged 6.0–15.6 years, mean 11.5 years) and sibling controls (aged...

The Contribution of Executive Functions to Emergent Mathematic Skills in Preschool Children

Mathematical ability is related to both activation of the prefrontal cortex in neuroimaging studies of adults and to executive functions in school-age children. The purpose of this study was to determine whether executive functions were related to emergent mathematical proficiency in preschool children. Preschool children (N = 96) were administered an executive function battery that was reduced empirically to working memory (WM), inhibitory control (IC), and shifting abilities by calculating composite scores derived from principal component analysis. Both WM and IC predicted early arithmetic competency, with the observed relations robust after controlling statistically for child age, maternal education, and child vocabulary. Only IC accounted for unique variance in mathematical skills, after the contribution of other executive functions were controlled statistically as well. Specific executive functions are related to emergent mathematical proficiency in this age range. Longitudinal studies using structural equation modeling are necessary to better characterize these ontogenetic relations.