Total Intelligence Quotient Score Research Articles

Trends in community response and long-term outcomes from pediatric cardiac arrest: A retrospective observational study

AimThis study aimed to investigate trends over time in pre-hospital factors for pediatric out-of-hospital cardiac arrest (pOHCA) and long-term neurological and neuropsychological outcomes. These have not been described before in large populations. MethodsNon-traumatic arrest patients, 1 day-17 years old, presented to the Sophia Children’s Hospital from January 2002 to December 2020, were eligible for inclusion. Favorable neurological outcome was defined as Pediatric Cerebral Performance Categories (PCPC) 1–2 or no difference with pre-arrest baseline. The trend over time was tested with multivariable logistic and linear regression models with year of event as independent variable. FindingsOver a nineteen-year study period, the annual rate of long-term favorable neurological outcome, assessed at a median 2.5 years follow-up, increased significantly (OR 1.10, 95%-CI 1.03-1.19), adjusted for confounders. Concurrently, annual automated external defibrillator (AED) use and, among adolescents, initial shockable rhythm increased significantly (OR 1.21, 95% CI 1.10-1.33 and OR 1.15, 95% CI 1.02-1.29, respectively), adjusted for confounders. For generalizability purposes, only the total intelligence quotient (IQ) was considered for trend analysis of all tested domains. Total IQ scores and bystander basic life support (BLS) rate did not change significantly over time. InterpretationLong-term favorable neurological outcome, assessed at a median 2.5 years follow-up, improved significantly over the study period. Total IQ scores did not significantly change over time. Furthermore, AED use (OR 1.21, 95%CI 1.10-1.33) and shockable rhythms among adolescents (OR1.15, 95%CI 1.02-1.29) increased over time.

Altered Functional Connectivity Strength in Distinct Brain Networks of Children With Early-Onset Schizophrenia.

Schizophrenia is regarded as a brain network or connectome disorder that is associated with neurodevelopment. Children with early-onset schizophrenia (EOS) provide an opportunity to evaluate the neuropathology of schizophrenia at a very early stage without potential confounding factors. But dysfunction in brain networks of schizophrenia is inconsistent. To identify abnormal functional connectivity (FC) in EOS patients and relationships with clinical symptoms, we aimed to reveal neuroimaging phenotypes of EOS. Prospective, cross-sectional. Twenty-six female/22 male patients (age:14.3 ± 3.45 years) with first-episode EOS, 27 female/22 male age- and gender-matched healthy controls (HC) (age:14.1 ± 4.32). 3-T, resting-state (rs) gradient-echo echo-planar imaging and three-dimensional magnetization-prepared rapid gradient-echo imaging. Intelligence quotient (IQ) was measured by the Wechsler Intelligence Scale-Fourth edition for Children (WISC-IV). The clinical symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). FC strength (FCS) from rs functional MRI (rsfMRI) was used to investigate functional integrity of global brain regions. In addition, associations between regionally altered FCS and clinical symptoms in EOS patients were examined. Two-sample t-test controlling for sample size, diagnostic method, brain volume algorithm, and age of the subjects, Bonferroni correction, Pearson's correlation analysis. A P-value <0.05 with a minimum cluster size of 50 voxels was considered statistically significant. Compared with HC, EOS patients had significantly lower total IQ scores (IQ:91.5 ± 16.1), increased FCS in the bilateral precuneus, left dorsolateral prefrontal cortex, left thalamus, and left parahippocampus (paraHIP), and decreased FCS in the right cerebellum posterior lobe and right superior temporal gyrus. The PANSS total score of EOS patients (PANSS total score:74.30 ± 7.23) was found to be positively correlated to FCS in the left paraHIP (r=0.45). Our study revealed that disrupted FC of brain hubs illustrate multiple abnormalities in brain networks in EOS patients. 1 TECHNICAL EFFICACY STAGE: 2.

Prenatal and postnatal exposures to heavy metal mixtures and IQ in 6-year-old children: a prospective cohort study in South Korea

BACKGROUND AND AIM: Humans are exposed to a mixture of heavy metals during their lifetime; however, evidence of neurotoxicity of such mixtures against critical time windows is still insufficient. We aimed to elucidate the associations of heavy metal mixtures across multiple time points with children’s intelligence quotient (IQ) in a prospective cohort study. METHODS: Prenatal exposure and exposure at age 4 and 6 to four types of heavy metals were quantified in pregnant women and their children who participated in the Environment and Development Cohort study. Children’ s IQ scores were assessed using the Wechsler Intelligence Scale at age 6. Linear regression models, Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression models, and elastic net (ENET) models were used to assess the associations of each heavy metal and their mixtures with IQ scores. RESULTS:Linear regression models indicated that postnatal blood lead level at the age of 6 years and manganese levels at the ages of 4 and 6 were significantly negatively associated with total IQ at 6 years of age. In the multi-chemical BKMR and WQS models, statistically significant inverse associations were found between the mixture of prenatal and postnatal heavy metal exposures and total IQ scores. Higher quantiles of metal mixtures were associated with lower children’s IQ. Interestingly, we found that manganese level at the age of 6 years was the most contributing factor to children’s IQ at 6 years of age in the mixture models of BKMR, WQS, and ENET. CONCLUSIONS:Multi-pollutant mixtures of prenatal and postnatal exposures to heavy metals affected child IQ at 6 years of age. We found a strong relationship between postnatal lead exposure and children’s IQ at the age of 6 years. Additional studies are warranted to confirm these associations and to control the exposure to different metals during pregnancy and preschool childhood. KEYWORDS: Bayesian kernel machine regression, elastic net, heavy metals, intelligence quotient, weighted quantile sum

Association Between Sleep Duration and Intelligence Quotient in 6-Year-Old Children.

Sufficient sleep during childhood is important for cognitive functions such as learning and successful school performance. This study aimed to investigate the effects of sleep duration on the intelligence quotient (IQ) of 6-year-old children and aimed to analyze whether these effects differed by sex. The IQ of 538 6-year-old Korean participants from the cohort study, "The Environment and Development of Children," was measured during follow-up using the Korean Educational Developmental Institute's Wechsler Intelligence Scale for Children. The total, verbal, and performance IQ scores were evaluated. The relationship between sleep duration and IQ scores after adjusting for maternal age, maternal educational level, maternal occupation, maternal IQ, exposure to secondhand smoking, gestational age, and monthly age and birth season was also assessed. Longer sleep duration was significantly associated with improved verbal IQ measures (β 0.55; p value 0.030). After stratifying participants by sex, a significant association was observed between sleep duration and total, verbal, and performance IQ scores in boys (total IQ 2.49, p value 0.012; verbal IQ 0.75, p value: 0.037; performance IQ 0.73, p value 0.048), but not in girls. The results indicated that only boys show a significant association between IQ scores and sleep duration. These findings support the hypothesis that sleep duration is associated with IQ, in a sex dependent manner. Future studies are needed for a thorough evaluation of the connection between sleep duration and health outcome in young children.

Facial Emotion Recognition in Children and Adolescents with Specific Learning Disorder.

Background: Some recent studies suggest that children and adolescents with different neurodevelopmental disorders perform worse in emotions recognition through facial expressions (ER) compared with typically developing peers. This impairment is also described in children with Specific Learning Disorders (SLD), compromising their scholastic achievement, social functioning, and quality of life. The purpose of our study is to evaluate ER skills in children and adolescents with SLD compared to a control group without learning disorders, and correlate them with intelligence and executive functions. Materials and Methods: Our work is a cross-sectional observational study. Sixty-three children and adolescents aged between 8 and 16 years, diagnosed with SLD, and 32 sex/age-matched controls without learning disorders were recruited. All participants were administered standardized neuropsychological tests, evaluating facial emotion recognition (NEPSY-II), executive functions (EpiTrack Junior), and intelligence profile (WISC-IV). Results: Emotion recognition mean score was significantly lower in the SLD group than in the controls group on the Mann–Whitney U test for unpaired samples (p < 0.001). The SLD group performed significantly lower than the control group in their abilities to identify neutral expressions, happiness, sadness, anger, and fear compared to controls (p < 0.001). ER scores were positively correlated to the executive functions scores. There was no correlation with the Total Intelligence Quotient scores but there is a significant positive correlation with Working Memory Index and Processing Speed Index measured by WISC.IV. Conclusion: Our study showed that children and adolescents with Specific Learning Disorders have facial emotion recognition impairment when compared with a group of peers without learning disorders. ER abilities were independent of their global intelligence but potentially related to executive functions.

Neuropsychological and neuroanatomical phenotype in 17 patients with cystinosis

BackgroundCystinosis is a rare autosomal recessive disorder caused by intracellular cystine accumulation. Proximal tubulopathy (Fanconi syndrome) is one of the first signs, leading to end-stage renal disease between the age of 12 and 16. Other symptoms occur later and encompass endocrinopathies, distal myopathy and deterioration of the central nervous system. Treatment with cysteamine if started early can delay the progression of the disease. Little is known about the neurological impairment which occurs later. The goal of the present study was to find a possible neuroanatomical dysmorphic pattern that could help to explain the cognitive profile of cystinosis patients. We also performed a detailed review of the literature on neurocognitive complications associated with cystinosis.Methods17 patients (mean age = 17.6 years, [5.4–33.3]) with cystinosis were included in the study. Neuropsychological assessment was performed including intelligence (Intelligence Quotient (IQ) with Wechsler’s scale), memory (Children Memory Scale and Wechsler Memory Scale), visuo-spatial (Rey’s figure test) and visuo-perceptual skills assessments. Structural brain MRI (3 T) was also performed in 16 out of 17 patients, with high resolution 3D T1-weighted, 3D FLAIR and spectroscopy sequences.ResultsIntellectual efficiency was normal in patients with cystinosis (mean Total IQ = 93). However the Perceptual Reasoning Index (mean = 87, [63–109]) was significantly lower than the Verbal Comprehension Index (mean = 100, [59–138], p = 0.003). Memory assessment showed no difference between visual and verbal memory. But the working memory was significantly impaired in comparison with the general memory skills (p = 0.003). Visuospatial skills assessment revealed copy and reproduction scores below the 50th percentile rank in more than 70% of the patients. Brain MRI showed cortical and sub-cortical cerebral atrophy, especially in the parieto-occipital region and FLAIR hypersignals in parietal, occipital and brain stem/cerebellum. Patients with atrophic brain had lower Total IQ scores compared to non-atrophic cystinosis patients.ConclusionsPatients with cystinosis have a specific neuropsychological and neuroanatomical profile. We suggest performing a systematic neuropsychological assessment in such children aiming at considering adequate management.

Plasma Homocysteine level in Children under Treatment with Antiepileptic Drugs and its Relation to Intelligence Quotient

Background: Epilepsy is one of the most common neurological disorders in children. It often requires long-term antiepileptic drug (AED) therapy. AEDs are frequently associated with cognitive and behavioral dysfunctions. Also, there is a relationship between AEDs use and homocysteine levels. Elevated homocysteine has been associated with cognitive dysfunction. However, such effect among epileptic children has not been well-studied.Aim of the work: To study plasma homocysteine level in children under treatment with AEDs and its relation to intelligence quotient (IQ).Patients and Methods: A case control study included 56 epileptic children on AED therapy for at least 6 months, and 36 healthy children (Controls). Study was conducted at Al-Azhar University Hospital (Damietta) from June 2016 to June 2018. Plasma homocysteine was measured using Enzymatic Recycling (Biotecnica Instruments SpA). IQ testing was conducted using Stanford-Binet Intelligence Scales, Fifth Edition.Results: Epileptic children exhibited significant elevation of Homocysteine level (P=0.005), and significant affection of all IQ parameters. There was significant negative correlation between homocysteine level with total working memory, total verbal IQ and total IQ. Multivariate regression analysis revealed that homocysteine showed a significant and independent association with total working memory, total verbal IQ and total IQ. None of the other studied factors revealed such association.Conclusion: Homocysteine was a significant and independent risk factor for low total working memory score, low total Verbal IQ and low total IQ scores. Further studies are required to confirm these results, and to evaluate the effect of homocysteine-lowering treatment on cognitive function in epileptic children.

The cognitive performance of indigenous schoolchildren in relation to their feeding during infancy

Nutrition during the first 3 years of life is critical to neurodevelopment. Native populations experience poverty, inequality, and food insecurity. Therefore, we analyzed the relationship between feeding during infancy and cognitive performance in schoolchildren of rural indigenous communities in Riobamba, Ecuador. Thirty-seven schoolchildren (5-6 years) were recruited. We determined duration of exclusive breastfeeding, weaning age, age of cow's milk incorporation, daily intake of cow's milk, age of solid and liquid incorporation, and sociocultural and anthropometric parameters. Verbal, manipulative, and total intelligence quotients were evaluated with Wechsler Preschool and Primary Scale of Intelligence. Means of verbal, manipulative, and total intelligence quotient scores were 86.46 ± 11.55, 96.39 ± 9.96, and 89.25 ± 10.43, respectively. Children were exclusively breastfed until 6.83 ± 3.97 months and weaned at 17.17 ± 5.58 months. Age of cow's milk incorporation was 12.58 ± 6.06 months, with a daily intake of 737.50 ± 417.50 mL. Solids were incorporated at 10.11 ± 4.43 months and liquids at 7.72 ± 3.30 months. Positive associations between duration of exclusive breastfeeding and manipulative (unadjusted: ρ = .545, P = .006; r = .491, P = .028; adjusted for children's body mass index, and ethnicity and educational level of mothers: r = .522, P = .041) and total (unadjusted: ρ = .483, P = .017; adjusted: r = .572, P = .036) intelligence quotients were found. Frequency of children with manipulative (χ2 [2] = 7.093, P = .029) and total (χ2 [2] = 7.198, P = .027) intelligence quotient ≥90 was higher in those exclusively breastfed >6 months. Furthermore, schoolchildren in the >6 months group had better manipulative (101.75 ± 9.08 vs 89.71 ± 8.56, P = .038) and total (94.50 ± 11.89 vs 84.86 ± 5.05, P = .036) intelligence quotient than those in the <6 months group, independent of anthropometric and sociocultural factors. Longer exclusive breastfeeding was related to better total intelligence quotient in rural indigenous schoolchildren.

Estimation of Mean Intelligence Quotient with Wechsler Scale in Iran: Systematic Review and Meta-Analysis.

The low intelligence quotient (IQ) level is one of the most common and important medical, social, and familial problems in all countries. The current study aimed to estimate mean IQ with the Wechsler scale in Iran by performing a systematic review and meta-analysis. In the current meta-analysis, all articles related to IQ conducted in Iran using the Wechsler scale were deeply searched by reviewing citation databases including Science Direct, PubMed, Scopus, Web of Science, Springer, SID, Magiran, Iranmedex, Medlib, and Google Scholar motor search and using valid keywords without time limits. Due to heterogeneity between studies, a random effects model was used to combine the results of studies. To investigate the heterogeneity of the studies, the I2 index was used. All statistical analyses were performed using STATA software version 11.1. The number of participants in the 51 studies was 5352. The mean total IQ score in Iran was estimated 97.12 (95% confidence interval [CI]: 88.71–105.52), the practical intelligence was 92.84 (95% CI: 79.14–106.55), and the verbal intelligence was 94.50 (95% CI: 83.90–105.10). The total IQ score in the northern, southern, central, eastern, and western regions of Iran was 97.08, 108.90, 92.31, 101.76, and 96.45, respectively. The mean IQ score in Iran in subjects under 20 years of age is 97.73 and in subjects over 20 years of age is 105.61. There is also no significant relationship between the mean total IQ in Iran and two parameters of the year of research and number of research samples. For prevention of decrease IQ and given that proper nutrition and breastfeeding directly contribute to increase IQ, nutrition should be provided free of charge in poorer areas during pregnancy until baby born. Moreover, the media should provide adequate education for breastfeeding and nutrition, because IQ affects people's academic, occupational, personal, and social performance, and also prevents elite immigration with suitable planning and provides conditions for elites to return to the country.

Effect of childhood nutrition counselling on intelligence in adolescence: a 15-year follow-up of a cluster-randomised trial.

The present study aimed to assess the effects of an early childhood nutrition counselling intervention on intelligence (as measured by the intelligence quotient (IQ)) at age 15-16 years. A single-blind, cluster-randomised trial. In 1998, in Southern Brazil, mothers of children aged 18 months or younger were enrolled in a nutrition counselling intervention (n 424). Counselling included encouragement and promotion of exclusive breast-feeding until 6 months of age and continued breast-feeding supplemented by protein-, lipid- and carbohydrate-rich foods after age 6 months up to age 2 years. The control group received routine feeding advice. In 2013, the fourth round of follow-up of these individuals, at the age of 15-16 years, was undertaken. IQ was assessed using the short form of the Wechsler Adult Intelligence Scale (WAIS-III). Mental disorders (evaluated using the Development and Well-Being Assessment (DAWBA)) and self-reported school failure, smoking and alcohol use were also investigated. Adjusted analyses were conducted using a multilevel model in accordance with the sampling process. Adolescents, mean (sd) age of 15·4 (0·5) years (n 339). Mean (sd) total IQ score was lower in the intervention group than the control group (93·4 (11·4) and 95·8 (11·2), respectively) but the association did not persist after adjustment. The prevalence of any mental disorders was similar between intervention and control groups (23·1 and 23·5 %, respectively). There were no differences between groups regarding school failure, smoking and alcohol use. Nutrition counselling intervention in early childhood had no effect on intelligence measured during adolescence.

Neurodevelopmental and cardiometabolic outcome in 4-year-old twins and singletons born after IVF

This prospective cohort study evaluated whether the cognitive development, neurological condition, anthropometrics and blood pressure of 4-year-old IVF twins differed from those of 4-year-old IVF singletons; 103 IVF singletons and 48 IVF twins born after conventional IVF treatment were included. Primary outcome was total intelligence quotient (IQ). Secondary outcomes were minor neurological dysfunction, anthropometrics and blood pressure. Unadjusted analyses found that the total IQ score of twins was lower than that of singletons, with a mean difference of −5.4 (–9.7 to −1.0). Weight (singletons: 18.6 [18.1 to 19.1] kg; twins: 16.9 [16.0 to 17.9] kg) and height (singletons: 108.8 [107.9 to 109.8] cm; twins: 105.9 [104.0 to 107.7] cm) of twins were lower than those of singletons (mean values [95% CI]). All differences disappeared after adjusting for mediators and confounders. Neurological outcome, systolic and diastolic blood pressure of twins and singletons were similar. Four-year-old IVF twins had a lower total IQ (−5.4 points), lowerbodyweight (−1.7 kg) and were shorter (−2.9 cm) than 4-year-old IVF singletons. After adjustment, the adverse twin effect disappeared, implying that increased risk for impaired health and development in twins also holds true for IVF twins, and is not altered by IVF.

Primary nocturnal enuresis is associated with lower intelligence quotient scores in boys from poorer socioeconomic status families.

To explore intelligence quotient in boys with primary nocturnal enuresis compared with normal boys considering their socioeconomic status. A total of 152 school-aged boys (including 55 boys with primary nocturnal enuresis and 97 matched normal controls) were assessed. Boys with a history of any neurological or urological disease were excluded. Two different districts of Tehran: Khani-Abad (a poor district) and Pirouzi (a middle class district) districts were enrolled according to socioeconomic status data reported by the World Health Organization. Intelligence tests were carried out using a validated Iranian translation of the Wechsler Intelligence Scale for Children Revised. Total, as well as performance intelligence quotient and verbal intelligence quotient scores and verbal-performance discrepancy (the difference between verbal and performance intelligence quotient scores for each individual) were compared using a t-test between boys with primary nocturnal enuresis in each district and their matched controls. Considering each district separately, the total intelligence quotient score was lower in primary nocturnal enuresis cases than controls only in the lower income district (90.7±23.3 vs 104.8±14.7, P=0.002). Similarly, boys with primary nocturnal enuresis ranked lower in verbal intelligence quotient (P=0.002) and performance intelligence quotient (P=0.004) compared with their matched normal controls only in lower income district, whereas in the higher income district, boys with primary nocturnal enuresis ranked similar in total intelligence quotient to their matched controls. Boys with primary nocturnal enuresis had a lower intelligence quotient compared with the control participants only in low-income district. It seems important to adjust the results of the intelligence quotient assessment in these children according to their socioeconomic status.

Effects of methylphenidate on body index and physical fitness in Korean children with attention deficit hyperactivity disorder.

The side effects of methylphenidate (MPH) on growth remain a controversial concern. This study aimed to investigate the effect of MPH on clinical symptoms, growth, and physical fitness in Korean children. Fifty male children with attention deficit hyperactivity disorder (ADHD) treated with methylphenidate (MPH-ADHD), 69 MPH-naïve male children with ADHD (Naïve-ADHD), and 60 age-matched and sex-matched healthy control subjects were recruited. Intelligence quotient (IQ), clinical symptoms of ADHD, body index (height, weight, and body mass index [BMI]), and physical fitness (muscular strength, endurance, flexibility, agility, speed, and balance) were assessed. Total IQ and performance IQ scores were significantly different among the three groups, as were mean Korean Attention Deficit Hyperactivity Disorder (K-ARS)-total, K-ARS-inattention, and K-ARS-hyperactivity scores. There was no significant difference in height, weight, or BMI among the three groups. There were significant differences in skill-related fitness scores for balance (healthy controls > MPH-ADHD > Naïve-ADHD) and agility shuttle test time (healthy controls < MPH-ADHD < Naïve-ADHD). Our findings support the effectiveness of MPH treatment for improving IQ, attention, and balance and agility measures of skill-related fitness in Korean children with ADHD. MPH was not associated with growth delays in height, weight, and BMI.

Hypersexuality, Paraphilic Behaviors, and Gender Dysphoria in Individuals with Klinefelter's Syndrome.

An increased risk of autistic traits in Klinefelter syndrome (KS) has been reported. In addition, some studies have shown an increased incidence of gender dysphoria (GD) and paraphilia in autism spectrum disorder. The aim of this study was to evaluate the presence of (i) paraphilic fantasies and behaviors; and (ii) GD symptomatology in KS. A sample of 46 KS individuals and 43 healthy male controls (HC) were evaluated. Subjects were studied by means of several psychometric tests, such as Autism Spectrum Quotient (AQ) and Reading the Mind in the Eyes Revised (RME) to measure autistic traits, Gender Identity/GD questionnaire (GIDYQ-AA), and Sexual Addiction Screening Test (SAST). In addition, body uneasiness psychopathological symptoms were assessed using Symptom Checklist 90 Revised (SCL-90-R). The presence and frequency of any paraphilic fantasy and behavior was assessed by means of a clinical interview based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria. Finally, all individuals included were assessed by Wechsler Adult Intelligence Scale-Revised to evaluate intelligence quotient (IQ). Data from a subsample of a previous published series of male to female GD individuals, with the battery of psychological measures useful to provide a psychopathological explanation of GD in KS population available, was also considered. When compared with HC, KS reported significantly lower total, verbal and performance IQ scores and higher SCL-90 obsession-compulsive symptoms (all P < 0.001). In line with previously reported findings, KS showed higher autistic traits according with both RME and AQ tests (P < 0.001). With respect to sexuality, KS showed a significant higher frequency of voyeuristic fantasies during masturbation (52.2% vs. 25.6%) and higher SAST scores (P = 0.012). A mediation role of obsessive symptoms on the relationship between Klinefelter and SAST was confirmed (unstandardized estimate b = 2.75, standard error = 0.43 P < 0.001). Finally, KS individuals showed significantly higher gender dysphoric symptoms than HC (P = 0.004), which were mediated by the presence of autistic traits (Sobel's test; P < 0.05). KS is associated with hypersexuality, paraphilic behaviors, and GD, which were mediated by obsessive-compulsive and autistic traits.

Neurophysiologic Evaluation of Children with Beta-Thalassemia Major

Neural pathway involvement is considered to be a neurological complication in Beta-thalassemia major (BTM). This study aimed to detect possible involvement of central and peripheral neural pathways in a group of neurologically asymptomatic patients with BTM. It was performed on 30 patients diagnosed as having BTM (group I), and 10 healthy children who were matched for age, sex, and height (group II). Serum ferritin, iron, glucose tolerance test, intelligence quotient (IQ) test, and electroencephalogram (EEG) were assessed in BTM patients. Electrophysiologic study was assessed in both groups. The mean age of the patients was 10.45 ± 2.88 years. They were 14 males and 16 females. The results of the present study showed that 66.7% of patients had subclinical sensory peripheral neuropathy. Twenty percent of the patients had abnormal somatosensory evoked potentials. Low average and slow learner total IQ score were found in 63.3% of the studied patients. These findings did not correlate with age, disease duration, serum iron, and ferritin. Twenty-three patients had mature EEG background activity, while seven patients had immature background activity. The EEG background maturity had significant correlation with age, duration of desferrioxamine therapy, and serum iron. There was no correlation between serum ferritin level, EEG, and electrophysiologic findings. Regular electrophysiologic monitoring and intellectual evaluation are recommended to detect relevant abnormalities and apply appropriate management.

Intelligence of Hearing-Impaired Children: An Evaluation Based on Demographic, Educational, and Audiological Characteristics

Studies to determine the intelligence level of children with special needs are performed by Guidance and Research Centers, university research centers, schools, and the relevant clinics of hospitals for a variety of reasons. International occupational organizations describe that gaining an understanding of the intelligence characteristics of hearing-impaired children in different cultures and societies is of critical importance to ensure that specialists and researchers performing intelligence tests can interpret their results correctly. Based on this consideration, the purpose of this study was to demonstrate the intelligence characteristics of hearing-impaired children through comparisons with children with typical development. In addition, I investigated the relationship of the intelligence quotient (IQ) score with basic demographic, educational, and audiological variables, and evaluated whether IQ scores differed according to these variables. The sample of the study consisted of 329 hearing-impaired children in different educational settings within the Eskisehir province. According to the results of the one sample t-test performed within the frame of the study’s main purpose, the total IQ scores of the hearing-impaired children, as determined by the WISC-R performance sub-tests, were higher than the scores of the standardization sample of Turkey. Pearson correlation analysis indicated that the WISC-R performance sub-tests had a moderate correlation with one another, and a high correlation with IQ scores. Among the different demographic variables, the educational level of both the father and mother had a significant effect on total IQ scores, although the fathers’ level of education showed a higher correlation with total IQ than the mothers’. In regards to the audiological variables, the degree of hearing loss did not have a significant correlation with total IQ. Based on the ANCOVA, in which the fathers’ level of education as covariate, it was determined that with respect to the gender, male children had higher total IQ scores than female children; and that, with respect to the educational setting variable, children receiving education at the Education and Research Center for Hearing Impaired Children (ICEM) and in inclusive settings had higher total IQ scores than children receiving education at the Ministry of National Education’s (MoNE) Elementary Schools for the Hearing Impaired. No significant difference was identified in terms of IQ scores between children using hearing aids and children using cochlear implants. Higher IQ scores were observed for the standardization group during the comparison of Turkey’s standardization sample with the hearing-impaired children sample. We believe that this may have been due to the fact that the test’s standardization data were somewhat not actual. The study findings indicate that individuals performing intelligence assessments on hearing-impaired children should take into account the socio-economic level of these children’s families, as well as the educational setting. Possible recommendations we can make to other researchers include determining the psychometric characteristics of the new version of this test and other non-verbal intelligence tests; conducting norm studies; testing the psychometric characteristics of intelligence tests with groups that have different special needs; and developing tests suitable for the Turkish culture.

Effect of low thyroid hormone bioavailability on childhood cognitive development: data from the Avon Longitudinal Study of Parents and Children birth cohort

BackgroundHypothyroidism is associated with impaired cognitive development. Whether free thyroxine (T4) concentrations at the lower end of the reference range also have a negative effect is less clear. A common genetic variant, the Thr92Ala substitution in deiodinase-2 can exacerbate low free T4 concentrations by reducing intracellular conversion of free T4 to free tri-iodothyronine. We aimed to see whether low thyroid hormone bioavailability (free T4 in the lowest quartile and the Thr92Ala substitution in deiodinase-2) in childhood adversely affects cognitive development. MethodsThe data from this study come from a retrospective cross-sectional analysis in a population-based birth cohort study, the Avon Longitudinal Study of Parents and Children. Children had thyroid function tested at age 7 years and extensive cognitive assessments at age 8 years. We assessed the odds of having a lower end intelligence quotient (IQ) (<85) if an individual had low thyroid hormone bioavailability. Analyses were adjusted for age, sex, other thyroid hormone variables, and social class. Findings422 (13·5%) of 3127 children had the Thr92Ala substitution, with 116 children (3·71%) having the combination of free T4 in the lowest quartile and the Thr92Ala substitution. We noted a strong association between children with free T4 in the lowest quartile and the Thr92Ala substitution and lower mean IQ (p=0·008, t test). Individuals with free T4 in the lowest quartile and the Thr92Ala substitution were more likely to have a total IQ score below 85 than individuals with free T4 above the lowest quartile without the substitution (odds ratio 3·03, 95% CI 1·38–6·67; p=0·006). There was no association with IQ below 85 in individuals with free T4 in the lowest quartile without the substitution (1·07, 0·82–1·39; p=0·59). When we considered total IQ as a continuous variable, children with free T4 in the lowest quartile and the Thr92Ala substitution had a lower IQ than did those with free T4 above the lowest quartile without the substitution (β=−0·34, −0·64 to −0·04, p=0·03). InterpretationCommon genetic variation in the intracellular thyroid hormone action pathway seems to substantially modify the effect of low serum thyroid hormone concentrations on IQ. This finding suggests that thyroid hormone concentrations alone do not entirely reflect thyroid status and raises the possibility that thyroxine supplementation in at-risk children might improve cognitive outcomes. FundingBupa Research Foundation, British Thyroid Foundation.

Diet Quality of UK Infants Is Associated with Dietary, Adiposity, Cardiovascular, and Cognitive Outcomes Measured at 7–8 Years of Age1–4

Whereas the influence of pregnancy diet and milk feeding on children's health and development is well characterized, the role of early food intake and eating behaviors is largely unexplored. This study aimed to determine whether the degree of adherence to complementary feeding guidelines was associated with dietary, obesity, cardiovascular, and cognitive outcomes at 7–8 y of age. Data were analyzed from the Avon Longitudinal Study of Parents and Children using parent-completed dietary questionnaires at 6 mo of age to calculate a Complementary Feeding Utility Index score. Regression analysis was used to explore associations between the index score and dietary patterns derived via principal component analysis (n = 4326), body-mass index (BMI) (n = 4801), waist circumference (n = 4798), blood pressure (n = 4685), and lipids (n = 3232) measured at age 7 y; and intelligence quotient (IQ) measured at age 8 y (n = 4429) after adjustment for covariates. The index score was negatively associated with a “processed” dietary pattern (β = −0.16; 95% CI: −0.20, −0.13; P < 0.001) but positively associated with a “health conscious” dietary pattern [β = 0.18 (95% CI: 0.14, 0.21); P < 0.001]. A higher index score was also positively associated with total, verbal, and performance IQ scores at 8 y of age [β = 1.92 (95%CI: 1.38, 2.47); P < 0.001 for total IQ). The index score was weakly associated with waist circumference [β = −0.15 (95%CI: −0.31, −0.002); P = 0.046] and diastolic blood pressure [β = −0.24 (95%CI: −0.47, −0.01); P = 0.043] at 7 y of age but was not associated with BMI or other cardiovascular risk factors. These findings suggest that adherence to current complementary feeding guidelines may have implications for some, but not all, health and development outcomes in childhood.

The effects of breastfeeding on cognitive and neurological development of children at 9 years

The effect of breastfeeding on cognitive development in the child remains controversial. The commonly observed association between breastfeeding and higher intelligence quotient (IQ) scores in children may result from the numerous confounding factors in this complex relationship. The aim of this study was to examine whether breastfeeding is associated with later differences in children's cognitive and neurological development. Secondary analysis from a 9-year follow-up study of children of 982 smokers recruited to a randomized controlled trial of anti-smoking education in pregnancy in a maternity hospital between November 1981 and October 1982; and all ex-smokers and a random 25% sample of non-smokers during the same period (total 1853 women). Cognitive and neurological development of children was assessed by psychologists in schools using the British Ability Scales and Quick Neurological Screening Test (QNST). Data on breastfeeding and factors relevant to child development were drawn from interviews with mothers at home. Main outcome measures were IQ and QNST scores. A total of 1218 (66%) children were followed up. In total, 61.6% of children were breastfed, median duration being 12 weeks. Before adjustment, breastfeeding was significantly associated with higher total, verbal and visual IQ scores in children, and increasing duration was significantly correlated with IQ scores. Total IQ was 5.49 points higher in breastfed children (P< or = 0.001), but became non-significant after adjustment. Total IQ scores were most strongly associated with maternal education, maternal age, parity, housing and chronic childhood illness. Breastfeeding was significantly associated with better QNST scores on bivariate analysis but not after adjustment. QNST scores were most strongly associated with maternal education and the child's sex. Breastfeeding was not associated with any crude IQ advantage or difference in neurological soft signs in children at 9 years. The greater IQ score associated with breastfeeding is accounted for by confounding, with maternal and socio-economic characteristics particularly important.

Headache and cognitive profile in children: a cross-sectional controlled study

We investigated whether children affected by tension-type headache and migraine without aura, compared with a healthy control group that was matched by age, culturally and socioeconomically display a diverse intellectual functioning and have a separate “cognitive profile”. A cross-sectional study was conducted from January 2006 to November 2008 at “Sapienza University” in Rome. A total of 134 children were diagnosed as being affected by either migraine without aura (93) or tension-type headache (41). On the basis of our exclusion/inclusion criteria, we enrolled 82 of these 134 children, 63 of whom were affected by migraine without aura and 19 by tension-type headache. On entry, cognitive functions were assessed in both the affected subjects and the control group by the Wechsler Intelligence Scale for Children-revised. Significant differences were found between the headache and control groups in the mean total intelligence quotient and verbal intelligence quotient scores (p < 0.001). Significant negative correlations were found between the total intelligence quotient, verbal intelligence quotient, performance intelligence quotient and the frequency of attacks (r = −0.55 and p < 0.001, r = −0.61 and p < 0.001, r = −0.29 and p < 0.01, respectively), as well as between the total intelligence quotient score and the age at headache onset (r = 0.234, p < 0.05). Our results suggest that the cognitive profile of children affected by headache should be assessed at the first child neurology outpatient observation. From a therapeutic point of view, although within a normal range, the abilities most likely to be less brilliant in such children are verbal skills.