Wechsler Intelligence Scale Research Articles

Investigating measurement invariance of the IDS-2 intelligence scales between migrant and non-migrant groups

Intelligence plays a crucial role in various aspects of human life, impacting health, academic achievement, and socio-economic success. However, cultural and linguistic disparities in intelligence testing pose challenges, particularly for individuals from migrant backgrounds. This study replicates and extends the landmark study by Wicherts and Dolan (2010) exploring measurement invariance of the German language intelligence test, the Intelligence and Development Scales – 2 (IDS-2), between children and adolescents from migrant (N = 132) and non-migrant (N = 1898) groups. The results revealed partial strict measurement invariance in the IDS-2 intelligence scale subtests across the examined groups. The breach of full strict measurement invariance is primarily due to intercept differences on the verbally loaded subtests—Naming Categories, Naming Opposites, and Story Recall—highlighting the confounding impact of language complexity on test outcomes. These discrepancies resulted in a cumulative intercept difference disadvantaging migrant participants of approximately 4 IQ points on the Full-Scale IQ Score. The findings indicate that while the IDS-2 scales generally assess intelligence consistently across diverse groups, the influence of language complexity on the verbal subtests may result in a disadvantage for children and adolescents with migration backgrounds. To address these biases, we propose the development of non-verbal and culturally fair intelligence tests.

Associations of fetal and infant growth patterns with behavior and cognitive outcomes in early adolescence

AbstractBackgroundFetal life and infancy might be critical periods for brain development leading to increased risks of neurocognitive disorders and psychopathology later in life. We examined the associations of fetal and infant weight growth patterns and birth characteristics with behavior and cognitive outcomes at the age of 13 years.MethodsPopulation‐based prospective cohort study from fetal life until adolescence. Pregnant women with a delivery date between April 2002 and January 2006 were eligible. Follow‐up measurements were available for 4716 children. Fetal weight was estimated in the second and third trimesters of pregnancy by ultrasonography. Infant weight was measured at birth and at 6, 12, and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change in SD greater than 0.67 between time points. Total, internalizing and externalizing problems and attention‐deficit hyperactivity disorder (ADHD) symptoms were measured using Child Behavior Checklist (CBCL/6–18), autistic traits by the Social Responsiveness Scale (SRS) and intelligence quotient (IQ) by the Wechsler Intelligence Scale for Children‐Fifth Edition (WISC‐V).ResultsOne week longer gestational age at birth was associated with a −0.03 SDS (95% Confidence Interval (CI): −0.04, −0.01) lower total behavior problems score, a −0.02 SDS (95% CI: −0.04, −0.01) lower ADHD symptoms score. Also an increase in birth weight of 500 g was associated with a lower odds of having high externalizing problems (OR 0.92 (95% CI: 0.86, 0.98) and of having a low IQ score (OR 0.79 (95% CI: 0.71, 0.88). Compared to children with normal fetal and infant growth, those with accelerated fetal and infant growth had a 0.27 SDS higher IQ (95% Confidence Interval 0.11, 0.44).ConclusionsBoth fetal and infant weight development are associated with behavioral and cognitive outcomes in early adolescence. Follow‐up studies are needed to assess whether these associations link to later life mental health outcomes.

Development of a Cognitive Assessment Checklist for First-Grade Mathematics: Utilizing Hierarchical Cognitive Diagnostic Modeling in Elementary Education

This study aimed to address the need for a comprehensive assessment tool to evaluate the mathematical abilities of first-grade students through cognitive diagnostic assessment (CDA). The primary challenge involved in this endeavor was to delineate the specific cognitive skills and sub-skills pertinent to first-grade mathematics (FG-M) and to determine the most suitable model for assessment. Employing a mixed-methods approach, the research identified nine cognitive attributes essential for FG-M and developed a Q-matrix delineating the relationship between these attributes. A preliminary version of the FG-M checklist comprising 74 items was formulated. Subsequently, the assessment tool was administered to 1018 first-grade students, with their teachers utilizing the FG-M checklist for evaluation. Results indicated a commendable accuracy in classifying the nine cognitive attributes, ranging from 0.68 to 0.92, with an average accuracy of 0.76. Furthermore, the validity of the scores was corroborated by a substantial correlation (r = 0.78) between scores from the FG-M checklist and the arithmetic subtest of the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Overall, the study concluded that the scores from the FG-M checklist are reliable for assessing the mathematical skills of first-grade students. The findings underscored the students’ proficiency in fundamental mathematical concepts such as cardinality, addition, subtraction, weight, and statistics. However, areas of weakness were identified in concepts related to multiplication, time, symmetry, and geometry. This research contributes significantly to the advancement of CDA in educational contexts, providing educators with a valuable tool for identifying students’ strengths and weaknesses in mathematical cognition.

Cognitive performance, mental health, and quality of life in β-thalassemia individuals: a comprehensive analysis

IntroductionBeta-thalassemia is a prevalent autosomal recessive haemolytic disorder, particularly in the Middle East. Patients with beta-thalassemia major (βTM) require iron chelation therapy and regular blood transfusions, while those with beta-thalassemia intermedia (βTI) exhibit milder symptoms. This study aimed to evaluate cognitive function, behavioural problems, quality of life, and related aspects in individuals with βTM and βTI.MethodsThe cross-sectional study included 20 βTM participants, 20 βTI participants, and 19 healthy controls. Participants underwent psychiatric interviews, the Wechsler Adult Intelligence Scale (WAIS-III), Symptom Checklist-90 Revised (SCL-90R), and Short-Form Health Survey (SF-36). Clinical data and laboratory investigations were also collected.ResultsβTM participants exhibited lower vocabulary and picture completion scores on the WAIS-III compared to other groups. βTI participants had significantly higher scores on SCL-90R subscales for somatization, depression, anxiety, paranoid ideation, and psychoticism. Both patient groups reported poorer quality of life across all SF-36 domains compared with controls. Longer disease duration correlated with lower levels of somatization, interpersonal sensitivity, depression, anxiety, and paranoid ideation. Less frequent blood transfusions were associated with better physical and mental health summary scores but also higher somatization. Elevated serum iron levels corresponded with increased anxiety, hostility, and psychoticism symptoms, while higher serum ferritin related to more obsessive–compulsive behaviours but less somatization and psychoticism.ConclusionsIndividuals with thalassemia exhibit cognitive deficits, psychological disturbances, and diminished quality of life, with distinct patterns depending on disease severity. Regular monitoring and appropriate interventions are crucial for optimizing their overall well-being and functioning.

Parent-reported autism spectrum disorder (ASD) symptomatology of children with ASD during the COVID-19 pandemic: a 1.5-year longitudinal study

Objectives The COVID-19 pandemic and the associative preventive measures have had profound societal impacts. Children and adolescents with a pre-existing diagnosis of autism spectrum disorder (ASD) were considered particularly vulnerable. Methods This longitudinal study examined parent-reported ASD symptomatology of children with pre-existing ASD diagnoses during the COVID-19 pandemic. The study involved 39 children and adolescents with ASD (5-19 years; 66% males) and utilized multiple regression analyses to assess ASD symptomatology (SRS-2) across three time points: pre-COVID-19 pandemic (T0), one year into the pandemic (T1; during the second national lockdown) and one and a half years into the pandemic (T2; during a period of less restrictive measures). Additionally, the study examined the potential moderating effects of Age, Sex, and full-scale intelligence quotient (FSIQ) on ASD symptomatology. Results The findings indicate relative stability of ASD symptomatology over time, irrespective of age, sex, or FSIQ. Contrary to previous research, no significant exacerbation or alleviation of ASD symptomatology during the COVID-19 pandemic was observed. Conclusions This study highlights the robustness of ASD symptomology, even in the face of significant external stressors such as the COVID-19 pandemic. The implications of these findings for further research and clinical practice in the field of ASD are discussed.

Wechsler Adult Intelligence Scale - IV México versus U.S. versions in the assessment of Mexican Americans.

To delineate score differences between the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and the WAIS-IV México in the assessment of balanced bilingual Mexican Americans and to determine the efficacy of five hold measures in predicting summary scores in each version. Hold measures were WAIS-IV Information, Vocabulary, and Matrix Reasoning subtests, picture vocabulary, and the Test of Premorbid Function (English)/Word Accentuation Test (Spanish). Using a repeated measures design, 60 neurologically intact participants were tested in a counterbalanced order, with WAIS-IV version as the repeated measure (mean intertest interval = 5.68 days). To minimize practice effects, the five visual-perceptual subtests, which contain the same items in each version, were administered only once during the initial session. All mean WAIS-IV México index/subtest scores were significantly higher than the U.S. equivalents (Full-Scale IQ by about .5 SD). Unexpectedly, most (83%) participants educated in the US to at least a high school level had numerically equal or higher scores on the U.S. version. Means on WAIS-IV language format indices/subtests were lower than those of visual-perceptual format indices/subtests within both versions (excepting Processing Speed Index/subtests in the U.S. version). All hold measures significantly predicted WAIS-IV summary scores for the U.S. version. Similarly for the México version, except for the Word Accentuation Test. When evaluating a balanced bilingual Mexican American, opting for the WAIS-IV México version will yield higher scores across the Full-Scale IQ, indices, and all core subtests unless the patient was educated in the US to at least a high school level.

Mitochondrial DNA copy number and neurocognitive outcomes in children.

Low mitochondria DNA copy number (mtDNAcn) has been linked to cognitive decline. However, the role of mtDNAcn in healthy cognitive development is unclear. We hypothesized early-life mtDNAcn would be associated with children's learning and memory. We quantified mtDNAcn in umbilical cord blood and child blood at ages 5-7 from participants in a prospective birth cohort. We administered the Children's Memory Scale (CMS) at ages 9-14 (N = 342) and the Wechsler Intelligence Scale for Children (WISC-IV) at ages 7 and 9 (N = 457). Associations between mtDNAcn tertiles and CMS and WISC were evaluated with linear regression and linear mixed-effects models, respectively. We examined non-linear associations using generalized additive mixed models. Relative to the middle tertile of mtDNAcn, lower childhood mtDNAcn was associated with lower WISC Working Memory (β = -2.65, 95% CI [-5.24, -0.06]) and Full-Scale IQ (β = -3.71 [-6.42, -1.00]), and higher CMS Visual Memory (β = 4.70 [0.47, 8.93]). Higher childhood mtDNAcn was linked to higher CMS Verbal Memory (β = 7.75 [2.50, 13.01]). In non-linear models, higher childhood mtDNAcn was associated with lower WISC Verbal Comprehension. Our study provides novel evidence that mtDNAcn measured in childhood is associated with children's neurocognitive performance. mtDNAcn may be a marker of healthy child development. Mitochondrial DNA copy number (mtDNAcn) may serve as a biomarker for early-life neurocognitive performances in the children's population. Both low and high mtDNAcn may contribute to poorer neurocognition, reflected through learning and memory abilities. This research elucidated the importance of investigating mitochondrial biomarkers in healthy populations and facilitated advancements of future studies to better understand the associations between mitochondrial markers and adverse children's health outcomes.

Cognitive and academic outcomes in children with myelin oligodendrocyte glycoprotein antibody-associated disease.

To describe the impact of paediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) on academic and cognitive outcomes. This was an observational, retrospective, and descriptive single-centre study, carried out on a paediatric case series of children with MOGAD. A total of 51 patients were included (22 females); their median age was 8 years and the median follow-up duration was 31.1 months (interquartile range 23.5). The most frequent clinical presentation was acute disseminated encephalomyelitis (54.9%), followed by optic neuritis (35.5%). At the last follow-up, regardless of the clinical phenotype at disease onset, 39.5% of patients with MOGAD received academic and educational interventions (p < 0.05 compared to before disease onset), including academic accommodations (p < 0.05) or the need for a learning support assistant (p < 0.05). Ten patients were evaluated with the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V). The overall IQ was calculated for six patients (mean = 92); two of these patients had an IQ lower than 85. No difference was found regarding prenatal and neonatal neurodevelopmental characteristics between this cohort and the general population. MOGAD was associated with a need for academic support; lower scores were found on the WISC-V. Patients with MOGAD should receive cognitive and academic assessments to inform educational planning and support academic success.

Characteristics of early cognitive development in children with Williams syndrome: a prospective cohort study

To investigate the early cognitive development characteristics of children with Williams syndrome (WS) at different age stages. From September 2018 to June 2023, 106 children diagnosed with WS at the Department of Pediatric Health Care, Children's Hospital, Zhejiang University School of Medicine, aged 1 to <5 years, were prospectively enrolled. All children underwent Gesell developmental diagnostic assessments to analyze the cognitive development characteristics of WS children across different age groups. The average age of the 106 WS children was (3.1±1.2) years; 58 were male, and 48 were female. There were no significant differences in developmental levels between males and females in the five domains of gross motor skills, fine motor skills, language, personal-social skills, and adaptive behavior (P>0.05). The incidence rates of mild, moderate, severe, and profound developmental disabilities among children of different age groups showed no significant differences (P>0.05). Comparisons of developmental levels in gross motor skills, language, personal-social skills, and adaptive behavior among different age groups were also not statistically significant (P>0.05). With the increase of age, the developmental level of fine motor skills showed a decreasing trend (P<0.05). There were no significant differences in verbal IQ and non-verbal IQ within each age group of WS children (P>0.05). The overall developmental level of WS children stabilizes with age, and their early language abilities do not significantly exceed their non-verbal abilities.

Developmental Profile of Children with Autism Spectrum Disorder Versus Social Communication Disorder: A Pilot Study.

Social Communication Disorder (SCD), introduced in the DSM-5, is distinguished from Autism Spectrum Disorder (ASD) by the absence of restricted and repetitive behaviors or interests (RRBIs). To compare the adaptive, sensory, communication, and cognitive profiles of children with ASD and SCD. The assessments of nine children with SCD and ten with ASD were compared with either Fisher's Exact Test or the Mann-Whitney Test. Assessments included the Vineland Adaptive Behavior Scales, the Autism Diagnostic Observation Schedule (ADOS), the Short Sensory Profile, Bishop's Children's Communication Checklist, a pragmatics evaluation, and the Wechsler Intelligence Scale for Children IV. The total ADOS score and the second subtotal "Restricted and Repetitive Behaviors" were significantly higher (p = 0.022) in the ASD group than in the SCD group. The Vineland standard score for the "Socialization" domain was significantly lower (p = 0.037) in the ASD group (mean: 51 +/- 19) than in the SCD group (mean: 80 +/- 28). The working memory index score was also significantly lower (p = 0.013) in the ASD group compared to the SCD group. While ASD and SCD share similarities in communication and pragmatic difficulties, some distinctions have been identified, e.g. in executive functioning and the impact on socialization, which may be linked to the absence of RRBIs in SCD. These findings highlight the challenges posed by this nosographic separation during diagnostic evaluations due to the scarcity of discriminative tools.

The School Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) as a cognitive function screening tool in children with epilepsy

Background Children with epilepsy are at high risk of cognitive impairment that can affect quality of life. Intelligence quotient (IQ) measurement using the Wechsler Intelligence Scale for Children (WISC) is the gold standard test of cognitive function, but it is time-consuming and costly. The School Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) is a potential cognitive function screening tool that can be used in children with epilepsy. Objective To assess the performance of SYSTEMS-R as a cognitive function screening tool in children aged 6-15 years with epilepsy. Methods This cross-sectional diagnostic test study was conducted in children aged 6-15 years with epilepsy. All subjects were assessed using both SYSTEMS-R and WISC 4th edition. The sensitivity, specificity, positive and negative predictive value, likelihood ratios of the positive and negative tests, and accuracy of SYSTEMS-R was calculated, with WISC as the gold standard test. Results Based on the SYSTEMS-R, the prevalence of cognitive impairment in children aged 6-15 years with epilepsy in our population was 86.4%. With WISC as the gold SYSTEMS-R had 84% sensitivity, 91% specificity, 98% positive predictive value, and 47% negative predictive value. The likelihood ratio of a positive SYSTEMS-R test was 10.11 and the likelihood ratio of a negative test was 0.17. The overall accuracy of SYSTEMS-R to detect cognitive impairment was 85%. Conclusion SYSTEMS-R has good sensitivity and specificity to assess cognitive function in children 6-15 years with epilepsy. It can be considered for widespread use in the early detection of cognitive impairment in pediatric epilepsy patients aged 6-15 years.

Association between working memory performance and parent and teacher ratings of working memory in 11-year-old children born preterm

ABSTRACT Working memory (WM) difficulties are often observed in children born preterm. We examined whether performance-based measures of WM components are associated with parent- and teacher-rated WM difficulties in the everyday life of children born very preterm and/or at very low birth weight (VPT/VLBW) at 11 years (n = 165). The WM components as defined in the original Baddeley’s model – phonological loop (PL), visuospatial sketchpad (VS), and central executive (CE) – were assessed with tasks from the Working Memory Test Battery for Children (WMTB-C) and the Wechsler Intelligence Scale for Children – Fourth edition (WISC-IV). Parents and teachers completed the WM subscale of the Behavioral Rating Inventory for Executive Functions (BRIEF). Measures of WM components were modestly associated with BRIEF scores, explaining 18.9% of the variance in parent-rated and 14.0% of teacher-rated WM difficulties. CE was the component most consistently associated with parent- and teacher-rated everyday WM. To conclude, our results suggest that tasks that utilize CE functions may best reflect WM outside of controlled test settings in the follow-up of VPT/VLBW children. However, performance and rating-scale measures provide unique information and are both needed to comprehensively assess WM skills.

The relationship between the ages and stages questionnaire, 3rd edition scores in early childhood and future cognitive abilities in young Nepalese children

BackgroundThe Ages and Stages Questionnaire 3rd edition (ASQ-3) could be a feasible tool in resource-poor settings. Little is known on the relationship between scores on the ASQ-3 and later intellectual abilities in these settings.AimsTo examine the relationship between ASQ-3 scores during the first and second year of life and intellectual abilities at 4 years of age in Nepalese children.MethodsIn a cohort of 600 children at-risk of stunting, the ASQ-3 was performed at 6–11 and 18–23 months, and the Wechsler Preschool and Primary Scales of Intelligence, fourth edition (WPPSI-IV) at 4 years. We examined the relationship between the ASQ-3 scores and WPPSI-IV full scale IQ (FSIQ) using Spearman correlation coefficients and linear regression models.ResultsCorrelations between ASQ-3 total scores and FSIQ was 0.17 (95% CI 0.07, 0.27) at 6–11 and 0.34 (95% CI 0.26, 0.44) at 18–23 months explaining 2 and 12% of the variance respectively. Except for the communication subscale at 18–23 months with moderate correlations, correlations between the ASQ-3 subscales and FSIQ were weak.ConclusionOur findings suggest a modest relationship between ASQ-3 scores in early childhood and intellectual abilities at 4 years.

Understanding sex/gender differences in intelligence profiles of children with Autism: A comprehensive WISC meta-analysis

BackgroundIntelligence assessment in children with autism spectrum disorders (ASD) often sparks debates about sex/gender differences. Specifically, the question arises whether girls exhibit lower performance on intelligence scales compared to boys. This meta-analysis examines nine studies (N=1105; 809 boys and 296 girls) to quantify sex/gender differences on the Wechsler Intelligence Scale for Children (WISC) in children with ASD, comparing their results to typically developing children. Method and proceduresRandom-effects meta-analyses on WISC indices and subtests were conducted to address the heterogeneity across effect sizes. Results for children with ASD were compared to those of typically developing children. Outcomes and resultsFindings revealed no significant differences in general intellectual functioning (full-scale IQ), verbal comprehension, working memory, or processing speed between boys and girls in children with ASD. Boys showed an advantage only in the perceptual reasoning index. At the subtest level, boys outperformed on certain tasks, while girls excelled in others. Conclusions and implicationsThe observed pattern of differences in the ASD population aligns quantitatively with those in typically developing populations. Differences, if present, are specific to certain indices rather than general intelligence. These insights contribute to a nuanced understanding of gender-related cognitive variations in the context of ASD.

Diet quality during pregnancy, adolescent brain morphology, and cognitive performance in a population-based cohort

BackgroundDiet quality during pregnancy may affect offspring’s neurobiology and cognitive performance in childhood. However, little is known about underlying mechanisms and potential long-term effects. ObjectivesTo examine associations of diet quality during pregnancy with offspring pre- and early-adolescent brain morphology and to investigate whether brain morphology mediates associations of diet quality during pregnancy with full-scale intelligence quotient (IQ) in early adolescence. MethodsWe studied 2223 and 1582 mother–child dyads with brain scans collected using magnetic resonance imaging at ages 10 and 14 y in the population-based Generation R Study in The Netherlands. We assessed dietary intake during pregnancy with 293-item food-frequency questionnaires and calculated predefined diet quality scores (total score 0–15), reflecting adherence to dietary guidelines. Cognitive performance was assessed using Wechsler Intelligence Scale for Children-V at age 14 y. We examined associations using multiple regression models, corrected for multiple testing. ResultsAfter adjustment for child age, sex, socioeconomic factors, maternal age, smoking, and psychopathological symptoms during pregnancy, we found that higher diet quality during pregnancy was associated with a larger total brain (B: 4.54, 95% confidence interval [CI]: 1.80, 7.28), cerebral white matter (1.83, 95% CI: 0.56, 3.10), cerebral gray matter (1.99, 95% CI: 0.63, 3.35), and subcortical volumes (0.16, 95% CI: 0.04, 0.28) of children at age 10 y. Similar results were found for age 14 y. Widespread differences in cortical thickness, gyrification, and surface area in both hemispheres were also observed. Better diet quality during pregnancy was associated with higher full-scale IQ scores of adolescents, particularly on verbal comprehension and matrix reasoning. The associations between diet quality during pregnancy and full-scale IQ in early adolescence were partially mediated by brain volumetric markers in pre-adolescence. ConclusionsDiet quality during pregnancy was associated with structural brain alterations in the offspring, which partly explained the relation between prenatal dietary patterns and cognitive outcomes in children.

6860 Cognitive Capacity in Children with Growth Hormone Deficiency

Abstract Disclosure: V. leal: None. V. Alvarez: None. S.S. Awadalla: None. Growth hormone (GH) is necessary for longitudinal growth and also has multiple other functions including neurologic development. Cognitive function in children with idiopathic isolated growth hormone deficiency (IGHD) has been poorly studied. This study aims to prospectively investigate cognitive capacity in children with IGHD.Cognitive function of 10 children with IGHD (peak GH &amp;lt;10 μg/L) was studied using Wechsler Intelligence Scales for Children IV: Intelligence Quotient, Verbal Comprehension Index, Perceptual Reasoning Index, and Working Memory and Processing Speed Indices.6 females and 4 males were included , Age was 10.04 ±2.01 years (M± DS) , height SDS was -1.86 ±0.19 . The IQ was 100.6 ±8.5, Verbal Comprehension was 99.3 ±8.5, Perceptual Reasoning was 102.5 ±9.1, Working Memory was 99.9 ±9.8, and Processing Speed was 98.9 ±13.1. Using Spearman correlation test ; a moderate positive correlation was observed between the GH peak and the intellectual coefficient IQ and peak GH: r=0.45, p=0.18, Perceptual reasoning and GH: r=0.43, p=0.2 without a statistical significance probably because of the sample size. In conclusion; The overall IQ score fell within the normal range, with lower scores in processing speed and working memory. These findings underscore the importance of considering not only the impact on linear growth but also on cognitive development when addressing growth hormone deficiency in the pediatric population Presentation: 6/3/2024

Neurodevelopmental outcomes of school-age children conceived after hysterosalpingography with oil-based or water-based iodinated contrast: long-term follow-up of a nationwide randomized controlled trial.

Does preconceptional exposure to oil-based iodinated contrast media during hysterosalpingography (HSG) impact children's neurodevelopment compared with exposure to water-based alternatives? Our study found no large-sized effects for neurodevelopment in children with preconceptional exposure to oil-based iodinated contrast media during HSG compared with water-based alternatives. HSG is widely used as a diagnostic tool in the female fertility work-up. Tubal flushing with oil-based iodinated contrast has been shown to enhance fertility outcomes in couples with unexplained infertility, increasing the chances of pregnancy and live birth compared with water-based alternatives. However, oil-based contrast contains higher doses of iodine and has a longer half-life, and concerns exist that iodinated contrast media can affect women's iodine status and cause temporary (sub)clinical hypothyroidism in mothers and/or foetuses. Considering that thyroid hormones are vital to embryonal and foetal brain development, oil-based contrast media use could increase the risk of impaired neurodevelopment in children conceived shortly after HSG. Here we examine neurodevelopmental outcomes in school-aged children conceived after HSG. This is a long-term follow-up of the H2Oil trial in which oil-based or water-based contrast was used during HSG (Netherlands; 2012-2014; NTR3270). Of 369 children born <6 months after HSG in the study, we contacted the mothers of 140 children who gave consent to be contacted for follow-up. The follow-up study took place from January to July 2022 (NCT05168228). The study included 69 children aged 6-9 years who were conceived after HSG with oil-based (n = 42) or water-based contrast (n = 27). The assessments targeted intelligence (Wechsler Intelligence Scale for Children), neurocognitive outcomes (computerized neurocognitive tests), behavioural functioning (parent and teacher questionnaires), and academic performance. Linear regression models, adjusted for age, sex, and parental educational attainment were employed to compare groups. School-aged children born to mothers after oil-based contrast HSG did not significantly differ from children born to mothers after water-based contrast HSG, in regards to intelligence, neurocognitive functioning, behavioural functioning, or academic performance, with the exception of better performance for visuomotor integration functions in children exposed to oil-based contrast preconception. After exploratory correction for multiple comparisons, none of the group differences was statistically significant. The small sample size of this follow-up study limited statistical power. This study provides evidence for the absence of large-sized differences between preconceptional exposure to the two contrast media types but does not rule out more subtle effects on neurodevelopment compared to naturally conceived children without preconceptional exposure to HSG. This study contributes to our knowledge about the long-term effects of different types of iodinated contrast media used in fertility work-up, indicating that choosing oil-based over water-based iodinated contrast media is unlikely to have major effect on the long-term neurodevelopmental outcomes of children conceived shortly after HSG. However, further research should focus on the overall safety of iodine exposure during HSG, comparing children conceived after HSG to those conceived naturally as both types of contrast contain high amounts of iodine. The original H2Oil randomized controlled trial was an investigator-initiated study that was funded by the two academic hospitals now merged into the Amsterdam University Medical Centre. The current follow-up study (Neuro-H2Oil) is funded through a research grant awarded to the authors by the Amsterdam Reproduction & Development (AR&D) research institute. S.K. is funded by a AMC MD/PhD Scholarship from the Amsterdam UMC. S.K. reports holding voluntary roles in the civil society organizations Universities Allied for Essential Medicines and People's Health Movement. V.M. reports receiving travel and speaker fees as well as research grants from Guerbet, Merck and Ferring. K.D. reports receiving travel and speaker fees as well as research grants from Guerbet. BWM is supported by a NHMRC Investigator grant (GNT1176437) and reports consultancy, travel support and research funding from Merck, consultancy for Organon and Norgine, and holding stock from ObsEva. The other authors report no conflict of interest. NCT05168228.

Long-term neurodevelopmental outcomes at three years in preterm infants born before 29 Weeks gestation following Preterm Premature Rupture of Membranes (PPROM).

To determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental impairment (NDI) at 3 years corrected age (CA) in infants born before 29 weeks of gestational age (GA). Infants born before 29 weeks GA between 2005 and 2017 were included. The primary outcome was a composite of death or NDI (full-scale intelligence quotient<85, cerebral palsy, vision or hearing impairment) at 3 years of CA. Infants were stratified by maternal PPROM status. Associations were explored using multivariate models. Of 1231 participants, 481 were in the PPROM group, and 750 were in the No PPROM group. After adjusting for factors, the odds ratio of death or NDI for PPROM vs. No PPROM was 1.22 (95% Confidence Interval 0.93-1.59). Our study suggests that PPROM was not associated with an increased risk of a composite outcome of death or NDI at 3 years CA.

The Draw-a-Person Test in Neuropsychological Assessment

The Draw-a-Person test (former Draw a Man test) comes from the intelligence diagnostics of children, but the procedure also gives a wealth of interesting results in patients with brain damage. Goal: The aim of the study was to investigate to what extent drawing ability is impaired in people with brain damage and how strong the connection is with other neuropsychological investigations. Methods: The result of the Draw-a-Person test (DAPT) was compared with the: Mini-Mental Status Examination, Verbal Learning and Memory Test, Number Connection Test, “Personalities” test from Kaufmann's Test battery, Hooper's Visual Organization Test and Mosaic test of the Hamburg Wechsler intelligence Scale. Participants: The data was collected as part of a field study in a clinic for Neurology and a neuropsychological practice, so there are often only preliminary diagnoses. Since this study is about the correlations of the tests only, differences in diagnosis are not considered as a bias. For the present study, the data from a total of 50 patients (mean age 70.2 ±13.0 years, 24 males, 26 females) were evaluated. The patients suffered from: stroke (n=19), dementia (n=10), traumatic brain injury (n=5), transient ischemic attack (n=4), heart attack (n=3), encephalitis (n=2), Parkinson's disease (n=2), cerebral hemorrhage (n=1), other diagnoses (n=4, e.g. vitamin-B12 deficiency, seizures, confusion). Results: The correlations to the DAP-Test were: Mini-Mental Status Examination Rho=0.66*; Verbal Learning and Memory Test 1st round: Rho=0.34*; 5th round: Rho=0.44*; 6th round: Rho=0.23 (n.s.); 7th round: Rho=0.30 (n.s.); Number Connection Test Rho= -0.29*; “Personalities” test Rho = 0.44*; Hooper’s Visual Organization Test Rho = 0.61*; Mosaic Test Rho = 0.57*. Conclusion: The DAP test is an easy-to-perform procedure that only takes a few minutes and is very economical. The test gives initial indications for many visual-constructive deficits as e.g. neglect, visual agnosia and correlates significantly with many other neuropsychological instruments.

Lamotrigine for cognitive deficits associated with neurofibromatosis type 1: A phase II randomized placebo-controlled trial.

To find proof-of-principle evidence for short-term treatment with lamotrigine to improve cognitive functioning of adolescents with neurofibromatosis type 1 (NF1). This was a double-blind, parallel-group, randomized, placebo-controlled clinical trial (the NF1-EXCEL trial: Examining the Cognitive and Electrophysiological benefit of Lamotrigine in Neurofibromatosis type 1; Clinicaltrials.gov identifier NCT02256124), with the aim of enrolling 60 adolescents with NF1 aged 12 to 17 years 6 months. The short-term study intervention was 200 mg of lamotrigine taken orally for 26 weeks. The primary outcome was performance IQ tested with the Wechsler Intelligence Scale for Children, Third Edition, complemented with secondary outcomes for visuospatial learning efficacy, visual perception, visual sustained attention, fine motor coordination, attention-deficit/hyperactivity problems, and executive functioning. We screened 402 adolescents with NF1, of whom 31 (eight females) entered the study. Complete-case analysis showed no effect of lamotrigine on either performance IQ (-0.23, 95% CI -6.90 to 6.44) or most secondary outcomes. Visual sustained attention showed a trend towards better performance in the lamotrigine group (-0.81, 95% CI -1.67 to 0.04). Lamotrigine did not improve cognitive functioning in adolescents with NF1. The small treatment effects make it unlikely that a larger sample size could have changed this conclusion.