Wide Range Achievement Test Research Articles

Does n-3 LCPUFA supplementation during pregnancy increase the IQ of children at school age? Follow-up of a randomised controlled trial

IntroductionDespite recommendations that pregnant women increase their docosahexaenoic acid (DHA) intake to support fetal brain development, a recent systematic review found a lack of high-quality data to support the long-term...

Prioritizing schizophrenia endophenotypes for future genetic studies: An example using data from the COGS-1 family study

Past studies describe numerous endophenotypes associated with schizophrenia (SZ), but many endophenotypes may overlap in information they provide, and few studies have investigated the utility of a multivariate index to improve discrimination between SZ and healthy community comparison subjects (CCS). We investigated 16 endophenotypes from the first phase of the Consortium on the Genetics of Schizophrenia, a large, multi-site family study, to determine whether a subset could distinguish SZ probands and CCS just as well as using all 16.Participants included 345 SZ probands and 517 CCS with a valid measure for at least one endophenotype. We used both logistic regression and random forest models to choose a subset of endophenotypes, adjusting for age, gender, smoking status, site, parent education, and the reading subtest of the Wide Range Achievement Test. As a sensitivity analysis, we re-fit models using multiple imputations to determine the effect of missing values.We identified four important endophenotypes: antisaccade, Continuous Performance Test-Identical Pairs 3-digit version, California Verbal Learning Test, and emotion identification. The logistic regression model that used just these four endophenotypes produced essentially the same results as the model that used all 16 (84% vs. 85% accuracy).While a subset of endophenotypes cannot replace clinical diagnosis nor encompass the complexity of the disease, it can aid in the design of future endophenotypic and genetic studies by reducing study cost and subject burden, simplifying sample enrichment, and improving the statistical power of locating those genetic regions associated with schizophrenia that may be the easiest to identify initially.

Impact of duration of untreated psychosis and premorbid intelligence on cognitive functioning in patients with first-episode schizophrenia

BackgroundThe neurotoxic hypothesis suggests that psychosis is toxic to the brain leading to clinical consequences. In this study, we hypothesized that a longer duration of untreated psychosis (DUP) in first episode schizophrenia (FES) patients is associated with poorer cognitive functioning, and that higher premorbid intelligence buffers against DUP-related cognitive impairment. MethodEighty-one FES patients completed a neuropsychological battery, the Brief Assessment of Cognition in Schizophrenia (BACS). Composite scores of the BACS, which were normalized to a matched healthy control of seventy-three subjects, were used as an index of general cognition. A median split using the Wide Range Achievement Test–Reading Test scores was used to divide the patients into low versus high premorbid IQ groups. Hierarchical linear regression was performed to examine predictors of general cognition, including DUP. ResultsLonger DUP was found to be a significant predictor of poorer general cognition. In addition, DUP predicted general cognition in the low premorbid IQ group but not in the high premorbid IQ group. ConclusionsOur findings demonstrate that longer DUP in FES patients is associated with worse cognitive scores, and that this association is more pronounced in a subgroup of patients who have lower premorbid intelligence. Our results suggest the importance of earlier identification and management of patients with low premorbid IQ, given that their cognition may be more vulnerable to the toxicity of psychosis.

Do neuropsychological test norms from African Americans in the United States generalize to a Zambian population?

Healthy Zambian adults (N = 324) were evaluated to determine to what degree a Western neuropsychological (NP) test battery, with African American norms adjusted for age, gender, and education could be used in healthy Zambians, including 157 men (48.46%) and 167 women (51.54%) with an average age of 38.48 (SD = 12.80) years and an average education level of 11.02 (SD = 2.58) years. The NP battery included tests of attention/working memory, executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. The Zambian Achievement Test (ZAT) and the U.S. Wide Range Achievement Test-4 (WRAT-4) reading subtest also were administered to assess literacy and quality of education. Similar to findings in Western countries, the Zambian results show substantial age and education effects on most tests and smaller, less consistent effects of gender. Beyond the basic demographic effects, urban/rural background had small effects on some cognitive variables, and the ZAT (but not WRAT-4) reading level was a robust predictor of performance on many NP tests, even when other background characteristics were controlled. Women in the United States tend to outperform men on tests of processing speed and episodic memory. However, Zambian women showed modest but statistically significant disadvantages versus their male counterparts. The results show that tests developed in the United States may be used in Zambia. Nevertheless, development and use of local cultural norms remains very important and is a must. New demographically corrected norms were developed for the cohort that was examined.

Exercise and academic achievement in children: Effects of acute class-based circuit training

PurposeFor schools, the increasingly imposed requirement to achieve well in academic tests puts increasing emphasis on improving academic achievement. While treadmill exercise has been shown to have beneficial effects on cognitive function and cycling ergometers produce stronger effect sizes than treadmill running, it is impractical for schools to use these on a whole-class basis. There is a need to examine if more ecologically valid modes of exercise might have a similar impact on academic achievement. Circuit training is one such modality shown to benefit cognitive function and recall ability and is easily operationalised within schools.MethodsIn a repeated measures design, twenty-six children (17 boys, 8 girls) aged 10–11 years (mean age 10.3; <i>SD</i> ± 0.46 years) completed the Wide Range Achievement Test (WRAT 4) at rest and following 30 minutes of exercise.ResultsStandardised scores for word reading were significantly higher post exercise (F(1,18) = 49.9, <i>p</i> = 0.0001) compared to rest. In contrast, standardised scores for sentence comprehension (F(1,18) = 0.078, <i>p</i> = 0.783), spelling (F(1,18) = 4.07, <i>p</i> = 0.06) mathematics (F(1,18) = 1.257, <i>p</i> = 0.277), and reading (F(1,18) = 2.09, <i>p</i> = 0.165) were not significantly different between rest and exercise conditions.ConclusionsThe results of the current study suggest acute bouts of circuit based exercise enhances word reading but not other areas of academic ability in 10–11 year old children. These findings support prior research that indicates acute bouts of exercise can selectively improve cognition in children.

Cavum Septi Pellucidi in Symptomatic Former Professional Football Players.

Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p < 0.0001; septum length: rho = 0.93; ICC 0.96; p < 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p < 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall, p = 0.04) and decreased test scores on a measure of estimate verbal intelligence (Wide Range Achievement Test Fourth Edition Reading Test, p = 0.02). Given the high prevalence of CSP in neuropathologically confirmed CTE in addition to the results of this study, CSP may serve as a potential early in vivo imaging marker to identify those at high risk for CTE. Future research is needed to investigate the pathomechanism underlying the development of CSP after repetitive head impacts, and its potential association with neuropathologically confirmed CTE.

Reading Ability as an Estimator of Premorbid Intelligence: Does It Remain Stable Among Ethnically Diverse HIV+ Adults?

The Wide Range Achievement Test, 3rd edition, Reading Recognition subtest (WRAT-3 RR) is an established measure of premorbid ability. Furthermore, its long-term reliability is not well documented, particularly in diverse populations with CNS-relevant disease. Objective: We examined test–retest reliability of the WRAT-3 RR over time in an HIV+ sample of predominantly racial/ethnic minority adults. Method: Participants (N = 88) completed a comprehensive neuropsychological battery, including the WRAT-3 RR, on at least two separate study visits. Intraclass correlation coefficients (ICCs) were computed using scores from baseline and follow-up assessments to determine the test–retest reliability of the WRAT-3 RR across racial/ethnic groups and changes in medical (immunological) and clinical (neurocognitive) factors. Additionally, Fisher’s Z tests were used to determine the significance of the differences between ICCs. Results: The average test–retest interval was 58.7 months (SD = 36.4). The overall WRAT-3 RR test–retest reliability was high (r = .97, p < .001) and remained robust across all demographic, medical, and clinical variables (all r’s > .92). ICCs did not differ significantly between the subgroups tested (all Fisher’s Z p’s > .05). Conclusions: Overall, this study supports the appropriateness of word-reading tests, such as the WRAT-3 RR, for use as stable premorbid IQ estimates among ethnically diverse groups. Moreover, this study supports the reliability of this measure in the context of change in health and neurocognitive status and in lengthy inter-test intervals. These findings offer strong rationale for reading as a “hold” test, even in the presence of a chronic, variable disease such as HIV.

Normative Data for the Cognitively Intact Oldest-Old: The Framingham Heart Study

Background/Study Context: The number of individuals who reach extreme age is quickly increasing. Much of the current literature focuses on impaired cognition in extreme age, and debate continues regarding what constitutes “normal” cognition in extreme age. This study aimed to provide oldest-old normative data and to compare cognitive performances of cognitively intact elderly individuals from the Framingham Heart Study.Methods: A total of 1302 individuals aged 65+ years from the Framingham Heart Study were separated into 5-year age bands and compared on cognitive tests. Multivariate linear regression analyses were conducted, adjusting for gender, the Wide Range Achievement Test—Third Edition (WRAT-III) Reading score, and cohort. Analyses also included comparisons between 418 individuals aged 80+ and 884 individuals aged 65–79, and comparisons within oldest-old age bands.Results: Normative data for all participants are presented. Significant differences were found on most tests between age groups in the overall analysis between young-old and oldest-old, and analysis of oldest-old age bands also revealed select significant differences (all ps <.05).Conclusion: As aging increases, significant cognitive differences and increased variability in performances are evident. These results support the use of age-appropriate normative data for oldest-old individuals.

WIDE RANGE ACHIEVEMENT TEST IN AUTISM SPECTRUM DISORDER: TEST-RETEST STABILITY.

The principal goal of this descriptive study was to establish the test-retest stability of the Reading, Spelling, and Arithmetic subtest scores of the Wide Range Achievement Test (WRAT-3) across two administrations in individuals with autism spectrum disorder. Participants (N = 31) were males ages 6-22 years (M = 15.2, SD = 4.0) who were part of a larger ongoing longitudinal study of brain development in children and adults with autism spectrum disorder (N = 185). Test-retest stability for all three subtests remained consistent across administration periods (M = 31.8 mo., SD = 4.1). Age at time of administration, time between administrations, and test form did not significantly influence test-retest stability. Results indicated that for research involving individuals with autism spectrum disorder with a full scale intelligence quotient above 75, the WRAT-3 Spelling and Arithmetic subtests have acceptable test-retest stability over time and the Reading subtest has moderate test-retest stability over time.

Validation of a Short, 3-Item Version of the Subjective Numeracy Scale.

Efficiency in scale design reduces respondent burden. A brief but reliable measure of numeracy may provide a useful research tool eligible for integration into large epidemiological studies or clinical trials. Our goal was to validate a 3-item version of the Subjective Numeracy Scale (SNS-3). We examined 7 separate cross-sectional data sets: patients in the emergency department (n = 208), clinic (n = 205), and hospital (n = 460; n = 2053) and patients with chronic kidney disease (n = 147), with diabetes (n = 318), and on hemodialysis (n = 143). Internal reliability of the SNS-3 was assessed with Cronbach's α. Criterion validity was determined by nonparametric correlations of the SNS-3 with SNS-8 and other measures of numeracy; construct validity was determined by correlations with measures of health literacy and education. The SNS-3 had good internal reliability (median Cronbach's α = 0.78) and correlated highly with the full SNS (median ρ = 0.91). The SNS-3 was significantly correlated with other measures of numeracy (e.g., median ρ = 0.57 with the Wide Range Achievement Test 4), health literacy (e.g., median ρ = 0.35 with the Shortened Test of Functional Health Literacy in Adults), and education (median ρ = 0.41), providing good evidence of criterion and construct validity. The SNS-3 is sufficiently reliable and valid to be used as a measure of subjective numeracy.

Visuospatial and mathematical dysfunction in major depressive disorder and/or panic disorder: A study of parietal functioning

The parietal cortex is critical for several different cognitive functions, including visuospatial processing and mathematical abilities. There is strong evidence indicating parietal dysfunction in depression. However, it is less clear whether anxiety is associated with parietal dysfunction and whether comorbid depression and anxiety are associated with greater impairment. The present study compared participants with major depression (MDD), panic disorder (PD), comorbid MDD/PD and controls on neuropsychological measures of visuospatial processing, Judgement of Line Orientation (JLO), and mathematical abilities, Wide Range Achievement Test (WRAT) Arithmetic. Only comorbid MDD/PD was associated with decreased performance on JLO, whereas all psychopathological groups exhibited comparably decreased performance on WRAT Arithmetic. Furthermore, the results were not accounted for by other comorbid disorders, medication use or psychopathology severity. The present study suggests comorbid depression and anxious arousal are associated with impairment in visuospatial processing and provides novel evidence indicating mathematical deficits across depression and/or anxiety. Implications for understanding parietal dysfunction in internalising psychopathology are discussed.

Age of first exposure to football and later-life cognitive impairment in former NFL players.

To determine the relationship between exposure to repeated head impacts through tackle football prior to age 12, during a key period of brain development, and later-life executive function, memory, and estimated verbal IQ. Forty-two former National Football League (NFL) players ages 40-69 from the Diagnosing and Evaluating Traumatic Encephalopathy using Clinical Tests (DETECT) study were matched by age and divided into 2 groups based on their age of first exposure (AFE) to tackle football: AFE <12 and AFE ≥12. Participants completed the Wisconsin Card Sort Test (WCST), Neuropsychological Assessment Battery List Learning test (NAB-LL), and Wide Range Achievement Test, 4th edition (WRAT-4) Reading subtest as part of a larger neuropsychological testing battery. Former NFL players in the AFE <12 group performed significantly worse than the AFE ≥12 group on all measures of the WCST, NAB-LL, and WRAT-4 Reading tests after controlling for total number of years of football played and age at the time of evaluation, indicating executive dysfunction, memory impairment, and lower estimated verbal IQ. There is an association between participation in tackle football prior to age 12 and greater later-life cognitive impairment measured using objective neuropsychological tests. These findings suggest that incurring repeated head impacts during a critical neurodevelopmental period may increase the risk of later-life cognitive impairment. If replicated with larger samples and longitudinal designs, these findings may have implications for safety recommendations for youth sports.

Brief clinical screening for academic underachievement in new-onset childhood epilepsy: Utility and longitudinal results

ObjectiveThis study was conducted to determine the lifetime rate and distribution of supportive academic and educational services provided to children with new- or recent-onset epilepsy and typically developing controls, the relationship of this history to objective academic test performance, and the course of performance over serial evaluations (baseline and 2 and 5years later). MethodsResearch participants were 91 children aged 8–18 at study entry, including 50 youth with recent-onset epilepsy (28 focal [FE] and 22 generalized [GE] epilepsy) and healthy first-degree cousin controls (n=41). The sample with epilepsy included children with uncomplicated epilepsy and normal imaging and development. Lifetime history of a diversity of supportive educational services was determined via a structured interview with parents at the baseline study visit. Associations were examined between these support services and participants' academic performance in reading, spelling, and arithmetic (Wide Range Achievement Test—Revision 3 [WRAT3] [12]) during three serial study visits including baseline and 2 and 5years later. ResultsChildren with epilepsy had a higher lifetime rate of provision of diverse academic supportive services compared to controls at the baseline visit (52% vs. 18%). These services antedated epilepsy diagnosis in the majority (80.8%) of the children with epilepsy. Among children with epilepsy, children who presented with academic services had significantly lower WRAT3 reading, spelling, and arithmetic performance at baseline and at 2- and 5-year follow-ups. ConclusionA brief structured clinical interview conducted with parents identifies children with epilepsy who are at academic risk at the time of diagnosis, with that risk persisting up to 5years later.

Academic skills of chronically unemployed drug-addicted adults.

The strong association between unemployment and drug addiction suggests that employment interventions are an important and needed focus of drug-addiction treatment. The increasing necessity of possessing basic academic skills to function in the workplace may require that some individuals receive educational training along with vocational training. This study investigated the academic skills of drug-addicted and chronically-unemployed adults (N = 559) who were enrolled in one of six studies conducted at the Center for Learning and Health in Baltimore, MD. Upon study enrollment, academic skills in math, spelling, and reading were examined using the Wide Range Achievement Test (WRAT-3 or WRAT-4) and educational history was examined using the Addiction Severity Index-Lite. Although participants completed an average of 11 years of education, actual academic skill level was at or below the seventh grade level for 81% of participants in math, 61% in spelling, and 43% in reading, and most participants were classified as Low Average or below based on age group norms. Despite the fact that participants in this analysis were studied across several years and were from diverse populations, rates of high school completion and academic skill levels were remarkably similar. Programs designed to improve the long-term employment status of drug-addicted individuals may benefit from the inclusion of basic adult education; future research on the topic is needed. Although establishing basic skills does not directly address chronic unemployment, it may help individuals obtain the jobs they desire and function effectively in those jobs.

School-Age Outcomes of Very Preterm Infants After Antenatal Treatment With Magnesium Sulfate vs Placebo

Survival rates for infants born at less than 28 weeks’ gestation have increased, but rates of adverse long-term neurodevelopmental outcomes remain high compared with outcomes for term infants. The ACTOMgSO4 (Australasian Collaborative Trial of Magnesium Sulphate) study was designed to determine whether antenatal magnesium sulfate given to women at risk of preterm birth at less than 30 weeks’ gestation was related to mortality and neurosensory morbidity, particularly cerebral palsy (CP), in early childhood. The aim of the present study was to determine outcomes into school age from antenatal magnesium sulfate compared with placebo. Of 1062 parturients at less than 30 weeks’ gestation with birth planned or expected within 24 hours, 535 were randomized to receive intravenously administered magnesium sulfate and 527 to receive normal saline placebo. These women had a total of 1255 fetuses alive at randomization, and 1066 survived to hospital discharge (n = 544 exposed, n = 522 placebo). The outcomes for the school-age follow-up were CP, motor function, general intellectual ability, academic skills, attention, executive function, behavior, growth, functional and other neurosensory outcomes, and mortality. The severity of gross motor dysfunction in children with CP was classified according to the Gross Motor Function Classification System or by the Movement Assessment Battery for Children (MABC). General cognitive ability was assessed using the Wechsler Intelligence Scale for Children. Academic skills were assessed using the Wide Range Achievement Test. Attention and executive function were assessed with tests sensitive to specific attentional and executive processes. Attention-deficit/hyperactivity disorder symptoms were evaluated with parent and teacher versions of the Conners’ ADHD/DSM-IV Scales. Of the 1255 fetuses alive at randomization, the known mortality rate to school age was 14.0% in the magnesium sulfate group (88/629) compared with 17.6% in the placebo group (110/626), not a statistically significant difference. The final analysis included 867 children (443 magnesium sulfate and 424 placebo) for follow-up at school age; outcomes were determined for 669 (77%). Both groups were assessed at a mean age of 8.4 ±1.0 years, corrected for prematurity. The groups were similar for important perinatal, sociodemographic, and 2-year outcome variables. The 2 groups had no statistically significant differences in proportions with CP or in its severity (8% vs 7%; odds ratio, 1.26; 95% confidence interval [CI], 0.84–1.91). A 96% agreement was found between a diagnosis or not of CP at age 6 to 11 years with that at age 2 years in children assessed at both ages; 11 children with CP at age 2 years no longer had the diagnosis at age 6 to 11 years, and 16 children with no CP at age 2 years had the diagnosis at 8 years. Motor function on the Gross Motor Function Classification System and distribution on the MABC centiles (29 vs 32 centile; mean difference, −2.8; 95% CI, −9.1 to 3.5) were similar between groups. The proportions with abnormal motor function based on the MABC and definite motor dysfunction were similar (27% vs 27%; odds ratio, 1.16; 95% CI, 0.88–1.52). The groups did not differ in cognitive, academic, attention, executive function, or behavioral outcomes or in any of the growth, functional, or other neurosensory outcomes. Potentially confounding social variables and sex of the child had little effect and changed no conclusions. In this study, antenatal magnesium sulfate was not associated with any long-term benefits or harms compared with placebo. Magnesium sulfate given to mothers just before preterm birth for fetal neuroprotection has been one of the few measures available to possibly improve neurologic outcome for preterm survivors. Other adequately powered studies are needed to evaluate long-term benefit of magnesium for fetal neuroprotection.

APOE and mild cognitive impairment: the Framingham Heart Study.

The risk apolipoprotein E-4 (APOE4) poses for mild cognitive impairment (MCI) may vary based on the neuropsychological definition of MCI. A community-based cohort study. Using two psychometric neuropsychological impairment definitions, we examined APOE4 and prevalent MCI among older adults or pre-MCI among middle-aged adults. Neuropsychological, clinical and genetic data were collected on 2,239 Framingham Offspring Cohort participants free from clinical stroke or dementia (62±9 years; 54% women). Prevalent amnestic MCI was defined from neuropsychological performances≥1.5 SD below the mean based on (i) age and education or (ii) age and Wide Range Achievement Test-3 Reading (WRAT-3 Reading) performance adjustment. In the entire sample, multivariable-adjusted logistic regressions found that APOE4 was associated with amnestic MCI when using the age and WRAT Reading definition (odds ratio [OR]=1.7, P=0.002) but not the age and education definition (OR=1.0, P=0.90). Results were modified by age, such that APOE4 was associated with amnestic MCI in participants≥65 years using both the age and WRAT Reading definition (OR=2.4, P<0.001) and the age and education definition (OR=1.7, P=0.04). APOE4 risk for prevalent amnestic MCI varies depending on the definition of objective neuropsychological impairment for MCI. Our findings support existing literature emphasising the need to refine MCI neuropsychological profiling methods.

The Wide Range Achievement Test–4 Reading subtest “holds” in HIV-infected individuals

Background: In order to detect HIV-associated neurocognitive decline, it is important to accurately estimate individuals’ premorbid levels of cognitive functioning. Although previous studies have operated under the assumption that word reading tests are valid and stable indicators of premorbid abilities in HIV infection, studies of other populations have found that this is not always the case. Therefore, it is important to empirically examine the validity of word reading tests as estimates of premorbid functioning specifically within the HIV population. Method: The Wide Range Achievement Test–4 Reading subtest (WRAT–4 Reading) was administered along with comprehensive neurocognitive assessments to 150 HIV seropositive (HIV+) and 76 HIV seronegative (HIV–) age-, education-, and sex-matched participants; a subset of 48 HIV+ individuals completed a second study visit (M = 14.4 months), in which the alternate version of the WRAT–4 was administered. Results: Although HIV+ individuals evidenced worse current neurocognitive functioning than HIV– participants, WRAT–4 Reading performance was comparable between groups. Longitudinally, HIV+ participants evidenced improved disease and neuropsychological functioning, yet WRAT–4 Reading demonstrated strong test–retest reliability and no practice effect, and did not differ between the initial and follow-up assessments. Test–retest differences in reading performance were minor and were not associated with changes in neurocognitive performance or changes in HIV disease. Conclusions: We found no evidence of WRAT–4 Reading performance decline in HIV infection, despite HIV+/HIV– group differences in neurocognitive functioning. Additionally, reading performances among HIV+ individuals demonstrated consistency across study visits. These results begin to support the validity of the WRAT–4 Reading subtest as an indicator of premorbid cognitive functioning in HIV+ individuals.

Functional status in children with ADHD at age 6-8: a controlled community study.

To examine the functional status (mental health, academic performance, peer problems) of a community-based sample of children who have attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls, and to investigate gender and subtype differences. Children aged 6 to 8 years were recruited through 43 Melbourne schools, using a 2-stage screening (parent and teacher Conners 3 ADHD index) and case confirmation (Diagnostic Interview Schedule for Children, Version IV; [DISC-IV]) procedure. Outcome measures were mental health disorders (DISC-IV), academic performance (Wide Range Achievement Test 4), and peer problems (Strength and Difficulties Questionnaire). Unadjusted and adjusted linear and logistic regression were used to compare ADHD and non-ADHD controls. A total of 179 children who have ADHD and 212 non-ADHD controls were recruited. Compared with controls, children who had ADHD had higher odds of externalizing (odds ratio [OR], 11.0; 95% confidence interval [CI], 5.6-21.6; P < .001) and internalizing (OR, 2.9; 95% CI, 1.2-7.2; P = .02) disorders; poorer reading (effect size, -0.66) and mathematics (effect size, -0.69) performance; and more peer problems (P < .001). Boys and girls who had ADHD were equally impaired. Only 17% of children in our ADHD group had been previously diagnosed. Previous diagnosis was higher in the Combined group and for boys. In their second year of school, children who had ADHD performed worse than controls across all functional domains, yet only a minority had been formally diagnosed with ADHD. Findings highlight the need for earlier diagnosis and intervention.

PO-0642 Neurodevelopmental Outcomes Of Vlbw Children At 6–8 Years Of Age

<h3>Background</h3> There is growing awareness that the majority of nondisabled survivors encounter more “subtle” problems such as academic under achievement, behavioural problems, and deficits in executive functions. <h3>Objective</h3> To compare gross motor function,cognitive function, academic competence and behavioural problems at school age between VLBW children and controls. <h3>Methods</h3> We enrolled children aged 6-to 8-year-old, who were born with BW ≤1,500 g and have been followed-up at our long-term, follow-up clinic. They were tested for cognitive function and academic achievement using Wechsler Intelligence Scale for Children-III(WISC-III) and Wide Range Achievement Test (WRAT). Child Behaviour Checklist for emotional/behavioural assessment was completed by the care givers. Gross motor function was assessed using Gross Motor Function Classification System (GMFCS). <h3>Results</h3> Thirty VLBW children were assessed at mean age of 7.5 years; 30 children born at term (matched for age, sex, and family income) served as controls. WISC-III scores were comparable between the two groups (99.8 ± 2.4 and 105.8 ± 1.7; p = 0.072 in VLBW and control group, respectively) as well as the WRAT scores. GMFCS-mild dysfunction was found only in 2 children (6.7%) of VLBWgroup. In contrast, VLBW children had more behavioural/emotional problems, especially in attention deficit/hyperactive (26.7% in VLBW group vs.3.3% in controls, p = 0.026). <h3>Conclusions</h3> In our cohort study, VLBW children at school age are at higher risk for behavioural/emotional problems, especially in attention deficit compared with children born at term. However, no differences in cognitive, academic, and gross motor function were found.

Cognitive Function Post Liver Transplant

Research Article| October 01 2014 Cognitive Function Post Liver Transplant AAP Grand Rounds (2014) 32 (4): 45. https://doi.org/10.1542/gr.32-4-45 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Cognitive Function Post Liver Transplant. AAP Grand Rounds October 2014; 32 (4): 45. https://doi.org/10.1542/gr.32-4-45 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cognitive ability, liver transplantation Source: Sorenson LG, Neighbors K, Martz K, et al. Longitudinal study of cognitive and academic outcomes after pediatric liver transplantation. J Pediatr. 2014; 165(1): 65– 72.e2; doi: https://doi.org/10.1016/j.jpeds.2014.03.032Google Scholar Investigators from the Functional Outcomes Group (FOG), which includes 20 pediatric liver transplant centers in the Studies of Pediatric Liver Transplantation (SPLIT) collaborative, sought to determine the evolution of cognitive and academic deficits in children after liver transplant. Study children were identified and recruited through the SPLIT registry, and were 5–6 years of age when enrolled and ≥2 years posttransplant. Cognitive performance was measured at enrollment (Time 1) and repeated when participants were 7–9 years old (Time 2). Patients were tested with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), 3rd edition, at Time 1 and the Wechsler Intelligence Scales for Children (WISC), 4th edition, at Time 2. Composite scores were generated for each including Full Scale IQ (FSIQ), Verbal IQ/Verbal Comprehension (VC), Performance IQ/Perceptual Reasoning (PR), and Processing Speed (PS); a Working Memory (WM) composite score was also generated for the WISC-IV. These scores have a mean of 100 and SD of 15 in the normal population. At both time points, the participants also completed the Wide Range Achievement Test, 4th edition, Word Reading and Math Computation subtests and parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Medical and demographic variables were also collected to determine which predicted cognitive performance. One hundred forty-four patients were tested at Time 1, and 93 (65%) at Time 2. At Time 2, more patients had below-average FSIQ, VC, WM, and Math Computation compared to these scores’ normal distribution. For FSIQ specifically, 29% had scores of 71–85, and 7% had scores ≤70, both of which were significantly different than a normative population (P = .0001). BRIEF scores were also significantly lower than a normative population, but no different than at Time 1. A total of 42% of participants received special education. Identified risk factors for lower FSIQ included one-person household (P < .002), parental education level of some high school or less (P < .01), weight z-score <-2 standard deviations at liver transplantation (P < .03), and intraoperative transfusion requirement (P < .0001). The investigators conclude that, although the majority of children who are post-liver transplant demonstrate average functioning, many have long-term cognitive and academic problems. They report that cognitive outcomes may be predicted by pretransplant and peritransplant variables. Drs Kasper and Neimark have disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Children with chronic disease often have cognitive impairments.1,2 Deficits in neurocognitive ability translate into reduced academic achievement, difficult social interactions, and lower quality of life. Identification of risk factors for poor outcomes will help direct limited fiscal resources. There is little scientific literature, however, to delineate long-term consequences of disease... You do not currently have access to this content.