Comprehensive neuropsychological evaluation of children and adolescents with sickle cell anemia: a hospital-based sample

Abstract Background: Individuals with sickle cell anemia may suffer symptomatic or silent cerebral infarcts leading to neurocognitive complications. This study investigated the cognitive and intellectual performance of children and adolescents with sickle cell anemia. Methods: The socioeconomic status, clinical aspects and behavioral profile of 15 young individuals with sickle cell anemia were evaluated. The Wechsler Intelligence Scale for Children, the Developmental Neuropsychological Assessment Test, and the Child Behavior Checklist were applied. Results: Participants with a history of stroke had lower intelligence quotient (IQ) scores. Alterations were found in attention and executive functioning, language, verbal and visual memory, visuospatial processing and sensorimotor skills. These alterations were found both in the children and adolescents who had had a cerebral infarction and in those who apparently had not. In the majority of cases, there were learning difficulties, a history of repeating school years and a need for specialist educational support. The most common additional diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV were depressive disorder, anxiety disorder and somatic disorder, as well as conditions associated with physical and psychosocial repercussions of sickle cell anemia. Conclusion: As sickle cell anemia is considered a progressive cerebral vasculopathy, it is a potential risk factor for neurocognitive and psychosocial development. Therefore, periodic neuropsychological and behavioral evaluations of children and adolescents with sickle cell anemia may represent a useful measure to reduce long-term biopsychosocial repercussions.

Desempenho de escolares em atenção e funções executivas no Nepsy e inteligência / Performance of school-aged children in attention and executive functions on the Nepsy and intelligence / Rendimiento de escolares en atención y funciones ejecutivas en el Nepsy e inteligencia

O presente estudo teve por objetivo traçar o perfil do desempenho de escolares no domínio atenção/funções executivas e inteligência, além de comparar o desempenho de crianças de escola pública e particular, e analisar as relações entre as variáveis sociodemográficas. Participaram 60 escolares de 6 a 12 anos. Foram verificadas correlações significativas entre desempenho no Wisc III e no domínio de atenção/funções executivas da bateria Nepsy com as variáveis sexo, tipo de escola, renda familiar e escolaridade dos pais. Quando comparadas com as crianças de escola particular, as de escola pública obtiveram desempenho significativamente inferior em todos os testes avaliados. Compararam-se os resultados por tipo de escola com os dados de normatização norte-americana do Nepsy e percebeu-se que as crianças brasileiras de rede pública obtiveram resultado significativamente inferior apenas no subteste de atenção visual, ao passo que os estudantes de escolas particulares obtiveram melhores escores em atenção visual e auditiva, em tarefas de planejamento, seleção e alternância de estímulos.

The present study aimed to profile the performance of students in attention/executive functions and intelligence domains, compare the performance of children in public and private schools, and analyse the relation between sociodemographic varia­bles. Participants were 60 students aged 6 to 12 years old. Significant correlations were found between performance on the Wisc III and attention/executive functions domain (Nepsy batery) with the variables gender, school type, family income, parent education. Public school children had significantly lower performance in all tests assessed compared to private school children. The results was compared by type of school with the North American normative data of Nepsy and it was noticed that Brazilian public children had significantly lower result only in visual attention subtest, while students from private schools had better scores in visual and auditory attention, in planning tasks, selection and alternating stimuli.

Este estudio tuvo como objetivo hacer el perfil del rendimiento de los estudiantes en el dominio de atención/funciones ejecutivas y de inteligencia, además de comparar el desempeño de los niños de las escuelas públicas y privadas, y analizar la relación entre las variables sociodemográficas. Participaron 60 estudiantes de 6 a 12 años. Se encontraron correlaciones significativas entre el desempeño en el Wisc III y en el dominio de la atención/ funciones ejecutivas de la batería Nepsy con las variables sexo, tipo de escuela, el ingreso familiar, la educación de los padres. Los niños de las escuelas públicas obtuvieron rendimiento significativamente más bajo en todas las pruebas evaluadas en comparación a los niños de escuela privada. Los resultados fueron comparados por tipo de escuela con los datos normativos norteamericanos del Nepsy y se observó que el grupo de niños brasileños de las escuelas públicas obtuvieron resultados significativamente más bajos sólo en la prueba atención visual, mientras que los estudiantes de las escuelas privadas tuvieron mejores puntuaciones en la atención visual y auditiva, en las tareas de planificación, selección y estímulos alternados.