Perinatal risk factors and neurocognitive outcomes in children and adolescents with sickle cell disease.

BACKGROUND: The literature on cognitive and academic outcomes for children with sickle cell disease (SCD) who experience perinatal risk factors is limited. We aimed to evaluate if low birthweight (LBW), gestational age, and history of neonatal intensive care unit (NICU) admission were associated with neurocognitive functioning, grade retention, or receipt of early intervention or formal educational support in children with SCD. PROCEDURES: This prospective birth cohort study included 336 participants, ages 8-18, with SCD, who received cognitive testing as part of standard of care and whose caregivers completed behavioral rating scales. Multivariable generalized linear regression models were used to examine associations between perinatal risks and outcome variables, after adjusting for demographic and medical covariates. RESULTS: The prevalence of NICU admission and LBW were 12.03% and 13.50%, respectively. Lower birthweight, earlier gestational age, and NICU admission were associated with worse working memory performance and receipt of early intervention services. Lower birthweight and NICU admission were also associated with slower processing speed. History of NICU admission was associated with caregiver ratings of hyperactivity and emotional dysregulation. The effects of perinatal risk factors on neurocognitive, academic, or educational outcomes were not dependent on SCD genotype. CONCLUSIONS: History of LBW or NICU admission was associated with worse cognitive outcomes and increased use of early intervention services among children with SCD. Early identification of perinatal risk factors will help identify children who will benefit from formal developmental or neuropsychological evaluations to manage the comorbidity of SCD and perinatal risks and facilitate increased intervention.

Reaching for the high note: judgments of auditory pitch are affected by kinesthetic position.

Auditory pitch is represented on a vertical continuum (e.g., high vs. low). In three experiments, we examined whether the kinesthetic experience of moving in a particular direction (e.g., walking up vs. down stairs; reaching up vs. down) would affect judgments of auditory pitch. Participants listened to three tones twice each, once while moving upward and once while moving downward, and estimated the pitch of each tone. In all experiments, participants' judgments of the tones' pitch were biased in the direction of their movement. Moreover, this effect is not due to visibility of the movement or to using a numerical response method. Our results suggest that kinesthetic information from one's own bodily movements biases pitch estimation, and several possible mechanisms for the effect are discussed.