Neuropsychological functioning of youths with sickle cell disease: comparison with non-chronically ill peers.

OBJECTIVE: To compare the neuropsychological functioning of children with sickle cell disease (SCD) with no evidence of overt clinical stroke to that of classmates without a chronic illness matched on gender, race, and age. We examined both overall level of performance and patterns of performance utilizing empirically derived construct scores of key domains of neurocognitive functioning. METHODS: An abbreviated neuropsychological battery of tests was given to 31 children with SCD and 31 case controls. Empirically derived construct scores were developed for primary analyses. RESULTS: Children with SCD had significantly lower scores on three level-of-performance construct scores: total, verbal, and attention/memory. Mean scores for children with SCD were lower than those for case controls on every level-of-performance construct score and every standardized test score. However, pattern-of-performance construct scores were not significantly different. CONCLUSIONS: Children with SCD without overt stroke demonstrate significant deficits in neurocognitive functioning compared to classroom case controls. These findings highlight the impact of SCD on general neurocognitive functioning and suggest that routine screening of cognitive functioning should be a requisite element of comprehensive care for children with SCD. Within the context of documented physical limitations, we conclude that children with SCD are at very high risk for impaired psychosocial outcomes.

Basic money-counting skills of children with mental retardation.

The thought processes involved in counting and comparing small amounts of money among children and adolescents with Down syndrome (n = 17), other children and adolescents with mental retardation of unknown etiologies (n = 17), and normally developing first graders (n = 15) were examined. Three different tasks that progressively reduced the cognitive demands placed on the children were used. Although not generally different from each other, the two groups of children with mental retardation had far greater difficulties with the tasks than normals. Also, as the complexity of the counting task increased, the number of comparison errors made by the children with mental retardation increased. Based on the findings, a program for teaching money principles to children with mental retardation was proposed.