Social-emotional functioning in pediatric hydrocephalus: comparison of the Hydrocephalus Outcome Questionnaire to the Behavior Assessment System for Children.

OBJECTIVE: Hydrocephalus can impact all areas of health, including physical, cognitive, and social-emotional functioning. The social-emotional health of children who have had surgery for hydrocephalus is not well characterized. In this study, the authors sought to examine social-emotional functioning using the Behavior Assessment System for Children, Third Edition (BASC-3) and the Hydrocephalus Outcome Questionnaire (HOQ) in 66 children aged 5 to 17 years. METHODS: Caregivers of pediatric patients with hydrocephalus completed the BASC-3 and the HOQ. BASC-3 internalizing, externalizing, and executive functioning caregiver-reported scores were compared with the BASC-3 normative sample using one-sample t-tests to evaluate overall social-emotional functioning. BASC-3 scores were correlated with the social-emotional domain of the HOQ using Pearson's r to determine if the HOQ accurately captured the social-emotional functioning of children with hydrocephalus in a neurosurgery setting. BASC-3 and HOQ scores of children with different etiologies of hydrocephalus were compared using the Kruskal-Wallis one-way analysis of variance to determine if differences existed between the following etiologies: intraventricular hemorrhage secondary to prematurity, myelomeningocele, communicating congenital hydrocephalus, aqueductal stenosis, or other. RESULTS: Children with hydrocephalus of all etiologies had more difficulties with social-emotional functioning compared with normative populations. Children with different hydrocephalus etiologies differed in executive functioning and overall HOQ scores but not in internalizing symptoms, externalizing symptoms, or social-emotional HOQ scores. The social-emotional domain of the HOQ correlated more strongly with the BASC-3 than did the physical and cognitive domains. CONCLUSIONS: These results have provided evidence that children who have had surgery for hydrocephalus may be at increased risk of social-emotional and behavioral difficulties, but etiology may not be particularly helpful in predicting what kinds or degree of difficulty. The results of this study also support the convergent and divergent validity of the social-emotional domain of the HOQ.

Cognitive predictors of academic achievement in young children 1 year after traumatic brain injury.

OBJECTIVE: To examine cognitive predictors of academic achievement in young children with traumatic brain injury (TBI) and orthopedic injury (OI) shortly after injury and 1 year postinjury. METHODS: Participants included 3- to 6-year-old children, 63 with TBI (46 with moderate TBI and 17 with severe TBI) and a comparison group of 80 children with OI. Academic achievement was assessed approximately 1 and 12 months postinjury using three subtests from the Woodcock-Johnson Tests of Achievement-Third Edition and the School Readiness Composite from the Bracken Basic Concepts Scale-Revised. General intellectual functioning, memory, and executive functions were measured at the initial assessment using standardized tests. RESULTS: Hierarchical linear regression was used to predict academic achievement at the initial and 1-year follow-up assessments. Memory and executive functions were significant predictors of academic achievement at both assessments after controlling for group membership and demographic variables. Executive function remained a significant predictor of some outcomes after taking general intellectual functioning into account. Predictive relationships did not vary across the TBI and OI groups. Similar results were obtained when regression analyses were completed with only TBI participants using the Glasgow Coma Scale score as a predictor, although memory and executive functioning were somewhat less robust in predicting academic achievement than before. CONCLUSION: Memory and executive function predict academic achievement after TBI in preschool children, although some of the associations may be accounted for by general intellectual functioning.