Children with neurofibromatosis type 1 (NF1) commonly have academic problems. While the neuropsychological profile of children with NF1 is variable, NF1 results in difficulties in a variety of cognitive domains including intellectual functioning, attention, executive functioning. Previous studies have suggested that cognitive functioning may relate to academic functioning in children with NF1; however, the evidence is limited and warrants further examination. Thus, this study will investigate the contribution of several cognitive domains (intellectual functioning, attention, working memory) on academic performance for school age children with NF1.

The association between cognitive functioning and academic performance was examined for school age children with NF1 (n = 40; ages 9-13). Intellectual functioning was assessed using the Differential Abilities Scales, Second Edition School-Age Version (DAS-II) General Conceptual Ability (GCA) score. Attention was examined using the DAS-II Recall of Digits-Forward (DF) subtest and Flanker Inhibitory Control and Attention Test (Flanker). Working memory was assessed using the DAS-II Recall of Digits-Backward (DB) subtest. Academic performance was measured using the Wechsler Individual Achievement Test, Third Edition (WIAT-III) Word Reading (WR), Pseudoword Decoding (PD), Reading Comprehension (RC), Numerical Operations (NO), and Math Problem Solving (MPS) subtests.

WR was significantly associated with DAS-II GCA (rs(38) = .689, p < .001) and DF (rs(38) = .470, p = .002) in addition to Flanker (rs(34) = .364, p = .029), but not DAS-II DB (rs(38) = .292, p = .072). PD was significantly correlated with DAS-II GCA (rs(38) = .695, p < .001), DF (rs(38) = .394, p = .012), and DB (rs(38) = .474, p = .002), but not Flanker (rs(34) = .306, p = .070). RC was significantly associated with DAS-II GCA (rs(38) = .483, p = .002) and DF (rs(38) = .346, p = .029), but not DAS-II DB (rs(38) = .306, p = .055) and Flanker (rs(34) = .269, p = .112). NO was significantly correlated with DAS-II GCA fc(38) = .777, p < .001), DF (rs(38) = .555, p = < .001), and DB (rs(38) = .576, p < .001) as well as Flanker (rs(34) = .386, p = .020). MPS was significantly associated with DAS-II GCA (rs(38) = .685, p < .001), DF (rs(38) = .586, p < .001), and DB (rs(38) = .543, p < .001), in addition to Flanker (rs(34) = .420, p = .011). Significant associations had medium to large effect sizes, while non-significant correlations had small to medium effect sizes. Notably, most of the non-significant correlations had trend-level statistical significance.

Concurrent cognitive functioning (intellectual functioning, attention, working memory) was associated with reading-related and mathematics functioning in school age children with NF1. Notably, intellectual functioning had the strongest association with academic performance across all reading-related and mathematics tasks. Future studies should examine the association between academic performance and additional cognitive domains (e.g., language, visuospatial abilities) in children with NF1 across a wider age range to allow for examination of developmental patterns.